OTHER BLOOD GROUP SYSTEM:

Lewis blood group system

INTRODUCTION:
The lewis blood group system is not manufactured by the
red blood cells.

Lewis antigens are not synthesized by red cells, but

incorporated into red cell membrane structure.

The lewis antigens are manufactured by tissue cells and

secreted into body fluid, then adsorbed onto the red cell
membrane from plasma.

Therefore lewis antigen is not an integral part of the

membrane structure.

lewis antigen development begin in the first week of birth

and continue to 6 years.
INHERITANCE:

The lewis gene (Le) code for L-fucosyltransferase enzyme

which add fucose sugar to the precursor substance one.

 fucose sugar added to the N-acetylglucosamine sugar.

The Le gene is located in the short arm of the

chromosome 19.

Lewis antigen production depends not only on the

inheritance of the lewis genes but also on the inheritance
of the secretor gene and H genes.
 INHERITANCE:
If a Le gene is inherited , Lea antigens are found in the
secretions and are adsorbed onto the red blood cells regardless of
the secretor status.
Therefore, an individual can be a non-secretor of ABH and still
secret Lea into the body fluids.
If the Se gene is inherited in addition to Le gene, the lweis
transferase converts the available H soluble structure to a Leb ,
And the red cells adsorbs Leb instead of Lea
 If the gene inherited from both parents is le, no antigen
structure is present on the red cells.
 SUMMARY OF LEWIS INHERITANCE AND
BIOCHEMISTRY CONCEPTS:
Lea and Leb are not alleles

Le(a-b+) red blood cells arises from the inheritance of an Le,

Se, and H gene.

A person can be a nonsecretor (sese) and still secrete Lea into

body fluid. Therefore, only antigens Lea are secreted by the
tissue cells and subsequently adsorbed to re blood cells from
plasma yielding the phenotype Le(a+b-).

Lewis antigens found in the secretion are glycoproteins

Lewis antigens found in the plasma are glycolipids.

Red cells adsorb only glycolipids not glycoproteins, onto the

membrane.
Substances present in secretions and antigens present
on red blood cells, depending on the Lewis, Sese, Hh,
and ABH genes inherited.
 LEWIS ANTIBODIES:
Antibodies to the lewis blood group antigen (anti- Lea and anti-
Leb) are generally produced by Le(a-b-) persons.

Lewis antibodies are considered naturally occurring because they

are present without previous exposure to the antigen positive red
cells.

They are generally IgM, do not cross placenta and do not cause
HDNF.

Can activate complement. Therefore can cause hemolytic

transfusion reaction.
LEWIS ANTIBODIES:
Anti- Lea is easily neutralized with plasma and body fluid
secretion.
Le(a-b+) person do not make Anti- Lea because:
1. the Lea antigen structure is contained within the Leb
antigen epitopes.
2. Le(a-b+) persons have Lea substances in their plasma and
saliva.
The lewis antigens dissociate from the red cells as they
adsorb. These antigen released into the plasma can
neutralized any lewis antibodies present in the recipient
plasma of Le(a-b-) persons.