Lewis Blood Group System

Lewis blood group system, classification of human blood based on the expression of glycoproteins called Lewis (Le) antigens on the surfaces of red blood cells or in body fluids, or both. The Lewis antigen system is intimately associated with the secretor system and ABO blood group system biochemically, though the genetic loci are not linked.

The system consists of two alleles, designated Le (dominant) and le; the presence of Le specifies the formation of antigen Le^a (identified 1946), which is found on the red cells of 20 percent of Europeans and in the saliva and other fluids of over 90 percent. Le^a is a water-soluble antigen; red blood cells acquire Lewis specificity secondarily by adsorbing antigen onto their surfaces from blood plasma. A second antigen, Le^b (identified 1948), occurs only when alleles Le and H (of the ABO blood group system) interact; Le^b is found only in secretors and reaches a frequency of 70 percent in Europeans.

It has been proposed that Le^a is made from a “precursor substance” in the presence of allele Le. In the further presence of alleles H and Se (secretor system), Le^a substance is partially converted to H substance; antigens Le^a, Le^b, and H are isolable. With the subsequent action of alleles A or B or both, H substance is converted and the ABO blood types are expressed, both in the body fluids and on the red blood cells. Variations in the genes present in the individual explain the various combinations of expression of the Lewis, ABO, and secretor systems in the body.