INTRODUCTION TO IMMUNOHEMATOLOGY.PPTX DMLT
- 1. INTRODUCTION TO IMMUNOHEMATOLOGY PRESENTED BY PUNAM SAHOO
- 2. INTRODUCTION Immunology – It is defined as the study of resistance or immunity to disease. Immunohematology – it is an application of the principles of immunology to the study of the red cell antigens &their corresponding antibodies in blood for resolving the problems of blood transfusion and some complications of pregnancy. Immunohematology is more commonly known as blood banking or transfusion medicine. Blood banking is the area of laboratory medicine dealing with preparing blood &blood components for transfusion as well as selection of appropriate compatible components for transfusion.
- 3. HISTORICAL OVERVIEWOF IMMUNOHEMATOLOGY In 1492 blood was taken from three young men and given to pope innocent VII in the hope of curing him. Unfortunately, all four died. This was the first time when a blood transfusion was recorded in history. Clotting was the main problem. Attempts to find nontoxic anticoagulants began in 1869 when sodium phosphate was recommended by Braxton and Hicks. Karl Landsteiner, in 1901 discovered the ABO blood groups in mankind. He also discovered the serious blood transfusion reaction due to the ABO system. He won the Nobel Prize. Edward E. Lindemann was the first person who succeeded in carrying out a vein-to-vein blood transfusion. This was a time-consuming procedure. Later on, Unger designed a special syringe-valve system that could transfuse blood without the help of anybody. In 1914, there was a breakthrough when Hustin reported using sodium citrate and glucose as a diluent and anticoagulant solution for the transfusion.
- 4. In 1915, Lewisohn determined the minimum amount of nontoxic citrate needed for anticoagulation and transfusion. Then transfusion became more practical and safer for the patient. In 1916, Rous and Turner introduced the dextrose-citrate solution to preserve the blood. The common use of glucose was delayed as a preservative for the RBCs. World War II increased research on preserving blood and plasma because of the demand. Dr. Charles Drew’s work during world war II for preserving and transfusing blood led to a widespread system of blood banks. In 19041 February, Dr. Charles Drew was appointed the first American red cross society director at Presbyterian Hospital. 1943 Loutit and Mollison of England introduced the acid-citrate dextrose solution (ACD) formula.
- 5. BLOOD GROUP GENETICS • The ABO blood group antigens are encoded by one genetic locus, the ABO locus, which has three alternative (allelic) forms—A, B, and O. A child receives one of the three alleles from each parent, giving rise to six possible genotypes and four possible blood types (phenotypes). • H-Gene - The H gene encodes an enzyme that is required in the expression of the H antigen on the surface of red blood cells. • The H antigen is produced by a specific fructosyltransferase. Depending upon a person's ABO blood type, the H antigen is converted into either the A antigen, B antigen, or both. If a person has blood group O, the H antigen remains unmodified.
- 6. Secretors & Non Secretors ;- • Secretor status refers to the presence or absence of water-soluble ABO blood group antigens in a person's bodily fluids, such as saliva, tears, breast milk, urine, and semen. People who secrete these antigens in their bodily fluids are referred to as secretors, while people who do not are termed non-secretors. • ANTIGEN & ANTIBODY IN BLOOD GROUP
- 7. BLOOD GROUP ANTIGEN Blood grouping is done based on the presence of antigens on the surface of RBCs. 1.There are two major antigens, A and B. 2.So the basic principle of blood donation is that there should be no antibody to match the RBCs’ surface antigen. 3.In the USA, blood group frequency is: 1. Blood group O = 45% 2. Blood group A = 41% 3. Blood group B = 10% 4. Blood group AB = 4% •
- 8. BLOOD GROUP ANTIBODY Formation Of ABO Antibodies: Blood group ABO system antibodies are stimulated by the bacteria and the other substances in our surroundings. These antibodies result from cross-reactivity and are initiated at birth upon exposure to foreign substances. These are usually low (titer) at birth for the detection until the infants are 3 to 6 months old. It is logical to perform only forward grouping in newborn babies. The peak level is 5 to 10 years of age and then progressively declines with advancing age. Patients older than 65 will have low titer; antibodies in the reverse grouping may be undetectable.
- 9. RH SYSTEM History Of The Rh System: The Rh system is second in importance to the ABO system. In 1939, Levine and Stetson found an unusual agglutin in the mother’s serum of a stillborn fetus to agglutinate 80% of random ABO-compatible donors. In 1940 Landsteiner and Weiner injected Blood from the monkey Maccacus rhesus into rabbits and guinea pigs, which resulted in the antibodies’ production. These antibodies agglutinated RBCs of around 85% of human donors. These two antibodies were the same. 1. The person who possessed the corresponding antigens was called Rh-positive. 2. The person who was lacking the antigens was called Rh-negative. 3. The rabbit anti-rhesus was named anti-LW after the Landsteiner and the Weiner. 4. The human antibodies are named the same as anti-Rh.