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Other other antigens


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What type of quantitative relationship is seen for I/i?
Reciprocal; lots of i at birth, decrases as I increases.
How does I develop?
Branches from i.
What is the frequency of the i phenotype?
very rare; 1 in 10,000
What 3 phenotypes exist for the Ii system?
I adult
I cord
i adult
What type of antigen is on cells in i adult patients?
Trace I
Much i
What are the sources of Ii antigens?
What cells are Ii Ag's on?
Saliva -> small amt of I
Human milk -> more I
Serum/plasma -> I and i
-On RBCs, Lymphocytes, pltlts
Which Anti-I/i is more common?
-B/c alloanti-I would be in homozygous i phenotypes, which are very rare.
When would Autoanti-I be detected? Why?
In the autocontrol IS; because it is IgM and reacts at cold temps.
-What is optimum reactivity for Anti-I?
-Does it activate complement?
-Enzyme response?
Enhanced with enzymes.
Doesn't cause HTR/HDN.
What is Autoanti-I commonly associated with? (2 things)
2. Mycoplasma pneumonia. KNOW THIS!!!
-What type of Ab is Anti-i?
-Optimum temp?
-Naturally occuring IgM
-RT, 4'C.
What distinguishes Anti-I from Anti-i?
Ability to react with cord cells or I- cells; Anti-i is better b/c there is much on these young cells.
What is Anti-i associated with?
Infectious mononucleosis
Occasional CAIHA.
-What type of Ab is Autoanti-IH?
-Optimum temp?
Naturally occuring IgM
RT, 4'C
What blood type ABO usually has Anti-IH?
What cells does the Ab react best with?
A1 individuals

Best w/ O/A2 cells with much I and H Ag to react with.
Anti-I: what cells does it react with?
All 4+ except Cord O
Anti-IH: what cells does it react with?
-A2 and O are 4+
-All others are 0-2+
What antigens are in the P blood group system?
P1, P, and Pk.
How frequent is P1 antigen?
What phenotypes exist for the P group?
P1 phenotypes have:
What antigens?
What antibodies?
How frequent in white/blacks?
Ag: P1 and P
Ab: None
80% of whites, 95% blacks.
P2 phenotypes have:
What antigens?
What antibodies?
How frequent in white/blacks?
Ag: P
Ab: Anti-P1
20% of whites, 5% blacks.
P1k and P2k phenotypes have:
What antigens?
What antibodies?
How frequent in white/blacks?
Ag: P1, pk or just pk
Ab: Anti-P
p phenotypes have:
What antigens?
What antibodies?
How frequent in white/blacks?
Ag: None
Ab: Anti-P+P1+pk
-What type of Ab is Anti-P1?
-Does it bind complement?
-What is optimum rxtn temp?
-Naturally occuring IgM or common alloantibody in P2 pts
- RT or 4'C
-How immunogenic are Anti-P1 reactions?
-Enzyme response?
-Varied reactivity
-Enzymes enhance.
-Doesn't cause HDN/HTR.
-What type of Ab is Anti-P?
-Does it bind complement?
-What is optimum rxtn temp?
-Naturally occuring IgM;rare alloantibody in Pk1/2 pts
-May bind complement.
- RT or 4'C
-How immunogenic are Anti-P reactions?
-Enzyme response?
What is Anti-P associated with?
ParoxysmalCH, IgG biphasic hemolysin.
What is Anti-P, P1, Pk also known as?
What type of Ab is Tja?
-Rare alloantibody in p phenotype patients.
-Naturally occuring
-IgM or IgG
Does Tja bind complement?
Does it cause HTR/HDN?
What is its optimum temp?
RT, 4'C, IAT. any
what type of hemolysis does Anti-P,P1,Pk cause?
In vitro.
What is Tja associated with?
Spontaneous abortions early in pregnancy.
Ok; of the P system ab's:
-Which is most significant?
-Which is insignificant?
-Which Ag is more frequent?
-What are the building blocks?
-P is significant
-P1 is insignificant
P1 is mre frequent than P
Paraglobosides are bblocks.
What is unique about the Lewis system?
Not a blood group system, because the Ags aren't made on RBCs.
Where are the Lewis antigens made?
In the plasma.
What are plasma Lewis Ags?
What are saliva Lewis Ags?
What genes affect Lewis Ag expression, and what type of inheritance exhibit?
Le (FUT3) and Se (FUT2);
Le and Se --> dominant
le and se --> amorph
What do the Le and Se genes encode?
What sugars are made when Se or Le antigens expressed?
Both = L-fucose.
What makes Le-a unique?
It is identical to Type 1 H chains except the Fuc is put on GlcNac instead of Gal.
What makes Le-b unique?
It is identical to Le-a except it has 2 Fuc's.
basically an H type-1 with an extra Fuc stuck on.
How frequent is H type 1 antigen?
Very frequent; 80% have it.
What phenotypes does these genes encode?
LeSe; Le sese; lele Se (sese)
LeSe --> Le(a-b+)
Le sese -> Le (a+b-)
sese --> Le(a-b-)
Which of these are secretors?
LeSe; Le sese; Lele, Se; sese
Secretors are LeSe, Lele Se
What's the most common type of Lewis phenotypes in whites and blacks?
Whites: Le(a-b+) 72%
Blacks: Le(a-b+) but only 50%
What is 2nd place for Lewis phenotypes?
Whites: Le(a+b-)
Blacks: Le(a-b-)
How developed are the lewis antigens at birth?
not very
Outline lewis antigen development from birth.
Le(a-b-), (a+b-),
(a+b+), (a-b+).
What is weird about Lewis antigens and pregnant women?
They go from a-b+ to a-b- and can develop an antibody.
Why does the Lewis antigen disappear in pregnancy?
Lipoprotein levels increase greatly, and bind all the antigen.
What cells are the lewis antigens found on?
Red cells
What antibodies do we worry about in the lewis system?
What patients develop
le --> Le(a-b-)
-What type of Ab is Anti-Lea?
-Does it bind complement?
-What is optimum temp?
Naturally occuring IgM; few G
Yes; it binds complement.
Temp is RT to AHG.
How does Anti-Le(a) respond to enzymes?
Is it significant? Cause HTR or HDN?
-Enzymes enhance it.
-Not significant if not active at Coombs.
-Rare cause of HTR, no HDN.
Why doesn't Lea cause HDN?
Because babies don't have developed lewis antigens.
Who is Anti-Leb mostly seen in?
Mostly Lea-b-, rare a+b-.
What type of antibody is Anti-Le(b)?
-Naturally occuring IgM; a few are IgG like anti-Lea.
What distinguishes Anti-Leb from Anti-Lea?
B binds complement.
Everything else is same as Lea.
What is Anti-LebH seen in?
Compound phenotypes
OK: how does an LeSe differ from an Lese?
LeSe has less Lea in saliva than an Lese, but LeSe has Leb in saliva and Lese doesn't.
How does leleSe differ from lelesese?
leleSe has Tpe 1H in saliva, but lelesese only has Type 1 in saliva.

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