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The discovery of the ABO blood group, over 100 years ago, caused great excitement.

Until
then, all blood had been assumed to be the same, and the often tragic consequences of blood
transfusions were not understood (Aly, R., Yousef, A., 2014). The ABO blood group antigens
remain of prime importance in transfusion medicine—they are the most immunogenic of all the
blood group antigens. The most common cause of death from a blood transfusion is a clerical
error in which an incompatible type of ABO blood is transfused. The ABO blood group antigens
also appear to have been important throughout our evolution because the frequencies of
different ABO blood types vary among different populations, suggesting that a particular blood
type conferred a selection advantage (Dean L., Bethesda, 2005). The presence of A and B
antigens on the surface of Red Blood Cells (RBC) and of anti-A and anti-B antibodies in the
serum determine the ABO blood group. Antigen A is present on the blood type A with a serum
containing anti-B antibody while blood type B will have antigen B with a serum containing anti-A
antibody. Blood type AB contains both antigens and no antibodies, and blood type O has no
antigens but have both antibodies (Hosoi, E., 2008). The data suggests that all from the group
members showed to be from the O blood type, meaning all the members of the group’s RBC
contain no antigens but have both antibodies. Genetic studies from Atienza in 1955 state that
these gene frequencies are in good agreement with the very large sample of: A=0.168;
B=0.160; O=0.672 in the Philippines (Atienza, R. Y., 1955). O+ is the most common blood type.
Different ethnic and racial groups have different frequency of the main blood types in their
populations. Approximately 45% of Caucasians are type O, but 51% of African-Americans and
57% of Hispanics are type O (The American National Red Cross, 2018).

QFR:
1. There is a difference between males and females in the number of RBCs in their system.
Studies suggest the erythropoietic drive (erythropoietin (Epo) is a hormone produced by the
kidney that promotes the formation of red blood cells by the bone marrow) in the intact adult
animal is determined in very large part by the delivery of oxygen to the juxtaglomerular
apparatus (JGA) of the kidney. Other mechanisms also play a part — including a baseline
marrow erythroid activity that maintains hemoglobin levels. In a study by Murphy, W. G. in 2014
suggests that women with end stage renal disease are resistant compared to age-matched
males with end stage renal disease, requiring greater doses of Epo to achieve the same (sub-
physiologic) haemoglobin level, consistent with the synergistic effect of androgen on
erythropoietic dynamics in the bone marrow. This however emphasises that females could
achieve the same levels of haemoglobin by increasing Epo production — they “choose” not to,
for whatever reason. Modulation of the JGA erythropoietic response to the level of red cell mass
is the probable cause of the sex difference in haemoglobin levels, since as explained above,
there is no compensatory response on the part of the JGA to the constitutively lower levels in
healthy adult females (Murphy, W. G., 2014).

In the case of infants and adults, infants pose more red blood cells than the adults. this is
because infants have nucleated RBCs that may persist longer than a week in immature infants.
The presence of nucleated RBCs for more than five days suggests hemolysis, hypoxic stress or
acute infections—thus imposing deviations in the infant’s system.. Infants have a lower immune
response and they need the nucleated RBCs for their immune system. Adults however, have a
more immune system and need no more nucleated RBCs for adaptation. This is why infants
have more RBCs than adults (Jacob, E. A., 2016

2. There is no direct correlation between White Blood Cell (WBC) count and sex; but, recent
studies indicate that in female patients had more circulating neutrophils, less lymphocytes, and
less monocytes, which indicate a more immune-compromised state, than male patients for a
few days postoperatively (gastrectomy) (Gwak, M. S., et al., 2007).

3. Blood type O is known as the universal donor, having no antigens and both antibodies, type
O can be accommodated by any blood type. Blood type B has the antigen A and antibody A.
When blood type O is transfused to a patient with blood type B, the antibodies of blood type O
will recognize the antigen B from blood type B, causing no harm to the patient (Baylor Scott &
White Health, 2018).

References:

Aly, R., & Yousef, A. (2014). Association of ABO Blood Group and Risk of Breast
Cancer. Journal of Blood Disorders & Transfusion,05(09). doi:10.4172/2155-
9864.1000241

Atienza, R. Y. (1955). The distribution of the ABO blood groups and Rh factor among Filipinos.
Proc. 5th int. Congr. Blood Transfus. (Paris, 1954), p. 26I.

Baylor Scott & White Health. (2018). Blood Type Genetics and Compatibility. Retrieved July 11,
2018, from https://www.bswhealth.com/patient-tools/blood-center/Pages/blood-type-
genetics-and-compatibility.aspx

Dean L. Blood Groups and Red Cell Antigens [Internet]. Bethesda (MD): National Center for
Biotechnology Information (US); 2005. Chapter 5, The ABO blood group. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK2267/

Gwak, M. S., Choi, S. J., Kim, J. A., Ko, J. S., Kim, T. H., Lee, S. M., . . . Kim, M. H. (2007).
Effects of Gender on White Blood Cell Populations and Neutrophil-Lymphocyte Ratio
Following Gastrectomy in Patients with Stomach Cancer. Journal of Korean Medical
Science,22(Suppl). doi:10.3346/jkms.2007.22.s.s104

Hosoi, E. (2008). Biological and clinical aspects of ABO blood group system. The Journal of
Medical Investigation,55(3,4), 174-182. doi:10.2152/jmi.55.174

Jacob, E. A. (2016). Hematological Differences in Newborn and Aging: A Review


Study. Hematology & Transfusion International Journal,3(3).
doi:10.15406/htij.2016.03.00067

Murphy, W. G. (2014). The sex difference in haemoglobin levels in adults — Mechanisms,


causes, and consequences. Blood Reviews,28(2), 41-47. doi:10.1016/j.blre.2013.12.003
The American National Red Cross. (2018). Blood Types. Retrieved July 11, 2018, from
https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-
donations/blood-types.html#

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