The rarest blood type in the world. Rh factor is the rarest blood group in humans. Blood type (AB0): essence, definition in a child, compatibility, what affects

Worldwide, there are only about 20% of people who have a 3 positive blood type. According to medical statistics, the third group with a positive Rh factor is one of the rarest, therefore it is of great value in transfusion, in medicine it is designated B (III). According to historical information, the 3rd blood group used to be called nomadic, since for the first time such plasma was found in nomads. Probably for this reason, such blood is more adaptable compared to other species. Not everyone knows that blood type affects the health and character of a person, his preferences, nutrition. Therefore, people who have this group should know all its features and what suits them and what does not.

The owners of the third positive blood group delight everyone with their light and open character. They quickly find a common language with other people, make new acquaintances and do not lose confidence and optimism even in very difficult situations. They have a pronounced sense of justice and stand up not only for their relatives, but also for strangers.

A great influence on people with such blood was a historical origin from nomads who are always in search of something new and make unexpected decisions, easily adapt to different conditions around them, such people do not have constancy.

Creative professions are suitable for people with 3 positive blood groups, which is explained by their restless nature.

Men are characterized by such qualities as wit, charm, assertiveness. A feature of women is inconstancy, they are windy and charming, they always have many admirers. With health, most of the carriers of the third blood group have no problems, but few suffer from dysfunction of the endocrine glands. Common pathologies are diabetes mellitus and multiple sclerosis. In many cases, people with such blood have low concentration and constant fatigue.

Features during pregnancy

The gestation period with the 3rd positive group usually proceeds without any complications, and there are also no pathologies. In rare cases, there may be incompatibility between the mother and the unborn child or newly made spouses. If the first problem occurs, it can be solved at the 28th week of pregnancy. If there is incompatibility in a young couple, then various solutions can be applied, from which you can choose the one that is most suitable.

First of all, it can be:

• expensive treatment;
• surrogacy;
• other ways to solve this problem.

It is important to note the aspect that with different types of blood of the parents, the third group will be the strongest. Therefore, a newborn baby will wear another group from dad or mom, which will not be the third. During pregnancy, certain complications can begin if they do not match, for example, one has a negative Rh, and the other parent will have a positive one. At the same time, a woman carrying a child will be under the strict supervision of doctors so that complications do not arise (miscarriage or the birth of a dead baby).

Before planning a pregnancy, it is imperative to pass an analysis on future parents for compatibility. It is the results of blood tests of future parents that will help to avoid sad situations during pregnancy, which will also preserve the health and life of the mother and the unborn child.

Health by blood type

Most of the world's population, which has a third positive group, do not know health problems in their lives. A minority of residents may face problems in the endocrine system. These people may develop diabetes or multiple sclerosis.

The discovery of K. Landsteiner suggests that 85% of carriers of group 3 have a positive Rh factor. The remaining 15% are Rh negative. Therefore, when transfusing blood from one person to another, the compatibility of the Rh donor and recipient is considered a prerequisite.

It is compatibility that all doctors pay attention to when blood 3 is needed positive. If the compatibility is low, then a precipitate may appear, leading to the destruction of blood cells - red blood cells. One of the worst cases of poor compatibility can be the patient's death.

It is important to note that the third group of Rh-positive has compatibility both with identical itself and with other groups. Compatibility with other groups can be characterized as follows:

• a positive third group can be combined with groups 1 and 3 with negative and positive Rh;
• compatibility with groups 3 and 4 (rhesus positive in both cases);
• the third c can be combined with groups 1 and 3 (Rhesus negative in both cases).

How to eat right

A person with this type of blood does not fit any special diet. Certain difficulties with the choice of food and the establishment of the correct diet will not arise. This blood type makes it easy to assimilate both plant and animal products. This aspect will allow you to follow one diet, then a completely different one.

You should know that there are also prohibited foods (wheat, peanuts, buckwheat). It is better for a person with a 3 positive group to include in his diet: fat-free kefir or yogurt, beef liver, carrots, red fish, bananas and grapes, green tea. There is also an extensive list of foods that should not be consumed. These include: alcohol, coffee and black tea, tomatoes and tomato juice, ketchup and mayonnaise, pork, chicken and wheat bread, ice cream and other sweets. Knowing your blood type, it is important to properly monitor your health, eat and plan pregnancy.

The first attempts at blood transfusion were made by ancient doctors. They also concluded that people have different blood: in some cases, blood transfusion from one person to another really helped get rid of the disease, in others it led to the death of the recipient.

There are 4 blood types in total. The first, or zero, is the most common, it is present in more than 30% of the world's population.

Features of blood groups are determined by:

• Agglutinogens- protein substances that are found in erythrocytes;
• Agglutinins- protein substances in plasma.

The first blood group is characterized by the absence of agglutinogens in erythrocytes and the presence of alpha and beta agglutinins in plasma.

Rh compatibility problems

What does 1 positive group mean? The presence in the blood of a specific protein Rh. In Rh-negative people, it is absent. This criterion is important to consider when conducting a blood transfusion. If Rh is positive- it means that a person can be transfused with blood with positive and negative Rh. If negative, only Rh- blood can be transfused.

Significance for blood transfusion

With the compatibility of blood groups, everything is more complicated. Owners of group I (0) are universal donors: since they do not have agglutinogens, this blood can be transfused to people with any kind of agglutinogen.

The first one with a negative Rh can be transfused to any donor in general, and the positive one - to any blood group and a positive Rh factor. But the owner of the first blood group himself can only be transfused with his group.

History of the first blood group

Scientists believe that the history of mankind began precisely with the I blood group - it was she who flowed in the veins of our ancient ancestors, who were the first people. They were strong, hardy, hunted wild animals - this helped them survive.

At that time, a person was not yet intelligent enough, there was no talk of any negotiations and democracy. Everyone who disagreed with the opinion of the strongest member of the tribe was destroyed. Therefore, the first man had a reputation for being cruel and authoritarian. Some traits are still present in the character of modern owners of this blood type.

The same opinion is shared by Japanese researchers. They are sure that people with the first positive group got a purposeful, strong-willed, sometimes cruel and aggressive character. These character traits are most pronounced in men. However, women are also characterized by self-righteousness and authoritarianism.

Significance for pregnancy

The probability of having a child with the I blood group is in those couples where at least one of the parents is a carrier of this group, unless there is a carrier of the 4th in the couple. If both parents have the first group, the baby will definitely be born with the same.

The table shows the probability of inheritance.

A child can inherit the blood type of the father or mother. But the Rh factor is more often transmitted by the mother. If the baby inherits the father's Rh, which differs from the mother's, there will be a Rh conflict.. Complications can begin during pregnancy.

In this case, the mother needs to be injected with special drugs so that she can bear and give birth to a child. Also, if the couple plans to have more children, anti-Rhesus serum is administered to the woman after childbirth.

The nature of people with 1 blood group

After numerous studies, scientists have found that these people are characterized by:

• Increased emotionality and irascibility;
• Leadership skills;
• The instinct of self-preservation and careful assessment of their capabilities before making a risky decision;
• Purposefulness.

In striving for their goal and profit, they are reckless, ready to sacrifice moral principles, abandon small goals in favor of one, but large.

People with the first blood group are sensitive to criticism - up to a break with loved ones, who often point out their mistakes. At the same time, other people's mistakes are rarely forgiven. They are jealous and demanding. Often seek to take the chair of the head. And, having achieved the goal, they become strict and often merciless bosses.

Careerism, perseverance and authoritarianism are characteristic of both sexes. Because of this, they are prone to stress, overwork and nervous exhaustion. Therefore, the lifestyle and diet should balance such a difficult character so that you do not have to say goodbye to health ahead of time.

These people have a slow metabolism, and from it - a tendency to rapid weight gain. The situation is exacerbated by malnutrition.

Since representatives of this blood type are descended from hunters, they are advised to include more meat in their diet - but with some nuances.

Fatty foods are the first to be banned - it leads to problems in the functioning of the cardiovascular system. What is not recommended to eat?

It is worth limiting consumption, and it is better to completely abandon:

1. Sala- due to a tendency to be overweight and problems with blood vessels.
2. Rice and lentils- May cause bloating.
3. Pure ice cream and milk. Often these people have poor digestibility of milk protein.
4. Coffee and too strong tea, alcohol- contributes to the accumulation of tension, stress, excess energy, leads to hypertension.
5. Peanuts and its oils, soybeans.
6. Salty and smoked food, excess spices.
7. fried food especially with lots of oil. The best option is boiled, stewed or baked foods.

To rationally spend calories and not gain weight, you need to exercise. For those who hate sports, regular walking is fine - but not less than 40-60 minutes a day.

If there are no contraindications, you can and even need to work out in the gym. Outdoor sports are suitable for running, skiing, playing sports. It will not be superfluous to sign up for a pool to relieve excess tension from the back muscles.

Video: Nutrition by blood group. Hunters, herbivores, Aryans

Frequent health problems

Depending on the blood type, there is also an innate tendency of a person to certain diseases. This does not mean that the patient will absolutely manifest a certain group of ailments: if you are attentive to your health, engage in prevention - they can be avoided.

But if you let everything take its course, do not follow the recommendations regarding nutrition and physical activity - the risk of these diseases increases significantly.

Also, this group is characterized by problems with the thyroid gland. And men have an increased tendency to hemophilia.

Blood group - a specific set of properties of red blood cells, different or the same in many people. It is impossible to identify a person only by characteristic changes in the blood, but this makes it possible, under certain conditions, to detect the relationship between the donor and the recipient, and is an indispensable requirement for organ and tissue transplantation.

Blood groups in the form in which we are used to talking about them were proposed by the Austrian scientist K. Landsteiner in 1900. 30 years later, he received the Nobel Prize in Medicine for this. There were other options, but Landsteiner's AB0 classification proved to be the most convenient and practical.

At present, knowledge of cellular mechanisms, discoveries of genetics are added. So what is a blood group?

What are blood groups

The main "participants" that make up a certain blood group are red blood cells. There are about three hundred different combinations of protein compounds on their membrane, which are controlled by chromosome number 9. This proves the hereditary acquisition of properties, the impossibility of their change during life.

It turned out that with the help of only two typical antigen proteins A and B (or their absence 0) it is possible to create a “portrait” of any person. Because the corresponding substances (agglutinins) are produced in plasma for these antigens, they are called α and β.

So four possible combinations turned out, they are also blood types.

AB0 system

How many blood groups, so many combinations in the AB0 system:

• the first (0) - has no antigens, but there are both agglutinins in plasma - α and β;
• the second (A) - in erythrocytes there is one antigen A and β-agglutinin in plasma;
• the third (B) -B-antigen in erythrocytes and α-agglutinin;
• the fourth (AB) - has both antigens (A and B), but there are no agglutinins.

The designation of the group in Latin letters has been fixed: large ones mean the type of antigen, small ones - the presence of agglutinins.

Scientists have identified another 46 classes of compounds that have the properties of antigens. Therefore, in clinical conditions, only a single group affiliation of the donor and recipient in blood transfusion is never trusted, but an individual compatibility reaction is carried out. However, one protein has to be constantly reckoned with, it is called the “Rh factor”.

What is "Rh factor"

The researchers found the Rh factor in the blood serum and confirmed its ability to stick together red blood cells. Since then, the blood group has been necessarily added with information about the person's Rh affiliation.

About 15% of the world's population has a negative reaction to Rh. Studies of the geographical and ethnic characteristics of blood groups have shown that the population differs in group and Rhesus: black people are overwhelmingly Rh-positive, and in the Spanish province with Basques living, 30% of the inhabitants do not have the Rh factor. The reasons for this phenomenon have not yet been established.

Among the Rh antigens, 50 proteins were identified, they are also designated in Latin letters: D and further alphabetically. Practical application finds the most important D Rh factor. It occupies 85% of the structure.

Other group classifications

The discovery of unexpected group incompatibility in all the analyzes done continues to develop and does not stop research on the significance of different erythrocyte antigens.

1. The Kell system - ranks third in identification after Rh belonging, takes into account 2 antigens "K" and "k", forms three possible combinations. It is important during pregnancy, the occurrence of hemolytic disease of the newborn, complications of blood transfusion.
2. The Kidd system - includes two antigens associated with hemoglobin molecules, provides for three options, is important for blood transfusion.
3. Duffy system - adds 2 more antigens and 3 blood groups.
4. The MNSs system is more complex, includes 9 groups at once, takes into account specific antibodies during blood transfusion, and clarifies the pathology in newborn babies.

The definition is shown taking into account different group systems

The Vel-negative group was discovered in 1950 in a patient suffering from colon cancer. She had a severe reaction to the second blood transfusion. During the first transfusion, antibodies to an unknown substance were formed. The blood was single-group by Rhesus. The new group began to be called "Vel-negative". Subsequently, it was found that it occurs with a frequency of 1 case per 2.5 thousand. Only in 2013, an antigen protein called SMIM1 was discovered.

In 2012, a joint study by scientists from the USA, France and Japan identified two new protein complexes in the erythrocyte membrane (ABCB6 and ABCG2). They, in addition to antigenic properties, are engaged in the transfer of electrolyte ions from the outside into the cells and back.

In medical institutions there is no way to find out blood groups by all known factors. Only the group affiliation in the AB0 system and the Rh factor are determined.

Methods for determining blood groups

Methods for determining group membership depend on the serum or erythrocyte standard used. The most popular 4 ways.

Standard Simple Method

It is used in medical institutions, at feldsher-obstetric stations.

The patient's erythrocytes are taken in capillary blood from a finger, standard sera with known antigenic properties are added. They are made under special conditions at the "Blood Transfusion Stations", labeling and storage conditions are strictly observed. Each study always uses two series of sera.

On a clean white plate, a drop of blood is mixed with four types of serum. The result is read in 5 minutes.

Defined group in the sample where there is no agglutination. If it is not found anywhere, then this indicates the first group, if in all samples, the fourth group. There are cases of questionable agglutination. Then the samples are looked at under a microscope, other methods are used.

Double cross reaction method

It is used as a clarifying method when agglutination is doubtful with the first method. Here the erythrocytes are known and the patient's serum is taken. The drops are mixed on a white plate and also evaluated after 5 minutes.

Zolicloning method

Natural sera are being replaced by synthetic anti-A and anti-B soliclones. Serum controls are not required. The method is considered more reliable.

If there is no reaction to anti-A agglutinins in the upper row, then there are no corresponding antigens in the patient's erythrocytes, this is possible with the third group

Express determination method

Provided for field use. Blood type and Rh factor are determined simultaneously using plastic cards with wells of the "Erythrotest-Groupcard" set. The necessary dried reagents are already applied to the bottom of them.

The method allows you to set the group and Rhesus even in a preserved sample. The result is “ready” after 3 minutes.

Method for determining the Rh factor

Used venous blood and standard sera of two types, Petri dish. Serum is mixed with a drop of blood, put in a water bath for 10 minutes. The result is determined by the appearance of agglutination of erythrocytes.

Without fail, Rh is determined:

• in preparation for a planned operation;
• during pregnancy;
• from donors and recipients.

Blood compatibility issues

It is believed that this problem is caused by the urgent need for blood transfusions 100 years ago during the First World War, when the Rh factor was not yet known. The large number of complications of single blood transfusions has led to subsequent research and limitations.

Currently, vital signs have made it possible to transfuse in the absence of one-group donor blood of no more than 0.5 liters of Rh-negative 0 (I) group. Modern recommendations suggest using erythrocyte mass, which is less allergenic to the body.

The information in the table is used less and less

The above systematic studies of other groups of antigens have changed the existing opinion about people with the first Rh-negative blood group as universal donors, and with the fourth Rh-positive, as recipients suitable for any donor properties.

Until now, plasma prepared from is used to compensate for a sharp protein deficiency, since it does not contain agglutinins.

Before each transfusion, a test for individual compatibility is carried out.: a drop of the patient's serum and a drop of donor blood are applied to a white plate in a ratio of 1:10. After 5 minutes check agglutination. The presence of small dotted flakes of erythrocytes indicates the impossibility of transfusion.

The direct harm of such a diet has been proven when trying to use it for the treatment of obesity.

Are blood types related to human health and character?

The conducted studies allowed to establish predisposing factors for the occurrence of some pathology.

• Reliable data are provided on a greater propensity for diseases of the cardiovascular system of persons with the second, third and fourth groups than with the first.
• But people with the first group are more likely to suffer from peptic ulcer disease.
• It is believed that for the B (III) group, the occurrence of Parkinson's disease is more dangerous.

D'Adamo's theory, widely promoted over the past 20 years, has been debunked and is not considered scientific in connection with the type of diet and the danger of certain diseases.

The connection of group membership with character should be taken into account at the level of astrological predictions.

Each person should know their blood type and Rh factor. No one can be isolated from emergency situations. The analysis can be done in your clinic or at the blood transfusion station.

Blood type is an important genetic trait of a person. It is laid at the gene level by parents at conception.

The blood type and Rh factor largely determine the character of a person and his individual characteristics. A person with each blood group has a certain predisposition to diseases, to a particular type of activity, lifestyle, etc.

We will talk about the characteristics of carriers of the second positive blood group in this article.

In 1900, the Austrian immunologist Landsteiner conducted a study, as a result of which he found that the blood of different people differs in the composition of antigens and antibodies to it.

The scientist came to the conclusion that the same blood never contains both antigens and antibodies of the same name. This discovery became a new step in the development of medicine, and Landsteiner was awarded the Nobel Prize for it.

According to the AB0 classification, the blood group is named according to which antigen is present in it: antigen A is present in the 2nd blood group, therefore its designation according to this classification is A (II).

For reference. The second blood type is possessed by 30-40% of the world population.

Transfusion compatibility

Blood transfusion is a procedure used by modern medicine, during which the patient is injected with the blood (or its individual components) of another person.

When transfusing blood, its group and Rh affiliation play a paramount role.

A person who donates his blood for a transfusion is called a donor. The person who receives blood during a transfusion is called a recipient.

Owners of the second positive blood type can become ideal donors only for owners of the same group and Rh factor.

In case of urgent need, the blood of the second positive group can be infused into the owners of the fourth blood group (the so-called universal recipients) with a positive Rh factor. However, nowadays in medicine they try to avoid such a practice.

If a person with a second positive blood group needs a blood transfusion, then, in addition to his own, blood of the first group (because its owners are universal donors) with a positive Rh factor will suit him.

With the infusion of blood that is incompatible in group or Rh factor, the red blood cells begin to stick together, lumps are formed that clog the capillaries. Then the lumps of red blood cells are destroyed, and the harmful decay products poison the blood. This process is very dangerous for humans and can be fatal.

Predisposition to diseases

Over the years, all blood groups have been studied. As a result, it was possible to find out that the owners of each group are prone to certain diseases. This information allows you to study the list of ailments to which the body is predisposed, and to focus on their prevention.

Owners of the second positive blood group are predisposed to such diseases:

1. The digestive system. People with this blood type are prone to gastritis and pancreatitis with low acidity. Even in this type of people, stones often form in the ducts of the gallbladder, and its inflammation (cholecystitis) develops.
2. The cardiovascular system. As for the heart, there is a tendency to coronary disease, heart disease. Of vascular diseases, people with the second blood group are prone to atherosclerosis and thrombosis.
3. Circulatory system. There is a predisposition to one of the most terrible blood diseases - acute leukemia.
4. excretory and urinary system. Carriers of the second blood group are prone to the development of urolithiasis.
5. Thyroid. Often there are pathologies in the functioning of the thyroid gland.
6. Infectious diseases. There is a predisposition to smallpox and foodborne infections.
7. Teeth. People in this group are prone to caries and other dental diseases.
8. Oncological diseases. There is a predisposition to cancer of the stomach and blood.

People with the second positive blood type are prone to obesity.

Diet

People with a second positive blood group need to adhere to certain dietary rules that will favorably affect the state of the body. It is important to get a maximum of vitamins and minerals from foods for the normal functioning of all organ systems.

It should be remembered that there are foods that are contraindicated for carriers of the second blood group because of their tendency to disease (for example, too fatty foods can provoke gastritis or obesity).

Let's take a closer look at useful and harmful products.

Healthy foods

People with the second positive blood group are genetically predisposed to vegetarianism. The basis of their diet should be vegetables and fruits.

Vegetables are a real storehouse of vitamins and minerals, an excellent source of fiber and organic acids. It must be remembered that during heat treatment, vegetables lose some of their beneficial properties, so it is advisable to eat them fresh. However, eating only raw vegetables is also not recommended, as this can adversely affect bowel function.

The most useful vegetables for owners of the second positive blood group are cucumbers, bell peppers, carrots, beets, broccoli. In moderation, you can eat tomatoes, potatoes, white cabbage and eggplant.

Almost all fruits are useful, except for those that are too acidic - apples, peaches, apricots, kiwi, grapes, strawberries, cherries, currants, etc.

If you cannot completely exclude meat from the diet, it is recommended to use its dietary types - chicken, turkey, rabbit. The meat is preferably boiled, steamed or baked.

Fish for owners of the second blood group will be useful, but again - with the exception of fatty varieties.

An excellent source of protein will be legumes - beans, lentils, soybeans.

Vegetable oils will benefit - linseed, olive, pumpkin, sesame.

From drinks, preference should be given to natural fruit juices, tea and coffee.

harmful products

Since the organs of the gastrointestinal tract in people with a second positive blood group do not cope well with the digestion of meat products, any fatty meats - pork, lamb, etc. are categorically contraindicated.

It is also worth excluding fatty fish - cod, halibut, herring, mackerel, etc.

Due to the low acidity of the stomach, it is undesirable to include acidic foods in large quantities in the diet. All citrus fruits are contraindicated - lemons, oranges, tangerines, grapefruits.

It is undesirable to consume dairy products, as they slow down the metabolism and can contribute to the development of obesity. In very small quantities, you can use hard cheese, low-fat cottage cheese and natural yogurt.

You should also exclude all confectionery products - cakes, pastries, buns, sweets.

It is advisable to completely abandon the use of alcohol, as it can provoke disturbances in the functioning of the nervous system.

Compatibility when conceiving a child

Pregnancy is considered the safest when the parents of the unborn child have the same blood groups and Rh factors. In this case, the embryo in most cases receives the same blood type as the parents, develops safely and is born healthy.

However, there are cases when parents with the same group affiliation have a child with a different blood type. This often gives rise to thoughts of treason in the minds of men and becomes a cause of contention in the family. Such situations occur due to ignorance of the basics of genetics. The fact is that every person at birth receives genetic information from two parents - mother and father. Each of these signs a person can subsequently pass on to his child, so it is likely that a child will be born with a group affiliation different from his parents.

Inheritance of blood group from parents

As can be seen from the table, if both parents have the second blood group, then in one fourth of the cases they have a child with the first blood group. And if one parent has the second group, and the other parent has the third, the child can get absolutely any blood type with an equal degree of probability.

If the father and mother have different blood types, the child most often inherits the mother's. If it happens that the child receives a blood type different from the mother's, then an immunological conflict develops. In this case, there is a possibility of miscarriage or the birth of a premature baby.

The same situation occurs with the Rh factor. If the parents have the same, the child gets the same, and the pregnancy proceeds safely. If the mother's Rh factor is negative and the father's is Rh positive, and the child inherits a positive Rh factor, maternal and fetal incompatibility occurs.

In this case, the woman's body considers the fetus a foreign object and begins to fight it. Antibodies from the mother's circulatory system cross the placenta and begin to attack the embryo. The unformed organs of the child work hard to protect themselves from danger, and the erythrocytes of the fetus die.

Attention! An immunological conflict when a Rh-negative mother carries a Rh-positive fetus can provoke various diseases of the heart, stomach and other organs in a child and even death.

Video - What is the difference between blood types

Modern medicine makes it possible to prevent the negative consequences of incompatibility of blood groups, so it is important to start controlling pregnancy at a very early stage. In especially severe cases, when it is impossible to prevent the dangerous consequences of an immunological conflict in any other way, an intrauterine blood transfusion is performed from a donor to the fetus. The child is injected with his own group or (if it cannot be established) the first, but with a negative Rh factor. Thus, it is possible to stop the Rh conflict between mother and child and save his life.

The second positive blood type is one of the most common. Its owners have certain character traits - calmness, poise, perseverance.

At the genetic level, this group of people is prone to a number of diseases, the development of which should be tried to prevent. To do this, it is important to lead a healthy lifestyle and eat right, taking into account the above recommendations.

When creating a marriage and conceiving a child, it is also important to take into account the blood type of both partners, since genetic incompatibility can adversely affect the health of the child. However, if it so happened that the child was conceived by loving parents with a mismatch in blood types - do not despair, at the present stage, medicine is able to prevent undesirable consequences, saving the life and health of the child.

BLOOD GROUPS- normal immunogenetic signs of blood, allowing people to be grouped into certain groups according to the similarity of their blood antigens. The last received the name of group antigens (see), or isoantigens. A person's belonging to one or another G. to. is his individual biol, a feature, edges begins to form already in the early period of embryonic development and does not change throughout subsequent life. Some group antigens (isoantigens) are found not only in uniform elements and blood plasma, but also in other cells and tissues, as well as in secrets: saliva, amniotic fluid, went. - kish. juice, etc. Intraspecific isoantigenic differentiation is inherent not only in humans, but also in animals, in which their own special G. to.

Knowledge about G. to. underlie the doctrine of blood transfusion (see), are widely used in clinical practice and forensic medicine. Human genetics and anthropology cannot do without the use of group antigens as genetic markers.

There is a large literature on G.'s connection to. with various infectious and non-infectious human diseases. However, this issue is still in the stage of study and accumulation of facts.

The science of G. to. arose at the end of the 19th century. as one of the sections of general immunology (see). Therefore, it is natural that such categories of immunity as the concepts of antigens (see) and antibodies (see), their specificity, fully retain their significance in the study of isoantigenic differentiation of the human body.

Many dozens of iso-antigens have been discovered in erythrocytes, leukocytes, platelets, as well as in the blood plasma of people. In table. Table 1 presents the most studied isoantigens of human erythrocytes (about isoantigens of leukocytes, platelets, as well as isoantigens of serum proteins - see below).

The stroma of each erythrocyte contains a large number of isoantigens that characterize intraspecific group-specific signs of the human body. Apparently, the true number of antigens on the surface of human erythrocyte membranes significantly exceeds the number of already discovered isoantigens. The presence or absence of one or another antigen in erythrocytes, as well as various combinations of them, create a wide variety of antigenic structures inherent in people. If we take into account even the far from complete set of isoantigens discovered in blood plasma cells and proteins, then direct counting will indicate the existence of many thousands of immunologically distinguishable combinations.

Isoantigens that are in a genetic relationship are grouped into groups called the AB0 systems, Rhesus, etc.

Blood groups of the AB0 system

Blood groups of the AB0 system were discovered in 1900 by K. Landsteiner. Mixing erythrocytes of some individuals with normal blood sera of others, he found that with some combinations of sera and erythrocytes hemagglutination is observed (see), with others it is not. Based on these factors, K. Landsteiner came to the conclusion that the blood of different people is heterogeneous and can be conditionally divided into three groups, which he designated with the letters A, B and C. Shortly thereafter, Decastello and Sturli (A. Decastello, A. Sturli, 1902) found people whose erythrocytes and sera differed from the erythrocytes and sera of the three groups mentioned. They considered this group as a deviation from Landsteiner's scheme. However, Ya. Jansky in 1907 established that this G. to. is not an exception from Landsteiner's scheme, but an independent group, and, therefore, all people are divided into four groups according to immunol, blood properties.

Differences in the agglutinable properties of erythrocytes depend on the specific substances present in them - agglutinogens (see Agglutination), which, at the suggestion of Dungern (E. Dungern) and L. Hirschfeld (1910), are denoted by the letters A and B. In accordance with this designation erythrocytes of some individuals do not contain agglutinogens A and B (group I according to Jansky, or group 0), erythrocytes of others contain agglutinogen A (blood group II), erythrocytes of third parties contain agglutinogen B (blood group III), erythrocytes of the fourth contain agglutinogen A and B (IV blood group).

Depending on the presence or absence of group antigens A and B in the erythrocytes, there are normal (natural) isoantibodies (Hemagglutinins) in relation to these antigens in the plasma. Group 0 individuals have two types of group antibodies: anti-A and anti-B (alpha and beta). Individuals of group A contain isoantibody p (anti-B), individuals of group B contain isoantibody a (anti-A), and individuals of group AB do not have both hemagglutinins. The ratios between isoantigens and isoantibodies are presented in Table. 2.

Table 1. SOME HUMAN ERYTHROCYTE ISOANTIGEN SYSTEMS

Table 2. RELATIONSHIPS BETWEEN AB0 ISOANTIGENS IN ERYTHROCYTES AND SERUM ISOHEMAGGLUTININS

Table 3. DISTRIBUTION OF BLOOD GROUPS OF THE AB0 SYSTEM (in %) AMONG THE SURVEYED POPULATION OF THE USSR

The letter, not the numeric designation of G. to., is accepted, as well as the full spelling of the G. to. formula, taking into account both erythrocyte antigens and serum antibodies (0αβ, Aβ, Bα, AB0). As can be seen from Table. 2, the blood group is characterized equally by both isoantigens and isoantibodies. When determining G. to. it is necessary to take into account both of these indicators, since there may be persons with weakly expressed isoantigens of erythrocytes and persons in whom isoantibodies are insufficiently active or even absent.

Dungern and Hirschfeld (1911) found that group antigen A is not homogeneous and can be divided into two subgroups - A1 and A2 (according to the terminology proposed by K. Landsteiner). The erythrocytes of the A1 subgroup are well agglutinated by the corresponding sera, and the erythrocytes of the A2 subgroup are poorly agglutinated, and for their detection it is necessary to use highly active standard sera of the Bα and 0αβ groups. Group A1 erythrocytes occur in 88%, and group A2 - in 12%. Later, variants of erythrocytes with even more weakly expressed agglutinable properties were found: A3, A4, A5, Az, A0, etc. The possibility of the existence of such weakly agglutinating variants of group A erythrocytes must be considered in the practice of determining G. to. they are very rare. group antigen

B, unlike antigen A, is characterized by greater uniformity. However, rare variants of this antigen are also described - B2, B3, Bw, Bx, etc. Erythrocytes containing one of these antigens had weakly expressed agglutinable properties. The use of highly active standard Aβ and 0αβ sera also makes it possible to identify these weakly expressed B agglutinogens.

Group 0 erythrocytes are characterized not only by the absence of agglutinogens A and B in them, but also by the presence of specific specific antigens H and 0. Antigens H and 0 are contained not only in group 0 erythrocytes, but also in erythrocytes of the A2 subgroup, and least of all - in the erythrocytes of the A1 subgroup and A1B.

If the presence of antigen H in erythrocytes is beyond doubt, then the question of the independence of the existence of antigen 0 has not yet been finally resolved. According to the studies of Morgan and Watkins (W. Morgan, W. Watkins, 1948), a distinctive feature of the H antigen is its presence in biol, fluids of secretors of group substances and its absence in non-secretors. Antigen 0, unlike antigen H, A and B, is not secreted with secrets.

Of great importance in the practice of determining the antigens of the AB0 system, and especially the subgroups A1 and A2, were discovered by Boyd (W. Boyd, 1947, 1949) and independently by Renkonen (K. Renkonen, 1948) substances of plant origin - phytohemagglutinins. Phytohemagglutinins, specific concerning group antigens, are also called lectins (see). “Pectins are more often found in the seeds of leguminous plants of this family. Leguminosa. Water-salt extracts from the seeds of Dolichos biflorus and Ulex europeus can serve as an ideal combination of phytohemagglutinins to identify subgroups in groups A and AB. Lectins obtained from the seeds of Dolichos biflorus react with erythrocytes of the A1 and A1B groups and do not react with erythrocytes of the A2 and A2B groups. Lectins obtained from the seeds of Ulex europeus, on the contrary, react with erythrocytes of the A2 and A2B groups. Lectins from the seeds of Lotus tetragonolobus and Ulex europeus are used to detect the H.

In the seeds of Sophora japonica, lectins (anti-B) were found in relation to group B erythrocytes.

Lectins have been found that react with antigens of other systems of G. to. Specific phytoprecipitins have also been found.

A peculiar antigenically gray l, a blood variant was discovered by Y. Bhende et al., in 1952 in a resident of Bombay, erythrocytes to-rogo did not contain any of the known antigens of the AB0 system, and there were anti-A antibodies in the serum, anti-B and anti-H; this blood variant was called "Bombay" (Oh). Subsequently, a variant of Bombay-type blood was found in humans in other parts of the globe.

Antibodies in relation to group antigens of the AB0 system are normal, naturally occurring during the formation of the body, and immune, manifested as a result of human immunization, for example. with the introduction of foreign blood. Normal anti-A and anti-B isoantibodies are usually immunoglobulins M (IgM) and are more active at low (20-25°) temperatures. Immune group isoantibodies are more often associated with immunoglobulins G (IgG). Serum can, however, contain all three classes of group immunoglobulins (IgM, IgG and IgA). Secretory-type antibodies (IgA) are often found in milk, saliva, and sputum. OK. 90% of the immunoglobulins found in colostrum belong to the IgA class. The titer of IgA antibodies in colostrum is higher than in serum. At persons of group 0 both types of antibodies (anti-A and anti-B) usually belong to one class of immunoglobulins (see). Both IgM and IgG group antibodies can have hemolytic properties, i.e., bind complement if the corresponding antigen is present in the stroma of erythrocytes. In contrast, secretory-type antibodies (IgA) do not cause hemolysis because they do not bind complement. For erythrocyte agglutination, 50-100 times fewer IgM antibody molecules are required than IgG group antibody molecules.

Normal (natural) group antibodies begin to appear in a person in the first months after birth and reach a maximum titer by about 5-10 years. After that, the antibody titer remains at a relatively high level for many years, and then gradually decreases with age. The titer of anti-A hemagglutinins normally varies within 1: 64 - 1: 512, and the titer of anti-B hemagglutinins - within 1:16 - 1: 64. In rare cases, natural hemagglutinins can be weakly expressed, which makes it difficult to identify them. Such cases are observed at hypogammaglobulinemia or agammaglobulinemia (see). In addition to hemagglutinins, normal group hemolysins are also found in the sera of healthy people (see Hemolysis), but in a low titer. Anti-A hemolysins, like their corresponding agglutinins, are more active than anti-B hemolysins.

In humans, immune group antibodies can also appear as a result of parenteral intake of incompatible antigens in the body. Such processes of isoimmunization can take place during the transfusion of both whole incompatible blood and its individual ingredients: erythrocytes, leukocytes, plasma (serum). The most common immune antibodies are anti-A, which are formed in people of blood types 0 and B. Immune anti-B antibodies are less common. The introduction into the body of substances of animal origin, similar to the human A and B group antigens, can also lead to the appearance of group immune antibodies. Immune group antibodies can also appear as a result of isoimmunization during pregnancy if the fetus belongs to a blood group that is incompatible with the mother's blood group. Immune hemolysins and Hemagglutinins can also occur as a result of parenteral use in the treatment of professional, for the purposes of certain drugs (sera, vaccines, etc.) containing substances similar to group antigens.

Substances similar to human group antigens are widely distributed in nature and can be the cause of immunization. These substances are also found in some bacteria. It follows that some infections can also stimulate the formation of immune antibodies against group A and B erythrocytes. The formation of immune antibodies against group antigens is not only of theoretical interest, but is also of great practical importance. Persons with blood group 0αβ are usually considered universal donors, i.e. their blood can be transfused to persons of all groups without exception. However, the provision on a universal donor is not absolute, since there may be persons of group 0 whose blood transfusion due to the presence of immune hemolysins and hemagglutinins with a high titer (1: 200 or more) in it can lead to death. Among the universal donors, therefore, there may be "dangerous" donors, and therefore the blood of these individuals can only be transfused to patients with the same (0) blood group (see Blood transfusion).

Group antigens of the AB0 system, in addition to erythrocytes, were also found in leukocytes and platelets. IL Krichevsky and LA Shvartsman (1927) were the first to discover group antigens A and B in fixed cells of various organs (brain, spleen, liver, kidney). They showed that the organs of people of blood group A, like their erythrocytes, contain antigen A, and the organs of people of blood group B, respectively, of erythrocytes, have antigen

B. Subsequently, group antigens were found in almost all human tissues (muscles, skin, thyroid gland), as well as in cells of benign and malignant human tumors. The exception was the lens of an eye, in Krom group antigens are not found. Antigens A and B are found in spermatozoa, semen fluid. Amniotic fluid, saliva, gastric juice are especially rich in group antigens. There are few group antigens in the blood serum and urine, and they are practically absent in the cerebrospinal fluid.

Secretors and non-secretors of group substances. According to the ability to secrete group substances with secrets, all people are divided into two groups: secretors (Se) and non-secretors (se). According to R. M. Urinson (1952), 76% of people are secretors and 24% are non-secretors of group antigens. The existence of intermediate groups between strong and weak secretors of group substances has been proved. The content of group antigens in secretory and nonsecretory erythrocytes is the same. However, in the serum and in the tissues of non-secretory organs, group antigens are found to a lesser extent than in the tissues of secretors. The body's ability to secrete group antigens with secrets is inherited by dominant type. Children whose parents are non-secretors of group antigens are also non-secretors. Persons with a dominant secretion gene are able to secrete group substances with secrets, while persons with a recessive non-secretion gene do not possess this ability.

Biochemical nature and properties of group antigens. Group antigens A and B of the blood and organs are resistant to the action of ethyl alcohol, ether, chloroform, acetone and formalin, high and low temperatures. Group antigens A and B in erythrocytes and in secrets are associated with different molecular structures. Group antigens A and B of erythrocytes are glycolipids (see), and group antigens of secrets are glycoproteins (see). Group glycolipids A and B isolated from erythrocytes contain fatty acids, sphingosine and carbohydrates (glucose, galactose, glucosamine, galactosamine, fucose and sialic acid). The carbohydrate part of the molecule is associated with fatty acids through sphingosine. The glycolipid preparations of group antigens allocated from erythrocytes are haptens (see); they react specifically with the corresponding antibodies, but are unable to induce antibody production in immunized animals. Attachment of a protein (eg, horse serum) to this hapten converts group glycolipids into full-fledged antigens. This makes it possible to conclude that in native erythrocytes, which are full-fledged antigens, group glycolipids are associated with protein. Purified group antigens isolated from ovarian cystic fluid contain 85% carbohydrates and 15% amino acids. Average mol. the weight of these substances is 3 x x 105 - 1 x 106 daltons. Aromatic amino acids are present only in very small amounts; amino acids containing sulfur were not found. Group antigens A and B of erythrocytes (glycolipids) and secretions (glycoproteins), although associated with different molecular structures, have identical antigenic determinants. The group specificity of glycoproteins and glycolipids is determined by carbohydrate structures. A small number of sugars located at the ends of the carbohydrate chain are an important part of the specific antigenic determinant. As shown by chem. analysis [Watkins (W. Watkins), 1966], antigens A, B, Lea contain the same carbohydrate components: alpha-hexose, D-galactose, alpha-methyl-pentose, L-fucose, two amino sugars - N-acetyl glucosamine and N-acetyl-D-galactosamine and N-acetylneuraminic acid. However, the structures (antigenic determinants) formed from these carbohydrates are not the same, which determines the specificity of group antigens. L-fucose plays an important role in the structure of the determinant of the antigen H, N-acetyl-D-galactosamine in the structure of the determinant of the antigen A, and D-galactose in the structure of the determinant of the group antigen B. Peptide components do not participate in the structure of group antigen determinants. They are supposed to contribute only to a strictly defined arrangement in space and orientation of carbohydrate chains, give them a certain rigidity of the structure.

Genetic control of the biosynthesis of group antigens. The biosynthesis of group antigens is carried out under the control of the corresponding genes. A certain order of sugars in the chain of group polysaccharides is not created by a matrix mechanism, as for proteins, but arises as a result of a strictly coordinated action of specific glycosyl transferase enzymes. According to the hypothesis of Watkins (1966), group antigens whose structural determinants are carbohydrates can be considered as secondary products of genes. The primary products of genes are proteins - glycosyltransferases, catalyzing the transfer of sugars from the glycosyl derivative of nucleoside diphosphate to the carbohydrate chains of the glycoprotein precursor. Serol., genetic and biochemical studies suggest that the A, B and Le genes control glycosyltransferase enzymes that catalyze the addition of the appropriate sugar units to the carbohydrate chains of the preformed glycoprotein molecule. The recessive alleles of these loci function as inactive genes. Chem. the nature of the precursor substance has not yet been adequately determined. Some researchers believe that a common glycoprotein substance for all group precursor antigens is identical in its specificity to type XIV pneumococcal polysaccharide. On the basis of this substance, the corresponding antigenic determinants are built under the influence of genes A, B, H, Le. Substance of antigen H is the main structure, edges is included into all group antigens of the AB0 system. Other researchers [Feyzi, Kabat (T. Feizi, E. Kabat), 1971] presented evidence that the precursor of group antigens is the substance of antigen I.

Isoantigens and isoantibodies of the AB0 system in ontogenesis. Group antigens of the AB0 system begin to be detected in human erythrocytes in the early period of its embryonic development. Group antigens were found in fetal erythrocytes in the second month of embryonic life. Having formed early in the erythrocytes of the fetus, group antigens A and B reach the highest activity (sensitivity to the corresponding antibodies) by the age of three. The agglutinability of neonatal erythrocytes is 1/5 of the agglutinability of adult erythrocytes. Having reached a maximum, the titer of erythrocyte agglutinogens remains at a constant level for several decades, and then its gradual decrease is observed. The specificity of individual group differentiation inherent in each person remains throughout his life, regardless of the transferred infectious and non-infectious diseases, as well as the effects on the body of various physical and chemical. factors. During the entire individual life of a person, only quantitative changes occur in the titer of his group hemagglutinogens A and B, but not qualitative. In addition to the age-related changes mentioned above, a number of researchers noted a decrease in the agglutinability of group A erythrocytes in patients with leukemia. It is assumed that these individuals had a change in the process of synthesis of the precursors of antigens A and B.

Inheritance of group antigens. Soon after opening at people of G. to. it was noted that group antigenno-serol. the properties of the blood of children are in a strictly defined dependence on the blood group of their parents. Dungern (E. Dungern) and L. Hirschfeld, as a result of a survey of families, came to the conclusion that blood group traits are inherited through two independent genes, which they designated, as well as their corresponding antigens, with the letters A and B. Bernstein ( F. Bernstein, 1924), based on the laws of inheritance of G. Mendel, subjected to mathematical analysis the facts of inheritance of group traits and came to the conclusion that there is a third genetic trait that determines group 0. This gene, unlike the dominant genes A and B, is recessive . According to Furuhata's theory (T. Furuhata, 1927), genes are inherited that determine the development of not only antigens A, B and 0 (H), but also calamus hemagglutinins. Agglutinogens and agglutinins are inherited in a correlative relationship in the form of the following three genetic traits: 0αβp, Aβ and Bα. The A and B antigens themselves are not genes, but develop under the specific influence of genes. The blood type, like any hereditary trait, develops under the specific influence of two genes, one of which comes from the mother and the other from the father. If both genes are identical, then the fertilized egg, and therefore the organism that developed from it, will be homozygous; if the genes that determine the same trait are not the same, then the organism will have heterozygous properties.

In accordance with this, the genetic formula of G. to. does not always coincide with the phenotypic one. For example, phenotype 0 corresponds to genotype 00, phenotype A - genotype AA and AO, phenotype B - genotype BB and BO, phenotype AB - genotype AB.

Antigens of the AB0 system are not equally common among different peoples. Frequency, with a cut of G. to. meet among the population of some cities of the USSR, is presented on tab. 3.

G. to. AB0 systems are of paramount importance in the practice of blood transfusion, as well as in the selection of compatible pairs of donors and recipients for transplantation of tissue organs (see Transplantation). About biol. little is known about the significance of isoantigens and isoantibodies. Assume that normal isoantigens and isoantibodies of the AB0 system play a role in maintenance of a constancy of the internal environment of an organism (see). There are hypotheses about the protective function of the antigens of the AB0 system of the digestive tract, seminal and amniotic fluid.

Rh system blood type

Blood groups of the Rh (Rhesus) system take the second place in importance for honey. practices. This system was named after rhesus monkeys, whose erythrocytes were used by K. Landsteiner and A. Wiener (1940) to immunize rabbits and guinea pigs, from which specific sera were obtained. With the help of these sera, the Rh antigen was found in human erythrocytes (see Rh factor). The greatest progress in the study of this system has been achieved by obtaining isoimmune sera from multiparous women. This one of the most complex systems of isoantigenic differentiation of the human body includes more than twenty isoantigens. In addition to the five main antigens R h (D, C, c, E, e), this system also includes their numerous variants. Some of them are characterized by reduced agglutinability, i.e., they differ from the main R h antigens in quantitative terms, while other variants have qualitative antigenic features.

The successes of general immunology are largely associated with the study of antigens of the Rh system: the discovery of blocking and incomplete antibodies, the development of new research methods (Coombs reaction, hemagglutination reaction in colloidal media, the use of enzymes in immunol, reactions, etc.). Advances in diagnosis and prevention of hemolytic disease of newborns (see) are also achieved by hl. arr. when studying this system.

MNSs blood group

It seemed that the system of group antigens M and N, discovered by K. Landsteiner and F. Levin in 1927, was quite well studied and consisted of two main antigens - M and N (this name was given to the antigens conditionally). Further research, however, showed that this system is no less complex than the Rh system, and includes ca. 30 antigens (Table 1). The M and N antigens were discovered using sera obtained from rabbits immunized with human erythrocytes. In humans, anti-M and especially anti-N antibodies are rare. For many thousands of transfusions of blood incompatible with respect to these antigens, only isolated cases of the formation of anti-M or anti-N iso-antibodies were noted. Based on this, the group affiliation of the donor and recipient according to the MN system is usually not taken into account in the practice of blood transfusion. Antigens M and N can be found in erythrocytes together (MN) or each separately (M and N). According to A. And Rozanova (1947), the edges examined 10,000 people in Moscow, persons of the M blood group are found in 36%, N groups in 16%, and MN groups in 48% of cases. According to chem. In nature, the M and N antigens are glycoproteins. The structure of antigenic determinants of these antigens includes neuraminic acid. Its cleavage from antigens by treating the latter with neuraminidase of viruses or bacteria leads to inactivation of the M and N antigens.

The formation of M and N antigens occurs in the early period of embryogenesis, antigens are found in the erythrocytes of embryos of 7-8 weeks of age. Starting from the 3rd month M and N antigens in embryonic erythrocytes are well expressed and do not differ from adult erythrocyte antigens. The M and N antigens are inherited. One sign (M or N) the child receives from the mother, the other - from the father. It has been established that children can have only those antigens that their parents have. In the absence of one or another sign in the parents, children also cannot have them. Based on this, the MN system matters in court. practice in resolving issues of disputed paternity, motherhood and child replacement.

In 1947, with the help of serum obtained from a multiparous woman, Walsh and Montgomery (R. Walsh, C. Montgomery) discovered the S antigen associated with the MN system. Somewhat later, the s antigen was also found in human erythrocytes.

The S and s antigens are controlled by allelic genes (see Alleles). In 1% of people, S and s antigens may be absent. G. to. These persons are designated by the symbol Su. In addition to the MNSs antigens, the complex antigen U, consisting of components of the S and s antigens, is found in the erythrocytes of some individuals. There are also other diverse variants of antigens of the MNSs system. Some of them are characterized by reduced agglutinability, others have qualitative antigenic differences. Antigens (Hi, He, etc.) genetically related to the MNSs system were also found in human erythrocytes.

Blood groups of the P system

Simultaneously with the M and N antigens, K. Landsteiner and F. Levin (1927) discovered the P antigen in human erythrocytes. Depending on the presence or absence of this antigen, all people were divided into two groups - P+ and P-. For a long time it was believed that the P system was limited to the existence of only these two variants of erythrocytes, however, further research showed that this system is more complex. It turned out that the erythrocytes of the majority of P-negative subjects contain an antigen encoded by another allelomorphic gene of this system. This antigen was named P2, in contrast to the P1 antigen, which was previously referred to as P+. There are persons in whom both antigens (P1 and P2) are absent. The erythrocytes of these individuals are designated by the letter p. Later, the Pk antigen was discovered and the genetic relationship of both this antigen and the Tja antigen with the P system was proved. It is believed [Sanger (R. Sanger), 1955] that the Tja antigen is a complex of P1 and P2 antigens. Persons of group P1 are found in 79%, groups P2 - in 21% of cases. Persons of the Pk and p group are very rare. Sera for the detection of P antigens are obtained from both humans (isoantibodies) and animals (heteroantibodies). Both iso- and anti-P heteroantibodies are classified as complete cold-type antibodies, since the agglutination reaction they cause occurs best at t ° 4-16 °. Anti-P antibodies that are active at human body temperature are also described. Isoantigens and isoantibodies of system P have a certain wedge, value. There have been cases of early and late miscarriages caused by anti-R isoantibodies. Several cases of post-transfusion complications associated with the incompatibility of the blood of the donor and the recipient according to the system of P antigens have been described.

Of great interest is the established relationship between the P system and Donat-Landsteiner's cold paroxysmal hemoglobinuria (see Immunohematology). The reasons for the emergence of autoantibodies in relation to the own antigens P1 and P2 of erythrocytes remain unknown.

Kell system blood types

The Kell antigen (Kell) was discovered by Coombs, Murant, Race (R. Coombs, A. Mourant, R. Race, 1946) in the erythrocytes of a child suffering from hemolytic disease. The name to an antigen is given by a surname of a family, Kell antigen (K) and K antibodies were for the first time found in members of a cut. Antibodies reacting with erythrocytes of her husband, the child, and 10% of samples of erythrocytes received from other persons were found in mother. This woman received a blood transfusion from her husband, which appeared to promote isoimmunization.

Based on the presence of K antigen in red blood cells or its absence, all people can be divided into two groups: Kell-positive and Kell-negative. Three years after the discovery of the K antigen, it was found that the Kell-negative group is characterized not only by the absence of the K antigen, but by the presence of another antigen - K. Allen and Lewis (F. Allen, S. Lewis, 1957) found sera, which made it possible to open in in human erythrocytes, the Kra and Krv antigens related to the Kell system. Stroup, McIlroy (M. Stroup, M. Macllroy) et al. (1965) showed that the antigens of the Sutter group (Jsa and Jsb) are also genetically related to this system. Thus, the Kell system, as you know, includes three: pairs of antigens: K, k; Kra; KrD; Jsa and JsB, the biosynthesis of which is encoded by three pairs of allelic genes K, k; Kpb, Krv; jsa and jsb. Kell system antigens are inherited according to general genetic laws. The formation of antigens of the Kell system refers to the early period of embryogenesis. In the erythrocytes of newborns, these antigens are quite well expressed. Kik antigens have relatively high immunogenic activity. Antibodies to these antigens can occur both during pregnancy (in the absence of one or another antigen in the mother and the presence of them in the fetus), and as a result of repeated blood transfusions that are incompatible with respect to Kell antigens. Many cases of hemotransfusion complications and hemolytic disease of newborns are described, the cause of which was isoimmunization with antigen K. Antigen K, according to T. M. Piskunova (1970), examined 1258 residents of Moscow, was in 8.03% and was absent (group kk ) in 91.97% of the examined.

Duffy blood groups

Katbush, Mollison and Parkin (M. Cutbush, P. Mollison, D. Parkin, 1950) found antibodies in a patient with hemophilia that reacted with an unknown antigen. The latter was: they called the antigen Duffy (Duffy), by the name of the patient, or abbreviated Fya. Shortly thereafter, the second antigen of this system, Fyb, was also found in erythrocytes. Antibodies in relation to these antigens receive or from patients, the Crimea multiple blood transfusions were made, or from women whose newborn children suffered from hemolitic disease. There are complete and often incomplete antibodies, and therefore, to detect them, it is necessary to apply the Coombs reaction (see Coombs reaction) or to put an agglutination reaction in a colloidal medium. G. to. Fy (a + b-) occurs in 17.2%, the Fy group (a-b +) - in 34.3% and the Fy group (a + b +) - in 48.5%. The Fya and Fyb antigens are inherited as dominant traits. The formation of Fy antigens occurs in the early period of embryogenesis. The Fya antigen can cause severe post-transfusion complications in blood transfusions, unless incompatibility with this antigen is taken into account. The Fyb antigen, in contrast to the Fya antigen, is less isoantigenic. Antibodies against it are less common. The Fya antigen is of great interest to anthropologists, since it occurs relatively often in some peoples, while it is absent in others.

Blood groups of the Kidd system

Antibodies to antigens of the Kidd (Kidd) system were opened in 1951 by Allen, Diamond and Nedzelya (F. Allen, L. Diamond, B. Niedziela) in a woman named Kidd, a newborn child a cut suffered from hemolytic disease. The corresponding antigen in erythrocytes was designated Jka. Shortly thereafter, the second antigen of this system, Jkb, was found. The Jka and Jkb antigens are the product of allelic gene function. Antigens Jka and Jkb are inherited according to the general laws of genetics. It has been established that children cannot have antigens that are absent from their parents. Antigens Jka and Jkb are found in the population approximately equally often - in 25%, in 50% of people both antigens are in erythrocytes. Antigens and antibodies of the Kidd system have a certain practical value. They can be the cause of hemolytic disease of the newborn and post-transfusion complications with repeated transfusions of blood incompatible with antigens of this blood system.

Lewis blood groups

The first antigen of the Lewis (Lewis) system was discovered by A. Mourant in 1946 in human erythrocytes using serum obtained from a woman named Lewis. This antigen has been designated Lea. Two years later, Andresen (P. Andresen, 1948) reported the discovery of the second antigen of this system - Leb. MI Potapov (1970) found on the surface of human erythrocytes a new antigen of the Lewis - Led system, which expanded our understanding of the Lewis isoantigen system and gave reason to assume the existence of an allele of this trait - Lec. Thus, the existence of the following G. to. the Lewis system is possible: Lea, Leb, Lec, Led. Antibodies anti-Le Ch. arr. natural origin. However, there are antibodies that also arise as a result of immunization, for example, during pregnancy, but this is rarely observed. Anti-Le agglutinins are cold-type antibodies, i.e. they are more active at low (16°) temperatures. In addition to sera of human origin, immune sera were also obtained from rabbits, goats, and chickens. Grubb (R. Grubb, 1948) established the relationship between Le antigens and the body's ability to secrete ABN group substances with secrets. The Leb and Led antigens are found in secretors of AVH group substances, while the Lea and Lec antigens are found in non-secretors. In addition to erythrocytes, antigens of the Lewis system are found in saliva and in blood serum. Reiss and other researchers believe that the antigens of the Lewis system are the primary antigens of saliva and serum, and only secondarily they manifest themselves as antigens on the surface of the stroma of erythrocytes. Le antigens are inherited. The formation of Le antigens is determined not only by the Le genes, but is also directly influenced by the secretion (Se) and non-secretion (se) genes. The antigens of the Lewis system are not equally common among different peoples and, as genetic markers, are of undoubted interest to anthropologists. Rare cases of post-transfusion reactions caused by anti-Lea antibodies and even less often by anti-Leb antibodies have been described.

Lutheran blood types

The first antigen of this system was opened by S. Callender and R. Race in 1946 by means of the antibodies received from the patient, Krom repeatedly transfused blood. The antigen was named after the patient Lutheran (Lutheran) and designated by the letters Lua. A few years later, the second antigen of this system, Lub, was also discovered. Lua and Lub antigens can occur separately and together with the following frequency: Lua - in 0.1%, Lub - in 92.4%, Lua, Lub - in 7.5%. Anti-Lu agglutinins are more often of the cold type, i.e., the optimum of their reaction lies no higher than t ° 16 °. Very rarely, anti-Lub antibodies and, even more rarely, anti-Lua antibodies can cause post-transfusion reactions. There are reports of the significance of these antibodies in the origin of hemolytic disease of the newborn. Lu antigens are already detected in cord blood erythrocytes. Wedge, value of antigens of the Lutheran system in comparison with other systems is rather small.

Diego blood groups

The isoantigen Diego (Diego) was discovered in 1955 by Leiriss, Arende, Sisko (M. Layrisse, T. Arends, R. Sisco) in human erythrocytes with the help of incomplete antibodies found in the mother, the newborn child suffered from hemolytic disease. Based on the presence or absence of the Diego (Dia) antigen, the Indians of Venezuela could be divided into two groups: Di (a+) and Di (a-). In 1967, Thompson, Childer and Hatcher (R. Thompson, D. Childers, D. Hatcher) reported that they had anti-Dih antibodies in two Mexican Indians, i.e., the second antigen of this system was discovered. Anti-Di antibodies are incomplete and therefore Coombs' reaction is used to determine G. to. Diego. Diego antigens are inherited as dominant traits and are well developed by the time of birth. According to the materials collected by O. Prokop, G. Uhlenbruck in 1966, the Dia antigen was found in the inhabitants of Venezuela (different tribes), Chinese, Japanese, but it was not found in Europeans, Americans (whites), Eskimos (Canada), Australians, Papuans and Indonesians. The unequal frequency with which the Diego antigen is distributed among different peoples is of great interest to anthropologists. It is believed that Diego antigens are inherent in the peoples of the Mongolian race.

Auberger blood groups

The Au isoantigen was discovered thanks to the joint efforts of the French. and English. scientists [Salmon, Liber, Sanger (S. Salmon, G. Liberge, R. Sanger), etc.] in 1961. The name of this antigen is given by the first letters of the surname Auberger (Auberge) - women, antibodies were found in a cut . Incomplete antibodies arose, apparently, as a result of multiple blood transfusions. The Au antigen was found in 81.9% of the surveyed residents of Paris and London. It is inherited. In the blood of newborns, the Au antigen is well expressed.

Blood groups of the Dombrock system

The Do isoantigen was opened by J. Swanson et al. in 1965 with the help of incomplete antibodies obtained from a woman named Dombrock (Dombrock), who was immunized as a result of a blood transfusion. According to a survey of 755 inhabitants of Northern Europe (Sanger, 1970), this antigen was found in 66.36% of the Do (a+) group and was absent in 33.64% of the Do (a-) group. The Doa antigen is inherited as a dominant trait; in the erythrocytes of newborns, this antigen is well expressed.

System II blood groups

In addition to the group signs of blood described above, isoantigens were also found in human erythrocytes, of which some are very widespread, while others, on the contrary, are very rare (for example, among members of the same family) and approach individual antigens. Of the widespread antigens, G. to. systems Ii are of the greatest importance. A. Wiener, Unger * Cohen, Feldman (L. Unger, S. Cohen, J. Feldman, 1956) obtained from a person suffering from acquired hemolytic anemia, cold-type antibodies, with the help of which it was possible to detect an antigen in human erythrocytes, indicated by the letter “ I". Of the 22,000 erythrocyte samples examined, only 5 did not contain this antigen or had it in negligible amounts. The absence of this antigen was designated by the letter "i". Further research, however, showed that antigen i really exists. Individuals of group i have anti-I antibodies, which indicates a qualitative difference between antigens I and i. System II antigens are inherited. Anti-I antibodies are determined in a saline environment as cold-type agglutinins. Anti-I and anti-i autoantibodies are usually found in persons suffering from acquired cold-type hemolytic anemia. The cause of these autoantibodies is still unknown. Anti-i autoantibodies are more common in patients with certain forms of reticulosis, myeloid leukemia, and infectious mononucleosis. Anti-cold type I antibodies do not cause erythrocyte agglutination at t° 37°, but they can sensitize erythrocytes and promote complement addition, which leads to erythrocyte lysis.

Blood groups of the Yt system

Eaton and Morton (B. Eaton, J. Morton) et al. (1956) found in a person who was repeatedly transfused with blood, antibodies capable of detecting a very widespread Yta antigen. Later, the second antigen of this system, Ytb, was also discovered. The Yta antigen is one of the most widespread. It occurs in 99.8% of people. The Ytb antigen occurs in 8.1% of cases. There are three phenotypes of this system: Yt (a + b-), Yt (a + b +) and Yt (a - b +). Persons of the Y t phenotype (a - b -) were not found. The Yta and Ytb antigens are inherited as dominant traits.

Blood groups of the Xg system

All group isoantigens discussed so far do not depend on sex. They occur with equal frequency in both men and women. However, J. Mann et al. in 1962, it was established that there are group antigens, the hereditary transmission of which occurs through the sex chromosome X. The newly discovered antigen in human erythrocytes was designated Xg. Antibodies to this antigen were found in a patient with familial telangiectasia. On the occasion of profuse nosebleeds, this patient received multiple blood transfusions, which apparently was the reason for his isoimmunization. Depending on the presence or absence of the Xg antigen in the erythrocytes, all people can be divided into two groups: Xg (a +) and Xg (a-). In men, the Xg(a+) antigen occurs in 62.9% of cases, and in women - in 89.4%. It was found that if both parents belong to the Xg (a-) group, then their children - both boys and girls - do not contain this antigen. If the father is in the Xg(a+) group and the mother is in the Xg(a-) group, all boys are in the Xg(a-) group, since in these cases only spermatozoa with the Y chromosome, which determines the male sex of the child, enter the egg. The Xg antigen is a dominant trait; it is well developed in newborns. Thanks to the use of the Xg group antigen, it became possible to resolve the issue of the origin of some sex-related diseases (defects in the formation of certain enzymes, diseases with Klinefelter, Turner syndromes, etc.).

Rare blood groups

Along with the widespread antigens, quite rare antigens are also described. For example, Bua antigen is found by Anderson (C. Anderson) et al. in 1963, in 1 out of 1000 examined, and the antigen Bx - Jenkins (W. Jenkins) et al. in 1961 in 1 out of 3000 examined. Antigens that are even more rare in human erythrocytes have also been described.

Method for determining blood groups

The method for determining blood groups is the detection of group antigens in erythrocytes using standard sera, and for groups of the AB0 system, also the detection of agglutinins in the serum of the test blood using standard erythrocytes.

To determine any one group antigen, sera of the same specificity are used. The simultaneous use of sera of different specificity of the same system makes it possible to determine the complete group belonging of erythrocytes according to this system. For example, in the Kell system, the use of only anti-K serum or only anti-k makes it possible to establish whether the studied erythrocytes contain factor K or K. The use of both of these sera allows us to decide whether the studied erythrocytes belong to one of the three groups of this system: KK , kk, kk.

Standard sera for G.'s determination to. are prepared from the blood of people containing antibodies - normal (AB0 systems) or isoimmune (Rh, Kell, Duffy, Kidd, Lutheran systems, S and s antigens). To determine the group antigens M, N, P and Le, heteroimmune sera are most often obtained.

The determination technique depends on the nature of the antibodies contained in the serum, which are complete (normal sera of the AB0 system and heteroimmune) or incomplete (the vast majority of isoimmune) and show their activity in different media and at different temperatures, which determines the need to use different reaction techniques. The method of use of each serum is indicated in the accompanying instructions. The end result of the reaction using any technique is revealed in the form of the presence or absence of erythrocyte agglutination. When determining any antigen, positive and negative controls are necessarily included in the reaction.

Determination of blood groups of the AB0 system

Necessary reagents: a) standard sera of groups 0αβ (I), Aβ (II), Bα(III), containing active agglutinins, and group AB (IV) - control; b) standard erythrocytes of groups A (II) and B (III), which have well-defined agglutinable properties, and group 0 (1) - control.

G.'s definition to. of the AB0 system is made by reaction of agglutination at the room temperature on porcelain or any other white plate with the wettable surface.

There are two ways to determine the G. to. system AB0. 1. With the help of standard sera, which make it possible to determine which group agglutinogens (A or B) are in the erythrocytes of the blood under study, and on the basis of this, make a conclusion about its group affiliation. 2. Simultaneously with the help of standard sera and erythrocytes - cross method. This also determines the presence or absence of group agglutinogens and, in addition, establishes the presence or absence of group agglutinins (a, 3), which ultimately gives a complete group characteristic of the blood under study.

At G.'s definition to. system AB0 at patients and other persons, the Crimea is supposed to make blood transfusion, the first method is enough. In special cases, for example, when it is difficult to interpret the result, as well as when determining the blood group AB0 in donors, the second method is used.

When determining G. to. and the first and second methods, it is necessary to apply two samples (two different series) of standard serum of each group, which is one of the measures that prevent errors.

In the first method, blood can be taken from a finger, earlobe or heel (in infants) immediately before the determination. In the second (cross) method, blood is taken first from a finger or a vein into a test tube and examined after clotting, that is, after separation into serum and red blood cells.

Rice. 1. Determination of the blood group using standard sera. On the plate at the pre-written designations 0αβ (I), Aβ (II) and Bα (III), 0.1 ml of standard serum of each sample is dropped. Small drops of blood applied nearby are thoroughly mixed with the serum. After that, the plates are shaken and the presence of agglutination (positive reaction) or its absence (negative reaction) is observed. In cases where agglutination has occurred in all drops, a control study is made by mixing the test blood with serum of group AB (IV), which does not contain agglutinins and should not cause erythrocyte agglutination.

The first way (tsvetn. Fig. 1). 0.1 ml (one large drop) of standard serum of each sample is applied to the plate at pre-written notation so that two rows of drops are formed in the following horizontal order from left to right: 0αβ (I), Aβ (II) and Bα (III ).

The test blood is applied with a pipette or the end of a glass rod to a small (approximately 10 times smaller) drop next to each drop of serum.

The blood is thoroughly mixed with the serum with a dry glass (or plastic) rod, after which the plate is periodically shaken, while observing the result, which is expressed in the presence of agglutination (positive reaction) or its absence (negative reaction) in each drop. Observation time 5 min. To eliminate the non-specificity of the result as agglutination occurs, but not earlier than after 3 minutes, add one drop of isotonic sodium chloride solution to each drop, in which agglutination has occurred, and continue observations by shaking the plate for 5 minutes. In cases where agglutination has occurred in all drops, a control study is also done, mixing the test blood with the serum of group AB (IV), which does not contain agglutinins and should not cause erythrocyte agglutination.

Interpretation of the result. 1. If agglutination did not occur in any of the drops, this means that the test blood does not contain group agglutinogens, that is, it belongs to the O (I) group. 2. If the serum of group 0ap (I) and B a (III) caused erythrocyte agglutination, and the serum of group Ap (II) gave a negative result, this means that the test blood contains agglutinogen A, i.e. belongs to group A (II ). 3. If the serum of the 0αβ (I) and Aβ (II) groups caused erythrocyte agglutination, and the serum of the Bα (III) group gave a negative result, this means that the test blood contains agglutinogen B, i.e. belongs to group B (III) . 4. If the serum of all three groups caused agglutination of erythrocytes, but in the control drop with serum of the AB0 (IV) group the reaction is negative, this means that the test blood contains both agglutinogens - A and B, i.e. belongs to the AB (IV) group .

The second (cross) method (tsvetn. Fig. 2). Two rows of standard sera of the 0αβ (I), Aβ (II), Bα (III) group are applied to the plate at the pre-inscribed designations, as well as in the first method, and next to each drop, the blood under study (erythrocytes). In addition, one large drop of serum of the test blood is applied to the lower part of the plate at three points, and next to them - one small (approximately 40 times smaller) drop of standard erythrocytes in the following order from left to right: group 0 (I), A (II) and B(III). Group 0(I) erythrocytes are controls as they should not be agglutinated by any serum.

In all drops, the serum is thoroughly mixed with erythrocytes and then the result is observed by rocking the plate for 5 minutes.

Interpretation of the result. In the cross method, the result is first evaluated, which was obtained in drops with standard serum (top two rows), just as is done with the first method. Then the result obtained in the bottom row is evaluated, i.e., in those drops in which the test serum is mixed with standard erythrocytes, and, therefore, antibodies are determined in it. 1. If the reaction with standard sera indicates that the blood belongs to group 0 (I), and the serum of the test blood agglutinates erythrocytes of groups A (II) and B (III) with a negative reaction with erythrocytes of group 0 (I), this indicates the presence in of the studied blood of agglutinins a and 3, i.e., confirms its belonging to the 0αβ (I) group. 2. If the reaction with standard sera indicates that the blood belongs to group A (II), the serum of the test blood agglutinates erythrocytes of group B (III) with a negative reaction with erythrocytes of group 0 (I) and A (II); this indicates the presence of agglutinin 3 in the studied blood, i.e., confirms that it belongs to the A 3 (1D) group. 3. If the reaction with standard sera indicates that the blood belongs to group B (III), and the serum of the test blood agglutinates erythrocytes of group A (II) with a negative reaction with erythrocytes of group 0 (I) and B (III), this indicates the presence of of the studied blood of agglutinin a, i.e., confirms its belonging to the Bα (III) group. 4. If the reaction with standard sera indicates that the blood belongs to the AB (IV) group, and the serum gives a negative result with standard erythrocytes of all three groups, this indicates the absence of group agglutinins in the test blood, i.e. confirms that it belongs to the AB0 group (IV).

Determination of blood groups of the MNSs system

The determination of antigens M and N is carried out with heteroimmune sera, as well as blood groups of the AB0 system, i.e. on a white plate at room temperature. To study the other two antigens of this system (S and s), isoimmune sera are used, which give the clearest result in the indirect Coombs test (see Coombs reaction). Sometimes anti-S sera contain complete antibodies, in these cases the study is recommended to be carried out in a saline medium, similar to the determination of the Rh factor. Comparison of the results of determining all four factors of the MNSs system makes it possible to establish the belonging of the studied erythrocytes to one of the 9 groups of this system: MNSS, MNSs, MNss, MMSS, MMSs, MMss, NNSS, NNSs, NNss.

Determination of blood groups of Kell, Duffy, Kidd, Lutheran systems

The determination of these blood groups is performed by an indirect Coombs test. Sometimes the high activity of antisera allows the use of a conglutination reaction using gelatin for this purpose, similar to the determination of the Rh factor (see Conglutination).

Determination of blood groups of systems P and Lewis

Factors of the P and Lewis systems are determined in a saline medium in test tubes or on a plane, and for a clearer detection of antigens of the Lewis system, pre-treatment of the investigated erythrocytes with a proteolytic enzyme (papain, trypsin, proteinin) is used.

Definition of the Rh factor

The determination of the Rh factor, which, along with the groups of the AB0 system, is most important for wedges, medicine, is performed in various ways depending on the nature of the antibodies in the standard serum (see Rh factor).

Leukocyte groups

Leukocyte groups - the division of people into groups due to the presence of antigens in leukocytes that are independent of the antigens of the AB0, Rh, etc. system.

Human leukocytes have a complex antigenic structure. They contain antigens of the AB0 and MN system, unambiguous with those found in the erythrocytes of the same individual. This position is based on the pronounced ability of leukocytes to induce the formation of antibodies of the appropriate specificity, to agglutinate with group isohemagglutinating sera with a high antibody titer, and also to specifically adsorb anti-M and anti-N immune antibodies. The factors of the Rh system and other erythrocyte antigens are less pronounced in leukocytes.

In addition to the indicated antigenic differentiation of leukocytes, special leukocyte groups have been identified.

For the first time, information about leukocyte groups was received by the French. researcher J. Dosse (1954). By means of the immune serum received from persons, the Crimea made repeated repeated blood transfusions, and containing antileukocytic antibodies of agglutinating character (leukoagglutinating antibodies), the antigen of leukocytes which is found at 50% of the Central European population was revealed. This antigen has entered the literature under the name "Poppy". In 1959, Rud (J. Rood) et al, supplemented the idea of ​​leukocyte antigens. Based on the analysis of the results of a study of 60 immune sera with leukocytes from 100 donors, the authors concluded that there are other leukocyte antigens, designated 2,3, as well as 4a, 4b; 5a, 5b; 6a, 6b. In 1964, R. Payne et al. established the LA1 and LA2 antigens.

There are more than 40 leukocyte antigens, which can be assigned to one of three conditionally distinguished categories: 1) antigens of the main locus, or common leukocyte antigens; 2) antigens of granulocytes; 3) antigens of lymphocytes.

The most extensive group is represented by antigens of the main locus (HLA system). They are common to polymorphonuclear leukocytes, lymphocytes, and platelets. According to WHO recommendations, the alphanumeric designation HLA (Human Leucocyte Antigen) is used for antigens, the existence of which has been confirmed in a number of laboratories in parallel studies. With regard to recently discovered antigens, the existence of which needs further confirmation, use the designation with the letter w, which is inserted between the letter designation of the locus and the digital designation of the allele.

The HLA system is the most complex of all known antigen systems. Genetically, H LA antigens belong to four subloci (A, B, C, D), each of which combines allelic antigens (see Immunogenetics). The most studied are subloci A and B.

The first sublocus includes: HLA-A1, HLA-A2, HLA-A3, HLA-A9, HLA-A10, HLA-A11, HLA-A28, HLA-A29; HLA-Aw23, HLA-Aw24, HLA-Aw25, HLA-Aw26, HLA-Aw30„ HLA-Aw31, HLA-Aw32, HLA-Aw33, HLA-Aw34, HLA-Aw36, HLA-Aw43a.

Antigens belong to the second sublocus: HLA-B5, HLA-B7, HLA-B8, HLA-B12, HLA-B13, HLA-B14, HLA-B18, HLA-B27; HLA-Bw15, HLA-Bw16, HLA-Bw17, HLA-Bw21, HLA-Bw22, HLA-Bw35, HLA-Bw37, HLA-Bw38, HLA-Bw39, HLA-Bw40, HLA-Bw41, HLA-Bw42a.

The third sublocus includes antigens HLA-Cw1, HLA-Cw2, HLA-Cw3, HLA-Cw4, HLA-Cw5.

The fourth sublocus includes antigens HLA-Dw1, HLA-Dw2, HLA-Dw3, HLA-Dw4, HLA-Dw5, HLA-Dw6. The last two sublocuses are not well understood.

Apparently, not all HLA antigens of even the first two sublocuses (A and B) are known, because the sum of gene frequencies for each sublocus has not yet approached unity.

The division of the HLA system into subloci represents a major advance in the study of the genetics of these antigens. The HLA antigen system is controlled by genes located on the C6 chromosome, one per sublocus. Each gene controls the synthesis of one antigen. Having a diploid set of chromosomes (see Chromosome set), theoretically, each individual should have 8 antigens, practically with tissue typing, four HLA antigens of two subloci - A and B are still determined. Phenotypically, several combinations of HLA antigens can occur. The first variant includes cases when allelic antigens are ambiguous within the first and second sub loci. The person is heterozygous for antigens of both subloci. Phenotypically, four antigens are found in it - two antigens of the first sublocus and two antigens of the second sublocus.

The second option represents a situation where a person is homozygous for the antigens of the first or second sublocus. Such a person contains the same antigens of the first or second sublocus. Phenotypically, only three antigens are found in it: one antigen of the first sublocus and two antigens of the second sublocus, or, conversely, one antigen of the second sublocus and two antigens of the first.

The third option covers the case when a person is homozygous for both subloci. In this case, only two antigens are determined phenotypically, one for each sublocus.

The most frequent - the first variant of a genotype (see). Less common in the population is the second variant of the genotype. The third variant of the genotype is extremely rare.

The division of HLA antigens into subloci makes it possible to predict the possible inheritance of these antigens from parents to children.

The genotype of H LA antigens of children is determined by ran lotip, i.e. linked antigens controlled by genes located on the same chromosome, to-ruyu they receive from each of the parents. Therefore, half of the HLA antigens in a child is always the same with each of the parents.

Given the above, it is easy to imagine four possible variants of the inheritance of leukocyte antigens of the HLA subloci A and B. Theoretically, the coincidence of HLA antigens among brothers and sisters in the family is 25%.

An important indicator that characterizes each antigen of the HLA system is not only its location on the chromosome, but also the frequency of its occurrence in the population, or population distribution, which has racial characteristics. The frequency of occurrence of an antigen is determined by the gene frequency, which represents a part of the total number of individuals studied, expressed in fractions of a unit, with which each antigen occurs. The gene frequency of the HLA-system antigens is a constant value for a certain ethnic group of the population. According to J. Dosse et al., the gene frequency for the French. population is: HLA-A1-0.141, HLA-A2-0.256, HLA-A3-0.131, HLA-A9-0.247, HLA-B5-0.143, HLA-B7-0.224, HLA-B8-0.156. Similar indicators of gene frequencies of H LA antigens were established by Yu. M. Zaretskaya and V. S. Fedrunova (1971) for the Russian population. With the help of family studies of various population groups of the globe, it was possible to establish a difference in the frequency of occurring haplotypes. Features in the frequency of HLA haplotypes are explained by the difference in the population distribution of antigens of this system in different races.

Of great importance for practical and theoretical medicine is the determination of the number of possible HLA haplotypes and phenotypes in a mixed human population. The number of possible haplotypes depends on the number of antigens in each sublocus and is equal to their product: the number of antigens of the first sublocus (A) X the number of antigens of the second sublocus (B) = the number of haplotypes, or 19 X 20 = 380.

Calculations indicate that among approximately 400 people. it is possible to detect only two people who have similarity for two HLA antigens of subloci A and B.

The number of possible combinations of antigens that determine the phenotype is calculated separately for each sublocus. The calculation is carried out according to the formula for determining the number of combinations of two (for heterozygous individuals) and one (for homozygous individuals) in the sublocus [Mentzel and Richter (G. Menzel, K. Richter), n (n + 1) / 2, where n - the number of antigens in the sublocus.

For the first sublocus, the number of antigens is 19, for the second - 20.

The number of possible combinations of antigens in the first sublocus is 190; in the second - 210. The number of possible phenotypes for the antigens of the first and second sublocus is 190 X 210 = = 39900. That is, in about 40,000 approximately only in one case can one meet two unrelated people with the same phenotype for H LA antigens of the first and second subloci. The number of HLA phenotypes will increase significantly when the number of antigens in sublocus C and sublocus D is known.

HLA antigens are a universal system. They are found, in addition to leukocytes and platelets, also in the cells of various organs and tissues (skin, liver, kidneys, spleen, muscles, etc.).

Identification of the majority of antigens of the HLA system (loci A, B, C) is performed using serol, reactions: lymphocytotoxic tests, RSK against lymphocytes or platelets (see Complement fixation reaction). Immune sera, predominantly of a lymphocytotoxic nature, are obtained from individuals sensitized during multiple pregnancies, allogeneic tissue transplantation, or by artificial immunization as a result of repeated injections of leukocytes with a known HLA phenotype. Identification of H LA antigens of the D locus is performed using a mixed culture of lymphocytes.

The HLA system is of great importance in clinical practice, medicine, and especially in allogeneic tissue transplantation, since the mismatch of the donor and recipient for these antigens is accompanied by the development of a tissue incompatibility reaction (see Immunological incompatibility). In this regard, it seems quite justified to perform tissue typing when selecting a donor with a similar HLA phenotype for transplantation.

In addition, the difference between mother and fetus in terms of antigens of the HLA system during repeated pregnancies causes the formation of antileukocyte antibodies, which can lead to miscarriage or fetal death.

HLA antigens are also important in blood transfusion, in particular leukocytes and platelets.

Another system of leukocyte antigens independent of HLA are granulocyte antigens. This system of antigens is tissue specific. It is characteristic of myeloid cells. Granulocyte antigens are found in polymorphonuclear leukocytes, as well as in bone marrow cells; they are absent in erythrocytes, lymphocytes and platelets.

Three granulocyte antigens are known: NA-1, NA-2, NB-1.

Identification of the system of granulocytic antigens is carried out using isoimmune agglutinating sera, which can be obtained from re-pregnant women or individuals who have undergone multiple blood transfusions.

It has been established that antibodies against granulocyte antigens are important during pregnancy, causing short-term neutropenia in newborns. Granulocyte antigens also play an important role in the development of non-hemolytic transfusion reactions.

The third category of leukocyte antigens are lymphocytic antigens, which are unique to lymphoid tissue cells. One antigen from this category is known, designated LyD1. It occurs in humans with a frequency of approx. 36%. Identification of the antigen is carried out using RSK with immune sera obtained from sensitized individuals who have undergone multiple blood transfusions or have had repeated pregnancies. The significance of this category of antigens in transfusiology and transplantology remains poorly understood.

Whey Protein Groups

Serum proteins have group differentiation. The group properties of many blood serum proteins have been discovered. The study of a group of whey proteins is widely used in forensic medicine, anthropology, and, according to many researchers, is important for blood transfusion. Groups of serumal proteins are independent of serol, systems of erythrocytes and leukocytes, they are not connected with a floor, age and are inherited that allows to use them in court. - medical. practice.

Groups of the following serum proteins are known: albumin, postalbumin, alpha1-globulin (alpha1-antitrypsin), alpha2-globulin, beta1-globulin, lipoprotein, immunoglobulin. Most groups of whey proteins are detected by electrophoresis in hydrolyzed starch, polyacrylamide gel, agar or cellulose acetate, the alpha2-globulin (Gc) group is determined by immunoelectrophoresis (see), lipoproteins - by precipitation in agar; the group specificity of proteins related to immunoglobulins is determined by immunol, by the method - the agglutination delay reaction using an auxiliary system: Rh-positive erythrocytes sensitized with anti-Rhesus sera with incomplete antibodies containing one or another group antigen of the Gm system.

Immunoglobulins. Among the groups of whey proteins, the genetic heterogeneity of immunoglobulins (see) associated with the existence of inherited variants of these proteins, the so-called, is of the greatest importance. allotypes that differ in antigenic properties. It is most important in the practice of blood transfusion, forensic medicine, etc.

There are two main systems of allotypic variants of immunoglobulins: Gm and Inv. The characteristic features of the antigenic structure of IgG are determined by the Gm system (antigenic determinants localized in the C-terminal half of the heavy gamma chains). The second system of immunoglobulins, Inv, is due to antigenic determinants of light chains and therefore characterizes all classes of immunoglobulins. Antigens of the Gm system and the Inv system are determined by the agglutination delay method.

The Gm system has more than 20 antigens (allotypes), which are designated by numbers - Gm (1), Gm (2), etc., or by letters - Gm (a), Gm (x), etc. The Inv system has three antigen - Inv(1), Inv(2), Inv(3).

The absence of an antigen is indicated by a "-" sign [eg, Gm(1, 2-, 4)].

Antigens of immunoglobulin systems in people of different nationalities occur with unequal frequency. Among the Russian population, the Gm(1) antigen occurs in 39.72% of cases (M. A. Umnova et al., 1963). In many nationalities inhabiting Africa, this antigen is contained in 100% of cases.

The study of allotypic variants of immunoglobulins is important for clinical practice, genetics, anthropology, and is widely used to decipher the structure of immunoglobulins. In cases of an agammaglobulinemia (see), as a rule, antigens of the Gm system do not open.

In pathology accompanied by deep protein shifts in the blood, there are such combinations of antigens of the Gm system that are absent in healthy individuals. Some patol, changes in blood proteins can, as it were, mask the antigens of the Gm system.

Albumins (Al). Albumin polymorphism in adults is extremely rare. A double band of albumins was noted - albumins with greater mobility during electrophoresis (AlF) and slower mobility (Als). See also albumins.

Postalbumins (Ra). There are three groups: Ra 1-1, Ra 2-1 and Ra 2-2.

alpha1-globulins. In the area of ​​alpha1-globulins, there is a large polymorphism of alpha1-antitrypsin (alpha1-AT-globulin), which received the designation of the Pi system (protease inhibitor). 17 phenotypes of this system have been identified: PiF, PiJ, PiM, Pip, Pis, Piv, Piw, Pix, Piz, etc.

Under certain conditions of electrophoresis, alpha1-globulins have a high electrophoretic mobility and are located in front of albumins on the electrophoregram; therefore, some authors call them prealbumins.

alphag-antitrypsin belongs to glycoproteins. It inhibits the activity of trypsin and other proteolytic enzymes. Fiziol, the role of alpha1-antitrypsin has not been established, however, an increase in its level is noted in some fiziol, conditions and patol, processes, for example, during pregnancy, after taking contraceptives, with inflammation. A low concentration of alpha1 antitrypsin has been associated with the Piz and Pis allele. Note the relationship of insufficiency of alpha1-antitrypsin with hron, obstructive pulmonary diseases. These diseases are more likely to affect people who are homozygous for the Pi2 allele or heterozygous for the Pi2 and Pis alleles.

Alpha1-antitrypsin deficiency is also associated with a special form of pulmonary emphysema, which is inherited.

α2-Globulins. In this area, polymorphisms of haptoglobin, ceruloplasmin, and a group-specific component are distinguished.

Haptoglobin (Hp) has the ability to actively combine with hemoglobin dissolved in serum and form the Hb-Hp complex. It is believed that the molecule of the latter, due to its large size, does not pass through the kidneys and, thus, haptoglobin retains hemoglobin in the body. Its main fiziol, function is seen in it (see Gaptoglobin). It is assumed that the enzyme hemalfamethyloxygenase, which cleaves the protoporphyrin ring at the α-methylene bridge, acts mainly not on hemoglobin, but on the Hb-Hp complex, i.e., the usual exchange of hemoglobin includes its combination with Hp.

Rice. 1. Groups of haptoglobin (Нр) and electropherograms characterizing them: each of the haptoglobin groups has a specific electropherogram, which differs in location, intensity and number of bands; on the right, the corresponding groups of haptoglobin are indicated; the minus sign denotes the cathode, the plus sign denotes the anode; the arrow at the word "start" indicates the place of introduction of the test serum into the starch gel (to determine its haptoglobin group).

Rice. 3. Schemes of immunoelectrophoregrams of transferrin groups in their study in starch gel: each of the transferrin groups (black stripes) is characterized by a different location on the immunoelectrophoregram; the letters above (below) the stripes indicate the different groups of transferrin (Tf); dashed bars correspond to the location of albumin and haptoglobin (Hp).

In 1955, O. Smithies established three main groups of haptoglobins, which, depending on the electrophoretic mobility, are designated Hp 1-1, Hp 2-1 and Hp 2-2 (Fig. 1). In addition to these groups, other varieties of haptoglobin are rarely found: Hp2-1 (mod), HpCa, Hp Johnson-type, Hp Johnson Mod 1, Hp Johnson Mod 2, type F, type D, etc. Rarely, haptoglobin is absent in humans - agaptoglobinemia ( Nr 0-0).

Groups of haptoglobin occur with varying frequency in individuals of different races and nationalities. For example, in the Russian population, the Hp 2-1-49.5% group is most common, the Hp 2-2-28.6% group and the Hp 1-1-21.9% group are less common. In India, on the contrary, the Hp 2-2-81.7% group is most common, and the Hp 1-1 group is only 1.8%. The population of Liberia more often has the Hp 1-1-53.3% group and rarely the Hp 2-2-8.9% group. In the population of Europe, the Hp 1-1 group occurs in 10-20% of cases, the Hp 2-1 group in 38-58%, and the Hp 2-2 group in 28-45%.

Ceruloplasmin (Cp). Described in 1961 by J. Owen and R. Smith. There are 4 groups: SrA, SrAV, SrV and SrVS. The most common group is SV. In Europeans, this group is found in 99%, and in Negroids - in 94%. The CRA group in Negroids occurs in 5.3%, and in Europeans - in 0.006% of cases.

The group-specific component (Gc) was described in 1959 by J. Hirschfeld. With the help of immunoelectrophoresis, three main groups are distinguished - Gc 1-1, Gc 2-1 and Gc 2-2 (Fig. 2). Other groups are very rare: Gc 1-X, Gcx-x, GcAb, Gcchi, Gc 1-Z, Gc 2-Z, etc.

Gc groups are found with unequal frequency among different peoples. Thus, among residents of Moscow, the type Gc 1-1 is 50.6%, Gc 2-1-39.5%, Gc 2-2-9.8%. There are populations among which the type Gc 2-2 does not occur. In Nigerian residents, in 82.7% of cases, the Gc 1-1 type occurs, and in 16.7%, the Gc 2-1 type, and in 0.6%, the Gc 2-2 type. The Indians (Novaio) are almost all (95.92%) of the Gc 1-1 type. In most European peoples, the frequency of the Gc 1-1 type ranges from 43.6-55.7%, Gc 2-1-within 37.2-45.4%, Gc 2-2-within 7.1-10 .98%.

Globulins. These include transferrin, posttransferrin and the 3rd complement component (β1c-globulin). Many authors believe that posttransferrin and the third component of human complement are identical.

Transferrin (Tf) readily combines with iron. This connection breaks down easily. The specified property of a transferrin provides performance by it important fiziol, functions - transfer of iron of plasma to the deionized form and its delivery to bone marrow where it is used at a hemopoiesis.

Transferrin has numerous groups: TfC, TfD, TfD1, TfD0, TfDchi, TfB0, TfB1, TfB2, etc. (Fig. 3). Tf is present in almost all people. Other groups are rare and unevenly distributed among different peoples.

Posttransferrin (Pt). Its polymorphism was described in 1969 by Rose and Geserik (M. Rose, G. Geserik). The following groups of posttransferrins are distinguished: A, AB, B, BC, C, AC. He has. of the population, posttransferrin groups occur with the following frequency: A -5.31%, AB - 31.41%, B-60.62%, BC-0.9%, C - 0%, AC-1.72%.

The third complement component (C "3). 7 C" 3 groups have been described. They are indicated either by numbers (C "3 1-2, C" 3 1-4, C "3 1-3, C" 3 1 -1, C "3 2-2, etc.), or by letters (C" 3 S-S, C "3 F-S, C" 3 F-F, etc.). In this case, 1 corresponds to the letter F, 2-S, 3-So, 4-S.

Lipoproteins. Three group systems are distinguished, designated Ag, Lp and Ld.

Antigens Ag(a), Ag(x), Ag(b), Ag(y), Ag(z), Ag(t), and Ag(a1) were found in the Ag system. The Lp system includes antigens Lp(a) and Lp(x). These antigens occur with varying frequency in individuals of different nationalities. The frequency of the factor Ag (a) in Americans (whites) - 54%, Polynesians - 100%, Micronesians - 95%, Vietnamese - 71%, Poles - 59.9%, Germans - 65%.

Various combinations of antigens are also found with unequal frequency in people of different nationalities. For example, the group Ag (x - y +) in the Swedes occurs in 64.2%, and in the Japanese in 7.5%, the group Ag (x + y-) in the Swedes is found in 35.8%, and in the Japanese - in 53.9%.

Blood groups in forensic medicine

G.'s research to. is widely used in forensic medicine when resolving issues of controversial paternity, motherhood (see Maternity is controversial, Paternity is controversial), as well as in the study of blood for material evidence (see). The group affiliation of erythrocytes, group antigens of serum systems and group properties of blood enzymes are determined.

The group affiliation of the child's blood is compared with the blood group of the intended parents. At the same time, fresh blood obtained from these individuals is examined. A child can only have those group antigens that at least one parent has, and this applies to any group system. For example, the mother's blood type is A, the father's is A, and the child's is AB. A child with such G. to. could not be born from this couple, because in this child one of the parents must have antigen B in the blood.

For the same purposes, antigens of the MNSs, P, etc. system are examined. For example, when examining antigens of the R h system, a child’s blood cannot contain antigens Rho (D), rh "(C), rh" (E), hr "(e) and hr"(e) if this antigen is not in the blood of at least one of the parents. The same applies to the antigens of the Duffy system (Fya-Fyb), the Kell system (K-k). The more group systems of erythrocytes are examined when dealing with issues of child replacement, disputed paternity, etc., the greater the likelihood of a positive result. The presence in the blood of a child of a group antigen that is absent in the blood of both parents in at least one group system is an undoubted sign that makes it possible to exclude alleged paternity (or motherhood).

These issues are also resolved when the determination of group antigens of plasma proteins - Gm, Hp, Gc, etc., is included in the examination.

In solving these problems, they begin to use the determination of group characteristics of leukocytes, as well as group differentiation of blood enzyme systems.

To resolve the issue of the possibility of the origin of blood on material evidence from a particular person, the group properties of erythrocytes, serum systems and group differences in enzymes are also determined. When examining blood stains, the antigens of the following isosero l are often determined. systems: AB0, MN, P, Le, Rh. For G.'s definition to. in spots resort to special methods of a research.

Agglutinogens isosero l. systems can be detected in blood stains by applying appropriate sera by various methods. In forensic medicine, the most commonly used for these purposes are absorption reactions in quantitative modification, absorption-elution and mixed agglutination.

The absorption method lies in the fact that the titer of the sera introduced into the reaction is preliminarily determined. The sera are then brought into contact with material taken from the blood spot. After a certain time, the serum is sucked off from the blood stain and titrated again. By reducing the titer of one or another applied serum, the presence of the corresponding antigen in the blood stain is judged. For example, a blood stain significantly lowered the serum titer of anti-B and anti-P, therefore, there are B and P antigens in the test blood.

Absorption-elution and mixed agglutination reactions are used to detect blood group antigens, especially in cases where there are traces of small blood on evidence. Before setting up the reaction, one or more threads of material are taken from the spot under study, and they work with them. When detecting antigens of a number of isosero l. systems, blood on strings is fixed with methyl alcohol. For the detection of antigens, some fixation systems are not required: it can lead to a decrease in the absorption properties of the antigen. The threads are placed in the appropriate serum. If there is a group antigen on the thread in the blood that corresponds to serum antibodies, then these antibodies will be absorbed by this antigen. Then the antibodies remaining free are removed by washing the material. In the elution phase (the reverse process of absorption), the strands are placed in a suspension of red blood cells corresponding to the applied serum. For example, if serum a was used in the absorption phase, then group A erythrocytes are added, if anti-Lea serum was used, then, respectively, erythrocytes containing Le(a) antigen, etc. Then, thermal elution is performed at t ° 56 ° . At this temperature, antibodies are released into the environment, because their connection with blood antigens is disrupted. These antibodies at room temperature cause agglutination of the added erythrocytes, which is taken into account by microscopy. If there are no antigens corresponding to the applied sera in the test material, then antibodies are not absorbed in the absorption phase and are removed when the material is washed. In this case, no free antibodies are formed in the elution phase and the added erythrocytes are not agglutinated. That. it is possible to establish the presence in the blood of one or another group antigen.

The absorption-elution reaction can be performed in various modifications. Eg, elution can be made in fiziol, solution. The elution phase can be performed on glass slides or in test tubes.

The mixed agglutination method in the initial phases is performed as well as the absorption-elution method. The only difference is the last phase. Instead of the elution phase, in the mixed agglutination method, the threads are placed on a glass slide in a drop of erythrocyte suspension (erythrocytes must have an antigen corresponding to the serum used in the absorption phase) and after a certain time the preparation is observed microscopically. If the test object contains an antigen corresponding to the applied serum, then this antigen absorbs the antibodies of the serum, and in the last phase, the added erythrocytes will “stick” to the string in the form of nails or beads, since they will be retained by the free valencies of the antibodies of the absorbed serum. If there is no antigen corresponding to the applied serum in the test blood, then absorption will not occur, and all serum will be removed during washing. In this case, the above picture is not observed in the last phase, but free distribution of erythrocytes in the preparation is noted. The method of the mixed agglutination is approved by hl. arr. with respect to the AB0 system.

In the study of the AB0 system, in addition to antigens, agglutinins are also examined by the cover glass method. Pieces cut from the studied blood spot are placed on glass slides, and a suspension of standard erythrocytes of blood groups A, B and 0 is added to them. The preparations are covered with cover slips. If there are agglutinins in the spot, then when they dissolve, they cause agglutination of the corresponding erythrocytes. For example, if there is agglutinin a in the spot, agglutination of erythrocytes A is observed, etc.

For control, the material taken from the material evidence outside the area stained with blood is examined in parallel.

During the examination, the blood of the persons involved in the case is first examined. Then their group characteristic is compared with the group characteristic of the blood available on the physical evidence. If the blood of a person differs in its group characteristics from the blood on the material evidence, then in this case the expert may categorically reject the possibility that the blood on the material evidence originated from this person. If the group characteristics of the blood of a person and on material evidence coincide, the expert does not give a categorical conclusion, since in this case he cannot reject the possibility of the origin of blood on material evidence and from another person, the blood of which contains the same antigens.

Bibliography: Boyd W. Fundamentals of immunology, trans. from English, M., 1969; Zotikov E. A., Manishkina R. P. and Kandelaki M. G. Antigen of new specificity in granulocytes, Dokl. USSR Academy of Sciences, ser. biol., t. 197, no. 4, p. 948, 1971, bibliogr.; Kosyakov P. N. Iso-antigens and human isoantibodies in normal and pathological conditions, M., 1974, bibliogr.; Guidelines for the use of blood and blood substitutes, ed. A. N. Filatova, p. 23, L., 1973, bibliogr.; Tumanov A. K, Fundamentals of forensic medical examination of material evidence, M., 1975, bibliogr.; Tumanov A. K. and T about m and l and V. V. N. Hereditary polymorphism of isoantigens and blood enzymes in normal and human pathology, M., 1969, bibliogr.; Umnova M. A. and Urinson R. M. About the varieties of the Rh factor and their distribution among the population of Moscow, Vopr, anthropopol., century. 4, p. 71, 1960, bibliography; Unified methods of clinical laboratory research, ed. V. V. Menshikov, c. 4, p. 127, M. 1972, bibliogr.; Blood group immunology and transfusion techniques, ed. by J. W. Lockyer, Oxford, 1975; Blood and tissue antigens, ed. by D. Aminoff, p. 17, 187, 265, N. Y.-L., 1970, bibliogr.; Boorm a n K.E. a. Dodd B.E. An introduction to blood group serology, L., 1970; Fagerhol M.K.a. BraendM. Serum prealbumin, polymorphism in man, Science, v. 149, p. 986, 1965; Giblett E. R. Genetic markers in human blood, Oxford-Edinburgh, 1969, bibliogr.; Histocompatibility testing, ed. by E. S. Cur-toni a. o., p. 149, Copenhagen, 1967, bibliogr.; Histocompatibility testing, ed. by P. I. Terasaki, p. 53, 319, Copenhagen, 1970, bibliogr.; Klein H. Serumgruppe Pa/Gc (Postalbumin - group specific components), Dtsch. Z. ges. gerichtl. Med., Bd 54, S. 16, 1963/1964; Landstei-n e r K. t)ber Agglutinationserscheinungen normalen menschlichen Blutes, Wien. klin. Wschr., S. 1132, 1901; Landsteiner K. a. Levine P. A new agglutinable factor differentiating individual human bloods, Proc. soc. exp. Biol. (N. Y.), v. 24, p. 600, 1927; Landsteiner K. a. Wiener A. S. Agglutinable factor in human blood recognized by immune sera for rhesus blood, ibid., v. 43, p. 223, 1940; M o rg a n W. T. J. Human blood-group specific substances, in Immunchemie, ed. by O. Westhphal, B. a. o., p. 73, 1965, bibliogr.; O w e n J. A. a. Smith H. Detection of ceruloplasmin after zone electrophoresis, Clin. chim. Acta, v. 6, p. 441, 1961; P a y n e R. a. o. A new leukocyte isoantigen system in man, Cold Spr. Harb. Symp. quant. Biol., v. 29, p. 285, 1964, bibliogr.; Procop O. u. Uhlen-b g u c k G. Lehrbuch der menschlichen Blut-und Serumgruppen, Lpz., 1966, Bibliogr.; R a c e R. R. a. S a n g e r R. Blood groups in man, Oxford-Edinburgh, 1968; S h u 1 m a n N. R. a. o. Complement fixing isoantibodies against antigens common to platelets and leukocytes, Trans. Ass. amer. Phycns, v. 75, p. 89, 1962; van der Weerdt Ch. M.a. Lalezari P. Another Example of isoimmune neonatal neutropenia due to anti-Nal, Vox Sang., v. 22, p. 438, 1972, bibliogr.

P. H. Kosyakov; E. A. Zotikov (leukocyte groups), A. K. Tumanov (court medical), M. A. Umnova (meth. research).