1 / 92

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.

kylee
Télécharger la présentation

ABO sisxlis jgufebi

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  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

More Related