________________

4.8 Globoside blood group collection

The Globoside blood group collection conmprises of three antigens. These antigens originate from the
same ground substance from which the antigens of the blood group systems ABH and Lewis,and the I
collection are formed. The Globoside blood group collection is serologically very closely related to the P
blood group system. For a long time it was thought that they formed a single system

Antigens

The three antigens of the Globoside blood group collection are P, pk and LKE (or Luke). The ISBT symbols
and numeration are: GLOBI, GLOB2 and GLOB3; 209,001, 209,002 and 209,0021 respectively.

Almost 100% of the population is P-positive and thus the P antigen is present in virtually all P, or pl
subjects. The P antigen is fully developed at birth.

In practically all subjects the pk antigen has been transformed into P antigen and is often only found in
a very weak form. In case the P antigen is not present and neither are the pk and P, the antigens, then
the genotype is pp, which is very rare. Even more rare are the phenotypes in which the transformation
from pk to P did not occur (P1k and P2).

In table 4-XVI the frequencies, phenotypes, antigens and antibodies of the P-system and the Globoside
collection are represented.

The

grou

colle

Table 4-XVI Genotypes, phenotypes, antigens and antibodies of the P-system and the Globoside
collection Genotype Phenotype Antigen Frequency

possible anti

Caucasian (9) bodies in serum P1P (Pk)

P, P2, Pk
79%

none P (PK)

21%

P1Pk anti-P

P.pk

practically o Pk

practically o

anti-P, anti-P pp

none

practically o anti-P + Pk + P

Anti The (ISB) At bi any cost lan

P, pk

anti-P

pk

In v. The

Tabl

Antibodies

Anti-P is found in the serum of people with blood group pk or the p-phenotype, because these people
do not have P antigen. Sometimes, people with blood groups P2k, we have anti-P together with anti-P.
Anti-P occurs as alloantibody and as autoantibody. Allo anti-P can be both IgG and IgM . These rare
antibodies are found only in the serum of people with the rare blood group of P-phenotype.

Autoanti-P is a biphasic IgG-haemolysin. This antibody is found in patients with paroxymal cold
hemoglobinemia or in children after a viral infection. Biphasic haemolysins are cold antibodies of the
IgG class that are strongly complement binding. The activity of the antibodies occurs in two phases. In
the first phase the antibodies bind to the red blood cell at a low temperature (0-4 ° C) .
At this temperature they don't haemolyse. When the temperature, in the second phase, more than 28 °
C (optimally 37 ° C), complement is activated and the erythrocytes are lyse. A typical characteristic of
the activity of biphasic haemolysins is that quickly enough (a few minutes hours) after the patient is
exposed to cold, acute hemolysis may occur locally in the Blood stream. leading to hemoglobinuria. a
typical example is of a young child who lived a viral infection.