MNS antigen system

The MNS antigen system is a human blood group system based upon two genes (glycophorin A and glycophorin B) on chromosome 4. There are currently 46 antigens in the system, but the five most important are called M, N, S, s, and U.

The system can be thought of as two separate groups: the M and N antigens are at one location on the ECM and S, s, and U are on a closely related location. The two groups are very closely located together on chromosome 4 and are inherited as a haplotype.

The MN group
M+ and N+ RBCs are common (75% of population) and M+N+ cells are the most common genotype (50% of population). These antigens were an early discovery and are some of the oldest blood antigens known after the ABO system. They were first described by Karl Landsteiner and Philip Levine in 1927. Anti-M and anti-N antibodies are usually IgM and are rarely associated with transfusion reactions.

Anti-N is sometimes seen in dialysis patients due to cross-reactions with the residual formaldehyde from sterilizing the equipment. This is usually irrelevant for transfusion since this variant of the antibody does not react at body temperature.

The U and Ss groups
The S antigen is relatively common (~55% of the population) and the s antigen is very common (~89% of the population). Anti-S and anti-s can cause hemolytic transfusion reactions and hemolytic disease of the newborn.

The U antigen is a high incidence antigen, occurring in more than 99.9% of the population. The U was originally short for "Universal", though this is not the case. U negative RBCs can be found in people of African descent. This mutation in red cell surface structure also makes the RBCs S- and s-. Anti-U has been associated with both hemolytic transfusion reactions and hemolytic disease of the newborn.

Other MNS antigens
The other 41 identified antigens in the MNS group are low incidence, such as He (0.8% of the population) or high incidence, such as ENa (>99.9% of the population).