The Rh Blood Group System - Genetics and Nomenclature

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Created by
Jayna Ramesh

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  • The Rh Blood Group System
    • one of the most antigenic blood group systems
    • second only to ABO in importance in transfusion medicine
    • well-known cause of hemolytic disease of the fetus and newborn (HDFN)
  • The Rh Blood Group System
    • the principle antigen is D: Rh positive and Rh negative refer to the presence or absense of the D antigen
  • Genes
    • The Rh system is composed of 2 genes that encode for polypeptides that are responsible for the expression of 55 antigens
    • the 2 genes that encode the Rh proteins are RHD and RHCE
    • RHD encodes the D antigen
    • RHCE encodes the CE antigens in various combinations: ce, cE, or CE
  • RHCE and RHD genes
    • RHD encodes the D antigen (no little d)
    • the possible antigens are D, C, c, E, e
  • Fischer and Race
    Rh positive combinations: Dce, DcE, Dce, DCE
  • Fisher and Race
    Rh negative combinations: dce(f), dCe, dcE, dCE
  • Weiner Terminology
    • a modified version is used today to convey the a haplotype ( a combination of several alleles in a gene cluster)
  • 1940: Landsteiner and Weiner
    • injected rhesus monkeys blood into rabbits and guinea pigs and looked at serum produced
    • serum agglutinated 85% of human red cells
    • noticed this anti-rhesus activity paralleled reaction of mom's blood
    • anti-rhesus was changed to Rh
  • in 1941, Levine's group showed erythroblastosis fetalis (HDN) was the result of Rh group incompatibility between mother and child