4. What is the relevance of ABH determination in saliva or in other body fluids?

The demonstration of A, B, and H substances in saliva is evidence for the inheritance of an A gene, B
gene, H gene, and Se gene. The term secretor refers only to secretion of A, B, and H soluble antigens in
body fluids. These secreted antigens can be demonstrated in saliva by inhibition tests with ABH and
Lewis antisera.

These water-soluble blood group substances are readily detected in very minute quantities because
they have the property of reacting with their corresponding antibodies and thereby neutralizing (The
saliva is collected, heat inactivated, and used to attempt to neutralize weak reacting antiserum.) or
inhibiting the capacity of the antibody to agglutinate erythrocytes possessing the corresponding antigen.
The reaction is termed hemagglutination inhibition and provides a means of assaying the relative activity
or potency of these water-soluble blood group substances

References:

Harmening, D., (2012). Modern blood banking and transfusion practices. (6 th edition) Philadelphia: F.A.
Davis.

Harmening, D., (2005). Modern blood banking and transfusion practices. (5 th edition) Philadelphia: F.A.
Davis.

Quinley, E. (2011). Immunohematology: Principles and Practice. (3 rd edition) Lippincott Williams &
Wilkins, a Wolters Kluwer business

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5. Describe the development of the A, B, H substances.

The transferases encoded by the A, B, H, and Se alleles add a specific sugar to a precursor carbohydrate
chain. The sugar that is added is referred to as immunodominant because when it is removed from the
structure, the specific blood group activity is lost. The sugars can be added only in a sequential manner.
H structure is made first, then sugars for A and B antigens are added to H. The H and Se alleles encode a
fucosyltransferase that adds fucose (Fuc) to the precursor chain; thus, fucose is the immunodominant
sugar for. The A allele encodes N-acetyl-galactosaminyltransferase that adds N-acetyl-D galactosamine
(or GalNAc) to H to make A antigen on red cells. The B allele encodes galactosyltransferase that adds D-
galactose (or Gal) to H to make B antigen. Group AB individuals have alleles that make transferases to
add both GalNAc and Gal to the precursor H antigen. Attachment of the A or B immunodominant sugars
diminishes the serologic detection of H antigen so that the expressions of A or B antigen and of H
antigen are inversely proportional. Rare individuals who lack both H and Se alleles (genotype hh and
sese) have no H and, therefore, no A or B antigens on their red cells or in their secretions. However, H,
A, and B antigens are found in the secretions of some hh individuals who appear, through family studies,
to possess at least one Se allele.

A, B, and H antigens are constructed on carbohydrate chains that are characterized by different linkages
and composition of the terminal disaccharide; there are at least six of these types of disaccharide
linkages.9 Type 1 chains and Type 2 chains differ in the linkage of the terminal Gal to GlcNAc
disaccharide. Type 1 A, B, and H structures are present in secretions, plasma, and endodermally derived
tissues. They are not synthesized by red cells but are incorporated into the red cell membrane from the
plasma. Type 2 chains are the predominant ABH-carrying oligosaccharides on red cells and are also
found in secretions. Type 3 chains (repetitive form) are found on red cells from group A individuals.10
They are synthesized by the addition of Gal to the terminal GalNAc Type 2 A chains, thus forming Type 3
H; Type 3 H chains are subsequently converted to Type 3 A by the addition of GalNAc through the action
of A1-transferase, but not by A2-transferase

Reference: Brecher, M. (2005). AABB Technical Manual. 15 th edition. United States

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