Kell, Duffy, Kidd, & Lutheran Blood Group Systems

• null Jk phenotype: Jk (a-b-)
• anti-Jk3 occurs in null phenotype of Jk
• Jk = Kidd
• Kidd antigens

  • three alleles: Jka, Jkb, and silent allele Jk
• Kidd antigen

  • the expression of Kidd antigens is controlled by the SCL 14A1 gene on chromosome 18
• Kidd antigens

  • Kidd antigens are resistant to proteolytic enzymes such as papain and ficin (2)
• Kidd antigens are enhanced by enzymes because enzymes may cleave the surrounding structures, making the antigens more accessible
• Jka Jka individuals express the antigens more strongly than Jkb Jkb individuals
• Jk (a+b-) is a high frequency phenotype in blacks (51.1%)
• Jk (a+b+) is a high frequency phenotype in whites (50.3%) and Asians (49.1%)
• Kidd antibodies

  • Kidd antibodies are stimulated by pregnancy and blood transfusion are IgG
• Kidd Antibodies

  • the Jka antigen is quite immunogenic
• Kidd Antibodies

  • the reactions are usually weak, showing dosage
  • it is important to note they may not react with single dose panel cells, but will react strongly with homozygous cells
• Kidd Antibodies

  • They react best with polyspecific AHG (detects IgG and complement binding antibodies)
• Kidd antibodies are warm reacting
• Kidd antibodies bind complement
• Kidd Antibodies

  • the antibodies are notorious for weakening over time, and may become undetectable so they may not be found on pretransfusion testing
• Kidd Antibodies

  • Need to use AHG or enzyme treated cells to detect -- this makes Jk antigen very dangerous
• Kidd antibodies

  • may cause severe delayed transfusion reactions and have been implicated in HDFN
• Kidd antibodies

  • if you need to find Jk(a-b-) cells: Jk antigens are part of the urea transporter glycoprotein in the cell membrane
  • Normal cells lyse in 2M urea; Jk(a-b-) cells are not hemolyzed by 2M urea since it can't get into cell; can use this to screen for Jk(a-b-) donors
• Polynesian patients are more likely to have Jk (a-b-) phenotype, aka create Jk3
• polyspecific AHG is rabbit IgG and mouse complement binding Ab
• The Lutheran Blood Group

  • there are 25 antigens in this system
  • has antithetical alleles: Lua and Lub
• The Lu antigens are poorly developed at birth
• Lua is found in about 8% of African and European ethnicity
• Lub is common everywhere
• Lu antibodies have been implicated in mild, delayed, HTRs, but not in HDFN
• Lutheran antigens

  • The Lu antigens have IgSF (immunoglobulin superfamily) domains -- it could play a part in sickle cell disease and the adhesion of these cells to the vascular endothelium
• Lutheran antigens

  • The null phenotype Lu(a-b-) is very rare -- it reflects an inactive gene
• Lutheran Antigens

  • Lu antigens are destroyed by the treatment of red cells with trypsin
• Lutheran antigens

  • papain and ficin have little effect
• Lu antibodies

  • Lua antibodies
  • these may be naturally occuring or immune
• Lu antibodies

  • Lua antibodies
  • are often IgM but may also be IgG
• Lu antibodies

  • Lua antibodies
  • they are often cold reacting, but can react at IAT
• Lu antibodies

  • Lub antibodies
  • can be IgM or IgG
• Lu antibodies

  • Lub antibodies
  • can react at AHG, IS, or 37 degree phases
• Lu antibodies

  • Lub antibodies
  • may react with mixed field appearance
• Lu antibodies

  • anti-Lu3
  • reacts with both Lua and Lub (so all other read cells beside Lunull)
• IgSF - immunoglobulin superfamily
• IgSF helps cells to adhere