Spring 2022 Final ABO Blood Typing Exam Solutions – Rice University
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Explain The Concept of The ABO Blood Group System
All human beings belong to one of four blood groups. These groups are distinguished by the reaction between the red blood cells of one individual and the serum (the blood's liquid) of another. Either the blood cells are distributed evenly in the serum, or they club together (known as non-agglutination and agglutination). Red blood corpuscles are said to possess antigens called agglutinogens; there are two agglutinogens (A and B) and two agglutinins (anti-A and anti-B). Blood corpuscles may contain either A or B or both or neither. These form the four blood groups. Blood serum may contain either anti-A, or anti-B, or both or neither. Corpuscles containing A are agglutinated by serum containing anti-A. B corpuscles are similarly treated by anti-B. People possessing, for example. Corpuscles do not possess anti-A serum, but do possess anti-B. O people have serum containing both anti-A and anti-B. AB people have neither. Trouble following the wrong blood transfusions (A blood for a B person or vice versa) is almost entirely caused by the agglutinins in the recipient reacting against the introduced corpuscles. The agglutinins of the donor's blood generally do much less harm.
What is the role of Karl Landsteiner in Blood Group Development?
Karl Landsteiner Just as Sir Winston Churchill's actions seem to cover more than the life span of a single individual, so does the name of Karl Landsteiner occur relentlessly in the history of the development of blood group knowledge. Born in 1868, the son of an Austrian journalist, he became a doctor in 1891. At the end of the nineteenth century he was working in Vienna on the curious clumping together of blood from different individuals. In 1900 he described three blood types. In 1902 a fourth was added, thereby completing the A, B, O and then the AB blood classification of mankind. Even at that time Landsteiner foresaw the importance of the different blood groups, but it was not until the Great War's spilling of blood-and the subsequent urgent need for transfusion -that the importance of his work received general recognition. In 1922 Landsteiner emigrated to the United States, and became an American citizen as soon as he could.
Five years later, together with Dr Philip Levine, he discovered yet another blood grouping: they proclaimed all human beings to have either M, N or MN blood. This secondary classification is irrelevant to blood transfusion, as it does not matter what kind of M or N blood each person receives, but it is scientifically exciting and of extreme genetical relevance in cases of doubtful paternity Accused and unhappy males can be found not guilty of fathering some child if blood is examined and compared; but more about that later.
In 1930 Karl Landsteiner, then sixty-two, received a Nobel Prize. Seven years later he started work which led in 1940 to yet another discovery. Working this time with Dr Alexander Weiner, he hit upon the famous rhesus factor. It may seem valueless to care, let alone announce, that if a rabbit is injected with some blood from the monkey, Macacus rhesus, the rabbit then makes an antibody which clumps together the red blood cells of 84% of New York's white people. Yet the work was crucial. Without this breakthrough the 16% of women who have so-called Rh-negative blood, and who, until then, frequently produced jaundiced and dying babies, would not find their condition treated with such routine care in maternity units today; but also more about this later. Landsteiner finally died in 1943 when still in harness (he had a heart attack while at work in his laboratory). More than any other man he had made blood transfusion possible.
Briefly Describe the Development of Blood Transfusions
These began, as can be imagined, erratically and, curiously, with the assistance of Sir Christopher Wren. In 1665, Great Plague year, he suggested to the Cornishman, Dr Richard Lower that blood might be passed from one animal to another. Apparently the transfusion worked. Two years later Mr. Arthur Cogan, a Londoner, capped this tale by passing into himself blood from a pig, and legend claims success. It seems that Lower, who became Court Physician to Charles II, let things be, but one of Louis XIV's doctors, Jean Denys, gave a patient a transfusion of lamb's blood. There was, reasonably, a violent reaction; but, less reasonably, the patient lived. In 1668 another patient died after similar treatment. (The purpose of the transfusion - with calf's blood-had been to transfer gentle and bovine characteristics to a philandering husband.)
Thenceforth blood transfusions in France were forbidden. Not until 1818 did anyone attempt a transfusion of human blood, when Dr James Blundell, of London, tried it. The patient died. One trouble, which had nothing to do with blood group clumping, was the clotting of the blood. Many different techniques were tried to keep it fluid, and were soon successful. but then came the brick wall of blood groups. Some transfusions were entirely successful. Some were equally disastrous, and the whole of the nineteenth century had to pass before Landsteiner solved the riddle.
Now transfusions are a commonplace. Over 2,000,000 Americans receive them in a year. Britain uses over a million bottles of blood and plasma annually. Blood banks are every- where. There are even banks of extremely rare blood, as at the Chelsea Naval Station, Massachusetts (where, for example, Rh-null is kept, reported so far in only a handful of people). Swimming against this tide are, amongst others, Jehovah's Witnesses. Unlike Christian Scientists, who ignore medical healing but are not definitely forbidden to take blood, the Witnesses accept hospital treatment but not blood. They quote the Acts of the Apostles Chapter XV (... that ye abstain from meats offered to idols, and from blood') and Genesis ix, 4 ("But flesh with the life thereof, which is the blood thereof, shall ye not eat') as authority for their principle, and since 1945 have ruled out transfusions. There are over 50,000 active Witnesses in Britain, and they achieve world-wide publicity when the enforced lack of transfusion precedes a death. Mr Walter Stevens, for example, of Adelaide, refused permission in June 1965 for his wife to receive blood during a difficult delivery of twins. She died shortly afterwards, and the newspapers were quick to pounce.
Explain the Distribution of ABO Blood Groups in Europe and The World
All mankind, whether New Yorker, Eskimo or Aborigine, is either O, A, B or AB: The letters seem complex, and I, II, III, and IV would seem a much better and simpler method of classification. In fact Roman numerals were used originally, but these gave way to letters because the letters are more meaningful. A and B refer to the two clumping factors (technically these are two lipopolysaccharides. with both being known as agglutinogens) which human blood contains. It is these factors which cause all the trouble. Without them blood transfusions would be relatively plain sailing. Blood. type A (42% of Western Europe) has one of them, blood type B (9%) has the other, type AB (3%) has both and blood type O (46%) has neither. Group O are often called universal donors, and in World War Two only group O blood used to be sent to the front in many areas; but it is a misnomer. For various reasons not all group O blood can be pumped into A. B or AB people. Some group O donors are more universal than others. (It all depends upon the amount of anti-A or anti-B agglutinins in their serum. Some O's have a lot. Most do not.) Similarly the AB people, the rare 3% of us, are not the 'universal recipients they are frequently said to be.
To offset this nuisance value in transfusion the ABO groups are intriguing geographically. All races of man have them, but differently. During that war, for example, and during blood collection in Northern Wales, someone noticed that Welsh names (Jones, Evans, Williams) produced more O and B blood than English names. In fact, all Celts are now known to produce less A blood than the descendants of those who caused them to retreat. South-east England produces much more A blood even from its inter-mixed inhabitants today.
In fact, a history of Europe, albeit a short one, could be written from blood groups alone. The A people, whoever they were-but with a high A group percentage, seem to have occupied Europe with particular entrenchments in Scandinavia, Spain and Turkey. The O people fared less well and either preferred or were forced into the corners such as Ireland, Scotland, the Pyrenees, Iceland, Sardinia, Corsica and the Eastern Black Sea. Meanwhile the B's, never so plentiful, just get more so the further they are from Europe, whether up into Russia or down into the Middle East. The B's look like a second invasion force (the Mongols?) who were unable to oust the A's.
Globally the picture is more complex. South American Indians are 100% O. North American Indians are also rich in O but have more and more A towards the north. They have virtually no B. Maoris and Australian Aborigines are, like the Eskimos, half A and half O. West African blacks are mainly O (52%) but equally A and B (21% and 23%). Top B people are the Ainu of Japan (38%), the Asiatic Indians (37%) and Tartars (33%). Top AB's are the Congo Pygmies (10%), the Japanese (11%) and the Egyptians (10%). The O group is the most persistent. Some people have no A, like those South American Indians; some have no B, like many of the Indian groups further north; and some have no AB, like almost all the New World Indians; but no group anywhere has no O. Thirty per cent is about the lowest figure for O's, possessed by some Pygmy, Chinese, Russian and Tartar groups.
The blood group distribution therefore seems an awful mix-up. Why do the Basques have ABO proportions like the Australian Aborigines? Or why do the Greenland Eskimos and the French? Why do the Mongols, who are supposed to have supplied the ancestors of the Red Indian, have blood rich in B, while the Indians have next to none of it? The short answer is that advantages must exist for certain blood groups under certain conditions.
What Are Some Notable Advantages of ABO Blood Groups?
In recent years some hints of differing benefits have begun to show. Professor lan Aird, the surgeon, found O English people were more likely to get duodenal ulcers. More A people get stomach cancer (about 20%), pernicious anaemia (25%) and even diabetes mellitus than O's and B's. Such slender information, which by no means implies that the blood groups actually cause the diseases, is a long way from explaining. for example, why all the B's died out as the Asiatic groups, so rich in B blood, entered the New World via the Bering Straits-which they almost certainly did.
Extra facts about the ABO system are: the blood group of an individual is established irrevocably probably by the end of the second month of pregnancy; which group it is (useful in paternity trouble) can be found out by the twelfth week of pregnancy if the shed cells in the mother's amniotic fluid are examined; the muscle tissue of 4,000-year-old mummies has been blood grouped; bones long buried soon will be; dissimilar twins are more often of the same group than mere chance would indicate; and O mothers married to A fathers produce more miscarriages (certainly in Japan, and probably elsewhere) than A mothers married to O fathers.
How Do Courts Use the ABO Blood Groups to Determine Paternity?
Blood groups may be irksome in trans- fusions, but they are the breath of life in paternity cases. Many a male, harassed by accusations, has had cause to be grateful to his grouping, to hers, and to that of the child.
Can a man prove he is the father of a child? Can he prove that he is not? Briefly, the answers are 'No' and 'Probably', respectively. The key is blood. There are three ABO blood group genes, and four ABO blood groups. No child can acquire a gene, and consequently a blood grouping, if it is not possessed by either parent. If the wife is group O, the husband group O and the baby group A, that husband has no reason whatsoever to believe the baby is his. He can regard quizzically those of their friends who are A or AB. (The British courts accept blood group evidence and do now have the power to order tests in paternity cases; bringing Britain into line with, say, Scandinavia and some United States , such as New York. The procedure starts becoming really crucial when illegitimate children are to be given as much of the father's wealth as his legitimate offspring.)
The percentages are important. It is obviously easier to settle the paternity question if 88% of the population can be excluded rather than 3% or even 0%. (It's a wise mother who knows her lover's ABO blood group before she begins complicating the issue.) Taking the population as a whole, the probability of freeing a wrongfully accused man, using just the ABO groups, is only about 20%. So other groups are used, such as the MN and Rh groups.