Blood Groups and IgM Antibodies

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Questions and Answers

What is the primary isotype of naturally occurring antibodies?

  • IgE
  • IgA
  • IgM (correct)
  • IgG

How can IgM antibodies bind to specific antigens or pathogens?

  • Requiring T cell activation.
  • Only after the host has been exposed to the antigen.
  • Exclusively to antigens present in the host's own cells.
  • Even if the host has never been exposed to the antigen. (correct)

To what kind of structures are many antibodies reactive?

  • Structures common to many species, such as nucleic acids and phospholipids. (correct)
  • Unique structures found only in specific pathogens.
  • Structures altered by genetic modification.
  • Structures only found in the host organism's cells.

What determines a person's blood group?

<p>The specific surface antigens present on their red blood cells. (A)</p> Signup and view all the answers

Which process is initiated by the binding of antibodies to erythrocytes?

<p>A clumping effect, known as agglutination. (A)</p> Signup and view all the answers

What is the effect of agglutination on erythrocytes?

<p>It causes pore formation in the cell membrane, leading to cell death. (A)</p> Signup and view all the answers

What is the outcome of antibodies binding to multiple erythrocytes simultaneously?

<p>Agglutination and potential hemolytic reaction. (A)</p> Signup and view all the answers

In the context of blood groups, what do surface antigens on erythrocytes determine?

<p>The compatibility of blood for transfusions. (A)</p> Signup and view all the answers

Which of the following is a characteristic of natural antibodies?

<p>They are mostly of the IgM isotype. (B)</p> Signup and view all the answers

What is the composition of blood group antigens?

<p>Glycoproteins, glycosphingolipids and carbohydrate. (B)</p> Signup and view all the answers

What triggers a hemolytic reaction?

<p>Antibody recognition of antigens on erythrocyte cell surfaces. (D)</p> Signup and view all the answers

How does agglutination of erythrocytes contribute to cell damage?

<p>By causing pore formation in the cell membrane. (A)</p> Signup and view all the answers

What is a key characteristic of antigens found on cell surfaces?

<p>They are inherited from both parents. (C)</p> Signup and view all the answers

Which event immediately precedes pore formation in erythrocytes during a hemolytic reaction?

<p>The clumping of erythrocytes due to antibody binding. (D)</p> Signup and view all the answers

What is the role of IgM antibodies in immunity?

<p>To initiate an immune response even without prior exposure to an antigen. (D)</p> Signup and view all the answers

If agglutination leads to pore formation and cell death, what broader immunological process does this describe?

<p>The mechanism of natural immunity against incompatible blood types. (C)</p> Signup and view all the answers

How does the structure of blood group antigens contribute to their function?

<p>The carbohydrate component provides unique identifying markers. (A)</p> Signup and view all the answers

How do antibodies recognize antigens on the erythrocyte cell surface?

<p>Through the variable regions on the antibody that match the shape of the antigen. (B)</p> Signup and view all the answers

What is the significance of antibodies being able to bind to multiple erythrocytes at the same time?

<p>It facilitates agglutination, leading to a more effective immune response. (D)</p> Signup and view all the answers

Which of the following accurately describes the relationship between agglutination and hemolytic reactions?

<p>Agglutination precedes and facilitates the hemolytic reaction through pore formation. (D)</p> Signup and view all the answers

In an individual with type B blood, which antibodies are present in their plasma?

<p>Anti-A antibodies (D)</p> Signup and view all the answers

Why does the immune system react to donor cells in an ABO-incompatible transfusion?

<p>Because the donor cells are treated as foreign invaders. (B)</p> Signup and view all the answers

What is the consequence of administering type B blood to a recipient with type A blood?

<p>A rapid hemolysis of the transfused cells will occur due to ABO incompatibility. (B)</p> Signup and view all the answers

What antibodies are present in the plasma of a person with type O blood?

<p>Both anti-A and anti-B antibodies (A)</p> Signup and view all the answers

If a patient with type A blood receives a transfusion of type AB blood, why might this cause a problem?

<p>Type A blood contains antibodies that will attack the B antigens on the type AB blood. (C)</p> Signup and view all the answers

Which blood type is considered a 'universal recipient' due to the absence of anti-A or anti-B antibodies in their plasma?

<p>Type AB (B)</p> Signup and view all the answers

What is the term used to describe antigens on erythrocytes that can sometimes cause agglutination?

<p>Agglutinins (A)</p> Signup and view all the answers

A patient with type O blood requires a blood transfusion. Which blood type(s) can they safely receive?

<p>Only type O (A)</p> Signup and view all the answers

What is the immunological consequence of administering incompatible donor blood that leads to hemolysis?

<p>Antibodies in the recipient's plasma bind to antigens on the donor's erythrocytes. (C)</p> Signup and view all the answers

In an emergency transfusion, why is type O blood often considered the 'universal donor'?

<p>It lacks A and B antigens, so it is less likely to trigger an immune response in the recipient. (B)</p> Signup and view all the answers

What antigens and antibodies are present in a person with type AB blood?

<p>Both A and B antigens, and neither anti-A nor anti-B antibodies (D)</p> Signup and view all the answers

Why is administering type A blood to a person with type O blood problematic?

<p>Type O blood contains anti-A antibodies that will attack the A antigens on the type A erythrocytes. (A)</p> Signup and view all the answers

In ABO blood grouping, which genotype corresponds to the presence of both A and B antigens on the erythrocyte surface?

<p>Type AB (B)</p> Signup and view all the answers

If a recipient with type B blood receives type A blood, what immediate immunological reaction is expected?

<p>The recipient's anti-A antibodies will attack the antigens on the type A blood. (C)</p> Signup and view all the answers

Under what circumstances is a hemolytic transfusion reaction most likely to occur?

<p>Administering incompatible blood types where the recipient has antibodies against the donor's antigens. (A)</p> Signup and view all the answers

Why do individuals with type AB blood lack both anti-A and anti-B antibodies?

<p>The presence of both A and B antigens on their erythrocytes induces tolerance. (B)</p> Signup and view all the answers

Why is it generally less problematic if a recipient with type A blood receives a small amount of type B blood compared to the reverse situation?

<p>The amount of anti-A antibody is generally lower in donor blood than anti-B in donor blood. (A)</p> Signup and view all the answers

In blood transfusions, what is the role of antibodies reacting with antigens on foreign erythrocytes?

<p>To mark the foreign cells for destruction through immune mechanisms. (A)</p> Signup and view all the answers

What is the outcome when antibodies in the plasma react with antigens on transfused erythrocytes?

<p>The antibodies trigger a series of events leading to the destruction of the transfused erythrocytes. (A)</p> Signup and view all the answers

What characteristic of IgG antibodies is particularly relevant in the context of pregnancy?

<p>Their ability to cross the placenta. (B)</p> Signup and view all the answers

How does the presence or absence of the D antigen relate to Rh blood type?

<p>Individuals with the D antigen are Rh positive. (C)</p> Signup and view all the answers

What is the clinical significance of the Kell antigen system in Caucasians, considering the prevalence of the K allele?

<p>The majority of Caucasians lack the K antigen, potentially leading to alloimmunization risks. (A)</p> Signup and view all the answers

Considering the two proteins responsible for Rh serotypes, how are the C and E antigens related?

<p>C and E antigens are different regions of the same protein. (B)</p> Signup and view all the answers

What is the primary structural feature of the Kell antigen?

<p>A glycoprotein protruding from the plasma membrane. (C)</p> Signup and view all the answers

How do amino acid substitutions in the Kell glycoprotein contribute to different Kell antigen types?

<p>They create different structural variants, such as Jsa and Jsb antigens. (C)</p> Signup and view all the answers

After the ABO and Rh systems, what is the next most clinically significant blood group system?

<p>The Kell system. (C)</p> Signup and view all the answers

Considering the Rh system, why is the D antigen considered the most important?

<p>It elicits the strongest immune response. (A)</p> Signup and view all the answers

How do anti-Kell antibodies typically mediate red blood cell destruction?

<p>By opsonizing red blood cells, leading to phagocytosis in the spleen. (A)</p> Signup and view all the answers

If a pregnant woman lacks the K antigen and her fetus inherits the K antigen from the father, what is the potential immunological consequence?

<p>The mother will develop anti-K antibodies that can cross the placenta and attack fetal red blood cells. (B)</p> Signup and view all the answers

What characteristic differentiates IgG antibodies from other antibody isotypes, allowing them to cross the placenta, thus affecting fetal immunity?

<p>Their specific interaction with Fc receptors on placental cells. (B)</p> Signup and view all the answers

Which of the following blood group systems is most likely to cause hemolytic disease of the fetus and newborn (HDFN)?

<p>The Rh blood group system, specifically the D antigen. (B)</p> Signup and view all the answers

How does the structure of the Kell glycoprotein influence its role in red blood cell antigenicity?

<p>Its protruding structure from the plasma membrane increases exposure to antibodies. (D)</p> Signup and view all the answers

Why is the D antigen in the Rh system considered highly antigenic?

<p>Exposure to it readily triggers a strong immune response. (C)</p> Signup and view all the answers

If a patient requires a blood transfusion and has anti-Kell antibodies, which type of blood is safe to transfuse?

<p>Blood that is K negative. (A)</p> Signup and view all the answers

How does knowledge of Kell antigen prevalence in specific populations guide transfusion practices?

<p>It allows for more efficient matching of blood for patients, especially in chronically transfused individuals. (B)</p> Signup and view all the answers

Which property makes IgG antibodies capable of causing hemolytic disease of the fetus and newborn (HDFN)?

<p>Their ability to cross the placenta. (B)</p> Signup and view all the answers

What is the primary mechanism by which anti-Kell antibodies cause red blood cell destruction?

<p>Opsonization and phagocytosis of red blood cells by macrophages. (A)</p> Signup and view all the answers

How does the genetic variability within the Kell blood group system contribute to the complexity of blood transfusions?

<p>It increases the likelihood of alloimmunization in transfused patients. (B)</p> Signup and view all the answers

Which of the following best describes the antigens of the Rh blood group system that are of clinical importance?

<p>D, C, and E antigens (A)</p> Signup and view all the answers

What genetic characteristic is associated with the Duffy blood group system?

<p>A single amino acid substitution in the Duffy glycoprotein. (A)</p> Signup and view all the answers

What is the primary function of the Duffy glycoprotein in the context of malarial infections?

<p>It acts as a receptor that facilitates the entry of the malarial parasite into erythrocytes. (C)</p> Signup and view all the answers

Which of the following best describes the transfusion reactions associated with the Duffy blood group system?

<p>They are typically mild or moderate and often delayed after transfusion. (A)</p> Signup and view all the answers

How does the absence of Duffy antigens (a-b- phenotype) impact susceptibility to malaria?

<p>It confers partial resistance to malaria by preventing parasite entry into erythrocytes. (B)</p> Signup and view all the answers

How many alleles are associated with the Duffy blood group system?

<p>Two (A)</p> Signup and view all the answers

What is the significance of the N- and C-termini locations, in relation to the cell membrane, in the Kidd glycoprotein structure?

<p>Both N- and C-termini are located within the cytoplasm. (C)</p> Signup and view all the answers

Which characteristic is associated with the Kidd blood group system?

<p>Severe acute or delayed hemolytic transfusion reactions. (B)</p> Signup and view all the answers

What structural feature is characteristic of the Kidd glycoprotein?

<p>Ten transmembrane spanning domains with cytoplasmic N- and C-termini. (C)</p> Signup and view all the answers

How does the number of antigens relate to amino acid substitutions in the Kidd blood group system?

<p>Three antigens represent a single amino acid substitution. (D)</p> Signup and view all the answers

What function does the glycoprotein associated with the Kidd blood group system perform?

<p>It functions as a urea transporter in erythrocytes. (D)</p> Signup and view all the answers

In a population where the incidence of a+b+ is 50% and a+b- is 25% for the Kidd system, what can be inferred about the distribution of the Jk(a) and Jk(b) alleles?

<p>The Jk(a) and Jk(b) alleles are present at roughly equal frequencies. (D)</p> Signup and view all the answers

If a patient with no Duffy antigens receives blood containing Duffy antigens in a transfusion, what is the most likely immunological consequence?

<p>A mild to moderate, delayed hemolytic transfusion reaction. (C)</p> Signup and view all the answers

Considering genetic variations within the Duffy blood group system, how does this affect the development of vaccines against malaria?

<p>It creates challenges because the absence of Duffy antigens in some populations means the vaccine target is not universally present. (C)</p> Signup and view all the answers

How does the presence of 10 transmembrane spanning domains in the Kidd glycoprotein influence its function as a urea transporter?

<p>It creates an aqueous pore through the membrane for urea to pass. (C)</p> Signup and view all the answers

What would be the most appropriate initial step in managing a patient experiencing a delayed hemolytic transfusion reaction due to Kidd antibodies?

<p>Monitor the patient for signs of severe hemolysis and provide supportive care. (B)</p> Signup and view all the answers

How does the location of the N-glycosylation site on the Kidd glycoprotein contribute to its function?

<p>It alters the protein's immunogenicity, influencing antibody binding. (B)</p> Signup and view all the answers

Why are transfusion reactions involving Kidd system antibodies often delayed?

<p>Recipients often have low titers of Kidd antibodies, requiring an anamnestic response upon exposure. (A)</p> Signup and view all the answers

Which of the following scenarios poses the greatest risk of a severe hemolytic transfusion reaction related to the Kidd blood group system?

<p>A patient with Jk(a-b+) blood receiving Jk(a+b-) blood after prior sensitization. (C)</p> Signup and view all the answers

What is the expected outcome if a individual with a rare silent Jk allele receives a transfusion of Jk(a+b+) blood?

<p>A delayed hemolytic transfusion reaction if the individual develops anti-Jk3. (C)</p> Signup and view all the answers

Flashcards

Surface antigens

Red blood cells carry these which determine blood type.

IgM antibody binding

IgM antibodies bind to particular antigens or pathogens, even if the host has never been exposed to it before.

Effect of agglutination

Agglutination causes pore formation in the cell membrane, leading to cell death.

Agglutination

The binding of antibodies to erythrocytes causing a clumping effect.

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Antibody recognition

Antibodies recognize antigens on the erythrocyte cell surface.

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Natural antibodies

Mostly IgM isotype. They can bind to particular antigen/pathogen even if the host has never been exposed to it.

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Reactive groups

They are reactive to structures common many species such as nucleic acids, heat shock proteins, carbs and phospholipids

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Agglutinins

Ags are sometimes called agglutinins, which react with corresponding antibodies leading to hemolytic transfusion reactions.

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Type A blood

Type A blood has A antigens on erythrocytes and anti-B antibodies in plasma.

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Type B blood

Type B blood has B antigens on erythrocytes and anti-A antibodies in plasma.

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Type AB blood

Type AB blood has both A and B antigens on erythrocytes and neither anti-A nor anti-B antibodies in plasma.

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Type O blood

Type O blood has neither A nor B antigens on erythrocytes and both anti-A and anti-B antibodies in plasma.

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Incompatible transfusion

If donor cells are treated as foreign invaders, the immune system reacts, causing rapid hemolysis of transfused cells.

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Hemolytic transfusion reaction

Occurs when antibodies in the recipient's plasma bind to antigens on the donor's red blood cells, leading to cell destruction.

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Serum Antibodies

If A/B antigen is not present on erythrocytes, then the corresponding antibody will be present in the serum.

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Rhesus (Rh) System

A blood group system with 2 proteins responsible for different serotypes: D, C, and E.

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Rh D Antigen

The D antigen is very immunogenic and the most important in the Rh system; Rh+ or Rh- refers to its presence.

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C/E Antigens

The C and E antigens are different regions (serotypes) of the same protein within the Rhesus system.

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Rhesus Antibodies (IgG)

Small antibodies of the IgG class within the Rhesus system that can cross the placenta.

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Kell System

A blood group system named Kell, involving a glycoprotein that protrudes from the plasma membrane.

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AA Substitutions in Kell

Amino acid substitutions in the Kell glycoprotein leading to different types (e.g., Jsa, Jsb Ags).

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Kell Antigens

K (Kell) and k (Cellano) antigens are two main antigens within the Kell system.

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Kell system importance

Most important blood group after ABO and Rh systems.

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Anti-Kell Antibodies

Anti-Kell antibodies are usually of the IgG class.

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K allele

Prevalence: 91% are negative for K allele in Caucasians

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Duffy System

A blood group system where a single amino acid substitution in the Duffy glycoprotein defines the antigens.

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Kidd System

A blood group system. Three antigens represent substitutions within a single amino acid.

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Duffy Glycoprotein Function

Duffy glycoprotein acts as a receptor that facilitates the penetration of malarial parasites into erythrocytes.

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a-b- Phenotype

The a-b- phenotype confers resistance to malaria.

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Duffy System Transfusion Reactions

A moderate, delayed transfusion reaction is typical.

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Kidd System Transfusion Reactions

Can cause severe acute hemolytic transfusion reactions, often delayed after transfusion.

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Study Notes

  • Duffy glycoprotein involves a single amino acid substitution.
  • There are two alleles A and B in the Duffy system.
  • 70% of African Americans and 100% of West Africans are a-b-.
  • Duffy glycoprotein is the receptor that enables penetration of the malarial parasite into erythrocytes.
  • The a-b- phenotype confers resistance to malaria.
  • Duffy antibodies typically result in a moderate, delayed transfusion reaction.
  • In the UK, the incidence of Duffy phenotypes are: a+b- (20%), a+b+ (46%), and a-b- (34%).
  • The Kidd system involves 3 antigens represented by a single amino acid substitution.
  • The Kidd antigen is present on a glycoprotein with 10 transmembrane spanning domains.
  • The glycoprotein has cytoplasmic N- and C- termini, and 1 extracellular N-glycosylation site and acts as a urea transporter.
  • Kidd antibodies can cause severe acute hemolytic transfusion reactions, but are often delayed after transfusion.
  • In the UK, the incidence of Kidd phenotypes are: a+b- (25%), a+b+ (50%), and a-b+ (25%).

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