Introduction to Immunohematology

CLS 441

Prof. Dalia M. Mohsen

Pro. In Microbiology

Lecture:- 1

CONTENTS

Abbreviations
What is Immunoheamatology?
Historical Overview
Antigens and antibodies definition
Characteristics of blood group antibodies:
Classification of Blood Group Antibodies

Antigen and Antibody Reactions

Abbreviations
Ag Antigen
Ig - Immunologlobulin
Ab - Antibody
Hgb - Hemoglobin
AHG - Anti Human
globulin
IAT - Indirect
Antiglobulin Test
DAT- Direct
Antiglobulin Test
AIHA - Autoimmune
Hemolytic Anemia.

HDN - Hemolytic Disease of

New born
ATP - Adenosine
Triphosphate
CPD - Citrate phosphate
dextrose
EDTA - Ethyldiamine Tetra
Acetic acid
ACD - Acid Citrate
dextrose
MW - Molecular weight
Rh - Rhesus

What is Immunoheamatology?
Immunohematology is one of the specialized
branches of medical science.
It deals with the concepts and clinical techniques
related to modern transfusion therapy.
Merges aspects of hematology, immunology &
genetics.
Serologic, genetic, biochemical and molecular
study of antigens associated with membrane
structures on the cellular constituents of the
blood

Historical Overview
The era of blood transfusion.

began when William Harvey described the circulation of

blood in 1616.
Richard Lower, successfully performed the first animalto-animal blood transfusion.
In 1667, Jean Bapiste Denys, transfused blood from the
carotid artery of a lamb into the vein of a young man.
In 1818- James Blundell transfused human blood to
women suffering from hemorrhage at childbirth.
In 1900 Karl Landsteiner discovered the ABO blood
groups, which introduced the immunological era of blood
transfusion.

Antigens and antibodies

Antigens

Antigens: biological substance when introduce to

foreign circulation , it stimulate the immune
response to produce specific Antibody.
antigenmay also be formed inside the body
such as ABO antigen

Antibodies
Antibodies belong to protein called Immunoglobulin
produced by plasma cells react with Ag corresponding
specifically

Five major immunoglobulin (Ig) classes exist.

1.
2.
3.
4.
5.

IgG : with heavy chains gamma ().

IgA: with heavy chains alpha ()
IgM: with heavy chains mu ()
IgD: with heavy chains delta( )
IgE: with heavy chains epsilon()

Blood group antibodies are:

IgG, IgM and IgA.

Antibodies
It is a Y-shaped molecule made of 2 heavy chains & 2 light
chains.

Antibody

Antigen

Antibodies
Characteristics of blood group
antibodies:
IgG:

Is the predominant immunoglobulin in normal serum.

Accounting for about 85% of the total immunoglobulin
Is the only immunoglobulin to be transferred from mother
to fetus.
Is the smallest antibody which has a MW of 150,000
dalton
Is capable of binding complement.
Is predominantly produced during the secondary immune
response.

Antibodies
IgM:

Accounts for about 10% of the immunoglobulin pool.

Is the predominant antibody produced in a primary
immune response.
and has the largest MW of 900,000.
Because of its large size IgM cannot pass the
placental barrier to the fetus.
Is complement binding.

Antibodies
IgA:

Ig A with a MW of 160,000 constitutes 10

to 15 % of the total circulatory
immunoglobulin pool.
Is the predominant immunoglobulin in
secretions such as, tears, saliva,
colostrum, breast milk, and intestinal
secretions.

Antibodies
Type of Antibodies

Based on their development, blood group antibodies are

classified into Natural and Immune antibodies.

1. Natural antibodies:

Are red cell antibodies in the serum of an individual that are

not stimulated by previous red cell sensitization.

. Characteristics.

Exhibit optimum in vitro agglutination. sometimes referred to

as complete antibodies.
Give optimum reaction at a temperature of room or lower, and
they are also called cold agglutinins.
These antibodies are of high MW that they cant cross the
placental barrier, eg. IgM.

Antibodies
2. Immune antibodies:
Are antibodies stimulated by either transfusion or
pregnancy, i.e. as a result of immunization by red cells.
. Characteristics
Do not exhibit visible agglutination of salinesuspended erythrocytes, and called incomplete
antibodies
React optimally at a temperature of 370C, and are so
called warm agglutinins.
These antibodies can cross the placental barrier, e.g.
IgG

Classification of Blood Group Antibodies

1. Alloantibodies

Reacts with foreign Ag not present on patients

own RBC

Most produced as result of immune stimulation

via transfusion or pregnancy (usually during
delivery)

2. Autoantibodies

Reacts with an Ag on patients own cells & with

that same Ag on the cells of other individuals

Antigen and Antibody Reactions

Type of reaction:
1-Sensitization: simple combination between red cell
antigen and corresponding antibody in a vivo or vitro
without visible agglutination.
2-Hemoagglutiation: reaction between red cell bound
antigen and corresponding antibody with visual
agglutination.

3-Hemolysis: reaction between red cell

bound antigen and antibody with
complement fixation resulting in releases
of hemoglobin.

4-Neutralization (inhibition): reaction

between red cell antigen and corresponding
antibody both in soluble state with
precipitation.

5-Precipitation
Is the reaction of soluble Ag with soluble Ab.
The reaction results in the formation of Ag-Ab
complexes (lattices)

Antigen
Antibody

Factors affect Antigen Antibody Reaction

Complete or incomplete, cold or warm, natural or
immune types of antibodies.
Amount of antibody.
Amount of antigen.
Avidity of antibody.
PH of the reaction.
Temperature of the reaction.
Incubation time.
Saline concentration.
Type of additive (protein, enzyme).
Speed and time of centrifugation.