The prevention of Rh haemolytic disease of the fetus and newborn — general background

Contreras, Marcela

doi:10.1111/j.1471-0528.1998.tb10285.x

Cited by 37 publications

(30 citation statements)

References 23 publications

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“…In brief, C57BL/6 mice were immunized with three doses of 200 mg HEL (Sigma-Aldrich, St Louis, MO) in Freund's adjuvant (complete Freund adjuvant for the first dose and incomplete for the others) (Chondrex, Redmond, WA), and IgG was purified using protein G affinity chromatography. F(ab9) 2 fragments were prepared by digesting purified polyclonal anti-HEL IgG with immobilized pepsin using the Pierce F(ab9) 2 Preparation Kit (Thermo Scientific, Rockford, IL). The digested material was passed over a protein A column, which was prebound with rabbit IgG specific for mouse IgG, Fc (Jackson ImmunoResearch Laboratories, Indianapolis, IN) to remove any intact IgG from the F(ab9) 2 preparation.…”

Section: Antibodiesmentioning

confidence: 99%

“…The subsequent transplacental passage of these Abs can result in fetal RBC destruction, inducing hemolytic disease of the fetus and newborn (HDFN) (1). The administration of polyclonal anti-D Abs to RhDnegative mothers during gestation and immediately after delivery prevents anti-D immunization (2) and is the most successful clinical application of Ab or IgG-mediated immune suppression (AMIS) (3,4).…”

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confidence: 99%

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IgG-Mediated Immune Suppression to Erythrocytes by Polyclonal Antibodies Can Occur in the Absence of Activating or Inhibitory Fcγ Receptors in a Full Mouse Model

Bernardo

Amash

et al. 2015

The Journal of Immunology

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Polyclonal anti-D has been used to prevent RhD-negative mothers from becoming immunized against RhD positive fetal erythrocytes, and this mechanism has been referred as Ab or IgG-mediated immune suppression (AMIS). Although anti-D has been highly successful, the inhibitory mechanisms remain poorly understood. Two major theories behind AMIS involve the binding of IgG to activating or inhibitory FcγR, which can induce either erythrocyte clearance or immune inhibition, respectively. In this work, we explored the absolute role of activating and inhibitory FcγR in the AMIS mechanism using the HOD mouse model of RBC immunization. HOD mice contain a RBC-specific recombinant protein composed of hen egg lysozyme (HEL), OVA and human transmembrane Duffy Ag, and erythrocytes from HOD mice can stimulate an immune response to HEL. To assess the contribution of activating and inhibitory FcγR to AMIS, C57BL/6 versus FcRγ-chain−/− or FcγRIIB−/− mice were used as recipients of HOD-RBC alone or together with anti-HEL Abs (i.e., AMIS) and the resulting immune response to HEL evaluated. We show that anti-HEL polyclonal Abs induce the same degree of AMIS effect in mice lacking these IgG binding receptors as compared with wild-type mice. In agreement with this, F(ab′)2 fragments of the AMIS Ab also significantly reduced the Ab response to the HOD cells. In conclusion, successful inhibition of in vivo Ab responses to HOD-RBC by polyclonal IgG can occur independently of activating or inhibitory FcγR involvement. These results may have implications for the understanding of RhD prophylaxis.

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Section: Antibodiesmentioning

confidence: 99%

mentioning

confidence: 99%

IgG-Mediated Immune Suppression to Erythrocytes by Polyclonal Antibodies Can Occur in the Absence of Activating or Inhibitory Fcγ Receptors in a Full Mouse Model

Bernardo

Amash

et al. 2015

The Journal of Immunology

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“…That is why the ability to interact with FcγRIIIA and induce a fast clearance of D+ red cells in vivo are the main features that should be taken into account during anti-D monoclonal antibodies selection. On the other hand, it was observed that the immune response could be suppressed if anti-D was given as late as two weeks after D+ red cells entered the circulation (Contreras, 1998), and that the initial rate of the red cells clearance did not appear to influence the effectiveness of protection . Our data providing evidence that a fast clearance is not sufficient for inducing immunosuppression will be discussed below (Olovnikova et al, 2000).…”

Section: Clearance Of D+ Red Cells In Vivo Upon the Treatment With Pomentioning

confidence: 99%

Anti-RhD-Mediated Immunosuppression: Can Monoclonal Antibodies Imitate the Action of Polyclonal Antibodies?

Оловникова¹

2012

Immunosuppression - Role in Health and Diseases

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“…If [9][10] . In the 1 st trimester, women who are RhD negative are administered 50 μg IgG anti-D after spontaneous miscarriage followed by evacuation of the uterus, induced abortion (therapeutic termination of pregnancy), evacuation of the uterus because of mola hydatiforma, chorionic villus sampling or after operation for ectopic pregnancy.…”

Section: The Incidence Of Rhd Incompatible Pregnanciesmentioning

confidence: 99%

PREVENTION OF RhD ALLOIMMUNIZATION IN RhD NEGATIVE WOMEN

Ľubušký¹

2010

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Despite the introduction of anti-D prophylaxis into clinical practice, RhD alloimmunization still presents a problem to date. The actual incidence of RhD alloimmunization in pregnant women remains unknown in most countries. Anti-D immunoglobulin is administered to RhD negative women at a fixed dose and in much greater amounts than is actually necessary. On the other hand, it is not possible to diagnose cases where greater doses are needed. To optimize the prevention of RhD alloimmunization in RhD negative women, it is important to diagnose conditions that lead to fetomaternal hemorrhage (FMH), precisely determine the volume and subsequently administer the appropriate dose of anti-D immunoglobulin. The possibility to accurately detect FMH and precisely determine its volume would enable more effective and less costly prevention of RhD alloimmunization. Anti-D immunoglobulin could be administered only in indicated cases and only in doses essentially necessary for prevention of RhD alloimmunization.Methods and results. The Cochrane and UpToDate databases of systematic reviews, as well as national guidelines, were reviewed.Conclusions. Due to the medical significance and indispensable economic costs associated with prevention of RhD alloimmunization, it would be appropriate to establish exact methodical guidelines. The text itself should be limited to a list of potentially sensitising events during which anti-D immunoglobulin should be administered to RhD negative women if anti-D antibodies are not already present. Following each potentially sensitising event, the minimal dose of anti-D immunoglobulin necessary for prevention of RhD alloimmunization should be determined. After 20 weeks of gestation, the volume of FMH should also be determined to specify the necessary dose of anti-D immunoglobulin.

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The prevention of Rh haemolytic disease of the fetus and newborn — general background

Cited by 37 publications

References 23 publications

IgG-Mediated Immune Suppression to Erythrocytes by Polyclonal Antibodies Can Occur in the Absence of Activating or Inhibitory Fcγ Receptors in a Full Mouse Model

IgG-Mediated Immune Suppression to Erythrocytes by Polyclonal Antibodies Can Occur in the Absence of Activating or Inhibitory Fcγ Receptors in a Full Mouse Model

Anti-RhD-Mediated Immunosuppression: Can Monoclonal Antibodies Imitate the Action of Polyclonal Antibodies?

PREVENTION OF RhD ALLOIMMUNIZATION IN RhD NEGATIVE WOMEN

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