CHEMICAL CONNECTIONS OF BLOOD TYPES

Blood type (or blood group) is a genetic characteristic associated with the presence or absence of
certain molecules, called antigens, on the surface of red blood cells.

There are four common blood types for the ABO system:
 Type A, in which only the A antigen is present
 Type B, in which only the B antigen is present
 Type AB, in which both the A and B antigens are present
 Type O, in which neither the A nor the B antigen is present

Genetics of Blood Type

Generally, blood type is controlled by alleles for a single gene or for two or more very
closely linked genes.
Medical Significance of ABO Blood Type
The ABO system is the most important blood group system in blood transfusions. If red
blood cells containing a particular ABO antigen are transfused into a person who lacks that
antigen, the person’s immune system will recognize the antigen on the red blood cells as non-
self. Antibodies specific to that antigen will attack the red blood cells, causing them to
agglutinate, or clump and break apart. If a unit of incompatible blood were to be accidentally
transfused into a patient, a severe reaction (called acute hemolytic transfusion reaction) is likely
to occur in which many red blood cells are destroyed.
System
The Rhesus blood group system is controlled by two linked genes on chromosome 1. One
gene, called RHD, produces a single antigen, antigen D. The other gene, called RHCE, produces
the other four relatively common Rhesus antigens (C, c, E, and e), depending on which alleles
for this gene are inherited.

Rhesus Blood Group and Transfusions

After the ABO system, the Rhesus system is the second most important blood group
system in blood transfusions. The D antigen is the one most likely to provoke an immune
response in people who lack the antigen. People who have the D antigen (Rh+) can be safely
transfused with either Rh+ or Rh- blood, whereas people who lack the D antigen (Rh-) can be
safely transfused only with Rh- blood.
Unlike anti-A and anti-B antibodies to ABO antigens, anti-D antibodies for the Rhesus
system are not usually produced by sensitization to environmental substances. However, people
who lack the D antigen (Rh-) may produce anti-D antibodies if exposed to Rh+ blood. This may
happen accidentally in a blood transfusion, although this is extremely unlikely today. It may also
happen during pregnancy with an Rh+ fetus if some of the fetal blood cells pass into the
mother’s blood circulation.