@cantankerouscatfish yes!!! Here are some better, less blurry close ups of the fellow. They're like the shrimps of the air....... pretending to be a bird...
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Ok so main concepts for understanding blood compatibility (antigen-antibody interactions) and what causes hemolytic transfusion reactions below. Testing info and importance of blood donation + genetic distribution to follow
Our bodies, generally speaking, are pretty good at recognizing self and differentiating that from non-self. When our immune systems detects cells or components made by our body, it shouldn't react. When it detect foreign, potentially harmful substances, our white blood cells can respond in a variety of ways. One type of white blood cell, called B cells, produce antibodies.
Usually, we think of antibodies when we talk about diseases and vaccinations, but there are several types of antibodies which get produced in different kinds of reactions. In all cases, antibodies are proteins that recognize and bind with specific substances, known as antigens. That means each antibody has a target, like a specific protein or sugar, that it matches with like a lock with a key. The process of binding together is called agglutination and sometimes lots of antigen-antibody complexes get clumped together. Agglutination often acts as a signal for other cells to come respond to the threat, although it can sometimes neutralize targets directly.
Note: antigen =/= allergen! Allergens are a type of antigen that cause an allergic response
We can imagine with disease, once the body recognizes a foreign microbe through infection or vaccination, it can produce antibodies that target some part of the virus/bacteria/etc, like a protein structure on the microbe's surface. The antibodies bind to their targets and often work as huge flags to the immune system that there is a foreign material that needs to be destroyed.
Many blood transfusion reactions work in a similar way. Our red blood cells have many antigens, mostly proteins on or in the cell membrane. A, B, and D (the +/-) are examples of antigens, but there are a ton more. Our bodies are familiar with the antigens we produce and can react when exposed to foreign ones. When someone receives blood with antigens they don't make themselves, they may have an immune response as their body recognizes and attacks the foreign cells.
This image shows how agglutination can happen with 2 types of antibodies. They bind to red blood cells and can cause them to stick to each other. "Complement activation" refers to proteins involved in increasing immune system response to destroy and clear cells from the body
These types of antibody-mediated transfusion reactions can be acute and occur minutes to hours after the start of the transfusion, or they can be delayed days or weeks after. The antibodies signal for the immune system to destroy the foreign donor red blood cells, which is called hemolysis. The breakdown of cells can cause mild to severe side effects and complications as the pieces of red blood cells flood the body. It also ruins the intent of the transfusion itself, since the destroyed blood can't help fix the original blood problem.
Note: As a term, "blood transfusion reactions" can refer to a variety of reactions, including immune-mediated (hemolytic, non-hemolytic febrile, allergic reaction, and TRALI) and non-immune (infection, TACO) responses. Blood bank testing is mostly focused on preventing immune-mediated hemolytic reactions
Now, antibodies can be weird. People produce them in different amounts and strengths, they can be affected by age or illness, and our bodies remember how to produce them for different periods of time. Not everyone who is exposed to blood with foreign antigens produces antibodies against it or will have the same response. There are also a lot of different blood antigens; some can cause stronger or longer antibody response.
Many transfusion-related antigens also only cause reactions after repeat exposure. Much like vaccines or allergies, the first exposure primes the immune system, showing it what the foreign substance looks like. Then, the next time that substance appears, the immune system can respond faster and harder than it did before. Most antibodies in transfusions, including the one that targets D (the +/- of your blood type) antigen, work like this.
This means people may be exposed to new blood antigens during a transfusion, transplant, or through pregnancy (including ectopic and aborted pregnancies), and not have a significant response. But during a following exposure, their body then produces lots of antibodies against the antigen it has seen before and produce a reaction. People who receive multiple blood transfusions are at a much higher risk of repeat exposure to antigens they don't make.
The exception to this is ABO mismatching. A and B antibodies are naturally occurring, meaning that our bodies can produce them without having ever been exposed to other blood before. This means that we can have a large antibody response on first exposure to an incorrect type. Different countries and transfusion centers have different testing procedures and requirements, but ABO typing is given priority because of its ability to cause immediate, severe reactions.
Remember, people make antibodies against what they don't already have themselves. Those with type-A blood will not make A antibodies, but they can make B antibodies. Type-B blood can make A antibodies, but not B. Type-AB have both antigens, so they don't make antibodies for either.
O is not an antigen. Type-O blood means that there is a lack of A and B antigens. Therefore, these individuals can produce antibodies against A and B. Type-O blood can be used in emergency situations because lacking antigens means there is nothing to stimulate an immune response (unless you're quite unlucky enough to have the Bombay phenotype).
When testing blood for transfusions, the goal is reduce people's exposure to antigens they don't make that can cause reactions, especially A or B. We want to detect the presence of certain blood antigens in the recipient and match those to the antigens in the donor, so the donor isn't exposed to anything their body doesnt recognize.
But there are over 40 blood group systems that can produce different antigens, with varying degrees of clinical significance. Most people have never been exposed to foreign antigens before and/or don't make any antibodies that would cause hemolytic transfusion reactions, so testing every person for every antigen would be a waste of time and resources.
Generally, blood testing before a transfusion has two components: a type test to identify the presence of 3 antigens and a screening test for relevant antibodies.
A routine blood type is testing done to identify ABO and Rh(D) blood types. ABO because they can produce serious reactions with no previous blood exposure. D is part of the Rh blood system, which are involved in more significant hemolytic transfusion reactions than many other blood groups. D is positive if you make it, negative if you don't. There are other Rh antigens that can be tested for, including C, c, E, and e.
Blood typing utilizes antigen-antibody reactions to identify both the antigens present on a donor's red blood cells and the antibodies they produce. This is done in two stages, a front type and a back type.
A front type looks for the presence of A, B, or D antigens on the recipient's red blood cells, so we can learn what antigens their body makes. You add a solution containing antibodies to their red blood cells and check visually for agglutination. If the target antigen is present on the red blood cells, the antibodies bind to them and clumped complexes all stick together. You can visually see the clumps in different teating methods, either in a glass tube, little gel tubes that the complexes get stuck in, and laid out on slides/latex cards.
If there are no antigens to bind to, the blood won't stick together and no agglutination will be seen.
I think this figure shows the agglutination in tube really well. A strong reaction forms a very stuck-together little button, while weaker reactions break apart into small clumps. No antibody binding results in hazy, clumpless tube. Sometimes, the binding can be present but really weak, which might appear very hazy. Sometimes clumps can only be seen under a microscope. This is usually due to people having weak expression and not making a lot of the antigen.
A and B are the two antigens we look for in ABO typing. If you have agglutination with just A antisera, you have A antigens and are type A. The same is true for B. If you have agglutination with both, you have both antigens and are type AB. If there is no agglutination, your red blood cells have neither A not B, and you are type O.
We also use this type of test to identify Rh(D). Agglutination indicates it is present, while no clumping indicates absence.
However, blood typing tests dont always work perfectly because there are interferences that cause false positive, weak, or false negative results. Some people make few antigens, there are structural abnormalities that can disrupt antibody binding, and some drugs/conditions/other circumstances can cause agglutination when the person doesn’t actually make a specific antibody.
To help check the front blood type, a back type is also performed. This is another antigen-antibody test, but in the reverse direction. For the ABO blood system, the body naturally makes antibodies targeting what it doesn’t make. So, we can check a front type by seeing if the antibodies a patient makes correspond to the antigens they seem to have. If a patient has type B blood, they should make A antibodies but not B antibodies. If they are type O, they should make both A and B antibodies. AB individuals have both antigens, so they shouldn't produce antibodies to either.
Back typing is only used for antigens in the ABO system because they are naturally occuring. Other antibodies don't occur just because a person doesn't make the antigen. They only develop in individuals who have been exposed to antigens they don't make. That means plenty of D negative individuals do not make any D antibodies, since they have never been exposed to D antigens before. These types of antibodies are instead identified in the screening test described below.
With back typing, you take plasma from the recipient, which potientially contains their antibodies, and test it with red blood cells you know have A or B antigens on them. If there is agglutination, that indicates the patient makes antibodies against that specific sugar molecule. Likewise, that sugar should not be on their own red blood cells.
Here is my terrible chart of how this should be interpreted.
Now, there are instances where the front and back types dont match. Something either doesn’t agglutinate when it should, or does clump when it shouldn't. It may be that a patient is elderly and cannot produce many antibodies, leading to a weak/absent back type. Maybe they have a pan-agglutination problem from a benign disorder, and all tests appear positive due to red blood cells sticking together naturally. There are different subgroups of A antigen which react differently, leading to mismatching results. Blood bank employees are trained to notice these discrepancies and follow steps to identify what is causing them, so an accurate ABO blood type can be determined.
A screen is also performed as part of routine testing for transfusions. This test is looking for active antibodies the patient is producing to blood antigens outside of the ABO system. If there are antibodies present, that indicates that the person has been exposed to other blood and their immune system has responded. Another exposure to that antigen will likely cause a bigger antibody response, leading to a transfusion reaction. The antibodies often target Rh antigens like D, but also other groups you've probably never heard of like Kell, Kidd, and Duffy antigens.
Screens work similarly to back typing. We expose patient serum, which may contain antibodies, to red blood cells with different sets of clinically significant antigens on them (here we routinely use 3 different cell types for a screen). If the patient makes antibodies to any antigens, this causes agglutination with some or all of the screening cells. The pattern of which cells clump can help distinguish what antibody is being made, but generally more testing is required for positive screens to determine what is causing reactivity. People can make antibodies to multiple antigens at once, which can further complicate testing.
People who have antibodies should generally not be given blood with the corresponding antigens, to prevent transfusion reactions from occurring. But sometimes people can be given blood transfusions containing antigens they don't make themselves. When and what type of testing is done can vary depending on where you recieve care. This is because hospital procedure and medical decisions are made taking into account the likelihood/severity of reactions vs the danger of not receiving blood at all.
What is the likelihood that some patient has been exposed to other blood products before? What is the chance they were exposed to an antigen they dont have, or the likelihood they actually produce antibodies to it?Is there concern the patient will need more blood later, which could result in repeated exposure to foreign antigens? Does the antigen involved typically cause strong, dangerous responses? All of these things can be taken into account when deciding what level of risk a transfusion might pose.
This is why, in emergencies with massive bleeding, tests are sometimes be waived. Patients can be given the lowest risk blood available, type O, which should not cause antibody production in any of the ABO blood types (barring rare genetic conditions). Rh(D) and all other antigens matter less, because a negative reaction requires several statistically unlikely conditions to be met. It's usually better to give someone potentially unsafe blood than it is to let them bleed out.
We can compare this to other situations where long-term, dangerous complications are more likely. There are several medical conditions that may require repeat blood transfusions, so patients have the potential to be repeatedly exposed to foreign antigens. They are at much greater risk of transfusion reactions down the line. Many places have policies to prevent future complications for patients expecting repeated transfusions. They can identify some or all the significant antigens (like other Rh types, Kell, and Duffy antigens) the patient makes and then match that profile to the donor blood, so people are not exposed to anything they dont already have.
@three-owls-in-a-trenchcoat ok so it is highly genetically unlikely that a type-AB parent and and type-O parent produce a type-O child, because of how these genes are inherited and expressed.
Everyone carries two copies of the gene that decide their ABO blood system. You inherit one copy from each of your parents. You can inherit either an A, a B, or a null option, o, that produces neither A nor B antigens.
This means basically that your red blood cells have a one type of sugar molecule on its membrane or a different type of sugar molecule. O results in a no sugar attached.
But because there are two copies, you can have mixes of A, B, and o genes. Type A and B are codominant, which means if they both get inherited, both antigens get expressed/produced and you have type AB blood. However, A and B both dominate over o.
Imagine, in the image above, the A molecule had some empty spaces instead of sugar molecules. It would still have a lot of A that wins out and makes the molecule get seen as A blood. That means inheriting A and o genes (Ao) looks and tests similarly to blood with two (AA) copies. The same is true for Bo testing as B blood.
The way people have type-O blood is by inheriting two copies of the null gene. No sugars get added, only empty spots. (I like to use lowercase "o" to help remember that it's quiet)
When we want to predict the genetic likelihood of what children can inherit from their parents, we can use a Punnett square.
In this instance, we know the what copies each parent carries. Type AB people have one A copy and one B, but they can only pass one of them down to their offspring. Type O blood only occurs with two null oo copies. They must pass down an o copy, there isn't any option.
Now we can create possible options for how those gene copies are distributed to children. We fill out our square by adding the parents genotypes, AB and oo, to the outside edges of the square. Then we create the different combinations by adding each parent option to the squares below or beside them.
This shows that an AB parent has a 50% chance of giving their child an A gene, and a 50% chance of giving them a B gene. A type O parent has a 100% chance of giving their kid an o gene.
2/4 of our squares resulted in Ao genotypes. The other half had Bo genotypes. As we see above, Ao results in A blood and Bo results in B blood. So the child has a 50% chance of being type A and 50% chance of being type B. No type O because one parent has no o gene copy to give.
Now, there are 4 reasons I can think of where the situation you've described occurs and there's probably more
1. Someone is misremembering their blood type. This happens quite a lot. Thats why we test people's blood type regardless of what they say.
2. One of the tests was wrong. Tests can be impacted by internal factors like pan-agglutination (where everything tests as positive) or lack of antibody/antigen production resulting in weak reactions, and external factors like poor testing methods and lack of skill in interpreting results. Many of these issues cause test discrepancies that should be resolved by the hospital, but they do happen.
3. Rare genetic inheritance patterns. Sometimes due to the way genes physically get inherited or rare blood antigens, type AB and O parents could produce an O child, or someone who types as O. I don't really do that sort of science.
4. I did hear about a similarly unlikely case while doing my rotation in the blood bank. Babies are routinely typed after birth to see if there are mismatches with their parent that might cause them harm (cause some harmful antibodies can be passed from parent to child!). They had found the mother to be type o, while the baby was type AB. Eventually this was resolved when they were informed the baby had been conceived using an egg donor. The child recieved its genetic copy from a different person than the person who carried them and gave birth. Which I think is neat!
Ok so main concepts for understanding blood compatibility (antigen-antibody interactions) and what causes hemolytic transfusion reactions below. Testing info and importance of blood donation + genetic distribution to follow
Our bodies, generally speaking, are pretty good at recognizing self and differentiating that from non-self. When our immune systems detects cells or components made by our body, it shouldn't react. When it detects foreign, potentially harmful substances, our white blood cells can respond in a variety of ways. One type of white blood cell, called B cells, produce antibodies.
Usually, we think of antibodies when we talk about diseases and vaccinations, but there are several types of antibodies which get produced in different kinds of reactions. In all cases, antibodies are proteins that recognize and bind with specific substances, known as antigens. That means each antibody has a target, like a specific protein or sugar, that it matches with like a lock with a key. The process of binding together is called agglutination and sometimes lots of antigen-antibody complexes get clumped together. Agglutination often acts as a signal for other cells to come respond to the threat, although it can sometimes neutralize targets directly.
Note: antigen =/= allergen! Allergens are a type of antigen that cause an allergic response
We can imagine with disease, once the body recognizes a foreign microbe through infection or vaccination, it can produce antibodies that target some part of the virus/bacteria/etc, like a protein structure on the microbe's surface. The antibodies bind to their targets and often work as huge flags to the immune system that there is a foreign material that needs to be destroyed.
Many blood transfusion reactions work in a similar way. Our red blood cells have many antigens, mostly proteins on or in the cell membrane. A, B, and D (the +/-) are examples of antigens, but there are a ton more. Our bodies are familiar with the antigens we produce and can react when exposed to foreign ones. When someone receives blood with antigens they don't make themselves, they may have an immune response as their body recognizes and attacks the foreign cells.
This image shows how agglutination can happen with 2 types of antibodies. They bind to red blood cells and can cause them to stick to each other. "Complement activation" refers to proteins involved in increasing immune system response to destroy and clear cells from the body
These types of antibody-mediated transfusion reactions can be acute and occur minutes to hours after the start of the transfusion, or they can be delayed days or weeks after. The antibodies signal for the immune system to destroy the foreign donor red blood cells, which is called hemolysis. The breakdown of cells can cause mild to severe side effects and complications as the pieces of red blood cells flood the body. It also ruins the intent of the transfusion itself, since the destroyed blood can't help fix the original blood problem.
Note: As a term, "blood transfusion reactions" can refer to a variety of reactions, including immune-mediated (hemolytic, non-hemolytic febrile, allergic reaction, and TRALI) and non-immune (infection, TACO) responses. Blood bank testing is mostly focused on preventing immune-mediated hemolytic reactions
Now, antibodies can be weird. People produce them in different amounts and strengths, they can be affected by age or illness, and our bodies remember how to produce them for different periods of time. Not everyone who is exposed to blood with foreign antigens produces antibodies against it or will have the same response. There are also a lot of different blood antigens; some can cause stronger or longer antibody response.
Many transfusion-related antigens also only cause reactions after repeat exposure. Much like vaccines or allergies, the first exposure primes the immune system, showing it what the foreign substance looks like. Then, the next time that substance appears, the immune system can respond faster and harder than it did before. Most antibodies in transfusions, including the one that targets D (the +/- of your blood type) antigen, work like this.
This means people may be exposed to new blood antigens during a transfusion, transplant, or through pregnancy (including ectopic and aborted pregnancies), and not have a significant response. But during a following exposure, their body then produces lots of antibodies against the antigen it has seen before and causes a reaction. People who receive multiple blood transfusions are at a much higher risk of repeat exposure to antigens they don't make.
The exception to this is ABO mismatching. A and B antibodies are naturally occurring, meaning that our bodies can produce them without having ever been exposed to other blood before. This means that we can have a large antibody response on first exposure to an incorrect type. Different countries and transfusion centers have different testing procedures and requirements, but ABO typing is given priority because of its ability to cause immediate, severe reactions.
Remember, people make antibodies against what they don't already have themselves. Those with type-A blood have A antigens, so they will not make A antibodies, but they can make B antibodies. Type-B blood can make A antibodies, but not B. Type-AB have both antigens, so they don't make antibodies for either.
O is not an antigen. Type-O blood means that there is a lack of A and B antigens. Therefore, these individuals can produce antibodies against A and B. Type-O blood can be used in emergency situations because lacking antigens means there is nothing to stimulate an ABO immune response (unless you're quite unlucky enough to have the Bombay phenotype).
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Hey, we’re in line for some absurd temperatures here in the southwest this week. This is very important to know and keep in mind. Be safe, stay hydrated, stay out of the sun as much as you can.
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unfortunately very true. Doing Better does not always mean never being upset or never being triggered or never having trouble. often Doing Better means experiencing those things and being able to keep going/cope healthily/move on. if you’re in a bubble with no sensation, if you’re numbing yourself out, that’s not what recovering really is. it won’t help you have a happier life it’ll just make your world smaller and smaller until you can’t fit anywhere anymore. gotta learn to make peace with the hard stuff too, that’s the only way to keep going
Folks, if you don't know who Emi Koyama was, you should. Her website (eminism.org, which is a delightful pun) has a ton of her work entirely for free.
You can read the Transfeminist Manifesto in particular here. Emi considered it a historical document and she wrote a very good self-critique in 2008 (included in the document) on the subject of the Manifesto, white feminism, and the lack of inclusion of trans and genderqueer people who aren't trans women. I highly encourage everyone who wants to involve themselves in transfeminism to read her work, not because it is perfect, but because I do think Emi Koyama's Manifesto represents the best intentions for transfeminism: the desire to challenge cissexism, to take activism seriously and compassionately, and a commitment to being open and honest about where we fall short and how we can do better.
I really appreciate this quote from her, which I hadn't seen before, on the subject of feminism needing to "fit in" trans people:
Cis feminists do not own feminism. We don't need to "fit trans people into feminist theory"; we simply need to challenge cissexism in feminist movements and theories. Trans people do not need to be explained by feminist theory; we need to start from the fact that trans people exist and matter.
And it would be a crime to not mention how hard she fought specifically for women of color, to challenge racism and imperialism (white/western and non-white/non-western) in feminist spaces and in general, as well as her intersex activism, and far more. She had such a drive to contribute to, engage with, and push for more and better feminist discourse.
You will be remembered fondly, Emi Koyama. Thank you for all your work and for all your life.
I'm not fancy enough to be an urban homesteader. I'm just a liberal redneck who hacked out a garden from a city lot so I didn't completely lose my shit here.
Hey everyone. There's a new youtube feature that rolled out just yesterday that's raising some privacy concerns.
People in the U.S., U.K., Brazil, and Singapore can now share videos and chat with friends directly within the YouTube app. The update bring
This post talks about a new DM feature in youtube. What it fails to mention is that as part of this new feature is that when you send someone a link to a video, and they open it in the youtube app, they will see who sent them the link. Specifically, your channel name.
If your google account name is your real name, so is your channel name by default.
This means the new default behavior is that everyone you send a youtube link to will see your full name if they open it in the mobile app.
To turn this off:
Go to your youtube app settings
Go to Privacy
Turn off "Channel visibility for shared links"
Trimming the source id (the stuff after the '?' in links) will also prevent this from happening.
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ohhhh shit. target is recalling their up & up baby wipes (fragrance free & fresh cucumber scented) because they're contaminated with Burkholderia cepacia complex and Burkholderia gladioli, multiple people are reporting discoloration & infections. i just got a call about it cuz i had purchased those but i've already gone through them 😅 so no refund for me. but im fine. if you have these they're saying you need to immediately stop using them and bring them back to target for a full refund. this bacteria can cause life threatening infections in children/infants and people with compromises immune systems (ESPECIALLY cystic fibrosis!!) and i know lots of other chronically ill people follow me!!!!
You don’t know if it has bedbugs and you do not want bedbugs. Also if a passing dog has pissed on it that’s the sort of thing you can’t always tell until it’s in a closed space with you. If you can’t wipe it clean, leave it!
I brought the coolest and heaviest desk i have still ever seen to this day into my apartment without inspecting it and it infested my entire room with German cockroaches so
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