Blood Groups, Platelet Antigens, and Granulocyte Antigens - Nomenclature

AMA Manual of Style - Stacy L. Christiansen, Cheryl Iverson 2020

Blood Groups, Platelet Antigens, and Granulocyte Antigens
Nomenclature

Shakespeare has Romeo ask “What’s in a name?” and answer “that which we call a rose by any other name would smell as sweet.” Romeo was wrong, as he learned to his cost. Names matter.1

This chapter is devoted to nomenclature: systematically formulated names for specific entities. Nomenclature is “the means of channelling the outputs of systematic research for general consumption”2 and aims for international scope. Giangrande writes that international nomenclature efforts in coagulation “provide[d] an outstanding early example of international collaboration to resolve a scientific problem. This sort of co-operation is now commonplace, but was certainly not typical in [the post—World War II] period.”3(p710) To facilitate worldwide access to the latest terms, large computerized databases have been created, but even computerized databases require consistent use of nomenclature.4 Unique identifiers provide a home base for terms in large databases but are not practical for referring to entities throughout published articles and textbooks5—hence, names.

Biological nomenclature dates back at least to the 18th century and Linnaeus, the father of modern taxonomy. Since the mid-20th century, many biomedical disciplines have established committees to develop and promulgate official systems of nomenclature.

Accelerating knowledge in the mid-20th century, particularly from biochemistry and molecular biology, necessitated the standardized biomedical nomenclature systems, sometimes with striking results. In microbiology, with publication of the approved list of bacterial names in 1980,6 the number of names of bacteria decreased by an order of magnitude, from approximately 30 000 to approximately 2000 (now estimated7 to be <10 000). The CD (cluster of differentiation) nomenclature of cell-surface molecules is thought to have prevented mistakes in laboratory and clinical research.8

Those are some indications of the compelling need for systematic nomenclature, which requires the ongoing work of international groups. The development of nomenclature, however, faces challenges besides a multiplicity of names. There is tradition—“the ruins of previous systems”9(p7)—which investigators are often reluctant to give up. When disciplines converge—for instance, when the genetics of a physiologic system are delineated—preexisting systems of nomenclature may operate in parallel, and names proliferate.4

A system of nomenclature may face the test of sheer numbers. The count of assigned gene symbols has increased from several hundred10,11 to more than 39 000.12 Another challenge is to remain flexible. Those who deal with nomenclature accept it as a construct13,14,15,16 and have noted the need to reflect new knowledge.14,17 Biomedical classification is arbitrary and artificial, created by humans.18,19 Nomenclature needs to evolve, “directed by insights in genome evolution and metagenomics but also by practical concerns.”7(pp264-265)

Such flexibility, however, places a burden on clinicians, who must replace familiar names with new ones. Often, “colorful or descriptive names,”8(p1245) which are more easily retained,20 give way to more efficient terms, such as the alphanumeric epithets of many systems.

Nomenclature systems may differ markedly in approach. Stability is an overriding principle of the codes of taxonomic nomenclature, which avoid name changes.21 For instance, the bacteriologic code has a provision that a name may be rejected “whose application is likely to lead to accidents endangering health or life or both or of serious economic consequences.”22(p43) For example, the name Yersinia pseudotuberculosis subsp pestis for the plague bacillus was rejected and the name Y pestis retained22,23 because of concerns about public health hazards (owing to confusion of the name of the plague bacillus with that of the less virulent Y pseudotuberculosis24,25). In contrast, currency is an overriding principle of the official human gene nomenclature, with genes renamed to reflect new knowledge. (Of the approximately 260 gene symbols in the first Catalog of Gene Markers after introduction of the current system of gene nomenclature, more than half have been renamed.11,26) However, the principles of stability and currency are not mutually exclusive; for instance, the bacteriologic code requires name changes necessitated by revisions of taxonomy, and the human gene nomenclature acknowledges former names as aliases.

In medical nomenclature, the stylistic trend has been toward typographic simplicity, driven by computers. Terms lose hyphens, superscripts, subscripts, and spaces. However, such features have not been eliminated completely. For example, in 1950 standardized terms in pulmonary-respiratory medicine and physiology were put forth, and typographic features impossible on a typewriter were expressly retained, seen as indispensable components of a systematic and enlightening nomenclature.17 Software is capable of generating unusual characters, and typographic simplification and electronic sophistication may cross paths before medical nomenclature loses its last defining flourishes.

An umbrella resource for biomedical terminology is the Unified Medical Language System (UMLS), a project of the National Library of Medicine (UMLS Knowledge Source Server [UMLSKS]). UMLS is intended to provide integrated terminology (including synonyms and relationships among terms) for use in electronic applications (eg, computer systems, electronic health records, online dictionaries).27,28 A major component of UMLS is the Metathesaurus, a comprehensive repository of biomedical terms and their relationships. The Metathesaurus is accessible online at the UMLS Knowledge Source Server (https://www.nlm.nih.gov/research/umls/knowledge_sources/metathesaurus). That website offers concept and term searches that can be useful to medical authors and editors who seek explanations of particular terms, including their relationships to other terms (eg, human gene, protein, condition, and animal counterparts).28

In an ever-evolving health care system, it will be important to crosswalk research/genomic nomenclature with systems of medical coding, such as International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM)29 and Systematized Nomenclature of Medicine (SNOMED)30 with a high degree of specificity. Without the ability to do this, research and clinical care will be much more challenging in a future where genomic information is a part of the medical record.

Our purpose in the nomenclature chapter is not to explain how names should be devised (although we cite the sources of such rules) but rather which names should be used and how they should be styled. Official systems of nomenclature are not universally observed to the letter (literally or figuratively), but style that is consistent with official guidelines and within publications reduces ambiguity. Editors have the task of mediating between official systems and authors’ actual usage. To that end, the goals of this chapter are to present style for terms in selected fields and to explain terms so that they are more easily dealt with.Note: In this chapter, some style rules described elsewhere in this manual have been waived so as not to cause confusion regarding conventional presentation of terms (eg, in table cells, where normally initial caps would be used on each cell entry, lowercase is used unless the term is to be presented with an initial cap).

Principal Author: Cheryl Iverson, MA

Acknowledgment

Thanks to W. Gregory Feero, MD, PhD, JAMA, and Maine-Dartmouth Family Medicine Residency, Augusta, Maine; Trevor Lane, MA, DPhil, Edanz Group, Fukuoka, Japan; Karen Boyd, formerly with the JAMA Network; and Philip Sefton, MS, ELS, JAMA, for reviewing and providing comments.

References

1.Wilczek F. What’s in a scientific name? Wall Street J. May 27-28, 2017:C4.

2.Greuter W, Hawksworth DL. Preface. In: Greuter W, McNeill J, Farrie FR, et al. International Code of Botanical Nomenclature (St Louis Code). International Association for Plant Taxonomy; 2000. Updated June 28, 2018. Accessed July 23, 2019. https://bgbm.org/iapt/nomenclature/code/saintlouis/0000st.Institute.htm

3.Giangrande PL. Six characters in search of an author: the history of the nomenclature of coagulation factors. Br J Haematol. 2003;121(5):705-712. doi:10.1046/j.1365-2141.2003.04333.x

4.Cammack R. The biochemical nomenclature committees. IUBMB Life. 2000;50(3):159-161. doi:10.1080/152165400300001453

5.Beutler E, McKusick VA, Motulsky AG, Scriver CR, Hutchinson F. Mutation nomenclature: nicknames, systematic names, and unique identifiers. Hum Mutat. 1996;8(3):203-206. doi:10.1002/(SICI)1098-1004(1996)8:3<203::AID-HUMU1> 3.0.CO;2-A

6.Skerman VBD, McGowan V, Sneath PHA. Approved lists of bacterial names. Int J Syst Bacteriol. 1980;30(1):225-420. doi:10.1099/00207713-30-1-225

7.Vandamme PAR. Taxonomy and classification of bacteria. In: Murray PR, ed. Manual of Clinical Microbiology. 11th ed. ASM Press; 2015:255-265.

8.Singer NG, Todd RF, Fox DA. Structures on the cell surface: update from the Fifth International Workshop on Human Leukocyte Differentiation Antigens. Arthritis Rheum. 1994;37(8):1245-1248. doi:10.1002/art.1780370820

9.Wildy P. Classification and Nomenclature of Viruses: First Report of the International Committee on Nomenclature of Viruses. S Karger AG; 1971:1-26. Melnick JL, ed. Monographs in Virology. Vol 5.

10.Shows TB, McAlpine PJ. The 1981 catalogue of assigned human genetic markers and report of the nomenclature committee. Cytogenet Cell Genet. 1982;32(1-4):221-245. doi:10.1159/000131702

11.Evans HJ, Hamerton JL, Klinger HP, McKusick VA. Human Gene Mapping 5: Edinburgh Conference (1979): Fifth International Workshop on Human Gene Mapping. S Karger; 1979.

12.HUGO Gene Nomenclature Committee website. Accessed May 18, 2018. https://www.genenames.org

13.Staley JT, Krieg NR. Bacterial classification, I: classification of procaryotic organisms: an overview. In: Krieg NR, Holt JF, eds. Bergey’s Manual of Systematic Bacteriology. Vol 1. Williams & Wilkins; 1984:1-4.

14.Erzinclioglu YZ, Unwin DM. The stability of zoological nomenclature. Nature. 1986;320:687. doi:10.1038/321476b0

15.Lublin DM, Telen MJ. What is a blood group antigen? Transfusion. 1992;32(5):493. doi:10.1046/j.1537-2995.1992.32592327724.x

16.Lublin DM, Telen MJ. More about use of the term Drb. Transfusion. 1993;33(2):182. doi:10.1046/j.1537-2995.1993.33293158056.x

17.Pappenheimer JR, chairman; Comroe JH, Cournand A, Ferguson JKW, et al. Standardization of definitions and symbols in respiratory physiology. Fed Proc. 1950;9:602-605.

18.Madias JE. Killip and Forrester classifications: should they be abandoned, kept, reevaluated, or modified? Chest. 2000;117(5):1223-1226. doi:10.1378/chest.117.5.1223

19.Vandamme PAR. Taxonomy and classification of bacteria. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, eds. Manual of Clinical Microbiology. 8th ed. ASM Press; 2003:271.

20.Flexner CW. In praise of descriptive nomenclature. Lancet. 1996;347(8993):68.

21.Jeffrey C. Biological Nomenclature. 3rd ed. Routledge Chapman & Hall; 1989.

22.Lapage SP, Sneath PHA, Lessel EF, Skerman VBD, Seeliger HPR, Clark WA; Sneath PHA, ed. International Code of Nomenclature of Bacteria and Statutes of the Bacteriology and Applied Microbiology Section of the International Union of Microbiological Societies, 1990 Revision. American Society for Microbiology; 1992.

23.Euzéby JP. List of prokaryotic names with standing in nomenclature: genus Yersinia. Accessed July 30, 2019. http://www.bacterio.net/yersinia.html

24.Williams JE. Proposal to reject the new combination Yersinia pseudotuberculosis subsp pestis for violation of the first principles of the International Code of Nomenclature of Bacteria: request for an opinion. Int J Syst Bacteriol. 1984;34(2):268-269. doi:10.1099/00207713-34-2-268

25.Judicial Commission of the International Committee on Systematic Bacteriology. Rejection of the name Yersinia pseudotuberculosis subsp. pestis (van Loghem) Bercovier et al. 1981 and conservation of the name Yersinia pestis (Lehmann and Neumann) van Loghem 1944 for the plague bacillus. Int J Syst Bacteriol. 1985;35(4):540. doi:10.1099/00207713-35-4-540

26.Gray KA, Seal RL, Tweedie S, Wright MW, Bruford EA. A review of the new HGNC gene family resource. Hum Genomics. February 2, 2016:10:6. doi:10.1186/540246-016-0062.6

27.US National Library of Medicine. Unified Medical Language System. Published July 29, 2009. Updated December 21, 2017. Accessed July 23, 2019. https://www.nlm.nih.gov/research/umls/about_umls.html

28.Bodenreider O. The Unified Medical Language System (UMLS): integrating biomedical terminology. Nucleic Acids Res. 2004;32(database issue):D267-D270. doi:10.1093/nar/gkh061

29.World Health Organization. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Updated August 18, 2017. Accessed May 18, 2018. https://www.cdc.gov/nchs/icd/icd10cm.htm

30.Overview of SNOMED CT. Published October 5, 2016. Updated October 14, 2016. Accessed July 23, 2019. https://www.nlm.nih.gov/healthit/snomedct/snomed_overview.html

14.1 Blood Groups, Platelet Antigens, and Granulocyte Antigens.

14.1.1 Blood Groups.

Blood groups in humans are characterized by erythrocyte (red blood cell) antigens with common immunologic properties. Blood group systems are series of such antigens encoded by a single gene or by a cluster of 2 or 3 closely linked homologous genes.1,2,3

The International Society of Blood Transfusion (ISBT) recognizes 346 antigen specificities and 36 blood group systems.4,5,6,7 Other antigens may be assigned in the future but remain in officially designated series or collections. Some antigens are erythrocyte specific; others appear widely, but specifically, on cells of other organs and tissues.

The discovery of blood group antigens was prompted by hemolytic disease of the newborn and transfusion reactions, but many antigens have since been implicated in infection and other disease processes.1,8 Erythrocytes are estimated to contain millions of antigen sites.1

14.1.1.1 Traditional/Popular Nomenclature.

Traditional blood group system nomenclature is typically used in medical publications. “Until recently there was no attempt to be systematic. In the past, some blood groups were named after the individual . . . or animal . . . lacking the antigen. Others were named after the discoverers.”6(p509) Some laboratories still use the traditional names, and some laboratories use other traditional nomenclature. Sometimes the same entity (eg, a particular erythrocyte antigen) can be expressed by more than one term. Authors and editors should generally follow the recommendations herein.

The principal elements named are blood group systems, antigens, phenotypes, genes, and alleles.

14.1.1.1.1 Blood Group Systems.

Table 14.1-1 lists the blood group system names and symbols. (The column of derivations of names of blood group systems is provided for background interest.1,2,6,9,10,11,12,13,14,15,16,17)

Table 14.1-1. Blood Group System Names and Symbols

System name

System symbol

Derivation

ABO

ABO

Alphabetical (A and B); letter O may derive from “ohne” (German for without)

Chido/Rodgers

CH/RG

Names of antibody makers (Mrs Chido and Mr Rodgers)

Colton

CO

Name of antibody maker Coa (from Calton [should have been Ca but handwriting on tube was misread as Colton])

Cromer

CROM

Name of antibody maker (Mrs Cromer)

Diego

DI

Name of antibody maker (Mrs Diego)

Dombrock

DO

Named after proband

Duffy

FY

Name of antibody maker (Mr Duffy)

Forssman

FORS

Named after John Forssman, Swedish pathologist (Forssman antigen)

Gerbich

GE

Name of antibody maker (originally described by the “Yus-type” antibody)

Gill

GIL

Named after proband

Globoside

GLOB

Globoside synthetase

H

H

Concept (“heterogenetic”)

I

I

Concept (“individuality”)

Indian

IN

Geographic

John Milton Hagen

JMH

Initials of antibody maker

JR

JR

Rose Jacobs, name of antibody maker

Kell

KEL

Name of antibody maker (Kelleher)

Kidd

JK

Initials of infant of antibody maker (K already in use)

Knops

KN

Name of antibody maker (named after 1 of 3 siblings)

Kx

XK

Association with Kell and X chromosome

LAN

LAN

Langereis, name of antibody maker

Landsteiner-Wiener

LW

Names of investigators

Lewis

LE

Named after 1 of 2 original antibody makers

Lutheran

LU

Name of antibody maker (actually Lutteran10 or Luteran14)

MNS

MNS

M, N: the word immune S: location (Sydney, Australia) U (an antigen of this system): universal

Ok

OK

Family name initials (Kobutso; letters reversed because “Ko” was in use)

P

P1

Alphabetical

Raph

RAPH

Name of antibody maker

Rh

RH

Rhesus monkeys (antigens were LW antigens)

Rh-associated glycoprotein

RHAG

Rh-associated glycoprotein

Scianna

SC

Name of antibody maker (Scianna)

Xg

XG

X chromosome and location (Grand Rapids, Michigan)

Yt

YT

Name of antibody maker (Cartwright)

The ISBT prefers an all-capital style for blood group system symbols4 (see 14.1.1.2, ISBT Name and Number).

The following are examples of usage:

ABO incompatibility

A cell

type AB recipient

type O donor

Hemolytic disease of the newborn occurs primarily from incompatibilities of the Rh, ABO, or Kell blood groups.

14.1.1.1.2 Antigens.

Antigen terms use single or dual letters, often with a qualifier that is a letter (usually superscript) or number (subscript or typeset on the line).

A, A1, A2, Ax, B

Cra

Fya, Fyb

He

Jka, Jkb

K, k

Kpa, Kpb, Ku, Jsa, Jsb

K11, K12, K13, K14, Km

Lea, Leb, LebH, ALeb, BLeb

Lua, Lub

Lu3, Lu4, Lu5, Lu6

P1

Sc1, Sc2

Xga

The Rh system historically has used 3 alternative schemes: the Wiener system, the Fisher-Race system, and the Rosenfield (numerical) system.6 Although the first 2 models are not supported by genetic analysis, they are both used widely today because of their familiarity.6(p516) For an example of the 3 different systems for a single term, see below6(p516):

Rh1 (Rosenfield)

D (Fisher-Race)

Rh0 (Wiener)

14.1.1.1.3 Phenotypes.

In phenotypic expressions—terms that describe an individual’s blood group or type—the presence or absence of an antigen is often indicated by a plus or minus sign:

Antigen:

M

Phenotype:

M+

M+N+S−s+ erythrocytes

M+N+S−s+ phenotype

Lowercase letters that were superscripts in the antigen terms are set on the line in parentheses in phenotypic terms.

Antigen:

Lub

Phenotype:

Lu(b+)

More than 98% of the Western population is Lu(b+).

If the numerical terminology is used for the antigen, a colon is added in the phenotype.

Antigen:

Sc1

Phenotype:

Sc:1

the Sc:1,−2,3 phenotype

Other sample phenotypic terms include the following:

Fy(a−b+), Fy(a+b−), Fy(a−b−)

Jk(a−b+), Jk(a+b−), Jk(a+b+)

K+k−, Kp(a−b+), Js(a−b+)

Le(a−b+), Le(a+b−), Le(a−b−)

Lu(a−b+), Lu(a+b−), Lu(a+b+)

M+N+, M+,N−, M−N+, S+s+, S+s−, S−s+

P1, P2, P1k, P2k

Xg(a+), Xg(a−)

the silent phenotype Le(a−b−)

A superscript w can indicate a weak reaction:

M+w

K+w

Fy(a+w)

The ABO system is an exception: its phenotypic terms do not feature plus or minus signs; A (not A+) indicates A erythrocyte antigens; O (not A− B−) indicates the absence of A and B antigens:

Groups:

O, A, B, AB, Oh, OhA

Subgroups:

A1, A2, A1B, A2B

OhA individuals do not express the H determinant but have the A allele.

Terms for Rh phenotypes, which do not feature plus and minus signs, are also in use:

D-positive (Rh positive)

D-negative (Rh negative)

DccE, DCce

RH:1,2,3

Rhnull

Absence of C, c, E, and/or e antigens is indicated with 1 or 2 dashes15:

Dc− (1 dash)

D— (2 dashes)

Terms such as O+ (“O positive”), A+, and AB− are common parlance as shorthand for blood of the ABO system and its Rh specificity. However, in scientific articles, use standard terms that specifically indicate Rh status:

O Rh-positive

O Rh+

Note that this may be written either O Rh-positive or O Rh+.

An individual is considered Rh positive if his or her red blood cells express the D antigen. Conversely, Rh negative indicates the absence of the D antigen.1(p2266),6(p516) If the D antigen is present, the correct expression is Rh D-positive; if absent, Rh D-negative. Only if the specific Rh D status is being indicated is the word positive or negative preferred to the plus or minus sign.

group B, Rh D-negative

group A, Rh D-positive

In a blood group profile, elements from different systems may be separated by commas, as above, or, for more complex specificities, with semicolons:

The patient’s blood was group B, Rh-positive, D+ C+ c+ E− e+; M+ N+ S− s+; P1+; Le(a−b−); K− k+; Fy(a−b+); Jk(a+b−).18(p846)

Note that in phenotypic expressions commas do not appear within elements of the same blood group system:

Use: D+ C+ c+ E− e+

Not: D+, C+, c+, E−, e+

Commas may be dispensed with between blood groups in brief expressions:

K+Fy(a+)

14.1.1.1.4 Genes. As with International Standard Gene Nomenclature (the Human Genome Organization [HUGO] recommendations; see 14.6.2, Human Gene Nomenclature), the ISBT gene terms are italicized. Traditional blood group gene symbols are often mixed uppercase and lowercase letters. However, symbols recommended by the ISBT, like those of HUGO, use all capital letters.

Table 14.1-23,4,6(pp510-511),8,19 lists gene symbols associated with blood group systems.

Table 14.1-2. Gene Symbols and Associated Blood Group Systems

Traditional

ISBT

HUGO

ABO (ABO)

ABO

ABO

Chido/ Rodgers (CH/RG)

CH/RG

C4B, C4A

Colton (CO)

CO

AQP1

Cromer (CROM)

CROM

CD55

Diego (DI)

DI

SLC4A1

Dombrock (DO)

DO

ART4

Duffy (FY)

FY

DARC

Forssman (FORS)

GBGT1

GBGT1

Gerbich (GE)

GE

GYPC

Gill (GIL)

GIL

AQP3

Globoside (GLOB)

GLOB

B3GALNT1

H

H

FUT1

I (I)

IGTN

GCNT2

Indian (IN)

IN

CD44

John Milton Hagen (JMH)

JMH

SEMA7A

JR (Junior)

ABCG2

ABCG2

Kell (KEL)

KEL

KEL

Kidd (JK)

JK

SLC14A1

Knops (KN)

KN

CR1

Kx (XK)

XK

XK

LAN (Langereis)

ABCB6

ABCB6

Landsteiner-Wiener (LW)

LW

ICAM4

Lewis (LE)

LE

FUT3

Lutheran (LU)

LU

B-CAM

MNS

MNS

GYPA, GYPB, GYPE

Ok (OK)

OK

BSG

P (P1)

P1

P1

Raph (RAPH)

RAPH

CD151

Rh (RH)

RH

RHD, RHCE

Rh-associated glycoprotein (RHAG)

RHAG

RHAG

Scianna (SC)

SC

ERMAP

Xg (XG)

XG

XG

Yt (YT) (Cartwright)

YT

ACHE

Abbreviations: ISBT, International Society of Blood Transfusion; HUGO, Human Genome Organization.

Gene symbols expressed according to ISBT4 or HUGO19 are preferred to traditional symbols.

Parenthetic synonyms are helpful:

BSG (formerly Ok), OK (BSG, EMPRIN)

ERMAP (also called SC), SC (ERMAP)

The Lutheran inhibitor gene is expressed as follows:

In(Lu) [traditional]

INLU [standard]

Do not confuse In with the traditional Indian blood group gene symbol IN (recommended symbol: CD44).

14.1.1.1.5 Alleles.

The italicized blood group symbol (eg, BO, MNS, RH) is used for alleles (which are also distinguished by an asterisk and number).20 In the following example, compare the gene symbol and an allele term from the same blood group:

SC*1 [allele]

ERMAP [gene symbol]

Note that qualifiers that are subscripts in antigen terms are superscripts in allelic terms (eg, A1 antigen, A1 allele). The following are examples of genotypic terms.

A1O, A1A1, A1B, OO

MN, MM, NN, MSNs

DCe/DCe (R1R1)

DcE/dce (R2r)

dce/dce (rr)

D− −/D− −

LuaLua, LubLub, LuaLub

Lele, LeLe, lele

FyaFya, FybFyb, FyFy

Kk, Kpb,Kpb, JsbJsb

JkaJka, JkbJkb, JkaJkb

XgaXga, XgaXg, XgXg

XgaY, XgY

For expressing alleles, the ISBT gives an option: Fya or FY*01. Mixing the 2 styles, however (eg, FY*A), is not appropriate.17

14.1.1.2 ISBT Name and Number.

In the 1980s, the Working Party on Terminology for Red Cell Surface Antigens of the ISBT3,8,21,22 developed an alphanumeric system of blood group notation (Table 14.1-3), intended to provide “a uniform nomenclature that is both eye and machine readable and in keeping with the genetic basis of blood groups.”9(p273) The system does not replace traditional terminology; rather, its terms correspond to traditional terms. It is also used to assign new terms as needed. In the ISBT terminology, each blood group system has a symbol, usually of 1 to 3 capital letters, and a system number of 3 digits. “Each blood group antigen is given an identification number consisting of six digits. The first three numbers represent the system to which the antigen has been assigned. The second three digits identify the antigen. Each system has an alphabetic symbol. For example, the ABO system is number 001, and the A antigen is the first antigen of that system; thus it has the ISBT number 001001 or ABO001. By convention, zeros may be omitted, and numbers are separated by a dot (i.e., the A antigen would be 1.1 or ABO1).”6(p510)

Table 14.1-3. The Alphanumeric System of Blood Group Notation

System

Antigen No. within system

Name

Symbol

No.

001

002

003

004

ABO

ABO

001

A

B

A,B

A1

MNS

MNS

002

M

N

S

s

Rh

RH

004

D

C

E

c

Kx

XK

019

Kx




Sinistral (left-hand) zeros can be dropped from system and antigen terms, and system letter symbols can be used as part of the alphanumeric term. The following, for instance, are all acceptable for blood type AB:

AB

ABO:1,2,3

001:1,2,3

The following are acceptable terms for the antigen A,B:

A,B

ABO3

001003

Authors may use ISBT4 terms in parentheses after traditional terms:

AB (1.3)

D (RH1)

Lea (007001)

The patient’s red blood cells were negative for Cromer blood system antigens Cra (CROM1) and Tca (CROM2).

In systems that use plus and minus signs to express the presence and absence of particular antigens, phenotypic expressions in the numerical notation use a colon and numbers in place of letters, as in these examples:

LE:−1,2 [for Le(a−b+)]

FY:1,−2 [for FY(a+b−)]

Genotypic expressions are italicized:

FY 1/2 or FY*1/2 (for FyaFyb)

Tables of blood group systems, symbols, antigens, and ISBT numbers are available at the ISBT Committee on Terminology for Red Cell Surface Antigens website.4

14.1.2 Platelet-Specific Antigens.

The current system of human platelet antigen (HPA) nomenclature, adopted in 1990, is overseen by the Platelet Nomenclature Committee of the ISBT and the International Society on Thrombosis and Haemostasis.23,24 As with blood groups, there are platelet antigen systems and specific antigens within those systems. The HPA nomenclature pertains to “all protein alloantigens expressed on the platelet membrane, except those coded by genes of the major histocompatibility complex (MHC)”23 (see 14.8.5, HLA/Major Histocompatibility Complex). Currently, there are 6 HPA systems: HPA-1, HPA-2, HPA-3, HPA-4, HPA-5, and HPA-15.24

Complete tables of HPA terms are available at the Immuno Polymorphism Database (IPD-HPA) website.24,25 To date, 33 platelet-specific antigens have been characterized. Currently, there are 27 HPA systems (HPA1-14 and HPA15-27).7(pp453-455) Sample terms are listed in Table 14.1-4.

Table 14.1-4. Sample Terms From Human Platelet Antigen (HPA) Nomenclature

Term

Abbreviation

Antigen system

HPA-1

Associated glycoprotein

GpIIIa

CD designation of glycoprotein

CD61

Former names

Zw, P1A

Antigens

HPA-1a HPA-1b

Former antigen names

Zwa, P1A1 Zwb, P1A2

Gene

ITGB3

Alleles

ITGB3*001 ITGB3*002

Epitopes

HPA-1a HPA-1b

Locuslink ID

3690

Ref_Seq

NM_000212

Swiss-Prot

ITB3_Human

Nucleotide change

176T>C

For CD (clusters of differentiation) nomenclature, see 14.8.7, Lymphocytes. For gene and allele nomenclature, see 14.6.2, Human Gene Nomenclature. For database identifiers and nucleotide nomenclature, see 14.6.1, Nucleic Acids and Amino Acids.

14.1.3 Granulocyte Antigens.

The Granulocyte Antigen Working Party of the ISBT has formulated rules for well-defined human neutrophil antigens,26 as presented in Table 14.1-5, although at this writing they have not met with universal acceptance.6(p540),27,28

Table 14.1-5. ISBT Rules for Well-Defined HNAs

Antigen system

Antigen

Former name

Alleles

HNA-1

HNA-1a

NA1

FCGR3B*1 (CD16)


HNA-1b

NA2

FCGR3B*2 (CD-16)


HNA-1c

SH

FCGR3B*3 (CD-16)

HNA-2

HNA-2a

NB1

CD177*1

HNA-3

HNA-3a

5b

CTL2

HNA-4

HNA-4a

Marta

CD11B*1

HNA-5

HNA-5a

Onda

CD11A*1

Abbreviations: HNA, human neutrophil antigen; ISBT, International Society of Blood Transfusion.

See 14.8.6, Immunoglobulins, for Fc receptor terminology and 14.8.7, Lymphocytes, for CD terminology.

Principal Author: Cheryl Iverson, MA

Acknowledgment

Thanks to Emmanuel A. Fadeyi, MD, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, for reviewing and providing comments.

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