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ABO sisxlis jgufebi

ABO sisxlis jgufebi. Brian Poirier, MD UCDavis Medical Center 2010. Temebi. ABO sisxlis jgufebis genetikis safuZvlebi H, A, da B antigenebis warmoqmna ABO antigenebi da antisxeulebi ABO testireba ABO SeuTavsebloba. miznebi.

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ABO sisxlis jgufebi

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  1. ABO sisxlis jgufebi Brian Poirier, MD UCDavis Medical Center 2010

  2. Temebi • ABO sisxlis jgufebis genetikis safuZvlebi • H, A, da B antigenebis warmoqmna • ABO antigenebi da antisxeulebi • ABO testireba • ABO SeuTavsebloba

  3. miznebi • ABO sisxlis jgufebis memkvidreobiTobis aRwera, da sxvadasxva ABO fenotipebisa da genotipebis wyvilebis STamomavlobis prognozi. • sekretoruli da H genebis rolis axsna eriTrocitebSi H, A, da B antigenebis formirebaSi. • ABO antigenebisa da antisxeulebis urTierTqmedebis aRwera O, A, B, AB sisxlis jgufebisaTvis.

  4. miznebi (gagrZeleba) • ABO pirdapiri da uku- tipirebis procedurebis aRwera; Sedegebis interpretacia; nebismieri Seusabamobis (Tu aris) gadawyveta; • A1 da A2 antigenebs Soris raodenobrivi da xarisxobrivi gansxvavebebis aRwera. • sisxlis yvela jgufisaTvis ABO Tavsebadi komponentebis swori SerCeva.

  5. Tana-dominireba • “didi” simbolo ar niSnavs dominanturs • “patara” simbolo ar niSnavs recesiuls • gamonaklisebi #1 da #2 -sTvis: • sekretoruli genebi: Se da se • Lewis genebi: Le da le • H genebi: H da h

  6. ABO sisxlis jgufebismemkvidreobiToba • pirvelad aRwera Bernstein-ma 1924. • A, B, O genebi #9 qromosomaze • antigenebis eqspresia dafuZnebulia A, B, da O genuri alelebis kombinaciaze.

  7. fenotipebivsgenotipebi fenotipebigenotipebi jgufi O OO jgufi A AA an AO jgufi B BB an BO jgufi AB AB

  8. ABO fenotipebis sixSireebi aSS populaciebSi fenotipiTeTri Savi meqsikeli azieli O 45 49 56 43 A1 33 12 22 27 A2 8 8 6 iSviaTi B 10 19 13 25 A1B 3 3 4 5 A2B 1 1 iSviaTi iSviaTi

  9. B alelis msoflio ruka

  10. savarjiSo • dedas aqvs A jgufi, mamas - O: ra jgufebi SeiZleba hqondes STamomavlobas? • dedas aqvs A jgufi, mamas - B: ra jgufebi SeiZleba hqondes STamomavlobas?

  11. bioqimiis safuZvlebi • Itipis da II tipis jaWvebi • Se geni • H geni • H antigenis warmoqmna • A da B antigenebis warmoqmnas

  12. I tipis da II tipis jaWvebi I tipi: pirveladi glikoproteinebi sekretebsa da plazmaSi • nerwyvi, dedis rZe, kuWis wveni, naRveli, Sardi, Srati, plazma, sakvercxis kista. II tipi: pirveladi glikolipidebi RBC-ze • RBC, WBC, Trombocitebi, normoblasti, sperma, epidermuli da epiTeluri ujredebi.

  13. tipi 1: sekretoruli ABH glikoproteinuli substancia

  14. Se geni da H antigenis warmoqmna • sekretoruli = SeSe, Sese; arasekretoruli = sese • SemTxveviTi populaciis 80% aris an SeSe, an Sese • sekretoruli genis kodebi fucosyl transferase-sTvis • enzimi (FUT2) amatebs fukozas I tipis jaWvSi, bolo galaqtozasTan; miiReba H antigeni.

  15. H geni da H antigenis warmoqmna • fenotipebi: HH, Hh, hh • virtualurad, SemTxveviTi populaciis 100% aris an HH, an Hh; hh genotipi (H ararseboba = “bombeis fenotipi”) iSviaTia. • H geni, agreTve, axdens fukozil transferazis kodirebas (FUT1) • enzimi (fukozil transferaza) amatebs fukozas bolo galaqtozasTan II tipis jaWvSi • saboloo produqtia H antigeni

  16. H antigenis warmoqmna

  17. tipi 2: H, A, da B antigenebi • H Ag: Gal–GlcNAc–Gal-X | Fuc • A Ag: GalNAc–Gal–GlcNAc–Gal-X | Fuc • B Ag: Gal–Gal–GlcNAc–Gal-X | Fuc

  18. “A” geni da A antigenis warmoqmna • A antigenis formirebisaTvis, saWiroa eriTrocitebSi an sekretebSi/plazmaSi, iyos H antigeni; • A antigenis warmoqmna: N-acetilgalaqtozamini emateba H antigens, A antigenis warmosaqmnelad. • A Ag

  19. A antigenis warmoqmna

  20. “B” geni da B antigeniswarmoqmna • B antigenis formirebisaTvis, saWiroa eriTrocitebSi an sekretebSi/plazmaSi, iyos H antigeni; • B antigenis formireba: D-galaqtoza emateba H antigens B antigenis Sesaqmnelad.

  21. B antigenis warmoqmna

  22. narCeniHantigeni • rac ufro meti A an B antigeni warmoiqmneba, miT ufro naklebi H rCeba. • H-smiaxloebiTi raodenobebi sisxlis jgufebis mixedviT O>A2>B>A2B>A1>A1B

  23. leqtinebis gamoyeneba antigenis gasaZliereblad • Dolichos biflorus = anti-A1 • Ulex europaeus = anti-H

  24. SekiTxvebi? • rogor warmoiqmneba H antigeni? • urTierToba I tipis jaWvsa da Se gens Soris • urTierToba II tipis jaWvsa da H gens Soris • rogor warmoiqmneba A da B antigenebi? • sisxlis romel jgufSia H antigenis yvelaze maRali raodenoba? sisxlis romel jgufSia H antigenis yvelaze dabali raodenoba? rogor gansazRvravdiT amas?

  25. ABO antigenebi da antisxeulebi • ABO antigenebi dafuZnebulia sami genis kombinaciaze: A, B, an O • antisxeulebi klinikurad mniSvnelovani da “bunebrivia” • iwvevs yvelaze fatalur, mwvave HTR - s • zogi iwvevs HDFN - s • nerwyvi aneitralebs ABO antisxeulebs.

  26. O jgufi • yvelaze gavrcelebuli jgufi • genotipi: OO • antigeni: H • antisxeulebi: anti-A, anti-B, da anti-A,B • antisxeulebi bunebrivad aris warmoqmnili da Zalian Zlieria • anti-A,B (ZiriTadad IgG) SeuZlia gaiaros placenturi barieri da gamoiwvios HDFN

  27. A jgufi • genotipi: AA, AO • antigeni: A, H • antisxeulebi: anti-B (pirvel rigSi IgM) • A qvejgufebi • A1 (80%) da A2 (20%) ufro mniSvnelovani • A1Seicavs met A-s vidre A2 (raodenobrivi gansxvaveba); agreTve, xarisxobrivi sxvaoba. • A2B’s ~25% warmoqnis anti-A1 • A2’s 1-8% warmoqmnis anti-A1 • Dolichos biflorusectin-is leqtini iwvevs A1 -saglutinacias

  28. B jgufi • genotipi: BB, BO • antigeni: B, H • antisxeulebi: anti-A (pirvel rigSi IgM) • B qvejgufebi: ar aris mniSvnelovani

  29. AB jgufi • genotipi: AB • antigeni: A, B, Zalian cota H • antisxeulebi: ar aris • B qvejgufebi: ar aris mniSvnelovani • A2B: A2B individebis 25% gamoimuSavebs anti-A1 - s

  30. ABO testireba • ujredebis tipireba (pirdapiri meTodi) eriTrocituli antigenebis gansazRvrisaTvis • Sratis/plazmis tipireba (revers meTodi) SratSi antisxeulis gansazRvrisaTvis: • yuradReba miaqcieT sapirispiro reaqciebs • Tu “pirdapiri” reaqcia “reversis” sapirispiroa, ABO Seusabamoba ar aris.

  31. ABO jgufebis reagentebi • pirdapiri meTodis reagentebi • revers meTodis ujredebi

  32. pirdapiri meTodis reagentebi

  33. pirdapiri meTodi • reagenti: monoklonuri antisxeuli • maRali specifiuroba • IgM • savaraudod 3+ dan 4+ mde reaqcia • 1 wveTi • Anti-A=lurji; anti-B=yviTeli (akroflavinis saRebavi) • pacientis eriTrocituli A da B antigenebi aglutinirdebian cnobili SratiT (anti-A, anti-B)

  34. ujredebi revers meTodisaTvis

  35. revers tipireba • reagenti ujredebi: adamianis • savaraudod 2+ dan 4+ mde reaqcia • 4-5% ujreduli suspenzia • 1 wveTi • pacientis Sratis (an plazmis) Anti-A an anti-B antisxeulebi aglutinirdebian reagenti ujredebis A1da B antigenebTan.

  36. pirdapiri tipirebis procedura • RBC –s antigenebis gansazRvra.

  37. nabiji 1. moniSneT sinjarebi.

  38. nabiji 2: moamzadeT pacientis sisxlis 2-5% suspenzia.

  39. nabiji 3: CaawveTeT reagenti (1 wveTi).

  40. nabiji 3A: CaawveTeT reagenti Anti-A (1 wveTi).

  41. nabiji 3B: CaawveTeTreagenti Anti-B (1 wveTi).

  42. nabiji 4: daamateT TiTo wveTi pacientis eriTrocitebis 2-5% suspenzia TiToeul sinjaraSi.

  43. nabiji 5: aanjRrieT da daacentrifugeT(daaxloebiT 20 wami).

  44. jgufi A: 4+ aglutinacia anti-A -sTan0 aglutinacia anti-B -sTan

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