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Associations between atopic diseases and the polymorphic systems ABO, Kidd, Inv and red cell acid phosphatase.

In 239 German patients with atopic conditions (atopic dermatitis, hay fever, allergic rhinitis, bronchial asthma, and acute urticaria) the phenotype and gene distribution of 15 genetic blood polymorphisms (ABO, MNSs, rhesus, P, Kell, Duffy, Kidd, Hp, Gc, Gm, Inv, aP, PGM1, EsD, and 6-PGD) were analyzed and compared with those in 151 selected controls (individuals clinically free of allergic conditions and without allergy in the family history). The incidence of blood group antigens A and B was somewhat higher in patients than in controls. These observations are in accordance with the results of previous studies in other populations. In addition, our observations favor the hypothesis that there are also associations between the phenotypes Jk (a-b+), Inv(1) and red cell acid phosphatase aP A and aP AP on the one hand and atopic disposition on the other. The possible reasons for these associations are discussed.

ABO Blood-Group System↗

Balanced t(8;9)(q12;q33)pat carrier with phenotypic abnormalities attributable to a de novo terminal deletion of the long arm of chromosome 7.

A girl observed from birth to age 16 months had multiple congenital anomalies including growth and developemental retardation, microcephaly (-4SD), bulbous nose, prominent lips and philtrum, esotropia, latent hypermetropia, and spasticity. Chromosome analysis showed her to be a balanced carrier of a t(8;9)(q12;q33)pat translocation. In addition, she had a de novo deletion of a distal segment of the long arm of chromosome 7. Seven previously reported cases with deletions involving 7q were reviewed and had a number of nonspecific features in common, with microcephaly of a comparable degree in one of these. Studies of the Kidd (Jk) blood groups and Hageman factor were done because of the tentative assignment of their respective loci to distal 7q. Location of the Kidd (Jk) locus on the deleted segment can be excluded on the basis of heterozygosity of the proposita for the a and b alleles. Hageman factor was not decreased, which suggests that this locus is also not on the deleted segment.

Abnormalities, Multiple↗

Further evidence of heterogeneity within the Kidd blood group system.

Serological studies on blood of selected individuals show that red blood cells from individuals genetically JkaJk and JkbJk give single dose agglutination reactions with anti-Jka and anti-Jkb respectively, but react as strongly with anti-JkaJkb as do cells from random individuals. A Jk(a+b-) Oriental person has been found whose red blood cells give a single dose reaction with anti-Jka, but react more weakly than do cells from random people in tests with anti-JkaJkb. The results support a conclusion that the antigen recognized by anti-JkaJkb is a distinct and separate antigen of the Kidd blood group system.

Alleles↗

Transfusion reaction. An immunologic hazard of blood transfusion.

Twenty-three cases of delayed hemolytic transfusion reaction (DHTR) occurring at the Mayo Clinic from 1964 through 1973 are reviewed. Nineteen patients had clinical manifestations of hemolysis, of which fever was the most frequent presenting symptom. The degree of hemolysis served as an index of morbidity. In four cases, there was oliguria, two of these patients experiencing renal shutdown. In one case, hemolysis led to a disseminated intravascular coagulation syndrome. Death occurred subsequent of DHTR in three patients. The direct antiglobulin test was positive in all but one case; this finding coincided with elevated unconjugated bilirubin in 14 cases and decreased haptoglobin levels in 15 cases. Anti-Jka antibody accounted for somewhat more than one-third of reactions and, along with anti-E, c, D, Fya, and K antibodies accounted for 91 per cent of cases.

Adult↗

[Exclusion of MNSS, Kidd and Gm from the extreme end of the short portion of chromosome 8].

11 blood and seric group markers were studied in a case of 46,XX,del(8)(qter yields p22 :) in order to contribute to the exclusion map. MNSs and Jk are informative and could be excluded from the region. The proband is also definitly heterozygous for immunoglobulin Gm groups which were tentatively assigned to the short arm of chromosome 8 or 12.

Abnormalities, Multiple↗

[Hemolytic transfusion accident due to the blood group antibody anti-Jka].

A haemolytic transfusion incident caused by anti-Jka is reported about. In a 56 year old patient suffering from chronic iron deficiency anaemia an immunization in the Kidd system has taken place within 9 days. In the course of this immunization the fourth incompatible blood transfusion caused a severe transfusion incident. The necessity of serological compatibility testing by the indirect antiglobulin or enzyme test and the significance of making a strict indication for blood transfusions are referred to.

Anemia, Hypochromic↗

Appearance of maternal anti-JK a antibody following intrauterine transfusions and amniocentesis.

A case is presented that suggests that intrauterine transfusion carries the risk of sensitization to red cell antigens other than Rho. In this case intrauterine transfusions of JK a-positive red cells were followed by the appearance in the mother's serum of anti-JK a, an antibody known to cause hemolytic disease of the newborn. The use of the mother as a donor of red cells for her fetus will circumvent the problem of further maternal sensitization.

Adult↗

[Use of Groupamatic in surveying fetomaternal alloimmunizations].

The A.V.I.S. Blood Transfusion Center of Turin performs the screening of foetomaternal allo-immunizations for the S. Anna Hospital of Turin. This hospital includes 3 hospital departments and 3 obstetrical and gynaecological university departments. The number of births in one year is roughly 13.000, i.e. 50 mother-baby couples, are tested every day. The identification system and the sampling process are described. The program used on the Groupamatic system includes: 1.) First run: Blood typing of mother blood with screening of alloantibodies. Second run: Blood typing control, screening of immune anti-A and anti-B antibodies, syphilis screening. 2.) Washing of cord blood red blood cells: First run: Washed red blood cells ABO and Rhesus typing, direct Coombs test. Second run: Blood typing control. Automatic screening of maternal irregular alloantibodies and automatic indirect Coombs test on washed cordblood red cells are simultaneously controlled with standard manual techniques. Sampling and testing are processed within 24 hours after birth. The set of results concerning mother-baby couples are grouped on one card and sent to the hospital department for a quick MHNN prophylaxy. Results of tests performed on 6.351 pregnancies studied until birth are presented. The automated direct Coombs test was positive with: 1--95% of new borns from mother who have a high immune allo antibody anti-A/B titer (IgG after treatment with two Mercapto etanol greater than I/64). 2--100% of new borns from mother who have irregular allo antibodies in Rh, Kell, Duffy or Kidd systems.

ABO Blood-Group System↗

[Determination of biological individuality by blood group studies].

Author deals with the possibility of determination of the biological individuality by serological methods. Determination of HL-A tissue-compatibility antigens and system of MN/Ss and Rh seen to be the most suitable tools. Alloantigens, serum proteins and group of enzymes characterize the biological individual i. e. serological methods can be used as a tool of the identification of a person. Author deals with the possiblity of determination of various razes. For this purpose investigation of the following systems are necessary: ABO-, Rh-, MN/Ss-, Kell-, Duffy-, Lutheran, Kidd, Lewis and Diego. Nevertheless, this problem is not yet solved.

ABO Blood-Group System↗

On the incidence of blood group O and Gm(-1) phenotypes in patients with malignant melanoma.

Fifteen polymorphic systems of the blood (ABO, MNSs, Rhesus, P, Kell, Duffy, Kidd, Hp, Gc, Gm, Inv, aP, PGM1, EsD, and 6-PGD) were examined in 191 unrelated male and female patients suffering from malignant melanoma. These polymorphic systems were compared with the corresponding phenotype and gene frequencies of controls from the same geographical area (Rhineland-Palatinate). The only associations discovered were the ABO and Gm polymorphisms: The incidence of O and Gm(-1) phenotypes in patients is obviously higher than in controls. These observations agree with the findings in other population samples from Germany and Bulgaria.

ABO Blood-Group System↗

[Genetic analysis of a population with abnormalities of gene frequencies].

Nineteen out of the 53 blood donors of french village with 241 inhabitants (Cezay Loire) are Rh negative (D--). This discrepancy in the distribution is analysed. 1.--The study of the genetic erythrocyte markers (ABO and Rh system for 158 inhabitants, Kell, Rautenberg, Duffy, Kidd, MNSs, P1 Lutheran, PGM1, PGM2, 6 PGD, AK, ADA, Acid phosphatase systems for 104 inhabitants) show significant abnormal gene frequencies (No. 10%) compared with a control population from Saint-Etienne, for A1, Ms, r, P1 alleles; conversely rare alleles do not seem to exist. HLA system was not tested. 2.--The genetic study led to: a) a demographic study which implied 7840 registrar's certificates and the building up of 1364 families to which the 5096 subjects belonged identified and having lived in Cezay since 1607 (this date corresponds to the earliest registrar's certificate). b) it also led to the analysis of the origin and evolution of the genetic inheritance throughout the 13 generations of known inhabitants. The calculation of the chances of each generation having passed on its genetic material to following generations shows that: Cezay has an integrated population; 30% of the genes are renewed for each generation the average value of each founder can vary according to the various generations but there seems to exist a "founder effect" of the Rh--(D--) having been and lived in the village before 1860. Although they represent 68% of the total population, the tested samples can be contested for certain systems, in its constitution (formation, choice) which prevents from ascertaining the foundation effect observed. The authors underligne the contribution of immunogenetics to the genetics of populations, and show the incidence of the choice of samples in the method used.

Alleles↗

Multiple differences in red cell antigens and isoimmunization.

Data available for 175 families with maternal isoimmunization to red blood cell antigens, exclusive of A, B, and Rho, were analyzed for interaction of unrelated antigens. In 153 families the mother developed antibodies for single antigens, distributed among seven blood group systems; rare, high frequency antigens; and unclassified antigens. The immunizing fetal red blood cells ABO-incompatible with the mother in less than 5 per cent of instances, a finding attesting to the impact of ABO incompatibility on immunogenicity of most red blood cell antigens. No evidence was found for interference with immunization to one particular red blood cell antigen by simultaneous differences in unrelated antigens. Maternal immunization to more than one red blood cell antigen, encountered in 22 families, was associated in 13 instances with preceding blood transfusion to the mother and/or pregnancies in which fetal red blood cells contained only one of the immunizing antigens. In six of the remaining nine instances of multiple isoimmunization, Kidd antibodies were involved. Preceding immunization to a variety of red blood cell antigens was noted to interfere with immunization to potent immunogens: Rho (nine instances of complete, and one instance of partial, suppression), hr' (eight instances of suppression), and K (two instances of suppression). A mechanism, designated as "diversion of antigen", was proposed in order to explain the phenomena observed in human isoimmunization as well as in animal models in which preceding immunization to one red blood cell antigen affects immune responses to red blood cells carrying the immunizing and additional antigens.

ABO Blood-Group System↗

The risk of abbreviating the major crossmatch in urgent or massive transfusion.

The risk of abbreviating the major crossmatch in urgent situations by issuing blood after an "immediate spin" phase was evaluated by a retrospective study of 82,647 crossmatches performed on serum from approximately 13,950 patients. Although the initial screening test for unexpected antibodies for all patients failed to show agglutination or hemolysis of the reagent red blood cells, agglutination was subsequently noted during at least one crossmatch performed for 148 of them. Further evaluation of these patients' serums indicated that most positive reactions were due to weakly reactive low thermal amplitude antibodies. Eight of the incompatible crossmatches were related to antibodies in the Kell, Kidd or Rh systems, and a ninth antibody, anti-E, was identified through subsequent evaluation of a cold antibody-induced crossmatch incompatibility. Issuance of blood in urgent situations after an "immediate spin" phase of the crossmatch, for patients whose red blood cells have been typed, and whose serums have been screened for unexpected antibodies, has a low level of risk.

Antibody Specificity↗