ABO AND MN BLOOD GROUP

SYSTEM

 Group Members:
 Hafiza Aiman Jabeen
 Fatima Rizwan
 Hafsa Murtaza
 Maria Noor
 Sabeeha Siddique
Blood Group
Systems
“The blood group you belong to depends on
what you have inherited from your parents”
Classificatio There are more than 20 genetically determined blood
group systems known today.
n of Blood
Group Major Blood Grouping Systems- Based on
Agglutinogens on cell membrane, present widely &
Systems: causes severe transfusion reactions
ABO Blood Group System

Rh Blood Group System

Minor Blood Group Systems- Based on Agglutinogens

but present in few populations & causes mild
transfusion reactions.
MNS Blood Group System

P Blood Group System

Familial Blood Group Systems- Found

only in few families: Ex, Kell, Duffy,
Lutheran, Lewis, Deigo, Kidd etc.
ABO Blood Group
System
Introduction
In 1901, Karl Landsteiner published his discovery of a
: blood group system and he grouped red cells into three
categories: A,B & O

A fourth blood group AB was discovered later by

Decastello & Sturli.

These four groups are determined by the presence or

absence of blood group antigens on the RBCs and
accordingly an individual’s blood group is A, B, AB or O.

Later, Van Dungern and Hirsfeld divided group A into two

sub-groups A1 & A2.
 Landsteiner’s Law:

If an agglutinogen is If an agglutinogen is
present on red blood absent on red blood
cell membrane, the cell membrane, then
corresponding corresponding
agglutinin must be agglutinin must be
absent in the plasma. present in the plasma.
ABO Antigens:  Fully developed at birth & start developing
•Fully developed at birth & start developing at 5-6 weeks of
at 5-6lifeweeks of intrauterine life
intrauterine
Glycolipid in nature in
 Glycolipid nature
 They are actually oligosaccharides attached
directly to lipids on red cell membrane. 
•They are actually oligosaccharides attached directly to lipids on
red There
cell are many antigen sites per red blood
membrane. 
cell (approximately 8,00,000 )
•There are many antigens
 Soluble antigen sites per be
can red present
blood cell (approximately
in plasma,
8,00,000 )
saliva
Soluble and
antigens canother secretions.
be present in plasma, saliva and other
secretions.
 Also present in WBC, platelets & on tissues
other than red cell like salivary glands,
pancreas,
•Also present kidney,
in WBC, plateletsbody fluids.
& on tissues Exception:
other than red cell like
salivary
CNSglands, pancreas, kidney, body fluids. Exception: CNS
ABO Antibodies:  Naturally occuring
 IgM is
Naturally the predominant
occuring. antibody in Group A &
Group B individuals i.e, Anti-A & Anti-B
IgM is the predominant antibody in Group A & Group B individuals
IgG (with
i.e,Anti-A & Anti-Bsome IgM) is the predominant
antibody in Group O individuals i.e, Anti A,B
IgG (with some IgM) is the predominant antibody in Group O
(withi.e,
individuals some anti-A
Anti A,B (with& anti-B)
some anti-A & anti-B).
 They react in saline and readily agglutinate.
They react in saline and readily agglutinate.
 React & agglutinate RBC’s best at room temp.
React & agglutinate RBC’s best at room temp.
 They are absent at birth and  start to appear
Theyaround 3-6atmonths
are absent birth and as result
start of stimulus
to appear around 3-6bymonths as
result bacterial polysaccharides. 
of stimulus by (For this
bacterial polysaccharides.  (Forreason,
this reason,
newborn blood is only forward typed.)
newborn blood is only forward typed.)
 Blood
Blood grouping
Blood Transfusion
is
Grouping required Transplant candidates & Donors
for:
Susceptibility to various diseases

Parental Patients

Hemolytic disease of Newborns

Paternity Disputes

Routine Health Checkup

Blood Blood typing is a test that
Typing: determines a person’s blood type.

ABO Typing:
• ABO typing involves:
• Antigen typing
• Antibody detection
• The antigen typing is referred to as the
forward typing and the antibody detection
is the reverse typing.
 Forward typing must
Cells are tested with
determines antigens correlate with the
the antisera
Forward Typing: on patient's or reverse typing & any
reagents anti-A,
donor's cells discrepancy must be
anti-B
resolved.

Reverse typing 
Also known as determines Serum tested with
Reverse Typing: backtyping or serum antibodies in reagents A cells and
confirmation patient's or donor's B cells
serum or plasma
 Slide Method

Methods of
Blood Typing: Tube Method

Gel Card Method

Microplate Technique

Glass Microbead Method

Galileo Method
GENETICS OF ABO BLOOD GROUP SYSTEM
 ABO system contains three antigens; A,B and H.
 A single polymorphic gene encodes ABO blood group system.
 This gene is present on long arm of chromosome 9.
 This gene has three multiple alleles IA, IB and i.
 Antigen A production is specified by the allele IA.
 Antigen B production is specified by the allele IB.
 i does not specify any antigen.
 Alleles IA and IB are co-dominant to each other.
 Allele i is recessive to both alleles IA and IB.
PHENOTYPES OF ABO BLOOD GROUP SYSTEM

 PHENOTYPE A
produced by IAIA or IA I genotypes.
 PHENOTYPE B
produced by IBIB or IB i genotypes.
 PHENOTYPE AB
produced by IAIB genotype.
 PHENOTYPE O
produced by ii genotype.
BLOOD TYPES

Blood types are defined on the basis of specific

antigens present on the surface of RBCs.
They are not defined on the basis of antibodies
present in the plasma.
FOUR BLOOD TYPES

 Type A Blood
RBCs carry A antigens on them.
 Type B blood
RBCs carry B antigens on them.
 Type AB blood
RBCs carry both A and B antigens.
 Type O blood
RBCs carry no antigen other than H antigen
BLOOD TRANSFUSIONS
COMPATIBILITY TESTING
 performed to determine if a particular unit of blood can be transfused safely into a
certain patient.
 This includes
 ABO-Rh blood typing
 antibody screening
for unexpected red blood cell antibodies that could cause
problem in the recipient.
 cross-matching
1. Way for your healthcare provider to test your blood against a donor's blood to make
sure they are fully compatible .
2. takes 45 minutes to an hour.
3. essentially a trial transfusion done in test tubes to see exactly how your blood will
react with potential donor blood
HEALTH RISK INDICATORS BY
BLOOD TYPE
 Blood Type and Cardiovascular Disease
 Blood Type and Venous Thromboembolism (VTE) Risk
 Cancer Risk and Blood Type
 Dementia Risk Differs By Blood Type
 Risk of stomach conditions
 Risk Of Hemorrhage
 Blood Type and Cardiovascular
Disease:
 A research has indicated an association between blood type and risk of
developing coronary heart disease (CHD).
 Researchers identified blood type as a significant risk factor for the
development of CHD.
 Individuals with type
 A had 5%
 B had 11%
 and AB had 23%
 higher risk of developing CHD than those with type O blood.
Continue…..

 This is because of ABO gene

 Present in people with A,B and AB blood types.
 But type O does not have this gene
 This gene can also increase risk ok of coronary artery disease(CAD)
 Blood Type and Venous
Thromboembolism (VTE) Risk:
 A disease that includes deep vein thrombosis and pulmonary embolism, VTE
is characterized by the formation of blood clots within blood vessels and is
often fatal.
 Individuals with blood types A, B, and AB can have an increased risk of VTE
 This risk is of as much as 2.2 times that of type O individuals.
Cancer Risk and Blood Type:

 Gastric, or stomach, cancer is showing a 20 percent greater risk for its

development in type A individuals as compared to people with type O blood.
 In pancreatic cancer, type A, B, and AB individuals at greater risk than type
Os.
 Women with type O blood are less likely to develop ovarian cancer than all
other blood types, but may be more likely to develop renal cancer.
 In Skin cancer people with type O having a higher risk of developing the
disease than A, B, and AB individuals.
Dementia Risk Differs By Blood Type:

 People with type AB blood face a much higher risk of developing thinking and
memory problems that lead to dementia.

 Chances of this type of cognitive impairment in AB individuals are 82 percent

higher than in type A, B and O individuals.
 Type O blood may protect against memory problems(including Alzheimer’s
disease).
 A 2015 study published in Brain Research Bulletin found that out of 189
people who had undergone brain MRIs, the brains of those with blood type O
had the greatest amount of grey matter in their brains
Risk of stomach conditions:

 In 2010 study published in American journal of epidemiology, researchers

looked at data from more than 1 million people.
 People with blood type A had the highest risk for gastric cancers
 While people with blood type O were at greater risk for developing peptic
ulcers.
Risk Of Hemorrhage:

 According to new research people with type O may be at a higher risk of

uncontrolled bleeding.
 An observational study published in May 2018 in Critical Care looked at the
medical records of 900 Japanese people admitted to emergency care medical
centers for severe trauma between 2013 and 2016.

 Trauma-related death rates for those with type O blood were 28 percent,
compared to 11 percent among those with other blood types.

 The study authors suggest that type O blood contains lower levels of blood
clotting agents, which may contribute to more bleeding.
MN BLOOD SYSTEM
DISCOVEREY

 Antigen M and N were described by Karl Landsteiner and Philip Levine in 1927.

 Walsh and Montgomery discovered S that appeared to be genetically linked to M and N. its
antithetical partner, s was discovered in 1951.

 Weiner reported an antibody to high incidence antigen, U in 1953.

 The MNS system has been assigned the ISBT numeric designation 002.

 More than 46 antigens are known in this blood group but M, N,S, and s antigens remain the
most common.
 These antigens exist on outer end of glycophorin-A that is major protein in RBC membrane.
MNS ANTIGEN SYSTEM
 It is based upon two genes which are glycophorin A
and glycophorin B on chromosome 4.

 The system can be isolated into two groups; M and

N antigens.
 These two antigens are at the location on the ECM
(extracellular matrix).

 The two groups, M and N are closely located

together on chromosome 4 and are inherited as a
haplotype.

 The MNS antigen are also expressed in the kidney on

the renal endothelium and epithelium.
MN BLOOD GROUP SYSTEM

 In human it is under control of a pair of co-dominant allele which means an

autosomal locus found on chromosome 4 with two alleles designated LM and
LN.
 Blood type is due to a glycoprotein present on the surface of RBCs.
 MN blood group type is called minor blood group system.
 Anti-M and anti-N antibodies are usually IgM and are rarely associated with
transfusion reactions.
MN BLOOD GROUP

Genotype Phenotype blood type Antigen present on RBC

LM LM M M

LN LM MN M and N

LN LN N N
STRUCTURE AND FUNCTION OF
GLYCOPHORIN A AND B
 Glycophorins A and B are encoded by homologous genes (GYPA and GYPB) at
chromosome 4q28-q31 that undoubtedly arose by gene duplication.
 The known alleles for GYPA (M/N) and GYPB(S/s) are co-dominant.
 GYPA is very abundant, with about 1 million copies per RBC. GYPB is much
less abundant, with only about 20,000 copies per cell.
Functions of the molecules that carry
the MNS antigens
 Glycophorins A and B may serve as receptors for cytokines, bacteria and
viruses.

 But lack of the glycophorins do not result in disease, indicating that their
function is not physiologically significant.

 Scientists are interested in these glycophorins because they tolerate the MNS
antigens and may act as a receptor for plasmodium falciparum.
MNS GLYCOPROTEIN AND GENES

 The MNS blood group system consists of 48 antigens carried on (GPA), (GPB)
or on hybrids of these glycophorins.
 The hybrid proteins vary in length and based on their composition but also
have 19 amino acids leader sequence.
 GPA consists of 131 amino acids, GPB of 72 and both have a leader sequence
of 19 amino acids that is cleaved from the membrane bound protein.
 GPA is encoded by GYPA while GPB by GYPB.
MNS ANTIBODIES

 MNS antibodies display dosage, they react stronger against cells which are
homozygous than heterozygous for the antigen.

 Anti-M and anti-N are generally clinically insignificant.

 Anti-S, anti-s and anti-U are usually clinically significant.

CURRENT UPDATES

1- ABO and MN Blood Group systems in

relation to asthma:
 persons possessing different blood groups differ
in their susceptibilities to certain diseases
 non-significant differences between patients of
blood group ABO and Rh
 MN Blood Group reveals significant differences
between the two series
 the homozygous type MM being resistant
 the heterozygous type MN being susceptible to
asthma
2- Hyperbilirubinemia due to minor blood group
(anti-E) incompatibility in a newborn:
 minor blood group antigens C, c, E, e, Kell,
Duffy, Kidd, Diego, MNSs…………..common to
cause incompatibility
 3-5% of neonatal hemolytic jaundice ……due to
incompatibility of minor blood groups
 Severe hemolytic disease……….anti-c antibodies
 Case reported ……..male baby……32 year old
mother……..normal born…..but at the 4th day of
delivery showed jaundice……..rise in bilirubin
level
 Prenatal history………mother received
levothyroxine treatment…….due to
hypothyroidism
 indirect hyperbilirubinemia related with minor
group due to anti-E was diagnosed
 In response to antigenic stimulus the initial
maternal antibodies ……… (Ig)M antibodies but
these cannot cross the placenta
 IgG antibodies increases with further antigenic
stimuli ……………can cross the placenta
 + indirect coombs test in the mother
 Causing severe hemolytic disease in the fetus
and newborn
 Treatment:
phototherapy for about 28 hours and further
there was no need of other advanced treatments
such as intravenous immunoglobulin or exchange
transfusions
3- Relative Susceptibilities of ABO Blood
Group to Plasmodium falciparum Malaria:
 individuals with blood group A are highly
susceptible to falciparum malaria
 and with blood group O confer protection
against complicated cases.
 Samples of 293 children less than 6 years old
had been examined and analyzed
 results reported that:
 there were 16.1% complicated cases with
blood group O weighed against 40.9% of
uncomplicated controls
 individuals with blood group A and B were about
twice to have complicated malaria.
CAUSES:
 rosetting of parasitized erythrocytes ,cytoadherence
and anemia
Rosetting:
pathogenesis of severe malaria by obstructing
microvascular blood flow
 in blood group O erythrocytes rosetting is reduced and
rosettes formed in blood are usually smaller and
unstable
CYTOADHERENCE:
 antigens of blood groups A and B play a key role
in cytoadherence
 due to absence of these antigens on the surface
of blood group O erythrocytes, rosetting and
cytoadherence is reduced
ANEMIA:

 increased rate of destruction of RBCs in blood

group “O” individuals
 in case of high parasitaemia due to enhanced RBC
destruction……….. blood group O may lose its
apparent protection against falciparum malaria
 ANY
QUESTION