Blood 2: The Blood Group Free Download
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What happens if you get a blood transfusion with the wrong blood type?Even though a patient's own blood type is the first choice for blood transfusions, it's not always available at the blood bank.Try to save some patients' lives and learn about human blood types!(To receive the wrong blood type is life-threatening. In this game allowing three attempts is for learning purpose!)
People can happily receive blood from the same blood type as their own, but they have antibodies against any antigens not found on their own red blood cells.Look at the "Compatible blood chart" below!
ABO blood systemO can only receive blood from: OA can receive blood from: A and OB can receive blood from: B and OAB can receive blood from: AB, A, B and O
That said, they may transfuse white blood cells called granulocytes to help a person recover from an infection that has not responded to antibiotics. Healthcare professionals can collect granulocytes using a process called apheresis.
Blood transfusions are necessary when the body lacks enough blood to function properly. For example, a person may need a blood transfusion if they have sustained a severe injury or if they have lost blood during surgery.
ABO blood group is associated with differences in lifespan, cardiovascular disease, and some cancers, for reasons which are incompletely understood. To gain sex-specific additional insight about potential mechanisms driving these common conditions for future interventions, we characterized associations of ABO blood group antigen across the phenotype sex-specifically.
The tag SNP for the O antigen was inversely associated with diseases of the circulatory system (particularly deep vein thrombosis (DVT)), total cholesterol, low-density lipoprotein cholesterol (LDL-C), and ovarian cancer, and positively associated with erythrocyte traits, leukocyte counts, diastolic blood pressure (DBP), and healthy body composition; the tag SNP for the A1 antigen tended to have associations in reverse to O. Stronger associations were more apparent for men than women for DVT, DBP, leukocyte traits, and some body composition traits, whereas larger effect sizes were found for women than men for some erythrocyte and lipid traits.
Blood group has a complex association with cardiovascular diseases and its major risk factors, including blood pressure and lipids, as well as with blood cell traits and body composition, with some differences by sex. Lower LDL-C may underlie some of the benefits of blood group O, but the complexity of associations with blood group antigen suggests overlooked drivers of common chronic diseases.
ABO blood group is associated with several diseases [1]. People with blood group O have a lower risk of cardiovascular disease (CVD) [2], including myocardial infarction (MI), peripheral vascular disease, cerebral ischemic events [3], and venous thromboembolism [4], as well as of digestive system neoplasms (gastric and pancreatic cancer) [5] and ovarian cancer [6, 7], than people with other blood groups. Reasons for these differences are not entirely clear, although lower von Willebrand factor (vWF) is thought to be one contributing factor [8]. However, the mechanisms behind these differences have not been entirely elucidated, although they could shed light on the causes of cardiovascular disease, which is increasingly realized to be incompletely understood [9, 10].
Physiologically, blood groups are manifest as many differences [11], including in red blood cell (RBC) traits, vWF, low-density lipoprotein cholesterol (LDL-C), total cholesterol, apolipoprotein E [12], and some inflammatory markers [13], such as soluble E-selectin and intercellular adhesion molecule-1. However, exactly how these differences relate to common diseases and traits has not been systematically examined, although consistent characterization may help identify informative overall patterns or overlooked causes of common conditions. ABO blood group is also associated with several diseases, such as CVD [2, 4, 14] and some cancers [7, 15, 16], whose incidence differs by sex [17, 18], highlighting the possibility of sex-specific causes and the importance of sex-specific analysis, which has rarely been conducted previously, although is increasingly realized to be relevant [19] given shorter life expectancy in men than women. To address this gap, we conducted a phenome-wide association study (PheWAS), a genotype-to-phenotype approach [12, 20] which can be performed using summary statistics [21], to examine systematically the associations of tag single nucleotide polymorphisms (SNPs) for ABO blood group antigen with a wide range of diseases and related traits, using the largest available genome-wide association studies (GWAS), with sex-specific analysis and validation where possible.
UK Biobank summary statistics were available 19,586 different phenotypes encompassing diagnoses, family history, lifestyle, current health status, anthropometrics, physical characteristics, treatment records, biochemical assays, psychological health, and physical measurements provided by Neale Lab [30]. Information concerning the source, original questionnaire or measurement, of these phenotypes is available on the official website of the UK Biobank ( ) keyed on the phenotype and ID (Additional file 1: Table S2). To verify previous findings of blood group on ovarian cancer [6, 7], where only self-reported ovarian cancer is available in the UK Biobank, another European ancestry-based publicly available consortium, Ovarian Cancer Association Consortium (OCAC), was included in the primary analysis.
Subcategories recommended by the UK Biobank were used for inclusion and exclusion. However, the subcategories are largely reflective of the information collection approach. To make the categorization more etiologically coherent, binary outcomes were considered in groups, corresponding to selected International Classification of Diseases (ICD)-9/10 chapters, that might share causes and similar associations with blood group, i.e., circulatory, endocrine, respiratory, neoplasms, digestive, neurological, musculoskeletal, gynecologic and obstetric, hematopoietic, dermatologic, genitourinary, mental health, infectious diseases, sense organs, injuries and poisonings, symptoms, and others.
In addition to the categories above, continuous and categorical ordered phenotypes were classified in groups using the recommended categories for the UK Biobank [31], i.e., blood count, blood biochemistry, and physical measures.
Flowchart of phenotype inclusion through the study for the 4 tag SNPs for ABO blood group antigens. ICD-10 was used to classify binary phenotypes, while continuous phenotypes were categorized with reference to the recommended UK Biobank categories and the source of information
Heat maps for significant associations of tag blood group antigens with binary phenotypes. Different shades of red color represent positive associations, and different shades of blue represent negative associations. Darker colors represent smaller P values
Heat maps for significant associations of tag blood group antigens with continuous phenotypes. Different shades of red color represent positive associations, and different shades of blue represent negative associations. Darker colors represent smaller P values
Replications (Additional file 1: Table S5), where available, showed consistent directions of associations as the primary analysis with most replication results having similar effect sizes to the primary ones, particularly for the negative associations of A1 with white blood cell traits, creatinine, and standing height; of A2 with Hct and Hb; of B with ApoB, HbA1c, LDL-C, and monocyte traits; and of O with LDL-C, HDL-C, glucose, urea and C-reactive protein, and in the positive associations of A1 with ApoB, HDL-C, and urea; of A2 with MCV and MCH; of B with MCHC, Hct, albumin, and creatinine; and of O with Hct, creatinine, and white blood cell traits.
Consistent with previous findings, O blood group antigen was associated with lower risk of circulatory diseases, particularly DVT [2], lower risk of ovarian cancer [6, 7], and higher levels of several red blood cell traits [11], whereas the direction of these associations is opposite for blood group A [2, 6, 7]. Our study adds by differentiating the effects of A1 and A2 antigens, by giving effects by sex and by subtype of some diseases, and by showing that these differences for O and A1 antigens extend to white blood cell traits, specific blood biochemistry, and body composition.
In other relevant literature, ABO blood group has shown inconsistent associations with hypertension and blood pressure [37,38,39]. Here O was also positively associated with diastolic blood pressure in the UK Biobank, consistent with a population in central Asia [40], whereas the inverse association of A with DBP has also been reported in people of African ancestry [41]. Consistent with previous findings, O was negatively associated with LDL-C [42] and A1 positively with LDL-C [43, 44]; however, A2 was not related to LDL-C. B was also related to lower LDL-C, although the magnitude was larger for O. In addition, O was also associated with lower levels of several other lipid traits, including HDL-C, total cholesterol, ApoA, and ApoB. Differences by sex were evident for LDL-C, where associations with A1 and B antigens were stronger in women than men. Associations in the ABO gene with total cholesterol and LDL-C are consistent with GWAS [45, 46], so some effects of blood group on CVD may be due to LDL-C [47]. Meanwhile, the direction of associations with A1 was opposite to O, which may be relevant to CVD [48, 49], and has some consistency with previous findings [43, 44, 50]. Blood group was not associated with type 2 diabetes, where previous findings have been inconsistent [51, 52], while we show that O and B antigens are protective for glucose metabolism. Although O was associated with higher levels of some liver biochemistry phenotypes (ALP, AST) but lower ALT, a Mendelian randomization study showed that ALP or AST are not relevant to coronary artery disease, but ALT might be a protective factor for coronary artery disease [53], which is consistent with our findings. 781b155fdc