The Kell blood group glycoprotein also known as CD238 is a protein that in humans is encoded by the KEL gene. The Kell glycoprotein is a 732-amino-acid, single-pass, glycosylated protein that is expressed in the plasma membrane of red blood cells. It is covalently attached via a disulfide bond to the multipass XK protein. The KEL gene is highly polymorphic and forms the basis of the Kell antigen system. It is responsible for cleaving an inactive endothelin-3 precursor to its active form. The Kell–XK complex is also associated with red blood cell membrane integrity. The Kell protein is clinically important since it strongly immunogenic and can cause life threatening red blood transfusion reactions. In addition, Kell alloimmunization is caused by a direct maternal immune response to fetal KELL antigens or through a prior antigen-positive pregnancy or transfusion.
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