Henry S, Oriol R, Samuelsson B
Department of Clinical Chemistry and Transfusion Medicine, University of Göteborg, Sweden.
Vox Sang. 1995;69(3):166-82. doi: 10.1111/j.1423-0410.1995.tb02591.x.
This review summarises present knowledge of the chemistry, immunology, genetics and clinical significance of antibodies in the Lewis and secretor histo-blood group systems. Although red cell serology has laid the foundations for these systems, more recent advances have been made by studying Lewis and related glycoconjugates with monoclonal antibodies, determining structures by mass spectrometry and NMR spectroscopy, identifying enzymes and their specificities, and identifying the genes by molecular biology. The expression of Lewis system antigens is dependent on Lewis and secretor loci. Fucosyltransferases coded by genes at these loci compete and interact with each other and with other transferases to determine an individual's Lewis and secretor phenotype. Exocrine epithelial cells, mostly of endodermal origin, synthesise the Lewis antigens which, as plasma glycolipids, are secondarily acquired by cells of the peripheral circulation. Phenotyping red cells is often regarded as a simple way of determining the Lewis and sometimes the secretor status of an individual; however, the red cell phenotype is influenced by many factors and may not necessarily reflect someone's Lewis and secretor genotypes. Two main red cell Lewis groups are usually found, Lewis negative and Lewis positive. In Lewis-negative individuals, the secretor genotype does not affect the Lewis phenotype, but in Lewis-positive individuals, the non-secretor genotype generates the Le(a+b-) phenotype, the secretor genotype causes the Le(a-b+) phenotype, and the partial secretor genotype gives rise to the Le(a+b+) phenotype.
本综述总结了关于Lewis和分泌型组织血型系统中抗体的化学、免疫学、遗传学及临床意义的现有知识。尽管红细胞血清学为这些系统奠定了基础，但近年来通过用单克隆抗体研究Lewis及相关糖缀合物、利用质谱和核磁共振光谱确定结构、鉴定酶及其特异性以及通过分子生物学鉴定基因等方法取得了更多进展。Lewis系统抗原的表达取决于Lewis和分泌型基因座。这些基因座上的基因编码的岩藻糖基转移酶相互竞争、相互作用，并与其他转移酶相互作用，以确定个体的Lewis和分泌型表型。外分泌上皮细胞大多起源于内胚层，合成Lewis抗原，这些抗原作为血浆糖脂，随后被外周循环细胞获取。对红细胞进行表型分析通常被视为确定个体Lewis状态以及有时分泌型状态的一种简单方法；然而，红细胞表型受多种因素影响，不一定能反映某人的Lewis和分泌型基因型。通常可发现两种主要的红细胞Lewis血型，即Lewis阴性和Lewis阳性。在Lewis阴性个体中，分泌型基因型不影响Lewis表型，但在Lewis阳性个体中，非分泌型基因型产生Le(a+b-)表型，分泌型基因型导致Le(a-b+)表型，部分分泌型基因型产生Le(a+b+)表型。
