The term Rhesus blood group system refers to the five main Rhesus antigens (C, c, D, E and e) as well as the many other less frequent Rhesus antigens. The terms Rhesus factor and Rh factor are equivalent and refer to the Rh D antigen only. This article does not cite any references or sources. ...

Rhesus factor

Individuals either have, or do not have, the Rhesus factor (or Rh D antigen) on the surface of their red blood cells. This is usually indicated by 'RhD positive' (does have the RhD antigen) or 'RhD negative' (does not have the antigen) suffix to the ABO blood type. This suffix is often shortened to 'D pos'/'D neg', 'RhD pos'/RhD neg', or +/-. The latter is generally not preferred in research or medical situations, because it can be altered or obscured accidentally. Human red blood cells Red blood cells are the most common type of blood cell and the vertebrate bodys principal means of delivering oxygen from the lungs or gills to body tissues via the blood. ... ABO blood group antigens present on red blood cells and IgM antibodies present in the serum The ABO blood group system is the most important blood type system (or blood group system) in human blood transfusion. ... Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells. ...

In simplest terms, there may be prenatal danger to the fetus when a pregnant woman is RhD-negative and the biological father is RhD-positive. But, as discussed below, the situation is considerably more complex than that. Prenatal means before birth (is widely used in biology). ... “Unborn child” redirects here. ... A pregnant woman Pregnancy is the process by which a mammalian female carries a live offspring from conception until it develops to the point where the offspring is capable of living outside the womb. ...

History of discoveries

The Rhesus system is named after the Rhesus monkey, following experiments by Karl Landsteiner and Alexander S. Wiener, which showed that rabbits, when immunized with rhesus monkey red cells, produce an antibody that also agglutinates the red blood cells of many humans. Landsteiner and Alexander S. Wiener discovered this factor in 1937 (publishing in 1940).^[1] The significance of the Rh factor was soon realized. Dr. Phillip Levine working at the Newark Beth Israel Hospital made a connection between the Rh factor and the incidence of erythroblastosis fetalis, and Wiener realized adverse reactions from transfusions were also resulting from the Rh factor. Wiener then pioneered the exchange transfusion to combat erythroblastosis fetalis in newborn infants. This transfusion technique saved the lives of many thousands of infants before intrauterine transfusion was invented which enabled much more severely affected fetuses to be successfully treated. Drs. Neva Abelson and L.K. Diamond co-discovered a simple test for the Rh factor which was widely applied.^[2] Binomial name Macaca mulatta (Zimmermann, 1780) The Rhesus Macaque (Macaca mulatta), often called the Rhesus Monkey, is one of the best known species of Old World monkeys. ... Karl Landsteiner Karl Landsteiner (June 14, 1868 – June 26, 1943), was an Austrian biologist and physician. ... Dr. Alexander S. Wiener (1907-1976), a lifelong resident of New York City, was recognized internationally for his contributions to science. ... agglutination ... Human red blood cells Red blood cells are the most common type of blood cell and the vertebrate bodys principal means of delivering oxygen from the lungs or gills to body tissues via the blood. ... Dr. Alexander S. Wiener (1907-1976), a lifelong resident of New York City, was recognized internationally for his contributions to science. ... Philip Levine (10 August 1900 – 18 October 1987) was a physician whose clinical research advanced knowledge on the Rhesus factor, Hemolytic disease of the newborn (HDN) and blood transfusion. ... Erythroblastosis fetalis, also known as hemolytic disease of the newborn is a condition that develops in a fetus when antibodies produced by the mother attack the fetuss red blood cells. ... An exchange transfusion is a medical treatment in which apheresis is used to remove one persons red blood cells or platelets and replace them with transfused blood products. ... Erythroblastosis fetalis, also known as hemolytic disease of the newborn is a condition that develops in a fetus when antibodies produced by the mother attack the fetuss red blood cells. ... Neva Abelson (1910-2000) was a distinguished research physician who played a key role in developing the life-saving Rh blood factor test. ...

Rh nomenclature

The Rhesus system has two sets of nomenclatures, one developed by Doctors Fisher and Race and one by Dr. Wiener. Both systems reflected alternate theories of inheritance. The Fisher-Race system, which is more commonly in use today, utilizes the CDE nomenclature. This system originally postulated that there are three closely linked genes on each chromosome. The genes were designated as D and its hypothetical allele d; C and its allele c, E and its allele e. Each gene was supposed to control the product of the corresponding antigen (i.e., D gene produces D antigen, etc.) However, the d gene was hypothetical, not actual.

The Wiener system used the Rh-Hr nomenclature. This system theorized that there was one gene at a single locus on each chromosome of the pair which controls production of multiple antigens. This concept postulated that a gene R gives rise to the “blood factors” Rho, rh’, and hr” and the gene r will produce hr’ and hr”.

Notations of the two theories are used interchangeably in blood banking (e.g., Rho(D)). Wiener’s notation is more complex and cumbersome for routine use. Because it is simpler to explain, the Fisher-Race theory is more widely used.

DNA testing has shown that both theories are partially correct. There are in fact two linked genes, one with multiple specificities and one with a single specificity. Thus, Wiener's postulate that a gene could have multiple specificities (something many did not give credence to originally) has been proven correct. On the other hand, Wiener's theory that there is one gene has proven incorrect, as has the Fischer-Race theory that there are three genes.

The Rhesus system antigens

The proteins which carry the Rhesus antigens are transmembrane proteins, whose structure suggest that they are ion channels. The main antigens are C, D, E, c and e, which are encoded by two gene loci, the D locus and the CE locus. There is no d antigen. Lowercase "d" indicates the absence of the D antigen (the gene is either deleted or nonfunctional). Ion channels are pore-forming proteins that help to establish and control the small voltage gradient that exists across the plasma membrane of all living cells (see cell potential) by allowing the flow of ions down their electrochemical gradient. ...

Hemolytic disease of the newborn

Main article: Hemolytic disease of the newborn

Hemolytic disease of the newborn is also called Erythroblastosis Fetalis. This condition occurs when there is an incompatibility between the blood types of the mother and the baby. These terms do not indicate which specific antigen-antibody incompatibility is implicated. Hemolytic disease of the newborn, also known as HDN, is an alloimmune condition that develops in a fetus, when the IgG antibodies that have been produced by the mother and have passed through the placenta include ones which attack the red blood cells in the fetal circulation. ... Hemolytic disease of the newborn, also known as HDN, is an alloimmune condition that develops in a fetus, when the IgG antibodies that have been produced by the mother and have passed through the placenta include ones which attack the red blood cells in the fetal circulation. ...

• hemolytic comes from two words: hemo (blood) and lysis (destruction) or breaking down of red blood cells
• erythroblastosis refers to the making of immature red blood cells
• fetalis refers to the fetus

When the condition is caused by the RhD antigen-antibody incompatibility, it is called RhD Hemolytic disease of the newborn (often called Rhesus disease or Rh disease for brevity). Here, sensitization to Rh D antigens (usually by feto-maternal transfusion during pregnancy) may lead to the production of maternal IgG anti-RhD antibodies which can pass through the placenta. This is of particular importance to RhD negative females of or below childbearing age, because any subsequent pregnancy may be affected by the Rhesus D hemolytic disease of the newborn if the baby is Rh D positive. The vast majority of Rh disease is preventable in modern antenatal care by injections of IgG anti-D antibodies (Rho(D) Immune Globulin). The incidence of Rhesus disease is mathematically related to the frequency of RhD negative individuals in a population, so Rhesus disease is rare in East Asians and Africans, but more common in Caucasians. Schematic of antibody binding to an antigen An antibody is a protein complex used by the immune system to identify and neutralize foreign objects like bacteria and viruses. ... The placenta is an ephemeral (temporary) organ present in female placental vertebrates during gestation (pregnancy), but a placenta has evolved independently also in other animals as well, for instance scorpions and velvet worms. ... Rh disease (also known as Rh (D) disease, Rhesus disease, RhD Haemolytic Disease of the Newborn, Rhesus D Haemolytic Disease of the Newborn or RhD HDN) is one of the causes of hemolytic disease of the newborn (also known as HDN). ... Rh disease (also known as Rh (D) disease, Rhesus disease, RhD Haemolytic Disease of the Newborn, Rhesus D Haemolytic Disease of the Newborn or RhD HDN) is one of the causes of hemolytic disease of the newborn (also known as HDN). ... This article needs cleanup. ... Rho(D) Immune Globulin is a drug introduced under the tradename RhoGAM and MICRhoGAM which is used to prevent maternal sensitization to Rh D antigens on the surface of blood cells in a fetus (i. ... East Asia is a subregion of Asia. ... World map showing location of Africa A satellite composite image of Africa Africa is the worlds second_largest continent in both area and population, after Asia. ... The 4th edition of Meyers Konversationslexikon (1885-1890) shows the Caucasian race (in blue) as comprising Aryans, Semites and Hamites. The Caucasian race (sometimes called the Caucasoid race) is defined by the Oxford English Dictionary as, relating to a broad division of humankind covering peoples from Europe, the Middle East...

• Symptoms and signs in the Fetus:
  • Enlarged liver, spleen, or heart and fluid buildup in the fetus' abdomen seen via ultrasound.

• Symptoms and signs in the Newborn:
  • Anemia which creates the newborn's pallor (pale appearance).
  • Jaundice or yellow discoloration of the newborn's skin, sclera or mucous membrane. This may be evident right after birth or after 24 - 48 hours after birth. This is caused by bilirubin (one of the end products of red blood cell destruction).
  • Enlargement of the newborn's liver and spleen.
  • The newborn may have severe edema of the entire body.
  • Dyspnea or difficulty breathing.

Edema (American English) or oedema (British English), formerly known as dropsy or hydropsy, is swelling of any organ or tissue due to accumulation of excess lymph fluid, without an increase of the number of cells in the affected tissue. ...

Population data

The frequency of Rh factor blood types and the RhD neg allele gene differs in various populations.

Languages Basque - few monoglots Spanish - 1,525,000 monoglots French - 150,000 monoglots Basque-Spanish - 600,000 speakers Basque-French - 76,000 speakers [4] other native languages Religions Traditionally Roman Catholic The Basques (Basque: ) are an indigenous people[5] who inhabit parts of northeastern Spain and southwestern France. ...

Inheritance

The Rh(D) antigen is inherited on one locus (on the short arm of the first chromosome, 1p36.13-p34.3) with two alleles, of which Rh+ is dominant and Rh− recessive. The gene codes for a polypeptide on the red cell membrane. Rh− individuals (dd genotype) do not produce this antigen, and may be sensitized to Rh+ blood. Chromosome 1 is, by convention, the designation for the largest human chromosome. ... Peptides are the family of molecules formed from the linking, in a defined order, of various amino acids. ...

The Rhesus system is much more complex than the ABO blood type system because there are more than 30 combinations possible.^[4]

Two very similar epitopes, Cc and Ee, appear to be closely related to Rh. An epitope is the part of a macromolecule that is recognized by the immune system, specifically by antibodies, B cells, or cytotoxic T cells. ...

References

• Mollison PL, Engelfriet CP and Contreras M. Blood Transfusion in Clinical Medicine. 1997. 10th edition. Blackwell Science, Oxford, UK.

External links

• Rh at BGMUT Blood Group Antigen Gene Mutation Database at NCBI, NIH