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{{Protein
{{Infobox protein
   |Name=Kell protein
   |Name=Kell protein
   |image=
   |image=
   |caption=
   |caption=
   |Symbol=KEL
   |Symbol=KEL
   |AltSymbols=
   |AltSymbols=ECE3, CD238
   |HGNCid=6308
   |HGNCid=6308
   |Chromosome=7
   |Chromosome=7
Line 17: Line 17:
   |PDB=
   |PDB=
}}
}}
{{SI}}
The '''Kell antigen system''' (also known as '''Kell–Cellano system''') is a group of [[antigen]]s on the human red blood cell surface which are important determinants of [[blood type]] and are targets for [[autoimmune disease|autoimmune]] or [[alloimmunity|alloimmune]] diseases which destroy red blood cells. Kell can be noted as '''K''', '''k''', or '''Kp'''.<ref name="pmid13666821">{{cite journal |vauthors=Kaita H, Lewis M, Chown B, Gard E | title = A further example of the Kell blood group phenotype K-,k-,Kp(a-b-) | journal = Nature | volume = 183 | issue = 4675 | pages = 1586 |date=June 1959 | pmid = 13666821 | doi = 10.1038/1831586b0 | url = | issn = }}</ref><ref name="urlThe Kell blood group">{{cite web | url = https://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch08Kell | title = The Kell blood group -- Blood Groups and Red Cell Antigens | author = Dean L | date = | format = | work = NCBI Bookshelf | publisher = National Center for Biotechnology Information - United States National Institutes of Health | pages = | language = | archiveurl = | archivedate = | quote = | accessdate = 2009-05-04}}</ref>  The Kell antigens are [[peptides]] found within the '''Kell protein''', a 93-[[kilodalton]] [[transmembrane]] [[zinc]]-dependent [[endopeptidase]] which is responsible for cleaving [[endothelin-3]].<ref name="pmid7849312">{{cite journal |vauthors=Lee S, Wu X, Reid M, Zelinski T, Redman C | title = Molecular basis of the Kell (K1) phenotype | journal = Blood | volume = 85 | issue = 4 | pages = 912–6 | year = 1995 | pmid = 7849312 | doi = | issn = | url = http://bloodjournal.hematologylibrary.org/cgi/content/abstract/bloodjournal;85/4/912 }}</ref><ref name="pmid10438732">{{cite journal |vauthors=Lee S, Lin M, Mele A, Cao Y, Farmar J, Russo D, Redman C | title = Proteolytic processing of big endothelin-3 by the kell blood group protein | journal = Blood | volume = 94 | issue = 4 | pages = 1440–50 | year = 1999 | pmid = 10438732 | doi = | issn = | url = http://bloodjournal.hematologylibrary.org/cgi/content/abstract/bloodjournal;94/4/1440 }}</ref>
{{CMG}}


== Protein ==


The ''KEL'' gene encodes a type II transmembrane [[glycoprotein]] <ref>Russo DC, Lee S, Reid M, Redman CM. Topology of Kell blood group protein and the expression of multiple antigens by transfected cells.  Blood. 1994 Nov 15;84(10):3518-23.</ref> that is the highly [[Polymorphism (biology)#Genetic polymorphism|polymorphic]] Kell blood group antigen. The Kell glycoprotein links via a single [[disulfide bond]] to the [[XK (protein)|XK membrane protein]] <ref>Russo DC, Redman C, Lee S. Association of XK and Kell blood group proteins. J Biol Chem. 1998 May 29;273(22):13950-6.</ref> that carries the [[Kx antigen]]. The encoded protein contains sequence and structural similarity to members of the [[neprilysin]] (M13) family of [[zinc]] [[endopeptidase]]s.<ref name="entrez">{{cite web | title = Entrez Gene: KEL | url = https://www.ncbi.nlm.nih.gov/sites/entrez?Db=gene&Cmd=ShowDetailView&TermToSearch=3792| accessdate = }}</ref>


The '''Kell antigen system''' (also known as '''Kell-Cellano system''') is a group of [[antigen]]s on the human red blood cell surface which are important determinants of [[blood type]] and are targets for [[autoimmune disease|autoimmune]] or [[alloimmunity|alloimmune]] diseases which destroy red blood cells. The Kell antigens are [[peptides]] found within the '''kell protein''', a 93 [[kilodalton]] transmembrane [[zinc]]-dependent endopeptidase which is responsible for cleaving [[endothelin-3]].<ref>Lee S, Wu X, Reid M, Zelinski T, Redman C. ''Molecular basis of the Kell (K1) phenotype.'' Blood. 1995 Feb 15;85(4):912-6. PMID 7849312 </ref><ref>Lee S, Lin M, Mele A, Cao Y, Farmar J, Russo D, Redman C. ''Proteolytic processing of big endothelin-3 by the kell blood group protein.'' Blood. 1999 Aug 15;94(4):1440-50. PMID 10438732</ref>
There are several [[allele]]s of the [[gene]] which creates Kell protein. Two such alleles, ''K<sub>1</sub>'' (Kell) and ''K<sub>2</sub>'' (Cellano), are the most common. The kell protein is tightly bound to a second protein, [[XK (protein)|XK]], by a [[disulfide bond]]. Absence of the XK protein (such as through [[genetic deletion]] or through a single point mutation within the coding region of the XK gene <ref>{{cite journal |vauthors=Russo DC, Lee S, Reid ME, Redman CM | date = Mar 2002 | title = Point mutations causing the McLeod phenotype | url = | journal = Transfusion | volume = 42 | issue = 3| pages = 287–93 | doi=10.1046/j.1537-2995.2002.00049.x}}</ref>), leads to marked reduction of the Kell antigens on the red blood cell surface. Absence of the Kell protein (K<sub>0</sub>), however, does not affect the XK protein.<ref name="pmid11134029">{{cite journal |vauthors=Yu LC, Twu YC, Chang CY, Lin M | title = Molecular basis of the Kell-null phenotype: a mutation at the splice site of human KEL gene abolishes the expression of Kell blood group antigens | journal = J. Biol. Chem. | volume = 276 | issue = 13 | pages = 10247–52 | year = 2001 | pmid = 11134029 | doi = 10.1074/jbc.M009879200 }}</ref>


There are several [[allele]]s of the [[gene]] which creates Kell protein. Two such alleles, ''K<sub>1</sub>'' (Kell) and ''K<sub>2</sub>'' (Cellano), are the most common. The kell protein is tightly bound to a second protein, [[XK (protein)|XK]], by a [[disulfide bond]]. Absence of the XK protein (such as through [[genetic deletion]]), leads to marked reduction of the Kell antigens on the red blood cell surface. Absence of the Kell protein (K<sub>0</sub>), however, does not affect the XK protein.<ref>Yu LC, Twu YC, Chang CY, Lin M. ''Molecular basis of the Kell-null phenotype: a mutation at the splice site of human KEL gene abolishes the expression of Kell blood group antigens.'' J Biol Chem. 2001 Mar 30;276(13):10247-52. Epub 2000 Dec 27. PMID 11134029</ref>
The Kell protein has also recently been designated '''CD238''' ([[cluster of differentiation]] 238).


== Disease association ==
== Disease association ==
Kell antigens are important in [[transfusion medicine]], [[autoimmune hemolytic anemia]], and [[hemolytic disease of the newborn]]. Individuals lacking a specific Kell antigen may develop [[antibody|antibodies]] against Kell antigens when transfused with blood containing that antigen. Subsequent blood transfusions may be marked by destruction of the new cells by these antibodies, a process known as [[hemolysis]]. People without Kell antigens(K<sub>0</sub>), must be transfused with blood from donors who are also K<sub>0</sub> to prevent hemolysis.


[[Autoimmune hemolytic anemia]] (AIHA) occurs when the body produces an antibody against a blood group antigen on its own red blood cells. The antibodies lead to destruction of the red blood cells with resulting [[anemia]]. Similarly, a pregnant woman may develop antibodies against fetal red blood cells, resulting in destruction, anemia, and [[hydrops fetalis]] in a process known as [[Hemolytic disease of the newborn (anti-Kell)|hemolytic disease of the newborn]] (HDN). Both AIHA and HDN may be severe when caused by anti-Kell antibodies,<ref>Wiener CP, and Widness JA.  ''Decreased fetal erythropoiesis and hemolysis in Kell hemolytic anemia.'' American Journal of Obstetrics and Gynecology. 1996 174: 547-55 PMID 8623782</ref> as they are the most immunogenic antigens after those of the [[ABO blood group system|ABO]] and [[Rhesus blood group system]]s.
Kell antigens are important in [[transfusion medicine]], [[autoimmune hemolytic anemia]] and [[hemolytic disease of the newborn (anti-Kell)]]. Anti-K is the next most common immune red cell antibody after those in the ABO and Rh system. Anti-K typically presents as IgG class alloantibody. Individuals lacking a specific Kell antigen may develop [[antibody|antibodies]] against Kell antigens when transfused with blood containing that antigen. This is particularly true for the "K" antigen which shows a relatively high antigenicity and moderately low frequency (~9%) in Caucasian populations. Anti-K can also occur following transplacental hemorrhage (TPH) associated with childbirth making Kell an important concern for [[hemolytic disease of the newborn]]. Following the formation of anti-K, subsequent blood transfusions may be marked by destruction of the new cells by these antibodies, a process known as [[hemolysis]]. Anti-K does not bind complement, therefore hemolysis is extravascular. Individuals without K antigens(K<sub>0</sub>) who have formed an antibody to a K antigen, must be transfused with blood from donors who are also K<sub>0</sub> to prevent hemolysis.


==McLeod phenotype==
[[Autoimmune hemolytic anemia]] (AIHA) occurs when the body produces an antibody against a blood group antigen on its own red blood cells. The antibodies lead to destruction of the red blood cells with resulting [[anemia]]. Similarly, a pregnant woman may develop antibodies against fetal red blood cells, resulting in destruction, anemia, and [[hydrops fetalis]] in a process known as [[Hemolytic disease of the newborn (anti-Kell)|hemolytic disease of the newborn]] (HDN). Both AIHA and HDN may be severe when caused by anti-Kell antibodies,<ref name="pmid8623782">{{cite journal |vauthors=Weiner CP, Widness JA | title = Decreased fetal erythropoiesis and hemolysis in Kell hemolytic anemia | journal = Am. J. Obstet. Gynecol. | volume = 174 | issue = 2 | pages = 547–51 | year = 1996 | pmid = 8623782 | doi = 10.1016/S0002-9378(96)70425-8 }}</ref> as they are the most immunogenic antigens after those of the [[ABO blood group system|ABO]] and [[Rhesus blood group system]]s.
{{main|McLeod syndrome}}
McLeod phenotype (or McLeod syndrome) is an [[X-linked]] anomaly of the Kell blood group system in which Kell antigens are poorly detected by laboratory tests. The McLeod gene encodes the XK protein, a protein with structural characteristics of a membrane transport protein but an unknown function. The XK appears to be required for proper synthesis or presentation of the Kell antigens on the red blood cell surface.


==History==
== McLeod phenotype ==
The Kell group was named after the first patient described with antibodies to K<sub>1</sub>, a pregnant woman named Mrs. Kellacher in 1945.<ref>Coombs RRA, Mourant AE, Race RR. ''A new test for the detection of weak and incomplete Rh agglutinins.'' Br J Exp Pathol 1945;26:255</ref> Mrs. Cellano was likewise a pregnant woman with the first described antibodies to K<sub>2</sub>. The K<sub>0</sub> [[phenotype]] was first described in 1957 and the McLeod phenotype was found in Hugh McLeod, a Harvard dental student, in 1961. <ref>Chown B, Lewis M, Kaita K. ''A new Kell blood-group phenotype.'' Nature. 1957 Oct 5;180(4588):711. PMID 13860532</ref><ref>Allen FH Jr, Krabbe SM, Corcoran PA. ''A new phenotype (McLeod) in the Kell blood-group system.'' Vox Sang. 1961 Sep;6:555-60. PMID 13477267</ref>


== Other associations ==
{{main article|McLeod syndrome}}
Evidence supports a genetic link between the Kell blood group (on [[chromosome 7]] q33) and the ability to taste [[phenylthiocarbamide]], or PTC, a bitter-tasting [[thiourea]] compound.
McLeod phenotype (or McLeod syndrome) is an [[X-linked]] anomaly of the Kell blood group system in which Kell antigens are poorly detected by laboratory tests. The McLeod gene encodes the XK protein, a protein with structural characteristics of a membrane transport protein but of unknown function. The XK appears to be required for proper synthesis or presentation of the Kell antigens on the red blood cell surface.
<ref>Crandall BF, Spence MA. ''Linkage relations of the phenylthiocarbamide locus (PTC).'' Hum Hered. 1974;24(3):247-52.PMID 4435792</ref>
<ref>Conneally PM, Dumont-Driscoll M, Huntzinger RS, Nance WE, Jackson CE. ''Linkage relations of the loci for Kell and phenylthiocarbamide taste sensitivity.'' Hum Hered. 1976;26(4):267-71. PMID 976995</ref>
Bitter taste receptor proteins in the taste buds of the tongue that recognise PTC are encoded on nearby chromosome [[Locus (genetics)|locus]] 7 q35-6.


== References ==
== History ==


*{{OMIM|110900}} - OMIM entry for Kell protein
The Kell group was named after the first patient described with antibodies to K<sub>1</sub>, a pregnant woman named Mrs. Kellacher in 1945.<ref>Coombs RRA, Mourant AE, Race RR. ''A new test for the detection of weak and incomplete Rh agglutinins.'' Br J Exp Pathol 1945;26:255</ref> Mrs. Cellano was likewise a pregnant woman with the first described antibodies to K<sub>2</sub>. The K<sub>0</sub> [[phenotype]] was first described in 1957 and the McLeod phenotype was found in Hugh McLeod, a [[Harvard]] dental student, in 1961.<ref name="pmid13477267">{{cite journal |vauthors=Chown B, Lewis M, Kaita K | title = A new Kell blood-group phenotype | journal = Nature | volume = 180 | issue = 4588 | pages = 711 | year = 1957 | pmid = 13477267 | doi = 10.1038/180711a0 }}</ref><ref name="pmid13860532">{{cite journal |author1=Allen FH Jr |author2=Krabbe SM |author3=Corcoran PA | title = A new phenotype (McLeod) in the Kell blood-group system | journal = Vox Sang. | volume = 6 | issue = 5| pages = 555–60 | year = 1961 | pmid = 13860532 | doi = 10.1111/j.1423-0410.1961.tb03203.x }}</ref>
*{{OMIM|314850}} - OMIM entry for XK protein
<references/>


== External links ==
In 2010, researchers speculated that King [[Henry VIII of England]] had Kell-positive blood type, explaining the deaths of seven of his ten children at, or soon after, birth, and suggesting that his mental deterioration around age 40 could be explained by McLeod Syndrome;<ref>[http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7918883 A NEW EXPLANATION FOR THE REPRODUCTIVE WOES AND MIDLIFE DECLINE OF HENRY VIII], by Catrina Banks Whitley and Kyla Kramer, in ''[[the Historical Journal]]''; Volume 53 / Issue 04 / December 2010, pp 827-848; {{DOI|10.1017/S0018246X10000452}}</ref> this was supported by the revelation that Henry may have inherited Kell from his maternal great-grandmother, [[Jacquetta of Luxembourg]].<ref>{{cite journal | pmid = 24350322 | doi=10.4997/JRCPE.2013.417 | volume=43 | title=Henry VIII, McLeod syndrome and Jacquetta's curse |vauthors=Stride P, Lopes Floro K | journal=J R Coll Physicians Edinb | pages=353–60}}</ref>


* [http://www.ncbi.nlm.nih.gov/projects/mhc/xslcgi.fcgi?cmd=bgmut/systems_info&system=kell Kell at BGMUT] Blood Group Antigen Gene Mutation Database at [[NCBI]], [[NIH]]
== Other associations ==


Evidence supports a genetic link between the Kell blood group (on [[chromosome 7]] q33) and the ability to taste [[phenylthiocarbamide]], or PTC, a bitter-tasting [[thiourea]] compound.<ref name="pmid4435792">{{cite journal |vauthors=Crandall BF, Spence MA | title = Linkage relations of the phenylthiocarbamide locus (PTC) | journal = Hum. Hered. | volume = 24 | issue = 3 | pages = 247–52 | year = 1974 | pmid = 4435792 | doi = 10.1159/000152657 }}</ref><ref name="pmid976995">{{cite journal |vauthors=Conneally PM, Dumont-Driscoll M, Huntzinger RS, Nance WE, Jackson CE | title = Linkage relations of the loci for Kell and phenylthiocarbamide taste sensitivity | journal = Hum. Hered. | volume = 26 | issue = 4 | pages = 267–71 | year = 1976 | pmid = 976995 | doi = 10.1159/000152813 }}</ref> Bitter taste receptor proteins in the taste buds of the tongue that recognise PTC are encoded on nearby chromosome [[Locus (genetics)|locus]] 7 q35-6.


{{transfusion medicine}}
==Data tables==
{| border=1 style="border-collapse:collapse" cellpadding=4
|- bgcolor="#cccccc"
!colspan="10"|Frequency of kell factor
|-<!--This data table has some differences with the Lee (1965) data table regarding presentation which were done to improve the clarity of the data table and not done to change the meaning of the data table. The Lee (1965) data table did not repeat the phrase "by Lee" in front of the "Previous series", "Present series" and "Combined series" rows. Instead, the Lee (1965) data table made the phrase "by Lee" a separate row between the "Korean" row and the "Previous series" row. This data table repeats the phrase "by Lee" on all three rows which makes it so there does not have to be a separate row like in the Lee (1965) data table that only says "by Lee". This change reduces the vertical space required by this data table, and this change makes it clear that the "by Lee" phrase applies to all three of these rows at a glance. The Lee (1965) data table did not put a dividing line between the "No." and "%" columns, and it just used a space to separate them. This data table has a dividing line between these two columns to make it clear that they are separate columns. The Lee (1965) data table put the "No." and "%" row in the same row as the "Korean" row which made it seem like "No." and "%" were data entries of the "Korean" data label. This data table has the "No." and "%" row above the "Korean" row, so it can easily be seen that the "No." and "%" data labels are for the data entries within their columns and not data entries themselves for the "Korean" data label.-->
!style="background-color: gainsboro;" rowspan="2"| ||style="background-color: gainsboro;" rowspan="2"|Number<br> tested||style="background-color: gainsboro;" colspan="2"|K+||style="background-color: gainsboro;" colspan="2"|K-
|-
|style="background-color: gainsboro;font-weight:bold;" align="center"|[[Numero sign|No.]]||style="background-color: gainsboro;font-weight:bold;" align="center"|[[Percent sign|%]]||style="background-color: gainsboro;font-weight:bold;" align="center"|[[Numero sign|No.]]||style="background-color: gainsboro;font-weight:bold;" align="center" |[[Percent sign|%]]
|-
|style="background-color: gainsboro;font-weight:bold;" align="left" |[[Koreans|Korean]]||style="background-color: gainsboro;"| ||style="background-color: gainsboro;"| ||style="background-color: gainsboro;"| ||style="background-color: gainsboro;"| ||style="background-color: gainsboro;"|
|-
|style="background-color: #e6e6e6;font-weight:bold;" align="left"|&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;by Lee, Previous series||align="center"|52||align="center"|1||align="center"|1.92||align="center"|51||align="center"|98.08
|-
|style="background-color: #e6e6e6;font-weight:bold;" align="left"|&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;by Lee, Present series||align="center"|158||align="center"|0||align="center"|0.00||align="center"|158||align="center"|100.00
|-
|style="background-color: #e6e6e6;font-weight:bold;" align="left"|&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;by Lee, Combined series||align="center"|210||align="center"|1||align="center"|0.48||align="center"|209||align="center"|99.52
|-
|style="background-color: gainsboro;font-weight:bold;" align="left" |[[Chinese people|Chinese]]||style="background-color: gainsboro;"| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;|
|-
|style="background-color: #e6e6e6;font-weight:bold;" align="left"|&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;by Miller (1951)||align="center"|103||align="center"|0||align="center"|0.00||align="center"|103||align="center"|100.00
|-
|style="background-color: gainsboro;font-weight:bold;" align="left" |[[English people|English]]||style="background-color: gainsboro;"| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;| ||style="background-color: gainsboro;|
|-
|style="background-color: #e6e6e6;font-weight:bold;" align="left"|&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;by Race et al. (1954)||align="center"|797||align="center"|69||align="center"|8.66||align="center"|728||align="center"|91.34
|-
|style="background-color: lightgray;" colspan="6" |
|-
|colspan="8"|<center>Source: Table 5, Page 20, Samuel Y. Lee (1965)<ref name="Lee1965">Lee, Samuel Y. (1965). Further Analysis of Korean Blood Types. In ''[[Yonsei Medical Journal]]''. Volume 6. Page 20.<!--This data table, Table 5, is found on page 20 which is page 5/10 of the PDF document.--> Retrieved June 18, 2017, from [https://www.eymj.org/Synapse/Data/PDFData/0069YMJ/ymj-6-16.pdf link.]</ref></center>
|}


==References==
{{Reflist}}


[[Category:Transfusion medicine]]
== External links ==
[[Category:Hematology]]
* {{OMIM|110900}} - OMIM entry for Kell protein
[[Category:Blood antigen systems]]
* {{OMIM|314850}} - OMIM entry for XK protein
[[Category:Hematology]]
* [https://www.ncbi.nlm.nih.gov/gv/mhc/xslcgi.cgi?cmd=bgmut/systems_info&system=kell Kell] at [[BGMUT]] Blood Group Antigen Gene Mutation Database at [[National Center for Biotechnology Information|NCBI]], [[NIH]]
* {{MeshName|KEL+protein,+human}}


[[lt:Kell antigenas]]
{{Clusters of differentiation}}
{{transfusion medicine}}


 
[[Category:Clusters of differentiation]]
 
[[Category:Blood antigen systems]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Revision as of 09:33, 2 September 2017

Kell protein
Identifiers
SymbolKEL
Alt. symbolsECE3, CD238
Entrez3792
HUGO6308
OMIM110900
RefSeqNM_000420
UniProtP23276
Other data
LocusChr. 7 q33

The Kell antigen system (also known as Kell–Cellano system) is a group of antigens on the human red blood cell surface which are important determinants of blood type and are targets for autoimmune or alloimmune diseases which destroy red blood cells. Kell can be noted as K, k, or Kp.[1][2] The Kell antigens are peptides found within the Kell protein, a 93-kilodalton transmembrane zinc-dependent endopeptidase which is responsible for cleaving endothelin-3.[3][4]

Protein

The KEL gene encodes a type II transmembrane glycoprotein [5] that is the highly polymorphic Kell blood group antigen. The Kell glycoprotein links via a single disulfide bond to the XK membrane protein [6] that carries the Kx antigen. The encoded protein contains sequence and structural similarity to members of the neprilysin (M13) family of zinc endopeptidases.[7]

There are several alleles of the gene which creates Kell protein. Two such alleles, K1 (Kell) and K2 (Cellano), are the most common. The kell protein is tightly bound to a second protein, XK, by a disulfide bond. Absence of the XK protein (such as through genetic deletion or through a single point mutation within the coding region of the XK gene [8]), leads to marked reduction of the Kell antigens on the red blood cell surface. Absence of the Kell protein (K0), however, does not affect the XK protein.[9]

The Kell protein has also recently been designated CD238 (cluster of differentiation 238).

Disease association

Kell antigens are important in transfusion medicine, autoimmune hemolytic anemia and hemolytic disease of the newborn (anti-Kell). Anti-K is the next most common immune red cell antibody after those in the ABO and Rh system. Anti-K typically presents as IgG class alloantibody. Individuals lacking a specific Kell antigen may develop antibodies against Kell antigens when transfused with blood containing that antigen. This is particularly true for the "K" antigen which shows a relatively high antigenicity and moderately low frequency (~9%) in Caucasian populations. Anti-K can also occur following transplacental hemorrhage (TPH) associated with childbirth making Kell an important concern for hemolytic disease of the newborn. Following the formation of anti-K, subsequent blood transfusions may be marked by destruction of the new cells by these antibodies, a process known as hemolysis. Anti-K does not bind complement, therefore hemolysis is extravascular. Individuals without K antigens(K0) who have formed an antibody to a K antigen, must be transfused with blood from donors who are also K0 to prevent hemolysis.

Autoimmune hemolytic anemia (AIHA) occurs when the body produces an antibody against a blood group antigen on its own red blood cells. The antibodies lead to destruction of the red blood cells with resulting anemia. Similarly, a pregnant woman may develop antibodies against fetal red blood cells, resulting in destruction, anemia, and hydrops fetalis in a process known as hemolytic disease of the newborn (HDN). Both AIHA and HDN may be severe when caused by anti-Kell antibodies,[10] as they are the most immunogenic antigens after those of the ABO and Rhesus blood group systems.

McLeod phenotype

Main article: McLeod syndrome

McLeod phenotype (or McLeod syndrome) is an X-linked anomaly of the Kell blood group system in which Kell antigens are poorly detected by laboratory tests. The McLeod gene encodes the XK protein, a protein with structural characteristics of a membrane transport protein but of unknown function. The XK appears to be required for proper synthesis or presentation of the Kell antigens on the red blood cell surface.

History

The Kell group was named after the first patient described with antibodies to K1, a pregnant woman named Mrs. Kellacher in 1945.[11] Mrs. Cellano was likewise a pregnant woman with the first described antibodies to K2. The K0 phenotype was first described in 1957 and the McLeod phenotype was found in Hugh McLeod, a Harvard dental student, in 1961.[12][13]

In 2010, researchers speculated that King Henry VIII of England had Kell-positive blood type, explaining the deaths of seven of his ten children at, or soon after, birth, and suggesting that his mental deterioration around age 40 could be explained by McLeod Syndrome;[14] this was supported by the revelation that Henry may have inherited Kell from his maternal great-grandmother, Jacquetta of Luxembourg.[15]

Other associations

Evidence supports a genetic link between the Kell blood group (on chromosome 7 q33) and the ability to taste phenylthiocarbamide, or PTC, a bitter-tasting thiourea compound.[16][17] Bitter taste receptor proteins in the taste buds of the tongue that recognise PTC are encoded on nearby chromosome locus 7 q35-6.

Data tables

Frequency of kell factor
Number
tested		 K+ K-
No. % No. %
Korean
     by Lee, Previous series 52 1 1.92 51 98.08
     by Lee, Present series 158 0 0.00 158 100.00
     by Lee, Combined series 210 1 0.48 209 99.52
Chinese
     by Miller (1951) 103 0 0.00 103 100.00
English
     by Race et al. (1954) 797 69 8.66 728 91.34
Source: Table 5, Page 20, Samuel Y. Lee (1965)[18]

References

  1. ↑ Kaita H, Lewis M, Chown B, Gard E (June 1959). "A further example of the Kell blood group phenotype K-,k-,Kp(a-b-)". Nature. 183 (4675): 1586. doi:10.1038/1831586b0. PMID 13666821.
  2. ↑ Dean L. "The Kell blood group -- Blood Groups and Red Cell Antigens". NCBI Bookshelf. National Center for Biotechnology Information - United States National Institutes of Health. Retrieved 2009-05-04.
  3. ↑ Lee S, Wu X, Reid M, Zelinski T, Redman C (1995). "Molecular basis of the Kell (K1) phenotype". Blood. 85 (4): 912–6. PMID 7849312.
  4. ↑ Lee S, Lin M, Mele A, Cao Y, Farmar J, Russo D, Redman C (1999). "Proteolytic processing of big endothelin-3 by the kell blood group protein". Blood. 94 (4): 1440–50. PMID 10438732.
  5. ↑ Russo DC, Lee S, Reid M, Redman CM. Topology of Kell blood group protein and the expression of multiple antigens by transfected cells. Blood. 1994 Nov 15;84(10):3518-23.
  6. ↑ Russo DC, Redman C, Lee S. Association of XK and Kell blood group proteins. J Biol Chem. 1998 May 29;273(22):13950-6.
  7. ↑ "Entrez Gene: KEL".
  8. ↑ Russo DC, Lee S, Reid ME, Redman CM (Mar 2002). "Point mutations causing the McLeod phenotype". Transfusion. 42 (3): 287–93. doi:10.1046/j.1537-2995.2002.00049.x.
  9. ↑ Yu LC, Twu YC, Chang CY, Lin M (2001). "Molecular basis of the Kell-null phenotype: a mutation at the splice site of human KEL gene abolishes the expression of Kell blood group antigens". J. Biol. Chem. 276 (13): 10247–52. doi:10.1074/jbc.M009879200. PMID 11134029.
  10. ↑ Weiner CP, Widness JA (1996). "Decreased fetal erythropoiesis and hemolysis in Kell hemolytic anemia". Am. J. Obstet. Gynecol. 174 (2): 547–51. doi:10.1016/S0002-9378(96)70425-8. PMID 8623782.
  11. ↑ Coombs RRA, Mourant AE, Race RR. A new test for the detection of weak and incomplete Rh agglutinins. Br J Exp Pathol 1945;26:255
  12. ↑ Chown B, Lewis M, Kaita K (1957). "A new Kell blood-group phenotype". Nature. 180 (4588): 711. doi:10.1038/180711a0. PMID 13477267.
  13. ↑ Allen FH Jr; Krabbe SM; Corcoran PA (1961). "A new phenotype (McLeod) in the Kell blood-group system". Vox Sang. 6 (5): 555–60. doi:10.1111/j.1423-0410.1961.tb03203.x. PMID 13860532.
  14. ↑ A NEW EXPLANATION FOR THE REPRODUCTIVE WOES AND MIDLIFE DECLINE OF HENRY VIII, by Catrina Banks Whitley and Kyla Kramer, in the Historical Journal; Volume 53 / Issue 04 / December 2010, pp 827-848; doi:10.1017/S0018246X10000452
  15. ↑ Stride P, Lopes Floro K. "Henry VIII, McLeod syndrome and Jacquetta's curse". J R Coll Physicians Edinb. 43: 353–60. doi:10.4997/JRCPE.2013.417. PMID 24350322.
  16. ↑ Crandall BF, Spence MA (1974). "Linkage relations of the phenylthiocarbamide locus (PTC)". Hum. Hered. 24 (3): 247–52. doi:10.1159/000152657. PMID 4435792.
  17. ↑ Conneally PM, Dumont-Driscoll M, Huntzinger RS, Nance WE, Jackson CE (1976). "Linkage relations of the loci for Kell and phenylthiocarbamide taste sensitivity". Hum. Hered. 26 (4): 267–71. doi:10.1159/000152813. PMID 976995.
  18. ↑ Lee, Samuel Y. (1965). Further Analysis of Korean Blood Types. In Yonsei Medical Journal. Volume 6. Page 20. Retrieved June 18, 2017, from link.

External links

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