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ABO Blood Grouping System

Dr. Niaz Ahammed A.

yr M.D.S
Dpt of Prosthodontics
Classification of blood groups
Agglutinogens and Agglutinins
Landsteiners Laws
ABO blood grouping sysytem
ABO antigens
ABO antibodies
Types of ABO blood groups
ABO inheritance
Determination of blood groups

In 1901 Karl Landsteiner published his
discovery of a blood group system and he
grouped red cells into three categories; A,B
and O
A fourth blood group , AB was discovered later
by Decastello and Sturli.
Based on the type of antigen present or
absent, various blood grouping systems are
Major blood grouping systems:
- ABO blood grouping system
- Rh (CDE) blood grouping system
Minor blood grouping systems:
- MNS blood group system
- P blood group system
Familial blood group systems:
- Only in a few families. Ex: Kell, Duffy, Lutheran,
Lewis, Deigo, Kidd etc.
Agglutinogens and Agglutinins
Agglutinogens refer to antigens present on the
cell membranes of RBCs
Agglutinins: antibodies against the
agglutinogens, are present in plasma
Approximately 300 red cell antigens have now
been identified
18 blood group systems have been recognized

Blood grouping systems
Landsteiner law
If an agglutinogen is present on the red cell
membrane of an individual the corresponding
agglutinin must be absent in the plasma
If an agglutinogen is absent from the cell
membrane of RBCs of an individual, the
corresponding agglutinin must be present in
the plasma
ABO blood grouping system
It was the first to be recognized and most
Based on the presence of antigens called A and B
agglutinogens on the cell membrane of RBCs
H antigen is also present usually in all individuals
but it is non- antigenic
Almost everybody over the age of 6 months has
clinically significant anti-A and/or anti-B in their
ABO antigens
A,B and H antigens are glycoproteins and the differences in
terminal sugars determine the specificity of these antigens
L- fucose for H
L- fucose + N- acetyl-D- galactosamine for A
L- fucose + D- galactose for B
15 amino acids make up the protein backbone and four
sugars form side chains off this backbone
A & B antigens are also present in many other tissues like
salivary glands, pancreas, kidneys, liver, lungs and testis and
in body fluids like saliva, semen and amniotic fluid
H antigen- non antigenic

- L fucosyl transferase produced by H gene, attaches fucose and
yields H activity (group O)
N- acetyl- galactosaminyl transferase produced by A gene transfers
N-acetylgalactosamine and results in A activity
- galactosyl transferase produced by B gene attaches galactose and
confers B activity
Expression of ABH antigens on red cells is
controlled by genes that reside at two loci
ABH antigens results from action of enzymes
(tranferases) on the appropriate precursor
The substrate is a product of H gene
(chromosome 19) and converted to A or B by
the action of A or B- transferases
(chromosome 9)
Variants of A and B antigens
The principal sub groups of A are A1 and A2
A1 constitute 80% of those in gp A
A1 individuals agglutinated by Dolichos
biflorus lectin but not agglutinated by anti-H
lectin, Ulex europaeus
A2 individuals are agglutinated by Ulex
Variants of B are less common, but are
ABO antibodies
Individuals develop antibodies or agglutinins against A or B
antigen missing from their red blood cells
Anti A / agglutinin and Anti B/ agglutinins are present in
the plasma
O people also possess an antibody referred to as anti-A,B
which reacts with either A or B red blood cells
Bacteria with similar sugar moieties that confer A,B and H
reactivity provide antigenic stimulus
Anti A and anti B are globulins of IgM type
In individuals in O group, antibodies are of both IgM and
IgG classes
and agglutinins act best at low temperature ( 5- 20
degrees Celsius) and are called as cold antibodies
Two kinds of Anti-H also exist Oh (Bombay)
group and other in group A1 and A1B
Bombay blood is very rare but the antibody
is active at 37 degree Celsius and only
Bombay blood can be transfused

Types of ABO blood groups
Group A: A agglutinogen - B agglutinin
-A1 and A2 sub groups
Group B: B agglutinogen- A agglutinin
Group AB: A and B agglutinogen
- A1B and A2B sub groups
Group O: both anti A and anti B in plasma

ABO inheritance
The inheritance pattern of ABO genes follows
Mendalian autosomal genetics
Four major alleles are located at the ABO locus on
chromosome 9
6 common phenotypes described- A1, A2,B,
A1B,A2B and O
Most blood group genes are co-dominant (A and
O gene is a silent allele or amorph, with no
obervable expression
Co dominance: A state in which two diffrent alleles are
equally expressed
Silent genes or amorphs: those with no observable
Determination of ABO blood grouping
ABO blood group can be
determined by mixing one drop of
suspension of red cells with
a drop each of anti serum A
and antiserum B seperately on
a glass slide
Anti serum A will cause agglutination of RBCs having
antigen A and anti serum B will cause agglutination
of RBCs having B antigen
Population distribution of Blood groups in India
A group
B group
AB group
O group
Berne and Levy Physiology- Koeppan, Stanten
Guyton and Hall text book of medical
physiology- Hall
Text book of Physiology- A.K.Jain
Haematology clinical and lab practise Bick,
Bennet, Bynes, Cline
Wintrobes clinical haematology- Less, Foester

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