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ABO Blood system
Muhammad Asif zeb
Lecturer –Hematology
Khyba medical university
Peshawar
BloodGrouping
History - Karl
Landsteiner
 Discovered the ABO Blood
Group System in 1901
 He and his five co-workers
began mixing each ...
Landsteiners
Rule
Karl Landsteiner’s law :
If an antigen is present in the RBC’s of an
individual, the corresponding ant...
MajorABO
BloodGroup
ABO
Group
Antigen
Present
Antigen
Missing
Antibody
Present
A A B Anti-B
B B A Anti-A
O None A and B An...
ABO Basics
Blood group antigens are actually sugars
attached to the red blood cell.
Antigens are “built” onto the red ce...
Principle of
blood
grouping
There are two principles
1-almost all normal healthy individuals above 3-6
months of age have ...
Principle of
blood
grouping
2- These “naturally occurring” Abs are mostly IgM
class. That means that, they are Abs capable...
ABO and H
Antigen
Genetics
ABO chromo
9
O gene on
chrom 19
 Ags belonging to ABH blood group system are
present on RBCs a...
Genetics
 The ABO genes do not code for the production of
ABO antigens, BUT rather produce specific glycosyl
transferases...
RBC Precursor
Structure Glucose
Galactose
N-acetylglucosamine
Galactose
Precursor
Substance
(stays the
same)
RBC
There are two potential precursors substance (PS)
both are comprised of identical sugar (galactos-N-
acetyl gluctosamin - ...
HAntigen
 The inheritance of at least one H gene (HH or Hh)
elicits (obtain) the production of an enzyme called,
α-2-L-Fu...
Formation of
the H antigen Glucose
Galactose
N-acetylglucosamine
Galactose
Precursor
Substance
(stays the
same)
RBC
H anti...
A and B
Antigen
 The “A” gene codes for an enzyme (transferase) that
adds N-acetylgalactosamine to the terminal sugar of
...
Formation of
theA antigen Glucose
Galactose
N-acetylglucosamine
Galactose
RBC
Fucose
N-acetylgalactosamine
A antigen
Formation of
the B antigen Glucose
Galactose
N-acetylglucosamine
Galactose
RBC
Fucose
Galactose B antigen
Formation of
theAB
antigen
Glucose
Galactose
N-acetylglucosamine
Galactose
RBC
Fucose
Galactose B antigen
N-acetylgalactos...
Formation of
the H antigen Glucose
Galactose
N-acetylglucosamine
Galactose
Precursor
Substance
(stays the
same)
RBC
H anti...
H antigen
 Certain blood types possess more H antigen than
others:
O>A2>B>A2B>A1>A1B
Genetics
 The H antigen is found on the RBC when you have the
Hh or HH genotype, but NOT from the hh genotype
 The A ant...
Bombay
Phenotype
(Oh)
 Inheritance of hh
 The h gene is an amorph and results in little or no
production of L-fucosyltra...
Bombay
Phenotype
(Oh)
 The hh causes NO H antigen to be produced
 Results in RBCs with no H, A, or B antigen (patient
ty...
ABO
antibodies
 GroupA serum contains anti-B
 Group B serum contains anti-A
 GroupAB serum contains no antibodies
 Gro...
ABO
antibodies
 IgM is the predominant antibody in GroupA and Group
B individuals
 Anti-A
 Anti-B
 IgG (with some IgM)...
ABO
antibodies
 Reactions phase: Room temperature
 Complement can be activated with ABO antibodies
(mostly IgM, some IgG...
ABO
routine testing
 Several methods for testing the ABO group of an
individual exist.The most common method is:
 Serolo...
ABO
ROUTINE
TESTING
DIRECT OR FORWARD GROUPING
Test for antigens
• Patient’s cells containing unknown antigens tested
with...
Forward
Grouping
 Reaction of patient red blood cells tested with
Reagent anti-A and anti-B antisera
 Slide: 20-40% RBC ...
Forward
Grouping
Reaction Patterns for ABO Groups
Blood group Agglutination with
Anti-A
Agglutination with
Anti-B
A + -
B ...
Reverse
grouping
• serum is combined with cells having known Ag
content in a 2:1 ratio
• uses commercially prepared reagen...
Reverse
grouping
Reaction Patterns for ABO Groups
Blood Group Agglutination with
A cells
Agglutination with
B cells
A - +
...
 Grading of Agglutination:
Negative (0) No clumps or aggregates
Weak (+/-) Tiny clumps or aggregates barely
visible macro...
ABO blood
group
(forward blood
grouping)
Patient Red CellsTested With
InterpretationAnti-BAnti-APatient
001
04+2
4+03
4+4+4
ABO blood
group
(forward blood
grouping)
Patient Red CellsTested With
InterpretationAnti-BAnti-APatient
O001
A04+2
B4+03
A...
Reverse
Grouping
(Confirmatory
grouping
Patient SERUMTestedWith
InterpretationB CellsA1 CellsPatient
4+4+1
4+02
04+3
004
Reverse
Grouping
(Confirmatory
grouping
Patient SERUMTestedWith
InterpretationB CellsA1 CellsPatient
O4+4+1
A4+02
B04+3
AB...
Forward &
reverse
ABO blood
grouping
Reaction of CellsTested With
Reaction of SerumTested
Against ABO
Group
Anti-A Anti-B ...
Forward &
reverse
ABO blood
grouping
Reaction of CellsTested With
Reaction of SerumTested
Against ABO
Group
Anti-A Anti-B ...
ID card
system
 This ID-Card contains a mixture of human polyclonal
and monoclonal anti-A, human polyclonal anti-B and
hu...
Thank you….
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Abo blood group system Slide 1 Abo blood group system Slide 2 Abo blood group system Slide 3 Abo blood group system Slide 4 Abo blood group system Slide 5 Abo blood group system Slide 6 Abo blood group system Slide 7 Abo blood group system Slide 8 Abo blood group system Slide 9 Abo blood group system Slide 10 Abo blood group system Slide 11 Abo blood group system Slide 12 Abo blood group system Slide 13 Abo blood group system Slide 14 Abo blood group system Slide 15 Abo blood group system Slide 16 Abo blood group system Slide 17 Abo blood group system Slide 18 Abo blood group system Slide 19 Abo blood group system Slide 20 Abo blood group system Slide 21 Abo blood group system Slide 22 Abo blood group system Slide 23 Abo blood group system Slide 24 Abo blood group system Slide 25 Abo blood group system Slide 26 Abo blood group system Slide 27 Abo blood group system Slide 28 Abo blood group system Slide 29 Abo blood group system Slide 30 Abo blood group system Slide 31 Abo blood group system Slide 32 Abo blood group system Slide 33 Abo blood group system Slide 34 Abo blood group system Slide 35 Abo blood group system Slide 36 Abo blood group system Slide 37 Abo blood group system Slide 38 Abo blood group system Slide 39 Abo blood group system Slide 40 Abo blood group system Slide 41
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ABO blood group system was decover by Karal landsteine
which contain A, B, and o antigen on the surface of BC, WBC,s platatelet and other body tissue cells except brain cell, and anti A, antiB and Anti Ab natural occuring antibodies in plasma of B,A, and O blood group individual respectively

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Abo blood group system

  1. 1. ABO Blood system Muhammad Asif zeb Lecturer –Hematology Khyba medical university Peshawar
  2. 2. BloodGrouping
  3. 3. History - Karl Landsteiner  Discovered the ABO Blood Group System in 1901  He and his five co-workers began mixing each others red cells and serum together and inadvertently performed the first forward and reverse ABO groupings
  4. 4. Landsteiners Rule Karl Landsteiner’s law : If an antigen is present in the RBC’s of an individual, the corresponding antibody must be absent from the plasma If an antigen is absent in the RBC’s of an individual, the corresponding antibody must be present from the plasma ’.
  5. 5. MajorABO BloodGroup ABO Group Antigen Present Antigen Missing Antibody Present A A B Anti-B B B A Anti-A O None A and B Anti-A&B AB A and B None None
  6. 6. ABO Basics Blood group antigens are actually sugars attached to the red blood cell. Antigens are “built” onto the red cell. Individuals inherit a gene which codes for specific sugar(s) to be added to the red cell. The type of sugar added determines the blood group
  7. 7. Principle of blood grouping There are two principles 1-almost all normal healthy individuals above 3-6 months of age have “ naturally occurring Abs” to the ABO Ags that they lack These Abs termed naturally occurring because they were thought to arise without antigenic stimulation
  8. 8. Principle of blood grouping 2- These “naturally occurring” Abs are mostly IgM class. That means that, they are Abs capable of agglutinating saline/ low protein suspended red cell without enhancement and may activate complement cascade.
  9. 9. ABO and H Antigen Genetics ABO chromo 9 O gene on chrom 19  Ags belonging to ABH blood group system are present on RBCs and other body cells and body fluids.  The presence of A,B, and O Ags on RBCs depends upon the allelic genes, A,B, and O  An H genes at a separate locus codes for the precursor substance on which the A and B gene products act  The products of the A and B genes are enzymes that act as a specific transferases
  10. 10. Genetics  The ABO genes do not code for the production of ABO antigens, BUT rather produce specific glycosyl transferases  ABO produces a specific glycosyl transferases that add sugars to a basic precursor substance on the RBCs
  11. 11. RBC Precursor Structure Glucose Galactose N-acetylglucosamine Galactose Precursor Substance (stays the same) RBC
  12. 12. There are two potential precursors substance (PS) both are comprised of identical sugar (galactos-N- acetyl gluctosamin - galactose -glucose) but different in linkage.  Type I PS has a terminal galactose (Gal) linked to a subterminal N acetylgucoseamine (GlcNAc) in 1-3 linkage  Type II PS, has the same sugar combine in 1-4 linkage  ABH Ags on RBCs are derived from Type II chains
  13. 13. HAntigen  The inheritance of at least one H gene (HH or Hh) elicits (obtain) the production of an enzyme called, α-2-L-Fucosyl transferase, which transfers the sugar from the Guanosine diphosphate L-fucose (GDP-Fuc) donor nucleotide to the terminal galactose of the precursor chain.  The H substance must be formed for the other sugars to be attached in response to an inherited A and /or B genes
  14. 14. Formation of the H antigen Glucose Galactose N-acetylglucosamine Galactose Precursor Substance (stays the same) RBC H antigen Fucose
  15. 15. A and B Antigen  The “A” gene codes for an enzyme (transferase) that adds N-acetylgalactosamine to the terminal sugar of the H antigen  N-acetylgalactosaminyltransferase  The “B” gene codes for an enzyme that adds D- galactose to the terminal sugar of the H antigen  D-galactosyltransferase
  16. 16. Formation of theA antigen Glucose Galactose N-acetylglucosamine Galactose RBC Fucose N-acetylgalactosamine A antigen
  17. 17. Formation of the B antigen Glucose Galactose N-acetylglucosamine Galactose RBC Fucose Galactose B antigen
  18. 18. Formation of theAB antigen Glucose Galactose N-acetylglucosamine Galactose RBC Fucose Galactose B antigen N-acetylgalactosamine A antigen
  19. 19. Formation of the H antigen Glucose Galactose N-acetylglucosamine Galactose Precursor Substance (stays the same) RBC H antigen Fucose O antigen
  20. 20. H antigen  Certain blood types possess more H antigen than others: O>A2>B>A2B>A1>A1B
  21. 21. Genetics  The H antigen is found on the RBC when you have the Hh or HH genotype, but NOT from the hh genotype  The A antigen is found on the RBC when you have the Hh, HH, and A/A, A/O, or A/B genotypes  The B antigen is found on the RBC when you have the Hh, HH, and B/B, B/O, orA/B genotypes
  22. 22. Bombay Phenotype (Oh)  Inheritance of hh  The h gene is an amorph and results in little or no production of L-fucosyltransferase  Originally found in Bombay  Very rare (130 worldwide)
  23. 23. Bombay Phenotype (Oh)  The hh causes NO H antigen to be produced  Results in RBCs with no H, A, or B antigen (patient types as O)  Bombay RBCs are NOT agglutinated with anti-A, anti- B, or anti-H (no antigens present)  Bombay serum has strong anti-A, anti-B and anti-H, agglutinating ALL ABO blood groups  What bloodABO blood group would you use to transfuse this patient?? Another Bombay Group O RBCs cannot be given because they still have the H antigen You have to transfuse the patient with blood that contains NO H antigen
  24. 24. ABO antibodies  GroupA serum contains anti-B  Group B serum contains anti-A  GroupAB serum contains no antibodies  GroupO serum contains anti-A, anti-B, and anti-A,B
  25. 25. ABO antibodies  IgM is the predominant antibody in GroupA and Group B individuals  Anti-A  Anti-B  IgG (with some IgM) is the predominant antibody in GroupO individuals  Anti-A,B (with some anti-A and anti-B)
  26. 26. ABO antibodies  Reactions phase: Room temperature  Complement can be activated with ABO antibodies (mostly IgM, some IgG)  High titer: react strongly (4+)  Usually present within the first 3-6 months of life  Stable by ages 5-6 years  Decline in older age  Newborns may passively acquire maternal antibodies (IgG crosses placenta)  Reverse grouping (with serum) should not be performed on newborns or cord blood
  27. 27. ABO routine testing  Several methods for testing the ABO group of an individual exist.The most common method is:  Serology: This is a direct detection of the ABO antigens. It is the main method used in blood transfusion centres and hospital blood banks.  This form of testing involves two components: a) Antibodies that are specific at detecting a particular ABO antigen on RBCs.  b) Cells that are of a known ABO group that are agglutinated by the naturally occurring antibodies in the person's serum.
  28. 28. ABO ROUTINE TESTING DIRECT OR FORWARD GROUPING Test for antigens • Patient’s cells containing unknown antigens tested with known antisera • Antisera manufactured from human sera Aantisera used: Antisera Color Source Anti-A Blue Group B donor Anti-B Yellow Group A donor Anti-A,B Red Group O donor
  29. 29. Forward Grouping  Reaction of patient red blood cells tested with Reagent anti-A and anti-B antisera  Slide: 20-40% RBC suspension + anti-serum  Tube (12x75mm): 2-5% RBC suspension + anti-serum (centrifuge before read)
  30. 30. Forward Grouping Reaction Patterns for ABO Groups Blood group Agglutination with Anti-A Agglutination with Anti-B A + - B - + AB + + O - -
  31. 31. Reverse grouping • serum is combined with cells having known Ag content in a 2:1 ratio • uses commercially prepared reagents containing saline-suspended A1 and B cells
  32. 32. Reverse grouping Reaction Patterns for ABO Groups Blood Group Agglutination with A cells Agglutination with B cells A - + B + - AB - - O + +
  33. 33.  Grading of Agglutination: Negative (0) No clumps or aggregates Weak (+/-) Tiny clumps or aggregates barely visible macroscopically or to the naked eye 1+ Few small aggregates visible macroscopically 2+ Medium-sized aggregates 3+ Several large aggregates 4+ One solid aggregate
  34. 34. ABO blood group (forward blood grouping) Patient Red CellsTested With InterpretationAnti-BAnti-APatient 001 04+2 4+03 4+4+4
  35. 35. ABO blood group (forward blood grouping) Patient Red CellsTested With InterpretationAnti-BAnti-APatient O001 A04+2 B4+03 AB4+4+4
  36. 36. Reverse Grouping (Confirmatory grouping Patient SERUMTestedWith InterpretationB CellsA1 CellsPatient 4+4+1 4+02 04+3 004
  37. 37. Reverse Grouping (Confirmatory grouping Patient SERUMTestedWith InterpretationB CellsA1 CellsPatient O4+4+1 A4+02 B04+3 AB004
  38. 38. Forward & reverse ABO blood grouping Reaction of CellsTested With Reaction of SerumTested Against ABO Group Anti-A Anti-B A1 Cells B Cells 1 0 0 + + O 2 + 0 0 + A 3 0 + + 0 B 4 + + 0 0 AB
  39. 39. Forward & reverse ABO blood grouping Reaction of CellsTested With Reaction of SerumTested Against ABO Group Anti-A Anti-B A1 Cells B Cells 1 0 0 + + 2 + 0 0 + 3 0 + + 0 4 + + 0 0
  40. 40. ID card system  This ID-Card contains a mixture of human polyclonal and monoclonal anti-A, human polyclonal anti-B and human polyclonal anti-D antibodies.  The microtube ctl is the negative control.Two microtubes with neutral gel serve for reverse grouping with A1 and B cells.
  41. 41. Thank you….
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ABO blood group system was decover by Karal landsteine which contain A, B, and o antigen on the surface of BC, WBC,s platatelet and other body tissue cells except brain cell, and anti A, antiB and Anti Ab natural occuring antibodies in plasma of B,A, and O blood group individual respectively

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