MNS antigen system

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The MNS antigen system is a human blood group system based upon two genes (glycophorin A and glycophorin B) on chromosome 4. There are currently 50 antigens in the system, [1] [2] [3] [4] but the five most important are called M, N, S, s, and U.

Contents

The system can be thought of as two separate groups: the M and N antigens are at one location on the ECM and S, s, and U are on a closely related location. The two groups are very closely located together on chromosome 4 and are inherited as a haplotype.

The MN blood group

The MN blood group in humans is under the control of a pair of co-dominant alleles, LM and LN. Most people in the Inuit population are M/M, while this genotype is rare among Aborigines. In fact, they tend to possess the opposite genotype (N/N).[ citation needed ]

The MN blood group system is under the control of an autosomal locus found on chromosome 4, with two alleles designated LM and LN. The blood type is due to a glycoprotein present on the surface of a red blood cell (RBC), which behaves as a native antigen. Phenotypic expression at this locus is codominant because an individual may exhibit either one or both antigenic substances. Frequencies of the two alleles vary widely among human populations. [5]

M+ and N+ RBCs are common (75% of population) and M+N+ cells are the most common genotype (50% of population). These antigens were an early discovery and are some of the oldest blood antigens known after the ABO system. They were first described by Karl Landsteiner and Philip Levine in 1927. Anti-M and anti-N antibodies are usually IgM and are rarely associated with transfusion reactions.[ citation needed ]

Anti-N is sometimes seen in dialysis patients due to cross-reactions with the residual formaldehyde from sterilizing the equipment. This is usually irrelevant for transfusion since this variant of the antibody does not react at body temperature.[ citation needed ]

The U and Ss groups: an overview

The S antigen is relatively common (~55% of the population) and the s antigen is very common (~89% of the population). Anti-S and anti-s can cause hemolytic transfusion reactions and hemolytic disease of the newborn.The U antigen is a high incidence antigen, occurring in more than 99.9% of the population. The U was originally short for "Universal", though this is not the case. U negative RBCs can be found in people of African descent. This mutation in red cell surface structure also makes the RBCs S- and s-. Anti-U has been associated with both hemolytic transfusion reactions and hemolytic disease of the newborn.[ citation needed ]

Other MNS antigens

The other 41 identified antigens in the MNS group are low incidence, such as He (0.8% of the population) or high incidence, such as ENa (>99.9% of the population).

MNS glycoproteins and genes

Antigens of the MNS system are located on one of two glycoproteins: glycophorin A (GPA, CD235A) and glycophorin B (GPB, CD235B). [6] Each glycoprotein crosses the membrane once and has an external N-terminal domain (varying in length from 44 amino acids for GPB to 72 amino acids in length for GPA) [6] as well as a C-terminal cytosolic domain (GPB, 8 amino acids in length; GPA, 36 amino acids in length). [6]

MNS antibodies

Interpretation of antibody panel to detect patient antibodies towards the most relevant human blood group systems, including MNS.
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Further information: Blood compatibility testing Serology interpretation of antibody panel for blood group antigens.jpg
Interpretation of antibody panel to detect patient antibodies towards the most relevant human blood group systems, including MNS.

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ABO blood group system Classification of blood types

The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes. In human blood transfusions it is the most important of the 38 different blood type classification systems currently recognized. A mismatch in this, or any other serotype, can cause a potentially fatal adverse reaction after a transfusion, or an unwanted immune response to an organ transplant. The associated anti-A and anti-B antibodies are usually IgM antibodies, produced in the first years of life by sensitization to environmental substances such as food, bacteria, and viruses.

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Rh blood group system Human blood group systems

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Diego antigen system Human blood group system

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Glycophorin A

Glycophorin A , also known as GYPA, is a protein which in humans is encoded by the GYPA gene. GYPA has also recently been designated CD235a.

GYPB

Glycophorin B also known as sialoglycoprotein delta and SS-active sialoglycoprotein is a protein which in humans is encoded by the GYPB gene. GYPB has also recently been designated CD235b.

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Blood compatibility testing Testing to identify incompatibilities between blood types

Blood compatibility testing is conducted in a medical laboratory to identify potential incompatibilities between blood types in blood transfusion. It is also used to diagnose and prevent some complications of pregnancy that can occur when the baby has a different blood group from the mother. Blood compatibility testing includes blood typing, which detects the antigens on red blood cells that determine a person's blood type; testing for unexpected antibodies against blood group antigens ; and, in the case of blood transfusions, mixing the recipient's plasma with the donor's red blood cells to detect incompatibilities (crossmatching). Routine blood typing involves determining the ABO and RhD type, and involves both identification of ABO antigens on red blood cells and identification of ABO antibodies in the plasma. Other blood group antigens may be tested for in specific clinical situations.

The Lan blood group system is a human blood group defined by the presence or absence of the Lan antigen on a person's red blood cells. More than 99.9% of people are positive for the Lan antigen. Individuals with the rare Lan-negative blood type, which is a recessive trait, can produce an anti-Lan antibody when exposed to Lan-positive blood. Anti-Lan antibodies may cause transfusion reactions on subsequent exposures to Lan-positive blood, and have also been implicated in mild cases of hemolytic disease of the newborn. However, the clinical significance of the antibody is variable. The antigen was first described in 1961, and Lan was officially designated a blood group in 2012.

The Augustine blood group system is a human blood group system. It includes four red blood cell surface glycoprotein antigens which are encoded by alleles of the gene SLC29A1.

References

  1. Daniels G, Flegel WA, Fletcher A, et al. International Society of Blood Transfusion Committee on Terminology for Red Cell Surface Antigens: Cape Town Report. Vox Sang 2007; 92: 250-3.
  2. Poole J, Daniels G. Blood Group Antibodies and Their Significance in Transfusion Medicine. Transfus Med Rev 2007; 21: 58-71.
  3. Daniels G. Human Blood Groups. 2nd Ed. Oxford: Blackwell Science, 2002.
  4. ISBT Committee on Terminology for Red Cell Surface Antigens. "Table of blood group antigens within systems". International Society for Blood Transfusion. Archived from the original on 2011-08-18. Retrieved 2010-01-24.
  5. Ralph H. Kathan and Anthony Adamany. 1967. Comparison of Human MM, NN, and MN Blood Group Antigens. The Journal of Biological Chemistry, 242, 1736-1722.
  6. 1 2 3 Roback JD et al. AABB Technical Manual, 16th Ed. Bethesda: AABB Press, 2008.
  7. 1 2 Mais DD. ASCP Quick Compendium of Clinical Pathology, 2nd Ed. Chicago: ASCP Press, 2009.