Study notes on Minor blood group systems

Chromosomal locations of the Blood group systems

ISBT number
System
001
ABO
002
MNS
003
P
004
Rh
005
Lutheran
006
Kell
007
Lewis
008
Duffy
009
Kidd
010
Diego
011
Cartwright
012
Xg
013
Scianna
014
Dombrock
015
Colton
016
Landsteiner-Wiener
017
Chido-Rogers
018
H
019
Kx
020
Gerbich
021
Cromer
022
Knops
023
Indian
024
Ok
025
Raph
026
John Milton Hagen
027
I
028
Globoside
029
Gill
030
RHAG
031
FORS
032
Jr
033
Lan
034
Vel
035
HRF/CD59

I.

Chromosomal Number
9
4
22
1
19
7
19
1
18
17
7
X
1
12
7
19
6
19
X
2
1
1
11
19
11
15
6
3
9
6
9
4
2
1
11

MINOR BLOOD GROUP SYSTEMS

DIEGO BLOOD GROUP SYSTEM (010)
a
b
a
b
o Two sets of independent pairs of antithetical antigens: Di /Di abd Wr /Wr ; and three low
a
a
incidence antigens: Wd , Rb , WARR
a
o Di antigen has served as a useful tool in anthropologic studies of Mongolian ancestry
a
b
o Di and Di antigens are located on the Anion Exchange Molecule (AE-1), which is an integral
transport protein involved in exchange of bicarbonate and chloride in the RBC membrane
o Mutations in AE-1 can result in hereditary spherocytosis, congenital acanthocytosis, and
Southeast Asian Ovalocytosis
o Wright antigens were first classified as an independent blood group system and later as a
collection
a
b
o Both Anti- Di and Anti-Di are characterized as RBC stimulated, IgG antibodies that do not bind
complement and are reactive in indirect antiglobulin test
a
o Two types of Anti- Wr are known: a naturally occurring IgM and an Immune IgG.

CARTWRIGHT BLOOD GROUP SYSTEM (011)

a
o Composed of two antigens: Yt , a high incidence antigen present in 99.8% of the general
b
population, and its antithetical partner, Yt , a low incidence antigen present in 8% of the
population
o Yt antigens have been located on Erythrocyte Acetylcholinesterase, which is an enzyme involved
in neurotransmission.
o Both Cartwright antibodies are IgG antibodies reactive at IAT and are considered to be clinically
important because they are RBC stimulated.

XG BLOOD GROUP SYSTEM (012)

a
o Only the Xg antigen has been identified with no known antithetical partner
o Gene that encodes for the Xg allele is located on the short arm of X chromosome
a
o Xg antigen is carried by a protein with a cells adhesion properties that has been demonstrated to
have homology with the CD99 molecule
a
o Difference in the frequency of Xg antigen is noted between the sexes; (_____ for female, _____
for male)
a
o Anti-Xg antibodies are predominantly IgG reactive at IAT and sensitive to enzymes but not in
Dithiothreitol treatment. Most are due to RBC stimulation but have no associations with HDN.

SCIANNA BLOOD GROUP SYSTEM (013)

o SC system is composed of Sc1, Sc2 and Sc3 antigens
o Most anti-Sc1 and anti-Sc2 antibodies are IgG and RBC stimulated, IAT-reacting. Not involved in
any HTRs
o Anti-Sc3 is same in characteristics but is known to cause mild HTRs and HDNs

DOMBROCK BLOOD GROUP SYSTEM (014)

a
b
o Do and Do
a
y
a
o Gregory (Gy ), Holley (H ), and Joseph (Jo )
a
b
o Anti- Do and Anti-Do are described as IgG antibodies, RBC stimulated, react at IAT with PEG or
enzyme treatment. Does not cause HDN but has been reported to cause moderate HTRs
o Other antibodies have the same characteristics and have been implicated in some mild HTRs.

COLTON BLOOD GROUP SYSTEM (015)

a
b
ab
o Composed of three antigens: Co , Co , and Co3 (formerly Co )
o CO antigens have been located on the transport protein known as Channel-Forming integral
protein (CHIP), which forms the primary erythrocyte water channel and is responsible for water
permeability
o CHIP and CO antigens are expressed in the tissues of the proximal and descending tubules and
the collecting ducts of the kidney and are believed for 80% of water reabsorption
a
b
o Both anti- Co and anti- Co are IgG, RBC stimulated and reactive in IAT, and associated with
delayed HTRs
o Anti-Co3 has the same characteristics and has been known to cause severe HDN

CHIDO/RODGERS BLOOD GROUP SYSTEM (017)

o Includes nine antigens, which are subdivided into six Ch antigens, two Rodgers, and the WH
antigen
o It was postulated that the CH/RG antigens were associated with Human Leukocyte Antigen
(HLA) system; alleles for RG and CH have been located on two closely linked genes known as
C4A and C4B on chromosome 6
o Antigen products have been demonstrated on the C4d fragments of the C4A (Rodgers) and C4B
(Chido) glycoproteins of the C4 complement component
o Formerly, the anti-Ch/Rg antibodies were collectively grouped as HIGH-TITER, LOW-AVIDITY
(HTLA) along with other antibodies sharing common serologic properties
o Anti-Ch/Rg antibodies are usually stimulated in multi-transfused individuals lacking one or more
of the corresponding antigens, these antibodies are IgG and weakly reactive in the IAT phase of
testing

GERBICH BLOOD GROUP SYSTEM (020)

o Complex system that is composed of three high-incidence (Ge2, Ge3 and Ge4) and four lowb
a
a
a
incidence antigens (W , Ls , An , and Dh )
o GE antigens are inherited on chromosome 2 and are expressed on Glycophorin C (GPC) and/or D
(GPD)
o Individuals of the Leach phenotype (GE: -2, -3, -4) present with a change in RBC morphology in
the form of elliptocytosis
o Anti-GE2 and GE3 have also been noted as naturally occurring IgM antibodies and also
autoantibodies, implicated in delayed HTRs but not in HDNs
o Antibodies to the low-incidence GE antigens; anti-Wb, anti-Lsa, anti-Ana, and anti-Dha are
described as predominantly IgG with an IgM component and unable to bind complement

CROMER BLOOD GROUP SYSTEM (021)

a
a
a
a
b
o Composed of seven high incidence antigens (Cr , Tc , Dr , Es , IFC, UMC, and WES ) and three
b
c
a
low-incidence antigens (Tc , Tc , WES )
o Antigens are carried by Decay Accelarating Factor (DAF) which is involved with the regulation of
complement activation by accelerating the decay of C3 and C5 convertases
o Anti-CROM antibodies are described as predominantly IgG1, RBC stimulated, and reactive at IAT
testing, neutralization may be accomplished with concentrated serum, plasma, or urine
o CROM antibodies are rarely observed, with the majority of examples presenting in black
individuals

KNOPS BLOOD GROUP SYSTEM (022)

a
b
a
a
a
o Composed of five antigens: Kn (Knops), Kn , McC (McCoy), SI , and Yk (York)
o Alleles for the KN blood group have been located on chromosome 1, with the antigens residing
on complement receptor one (CR1/CD35)
o KN antibodies are characterized as IgG, RBC stimulated, and reacting weakly and variably at the
IAT. Viewed to be of little clinical importance because none has been associated with HTR or
HDN.

INDIAN BLOOD GROUP SYSTEM (023)

a
b
o Composed of two antithetical antigens: In and In which are of relatively low and high incidence,
respectively
o IN antigens are carried on the hematopoietic isoform of the CD44 marker, which is known for its
immune adhesion properties
o IN antibodies are characterized as IgG, RBC stimulated, and reactive in IAT

HUMAN LEUKOCYTE ANTIGENS (HLA) DETECTABLE ON RBCS

a
b
c
o Bg antigen, corresponds with HLA-B7, Bg with HLA-B17, and Bg with HLA-A28
o Bg antibodies are characterized as IgG and weakly-reacting. It reacts variably at IAT and is not
associated with any HTRs and HDNs

HIGH-INCIDENCE ANTIGENS UNRELATED TO THE PRINCIPAL BLOOD GROUP SYSTEMS

o Antigens of high frequency are defined as occurring 99.9% of the population
o Examples of high frequency antigens that are apparently unrelated to principal blood group
a
a
a
a
systems include: Augustine (At ), Cromer (Cr ), En , Gerbich, (Ge), Gregory (Gy ) and Holley (Hy),
a
a
a
Jacobs (Jr ), Joseph (Jo ), Langereis (Lan), Ok , and Vel (Ve)
o It should be noted however, that the At (a-), Cr (a-) and Jo (a-) phenotypes are predominantly
found in Blacks

LOW-INCIDENCE ANTIGENS UNRELATED TO THE PRINCIPAL BLOOD GROUP SYSTEMS

o Low-incidence antigens unrelated to the principal blood group systems are defined as antigens
with an incidence of less than 1%
a
a
a
o Examples include: Wright blood group system, Swann (Sw ), By, Mt , and Tr antigens

HIGH-TITER, LOW-AVIDITY (HTLA) ANTIBODIES

o Antibodies exhibit reactivity at high dilutions of serum, but the strength of agglutination is weak
at any dilution
o Antibodies formerly classified as HTLAs owing to similar serologic reactivity:
Anti-Ch (Chido), Anti-Rg (Rodgers), Anti-Kn (Knops), Anti-JMH (John Milton Hagen), Antia
a
Yk (York), Anti-Cs (Cost), Anti-McC (McCoy)

Dear students,
Please read the other blood group systems on Henry, 22nd edition, especially the biological
role for each blood group system. Refer to Harmening for more information regarding blood groups.
Your ever-loving instructor,
Sir Chino