Pre-auditory self-work materials.
3.1.Basic knowledge, skills, experiences, necessary for study the topic:
| Subject | To know | To be able to |
| Biophysics | Data about erythrocytes agglutination | Tell about RBC agglutination and hemolysis mechanism |
| Medical Biology | Data about blood groups inheritance | Solve tasks on blood groups inheritance |
| Pathophysiology | Hemolytic disease developmental mechanisms | Tell about newborns hemolytic disease developmental mechanisms, ABO and Rh-conflict ways and results |
| Pediatry with Neonatology | Blood groups inheritance mechanisms | Tell about newborns hemolytic disease developmental mechanisms, ABO and Rh-conflict ways and results |
| Neurology with Medical Genetics | Data about blood groups inheritance | Solve tasks on blood groups inheritance |
| Obstetrics and Gynecology | Data about blood groups inheritance, newborns hemolytic disease developmental mechanisms, ABO and Rh-conflict ways and results, hemotransfusiology biological bases | Prevent and treat ABO and Rh-conflict as well as newborns hemolytic disease |
| Surgery | Hemotransfusiology biological bases | To perform hemotransfusions, blood preparations and components transfusions as well |
| Anesthesiology and Rheanimatology | Data about blood groups inheritance, hemotransfusiology biological bases | To perform hemotransfusions, blood preparations and components transfusions as well |
3.2. Topic content
Historical data
1666 – London anatomist and physiologist Richard Lower transfused blood from one dog to another one and proved that hemotransfusions are possible to be applied for replacing therapy.
1666 - sheep blood has been transfused to the human being with significant improvement in France. The results were good may be because of transfused blood little amount (French doctor Zhan Deni).
1667 – two English doctors King and Kox transfused blood from animals of one species to the animals of another species and proved that these manipulations are very dangerous.
But about 20 hemotransfusions have been realized in the XVII-th century from animals to the human beings. Not all of them were with positive results.
1819 – English obstetrician Blendel has performed the first hemotransfusion from one human being to another one. He made transfusion to the woman dying from hemorrhagy after labors. Blood has been taken from her husband. The transfusion result was successful. Then the doctor has performed 11 hemotransfusions else to the women under similar conditions.
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Obstetrician Wolf did the same in Russia.
There were about 600 hemotransfusions in the XIX-th century.
1848 – the first manuel on hemotransfusions. It was in Russia. Its name was “Tractate about blood transfusion as the only meaning how to save decreasing life having been compiled in historical, physiological and surgical aspects”. Its author was Alexei Philomafitsky.
Blood groups are determined by protein molecules present on the surface of red blood cells. When blood from two individuals is mixed, sometimes clumping (agglutination) occurs. This clumping is because of the immunological reactions. But, why clumping occurs in some cases and not in other cases remained a mystery until the discovery of blood groups by Karl Landsteiner in 1901. He was honored with Nobel Prize in 1930 for this discovery. The immunological reaction is the antigen- antibody reaction. Landsteiner found two antigens or agglutinogens in red blood cells and named them as A antigen and В antigen. He noticed the corresponding antibodies or agglutinins in the serum called a antibody or anti A and (3 antibody or anti B. However, in the body, a particular antigen and the corresponding antibody cannot be present together. If present, it causes clumping of the blood.
Karl Landsteiner, the American scientist of Austrian origin has told about 3 blood groups (ABO system) in 1901. But soon he has told about seldom forth blood group.
1907 (practically in the same time) – Czech scientist Yan Yansky has informed about blood group signs on the background of which one can solve the question about blood transfusion from one human being to another one. It is important to mention that the scientist did not know about discovery made by Karl Landsteiner.
1926 – Institute of hemotransfusions has been opened in Moscow.
1940 – K. Landshteiner and his follower A.Winer have found antigen in monkey-rhesus blood and called it Rhesus-factor.
The ABO blood types are not found in equal numbers. For instance, in whites in the USA the distribution is type O – 47%, type A – 41%, type B – 9%, and type AB – 3%. Among blacks in the United States the distribution is type O – 46%, type A – 27%, type B – 20% and type AB – 7%.
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ANTIGENICITY AND IMMUNE REACTIONS OF BLOOD
At least 30 commonly occurring antigens, each of which can at times cause antigen-antibody reactions, have been found in human blood cells, especially on the surfaces of cells membranes. In addition to these, more than 300 others of less potency or that occur in individual families rather than having widespread occurrence are known to exist. Among the 30 or more common antigens, certain ones are highly antigenic and regularly cause transfusion reactions if proper precautions are not taken, whereas others are of importance principally for studying the inheritance of genes and therefore for establishing parentage, race, and so forth. Essentially all these antigens are either glycolipids or glycoproteins.
Bloods are divided into different groups and types in accordance with the types of antigens present in the cells. Two particular groups of antigens are more likely than others to cause blood transfusion reactions. These are so-called O-A-B system of antigens and the Rh system.
ABO SYSTEM
Two related antigens – type A and B – occur on the surfaces of the RBC in a large proportion of the population. Because of the way these antigens are inherited, people may have neither of them on their cells, they may have one, or they may have both simultaneously.
Strong antibodies that react specifically with either the type A or type B antigen almost always occur in the plasmas of persons who do not have the antigens on their red blood cells. These antibodies bind with the red cell antigens to cause agglutination of the red cells. Therefore, the type A and type B antigens are called agglutinogens, and the plasma antibodies that cause the agglutination are called agglutinins.
When neither A nor B agglutinogen is present, the blood group is group O (I). When only type A agglutinogen is present, the blood is group A(II). When only type B agglutinogen is present, the blood is group B(III). And when both A and B agglutinogens are present, the blood is group AB(IV).
When type A agglutinogen is not present in a person's red blood cells, antibodies known as “anti-A” agglutinins develop in his plasma. Also, when type B agglutinogen is not present in the red blood cells, antibodies known as “anti-B” agglutinins develop in the plasma.
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