Rh First Part Flashcards by Kyra Catedral

Hemolytic Disease of the Fetus and Newborn (HDFN) linked to Rh BGS by (4) in ____

1940

Levine and Stetson

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• Rh Antigens
From ‘______
Not necessarily the Rhesus monkey that has discovered Rh blood groups possible.

• It came from a woman who gave birth to a stillborn baby (dead upon birth), her second child

Rhesus monkey cells’

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Demonstrated by_______
They injected Rhesus monkey red cells to (2)

Landsteiner and Weiner

guinea pigs and rabbits.

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Current Rh Genetic Theory

2 genes linked in Chromosome 1

RHD and RHCE genes

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According to the ______ theory, there are two genes responsible for the production of Rh antigens

They are located in the same chromosome but in different loci in very close proximity

Considered to be haplotype?

current genetic theory

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Chromosome 6; Coexpressor

RHAG

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Not an
antigen, but rather
a
glycoprotein - related to the Rh
glycorprotein itself.

RHAG

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The absence of RHAG gene can affect the expression of…

RHD and RHCE antigens.

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• RH glycoprotein is made up of__\ amino acids that traverses to the plasma membrane____ times.

416

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Individuals who are Rh null most likely don’t have the Rh glycoprotein - will suffer a particular RBC morphology abnormality -____.

STOMATOCYTOSIS

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In 103rd AA

If SERINE →
If PROLINE →

Capital C

small c

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In 226th AA

If PROLINE →
If ALANINE →

Capital E

Small e

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One of the two major Rh nomenclatures

Three different genes on three different loci in CLOSE PROXIMITY on the same chromosome → STILL IN CHROMOSOME 1

Fisher-Race genetic theory

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One gene codes for three combinations

Weiner Genetic Theory

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R°, R1, R2, Rz, r, r’, r”, ry

Weiner Genetic Theory

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Dce, dce, DcE, DCe, dCe, dcE, DCE, dCE

Fisher race

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DCEce
12345

Rosenfield Numeric Technology

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Six digit number for every authenticated blood group specificity

FIRST THREE NUMBERS: BLOOD GROUP SYSTEM (004)

REMAINING THREE: Antigenic specificity

ISBT Numeric Terminology

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ISBT

Rh°
rh’
hr”

004001
004002
004005

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Antigens:

Most to least

WELL DEVELOPED EARLY IN FETAL LIFE

Exposure to at least 1 mL of Rh positive cells would stimulate antibody production of Rh negative persons

D> c>E>C>e

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It is one of the two major Rh nomenclature systems (the other being Wiener).

Fisher-Race system

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This theory proposes that three separate but closely linked genes on Chromosome 1 determine Rh antigen expression.
• Each gene controls the production of one of three pairs of Rh antigens:
• D or d
• C or c
• E or e

Fisher race

A person with dce/dce genotype would be_____ because they lack the D antigen.

Rh-negative

No Rh antigens are present at all

Rh-null

Absent (D) Present (CE) Other Rh antigens still present

Rh-negative (Rh-)

individuals lack all Rh antigens, causing serious red blood cell membrane instability.

Rh-null

is a modified form of Rh expression, where D, C, and e antigens are present but weakly expressed.

Rhmod

The _____proposes that one gene is responsible for producing three closely associated antigenic factors: • D (Rho factor) • C (hr’ factor) • E (hr” factor)

Weiner Genetic Theory

• In____, three separate genes on Chromosome 1 code for the Rh antigens (D, C/c, and E/e). • In_____, a single gene codes for a single structure (agglutinogen) that expresses three antigenic factors.

Fisher-Race Weiner’s Theory

The term_____\ is synonymous with antigen, meaning it stimulates antibody production.

agglutinogen

refers to the antibody produced against a specific antigen

Agglutinin

refer to the different antigenic subcomponents detected through serological reactions.

Blood factors

If a person inherits R° (Ro) → They express

D, c, e antigens.

If a person inherits R’ (R1) → They express

D, C, e antigens.

If a person inherits R² (R2) → They express

D, c, E antigens.

If a person inherits Rz (Rz) → They express

D, C, E antigens.

No Rh antigens present (complete absence of Rh system antigens)

Rh-null rr (equivalent to Rh-null)

Weakened Rh expression Rh antigens are weakly expressed due to RHAG mutation

Rhmod

If a person has D+, C+, E-, c+, e+, their Rh designation in Rosenfield notation would be: Rh:

1, 2, -3, 4, 5

Rosenfield notation If another person has D-, C-, E+, c+, e+, their Rh designation would be:

Rh: -1, -2, 3, 4, 5

assigns six-digit codes to each blood group antigen for standardized identification.

International Society of Blood Transfusion (ISBT)

If a blood sample contains D+, C-, E+, c+, e- the ISBT notation would be:

004001, 004003, 004004

Comparison Across Nomenclatures: • _____→ One gene produces multiple antigenic factors. • ____→ Three closely linked genes code for D, C/c, E/e. • ____→ Antigens are numbered in a set order (D, C, E, c, e). • ____→ A globally standardized six-digit system for antigen classification.

Weiner Fisher-Race Rosenfield ISBT

Rank (From Strongest to Weakest)

D c E C e

Rh antigens are present on red blood cells (RBCs) as early as the___\ of fetal development.

first trimester

IgG class are the most clinically significant because they can cause Hemolytic Disease of the Newborn (HDN) and Hemolytic Transfusion Reactions (HTR).

IgG1 and IgG3

If Rh-negative individuals receive Rh-positive blood, they can develop..

anti-D antibodies.

The immune response to Rh antigens follows this sequence: • _____is the first antibody produced (which does NOT cross the placenta). • IgM later switches to____, which can cross the placenta and attack fetal red cells

IgM IgG

• Caused by mutations in the RHD gene → Leads to fewer D antigens on the RBC surface. • Common in African-Americans. • Detected using Indirect Antiglobulin Test (IAT) or Indirect Coombs Test.

Genetic Weak D

• Some parts of the D antigen are missing → The individual may form anti-D antibodies against the missing parts if exposed to normal Rh-positive blood.

Partial D (Mosaic D)