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DETERMINATION BLOOD TYPES BY ABO SYSTEM
Daminov F.A.– DSc, Ass.Professor, head of the department of clinical
laboratory diagnosis with the course of clinical laboratory diagnostics of PGD;
Djabbarova N.R.- assistant of the department of clinical laboratory diagnosis
with the course of clinical laboratory diagnostics of PGD;
Kurbonova D.Z.- cadet of the department of clinical laboratory diagnosis
with the course of clinical laboratory diagnostics of PGD;
Samarkand state medical university
Samarkand, Uzbekistan
Currently, more than 250 red blood cell antigens have been identified, which
are grouped into more than 20 antigen systems. 13 systems are of clinical
significance: ABO, Rh-Hr, Kell, Duffy, MNSs, Kidd, Lewis, Lutheran, Diego,
Auberger, Dombrock, and I.
Keywords: erythrocytes, antigens, Rh factor, transfusiology, leucocyte
antigens;
Human erythrocytes contain antigens of several antigenic systems
simultaneously, and each antigenic system may consist of a dozen or more antigens.
The main antigenic systems are considered to be the ABO and Rh factor antigenic
systems. Other systems are not essential in practical transfusiology, so they are called
secondary.
Leukocyte antigens. Leukocyte antigens are localised in the membrane of
leukocytes. They may be similar to erythrocyte antigens, or they may be specific. The
latter belong to the leucocyte antigens [21,22,23,24].
Currently, about 70 leukocyte antigens have been identified, which are
divided into three groups:
- Common Leucocyte Antigens (HLA - Human Leucocyte Antigen)
- Polymorphonuclear Leucocyte Antigens.
- Lymphocyte Antigens.
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HLA-system is of great importance in blood, leucocyte and platelet
transfusion, in tissue transplantation. Antigens of this system are called
histocompatibility antigens. Antigens of polymorphonuclear leukocytes may play a
role in the occurrence of non-haemolytic post-transfusion reactions. The role of
lymphocyte antigens is currently poorly understood.
Platelet antigens
Platelet antigens are localised in the membrane of platelets. Platelets contain
antigens similar to erythrocytic and leucocytic antigens (HLA), as well as specific
antigens, which are referred to as platelet antigens. In haemotransfusion practice, they
have no special significance [5,6,7].
Plasma antigens.
Plasma antigens are united into 10 antigenic systems, on the basis of which
plasma (serum) blood groups are distinguished. Plasma antigens are localised on the
surface of plasma protein molecules and represent complexes of amino acids or
carbohydrates.
Cellular antigens are of primary importance in clinical transfusiology
[1,2,3,4].
GROUP ANTIGENS
The presence of antigens in the blood presupposes the existence of antibodies.
Currently, antibodies with the same name have been identified for almost all known
blood antigens (anti-A, anti-B, anti-Rhesus, anti-Kell, etc.). Unlike antigens, blood
group antibodies are not always present in humans. Only to the antigens of the ABO
group system is the presence of antibodies mandatory. These antibodies (agglutinins
α and β) are present in the blood plasma throughout life, combining in a certain way
with agglutinogens (antigens) of red blood cells [19,20,21].
Blood group antibodies are divided into innate (agglutinins α and β) and
isoimmune, which are formed in response to the ingestion of foreign group antigens
(antibodies of the Rh factor system) [16,17,18].
Congenital antibodies are complete antibodies (agglutinins) and cause
agglutination (sticking) of erythrocytes containing the corresponding antigen. They
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show their properties better in vitro at low temperatures and react less strongly at high
temperatures. Therefore, they are referred to as cold antibodies.
Isoimmune antibodies are incomplete antibodies. They are difficult to absorb
and are not destroyed by heat. These antibodies are thermal (most active at 37°C and
above) and agglutination occurs only in a colloidal medium [13,14,15].
ANTIGEN-ANTIBODY INTERACTION MECHANISM
In the process of interaction between antigen and antidiv two phases are
distinguished:
Phase 1 - the actual interaction of antigen and antidiv;
Phase 2 - manifestations.
In the first phase no changes visible to the eye or in the light microscope are
not revealed. Antidiv joins the antigenic determinant of one blood cell (fixed on the
cell) with its active centre and enters into interaction [10,11,12].
In the second phase, after fixation of antibodies on the surface of blood cells,
a complex of proteins from blood plasma (complement) joins the antigen-antidiv
complex. Then the formed antigen-antidiv-complement complex destroys (lyses)
the cell membrane. Visually it is manifested as agglutination (sticking of
erythrocytes), or as cytolysis (destruction of blood cells). Haemolysis of red blood
cells occurs [6,7,8,9].
The ABO system is the main system that determines the compatibility or
incompatibility of transfused blood. Compatibility is the combination of donor and
recipient blood in terms of antigens and antibodies, in which no immunological
interactions occur. The basis for dividing people by blood groups in the ABO system
is the isoagglutination reaction. Isoagglutination is a reaction between serum and
erythrocytes of the same species of animal, resulting in sticking of erythrocytes. The
adhesion of erythrocytes of one species of animal by the serum of another species is
called heteroagglutination. Isoagglutination is an immunological reaction between
agglutinogens (antigens) and agglutinins (antibodies) [1,2,3,4,5].
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