UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Red blood cell antigens and antibodies

Author
Lynne Uhl, MD
Section Editor
Arthur J Silvergleid, MD
Deputy Editor
Jennifer S Tirnauer, MD

INTRODUCTION

The surface of the red blood cell (RBC) is coated with antigens (sugars and proteins) that are integrally linked to membrane proteins or lipids. The clinical relevance of these antigens for blood component transfusion and tissue/organ transplantation lies in the ability of these surface molecules to incite an immune response. In addition, some RBC surface antigens have cellular functions with clinical relevance, and others are targets of immune attack in certain infections.

This topic will review clinically relevant RBC antigens and respective antibodies, and settings in which they may be important. Additional discussions of certain clinical issues are presented separately:

Pretransfusion testing – (See "Pretransfusion testing for red blood cell transfusion".)

Hemolytic anemia – (See "Pathogenesis of autoimmune hemolytic anemia: Warm agglutinins and drugs", section on 'Characteristics of the antibodies'.)

Rh(D) hemolytic disease of the fetus and newborn (HDFN) – (See "Overview of Rhesus D alloimmunization in pregnancy".)

                                          

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Wed May 18 00:00:00 GMT+00:00 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Daniels G, Reid ME. Blood groups: the past 50 years. Transfusion 2010; 50:281.
  2. Flegel WA. Pathogenesis and mechanisms of antibody-mediated hemolysis. Transfusion 2015; 55 Suppl 2:S47.
  3. Technical Manual, 18th edition, Fung M, Grossman BJ, Hillyer CD, et al. (Eds), AABB Press, Bethesda, MD 2014.
  4. Denomme GA. The structure and function of the molecules that carry human red blood cell and platelet antigens. Transfus Med Rev 2004; 18:203.
  5. Curtis BR, Edwards JT, Hessner MJ, et al. Blood group A and B antigens are strongly expressed on platelets of some individuals. Blood 2000; 96:1574.
  6. Curtis BR, Fick A, Lochowicz AJ, et al. Neonatal alloimmune thrombocytopenia associated with maternal-fetal incompatibility for blood group B. Transfusion 2008; 48:358.
  7. Kamphuisen PW, Eikenboom JC, Bertina RM. Elevated factor VIII levels and the risk of thrombosis. Arterioscler Thromb Vasc Biol 2001; 21:731.
  8. Morange PE, Tregouet DA, Frere C, et al. Biological and genetic factors influencing plasma factor VIII levels in a healthy family population: results from the Stanislas cohort. Br J Haematol 2005; 128:91.
  9. Trégouët DA, Heath S, Saut N, et al. Common susceptibility alleles are unlikely to contribute as strongly as the FV and ABO loci to VTE risk: results from a GWAS approach. Blood 2009; 113:5298.
  10. Reid ME, Bird GW. Associations between human red cell blood group antigens and disease. Transfus Med Rev 1990; 4:47.
  11. Wolpin BM, Chan AT, Hartge P, et al. ABO blood group and the risk of pancreatic cancer. J Natl Cancer Inst 2009; 101:424.
  12. Amundadottir L, Kraft P, Stolzenberg-Solomon RZ, et al. Genome-wide association study identifies variants in the ABO locus associated with susceptibility to pancreatic cancer. Nat Genet 2009; 41:986.
  13. Risch HA, Yu H, Lu L, Kidd MS. ABO blood group, Helicobacter pylori seropositivity, and risk of pancreatic cancer: a case-control study. J Natl Cancer Inst 2010; 102:502.
  14. Dipta TF, Hossain AZ. The Bombay blood group: are we out of risk? Mymensingh Med J 2011; 20:536.
  15. Human Blood Groups, 3, Geoff Daniels. (Ed), Wiley-Blackwell, 2013.
  16. Roath S, Todd CE, Shaw D. Transient acquired blood group B antigen associated with diverticular bowel disease. Acta Haematol 1987; 77:188.
  17. Daniel-Johnson J, Leitman S, Klein H, et al. Probiotic-associated high-titer anti-B in a group A platelet donor as a cause of severe hemolytic transfusion reactions. Transfusion 2009; 49:1845.
  18. Julius CJ, Wade M, Waheed A, et al. Common variable immunodeficiency: diagnosis by absent ABO reverse type. Immunohematology 1997; 13:80.
  19. Linz WJ, Currie RT. ABO discrepancy: reverse type. Transfusion 2007; 47:1.
  20. Beattie KM. Perspectives on some usual and unusual ABO phenotypes. In: A seminar on antigens on blood cells and body fluids, Bell CA (Ed), American Association of Blood Banks, Washington, DC 1980. p.97.
  21. The ABO Blood Group System. In: Modern Blood Banking and Transfusion Practices, Harmening DM (Ed), 1999. p.113.
  22. Josephson CD, Castillejo MI, Grima K, Hillyer CD. ABO-mismatched platelet transfusions: strategies to mitigate patient exposure to naturally occurring hemolytic antibodies. Transfus Apher Sci 2010; 42:83.
  23. Van Kim CL, Colin Y, Cartron JP. Rh proteins: key structural and functional components of the red cell membrane. Blood Rev 2006; 20:93.
  24. Avent ND, Reid ME. The Rh blood group system: a review. Blood 2000; 95:375.
  25. Westhoff CM. The Rh blood group system in review: a new face for the next decade. Transfusion 2004; 44:1663.
  26. Reid MR, Lomas-Francis C. The blood group antigen facts book, Harcourt Brace and Company, 1997.
  27. Denomme GA, Wagner FF, Fernandes BJ, et al. Partial D, weak D types, and novel RHD alleles among 33,864 multiethnic patients: implications for anti-D alloimmunization and prevention. Transfusion 2005; 45:1554.
  28. Kumpel B. Are weak D RBCs really immunogenic? Transfusion 2006; 46:1061.
  29. Shao CP. Transfusion of RhD-positive blood in "Asia type" DEL recipients. N Engl J Med 2010; 362:472.
  30. Chou ST, Jackson T, Vege S, et al. High prevalence of red blood cell alloimmunization in sickle cell disease despite transfusion from Rh-matched minority donors. Blood 2013; 122:1062.
  31. Karafin MS, Field JJ, Gottschall JL, Denomme GA. Barriers to using molecularly typed minority red blood cell donors in support of chronically transfused adult patients with sickle cell disease. Transfusion 2015; 55:1399.
  32. Muller CL, Schucker JL, Boctor FN. When anti-G and anti-C antibodies masquerade as anti-D antibody. J Matern Fetal Neonatal Med 2011; 24:193.
  33. O'Brien KL, Haspel RL, Uhl L. Anti-D alloimmunization after D-incompatible platelet transfusions: a 14-year single-institution retrospective review. Transfusion 2014; 54:650.
  34. Borén T, Falk P, Roth KA, et al. Attachment of Helicobacter pylori to human gastric epithelium mediated by blood group antigens. Science 1993; 262:1892.
  35. Ilver D, Arnqvist A, Ogren J, et al. Helicobacter pylori adhesin binding fucosylated histo-blood group antigens revealed by retagging. Science 1998; 279:373.
  36. Hellberg A, Westman JS, Olsson ML. An update on the GLOB blood group system and collection. Immunohematology 2013; 29:19.
  37. Yu LC, Twu YC, Chou ML, et al. The molecular genetics of the human I locus and molecular background explain the partial association of the adult i phenotype with congenital cataracts. Blood 2003; 101:2081.
  38. Hossaini AA. Neutralization of Lewis antibodies in vivo and transfusion of Lewis incompatible blood. Am J Clin Pathol 1972; 57:489.
  39. WORLLEDGE SM, ROUSSO C. STUDIES ON THE SEROLOGY OF PAROXYSMAL COLD HAEMOGLOBINURIA (P.G.H.), WITH SPECIAL REFERENCE TO ITS RELATIONSHIP WITH THE P BLOOD GROUP SYSTEM. Vox Sang 1965; 10:293.
  40. Reid ME. MNS blood group system: a review. Immunohematology 2009; 25:95.
  41. Wikman A, Edner A, Gryfelt G, et al. Fetal hemolytic anemia and intrauterine death caused by anti-M immunization. Transfusion 2007; 47:911.
  42. Bakhtary S, Gikas A, Glader B, Andrews J. Anti-Mur as the most likely cause of mild hemolytic disease of the newborn. Transfusion 2016; 56:1182.
  43. Symmans WA, Shepherd CS, Marsh WL, et al. Hereditary acanthocytosis associated with the McLeod phenotype of the Kell blood group system. Br J Haematol 1979; 42:575.
  44. Marsh WL, Marsh NJ, Moore A, et al. Elevated serum creatine phosphokinase in subjects with McLeod syndrome. Vox Sang 1981; 40:403.
  45. Neote K, Mak JY, Kolakowski LF Jr, Schall TJ. Functional and biochemical analysis of the cloned Duffy antigen: identity with the red blood cell chemokine receptor. Blood 1994; 84:44.
  46. Afenyi-Annan A, Kail M, Combs MR, et al. Lack of Duffy antigen expression is associated with organ damage in patients with sickle cell disease. Transfusion 2008; 48:917.
  47. Miller LH, Mason SJ, Clyde DF, McGinniss MH. The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy. N Engl J Med 1976; 295:302.
  48. McDougall DC, McGregor M. Jk:-3 red cells have a defect in urea transport: a new urea-dependent lysis test. Transfusion 1988; 28:197.
  49. Wester ES, Johnson ST, Copeland T, et al. Erythroid urea transporter deficiency due to novel JKnull alleles. Transfusion 2008; 48:365.
  50. Heaton DC, McLoughlin K. Jk(a-b-) red blood cells resist urea lysis. Transfusion 1982; 22:70.
  51. Sands JM, Gargus JJ, Fröhlich O, et al. Urinary concentrating ability in patients with Jk(a-b-) blood type who lack carrier-mediated urea transport. J Am Soc Nephrol 1992; 2:1689.
  52. Parsons SF, Lee G, Spring FA, et al. Lutheran blood group glycoprotein and its newly characterized mouse homologue specifically bind alpha5 chain-containing human laminin with high affinity. Blood 2001; 97:312.
  53. An X, Gauthier E, Zhang X, et al. Adhesive activity of Lu glycoproteins is regulated by interaction with spectrin. Blood 2008; 112:5212.
  54. Rowe PC, McLean RH, Wood RA, et al. Association of homozygous C4B deficiency with bacterial meningitis. J Infect Dis 1989; 160:448.
  55. Dunckley H, Gatenby PA, Hawkins B, et al. Deficiency of C4A is a genetic determinant of systemic lupus erythematosus in three ethnic groups. J Immunogenet 1987; 14:209.
  56. Pasvol G, Anstee D, Tanner MJ. Glycophorin C and the invasion of red cells by Plasmodium falciparum. Lancet 1984; 1:907.
  57. Reynolds MV, Vengelen-Tyler V, Morel PA. Autoimmune hemolytic anemia associated with autoanti-Ge. Vox Sang 1981; 41:61.
  58. Mochizuki T, Tauxe WN, Ramsey G. In vivo cross-match by chromium-51 urinary excretion from labeled erythrocytes: a case of anti-Gerbich. J Nucl Med 1990; 31:2042.
  59. Hildebrandt M, Hell A, Etzel F, et al. Determination and Successful Transfusion of Anti-Gerbich-Positive Red Blood Cells in a Patient with a Strongly Reactive Anti-Gerbich Antibody. Infusionsther Transfusionsmed 2000; 27:154.
  60. Noumsi GT, Tounkara A, Diallo H, et al. Knops blood group polymorphism and susceptibility to Mycobacterium tuberculosis infection. Transfusion 2011; 51:2462.