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Saturday, October 4, 2014

Blood Type





A blood type is a classification of blood based on the presence or absence of antigens on the surface of red blood cells (RBCs). [1]












Blood types are inherited and represent contributions from both parents. [1]

Inheritance of Blood Types

Parent 1ABABABABBAAOOO
Parent 2ABBAOBBABAO
Possible
blood
type
of
child
OXXXXXX
AXXXXXXX
BXXXXXXX
ABXXXX
(Image Source: http://www.redcrossblood.org/learn-about-blood/blood-types)


The two most important human blood groups are ABO and the RhD antigen; they determine someone's blood type (A, B, AB and O, with + and − denoting RhD status). [1]

33 blood-group systems have been identified, including the ABO and Rh systems. [2][23] Thus, in addition to the ABO antigens and Rh antigens, many others--like the Duffy Antigen which we will come to--are expressed on the RBC surface membrane.

The Importance of Compatibility


Main symptoms of acute hemolytic reaction
due to blood type mismatch. [24][25]


If a unit of incompatible blood is transfused between a donor and recipient, it can trigger a severe acute hemolytic reaction (AHR). [1]

AHR occurs when antibodies attack RBCs and bind components of the complement system to cause massive hemolysis (RBC destruction) of the transfused blood. Renal failure and shock are likely to occur, and death is a possibility. [1]






A pregnant woman can make antibodies if her fetus has an antigen that she does not have. This can happen if the fetus' blood cells pass into the mother's blood stream. IgG antibodies are small and can cross the placenta and cause hemolysis of fetal RBCs, which in turn can lead to hemolytic disease of the newborn (HDN).[3]

Rh disease can occur in pregnancies of Rh negative women where the fetus's father is Rh positive, leading to a Rh+ pregnancy. During birth, the mother may be exposed to the infant's blood, and this causes the development of antibodies, which may affect the health of subsequent Rh+ pregnancies. [4]  The effects of this disease can range from mild (anemia) to severe (HDN, hydrops fetalis* or stillbirth). 
*Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments. [5]

If a pregnant woman is known to have these antibodies, the Rh blood type of a fetus can be tested by analysis of fetal DNA in maternal plasma to assess the risk to the fetus of Rh disease. [6]

One of the major advances of twentieth century medicine was to prevent this disease by stopping the formation of antibodies by Rh negative mothers with an injectable medication called Rho(D) immune globulin. [7][8] 

Rho(D) immune globulin is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system. [9]






Compatibility Chart








COMPATIBLE

Patient's
ABO Group
Antigen
on Red Cells
Antibody in Serum
Whole
Blood
Red Blood Cells
Plasma

O
No A or B
Anti-A Anti-B
O
O
O
A
B
AB

A
A
Anti-B
A
A
O
A
AB

B
B
Anti-A
B
B
O
B
AB

AB
A and B
None
AB
AB
A
B
O
AB
(Image Source: www.pathology.med.umich.edu/bloodbank/manual/bb_chart/)

An individual's blood type can change through addition or suppression of an antigen in infection, malignancy, or autoimmune disease. [13][14][15][16]

Certain blood types may affect susceptibility to infections, an example being the resistance to specific malaria species seen in individuals lacking the Duffy antigen. [17]  Located on the surface of RBC's, the Duffy Antigen, a receptor for human malarial parasites, is less common in ethnic groups from areas with a high incidence of malaria. [18] For example, Duffy-negative blood occurs much more frequently in people of African origin. [19]  

Historically, blood types have been used in forensic science and were formerly used to demonstrate impossibility of paternity (a type AB man cannot be the father of a type O infant), but both of these uses are being replaced by genetic fingerprinting, which provides greater certainty. [20]


A popular belief in Japan is that a person's ABO blood type is predictive of their personality, character, and compatibility with others. The theory reached Japan in a 1927 psychologist's report, and the militarist government of the time commissioned a study aimed at breeding better soldiers. [21]  The fad faded in the 1930s and ultimately with the discovery of DNA in the following decades. Yet, the myth still persists in Japanese popular culture. [22]








UPDATES /RELATED
MEDICAL DAILY  (Video) MARCH 20, 2015 In the Blood: Antigens In Red Blood Cells Determine Human Blood Types

LIVE SCIENCE  APRIL 7, 2015  Boy Gets Food Allergies from Blood Transfusion


MEDICAL DAILY  JANUARY 27 2015   True Blood: 7 Little-Known Facts About Blood

LIVE SCIENCE JANUARY 17, 2015   Your Blood Type May Put You at Risk for Heart Disease

 MEDICAL DAILY  APRIL 29, 2015  Blood Donations Made Simple: New Process Renders Type A And B Blood 'Neutral'

 MEDICAL DAILY  MAY 30, 2013 Why Donating Blood Is Good For Your Health  





REFERENCES

[1] Blood type Author: Wikipedia contributors Publisher: Wikipedia, The Free Encyclopedia. Date of last revision: 26 September 2014 22:43 UTC Date retrieved: 3 October 2014 22:57 UTC Permanent link: http://en.wikipedia.org/w/index.php?title=Blood_type&oldid=627215494 Primary contributors: Revision history statistics Page Version ID: 627215494
[2] "Table of blood group systems v3.0". International Society of Blood Transfusion. October 28, 2012.
[3] http://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn
[4] http://en.wikipedia.org/wiki/Rh_disease
[5] "Hydrops Fetalis: eMedicine Pediatrics: Cardiac Disease and Critical Care Medicine".
[6] "Use of Anti-D Immunoglobulin for Rh Prophylaxis". Royal College of Obstetricians and Gynaecologists. May 2002.
[7] "Pregnancy – routine anti-D prophylaxis for D-negative women". NICE. May 2002.
[8] American Association of Blood Banks (24 April 2014)
[9] "WHO Model List of EssentialMedicines". World Health Organization. October 2013.
[10] The Chief Medical Officer’s National Blood Transfusion Committee (2008?). "The appropriate use of group O RhD negative red cells". National Health Service.
[11] Dennis O'Neil (1999). "Blood Components". Palomar College.
[12] "Ways to Keep Your Blood Plasma Healthy".
[13] Dean 2005, The ABO blood group "... A number of illnesses may alter a person's ABO phenotype ..."
[14] Stayboldt C, Rearden A, Lane TA (1987). "B antigen acquired by normal A1 red cells exposed to a patient's serum". Transfusion 27 (1): 41–4. doi:10.1046/j.1537-2995.1987.27187121471.x. PMID 3810822.
[15] Matsushita S, Imamura T, Mizuta T, Hanada M (November 1983). "Acquired B antigen and polyagglutination in a patient with gastric cancer". The Japanese Journal of Surgery 13 (6): 540–2. doi:10.1007/BF02469500. PMID 6672386.
[16] Kremer Hovinga I, Koopmans M, de Heer E, Bruijn J, Bajema I (2007). "Change in blood group in systemic lupus erythematosus". Lancet 369 (9557): 186–7; author reply 187. doi:10.1016/S0140-6736(07)60099-3. PMID 17240276.
[17] Miller LH, Mason SJ, Clyde DF, McGinniss MH (August 1976). "The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy". The New England Journal of Medicine 295 (6): 302–4. doi:10.1056/NEJM197608052950602. PMID 778616.
[18] Kwiatkowski DP (August 2005). "How Malaria Has Affected the Human Genome and What Human Genetics Can Teach Us about Malaria". American Journal of Human Genetics 77 (2): 171–92. doi:10.1086/432519. PMC 1224522. PMID 16001361. "The different geographic distributions of α thalassemia, G6PD deficiency, ovalocytosis, and the Duffy-negative blood group are further examples of the general principle that different populations have evolved different genetic variants to protect against malaria."
[19] Nickel RG, Willadsen SA, Freidhoff LR et al. (August 1999). "Determination of Duffy genotypes in three populations of African descent using PCR and sequence-specific oligonucleotides". Human Immunology 60 (8): 738–42. doi:10.1016/S0198-8859(99)00039-7. PMID 10439320.
[20] Johnson P, Williams R, Martin P (2003). "Genetics and Forensics: Making the National DNA Database". Science Studies 16 (2): 22–37. PMC 1351151. PMID 16467921.
[21] "Despite scientific debunking, in Japan you are what your blood type is". MediResource Inc. Associated Press. 2009-02-01.
[22] Nuwer, Rachel. "You are what you bleed: In Japan and other east Asian countries some believe blood type dictates personality". Scientific American.
[23] Joshua E. Brown (22 February 2012). "Blood Mystery Solved". University Of Vermont.
[24] Possible Risks of Blood Product Transfusions from American Cancer Society. Last Medical Review: 03/08/2008. Last Revised: 01/13/2009
[25] 7 adverse reactions to transfusion Pathology Department at University of Michigan. Version July 2004, Revised 11/5/08



ADDITIONAL RESOURCES


http://www.pathology.med.umich.edu/bloodbank/manual/bb_chart/
http://www.redcrossblood.org/
http://www.bloodbook.com/compat.html
http://en.wikipedia.org/wiki/Blood_plasmahttp://en.wikipedia.org/wiki/Duffy_antigen_system
http://en.wikipedia.org/wiki/Hydrops_fetalis
http://en.wikipedia.org/wiki/Rho(D)_immune_globulin
http://www.canadiancrc.com/paternity_determination_blood_type.aspx



IMAGE CREDITS


"ABO blood type" by InvictaHOG - Own work. Licensed under Public domain via Wikimedia Commons -http://commons.wikimedia.org/wiki/File:ABO_blood_type.svg#mediaviewer/File:ABO_blood_type.svg

"Main symptoms of acute hemolytic reaction" by Mikael Häggström.When using this image in external works, it may be cited as follows:Häggström, Mikael. "Medical gallery of Mikael Häggström 2014". Wikiversity Journal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 20018762. - See above. All used images are in public domain.. Licensed under Public domain via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Main_symptoms_of_acute_hemolytic_reaction.png#mediaviewer/File:Main_symptoms_of_acute_hemolytic_reaction.png

"1910 Erythroblastosis Fetalis" by OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.. Licensed under Creative Commons Attribution 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:1910_Erythroblastosis_Fetalis.jpg#mediaviewer/File:1910_Erythroblastosis_Fetalis.jpg

"Blood Compatibility" by InvictaHOG - Criado por mim no Adobe Illustrator 8/24/06 e liberado para domínio público. Licensed under Public domain via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Blood_Compatibility.svg#mediaviewer/File:Blood_Compatibility.svg

"Plasma donation compatibility path" by Giancaldo at English Wikipedia - https://en.wikipedia.org/wiki/File:Plasma-donation.svg. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Plasma_donation_compatibility_path.svg#mediaviewer/File:Plasma_donation_compatibility_path.svg




















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