Document Detail


IgG1 and IgG3 anti-D in maternal serum and on the RBCs of infants suffering from HDN: relationship with the severity of the disease.
MedLine Citation:
PMID:  12473131     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Anti-D IgG antibodies that are responsible for severe cases of HDN belong chiefly to IgG1 and IgG3 subclasses. The relationship between the concentrations of IgG1 anti-D and IgG3 anti-D in maternal serum and the amount bound to the surface of infants' RBCs is not known. In addition, the contribution of the two subclasses to the severity of HDN is not well established. STUDY DESIGN AND METHODS: Blood samples from 40 infants suffering from severe forms of HDN due to anti-D were collected before transfusion together with sera from their respective mother. The amount of total anti-D IgG as well as IgG1 anti-D and IgG3 anti-D on infants' RBCs and the concentration in maternal sera were determined by ELISA. RESULTS: The median percentages of IgG1 anti-D and of IgG3 anti-D in maternal sera were 90 and 10 percent, respectively, whereas on infants' RBCs they were 97 and 3 percent, respectively. The differences between maternal and infantile percentages were significant (p < 0.001). IgG1 and IgG3 anti-D bound to infants' RBCs increased concomitantly with the concentration of IgG1 and IgG3 anti-D in maternal sera. The severity of HDN correlated positively with the concentration of IgG1 anti-D in maternal sera, but negatively with the amount of IgG3 anti-D bound to infants' RBCs. In addition, the existence of a high proportion of IgG3 anti-D in maternal serum was associated with a delayed risk of fetal anemia. CONCLUSION: The proportion of IgG3 anti-D relative to the total anti-D IgG on infants' RBCs is only one- third of the proportion present in maternal serum. The study of the correlations between the amount of IgG1 anti-D and IgG3 anti-D and the severity of HDN suggests that IgG1 anti-D are more important than IgG3 anti-D in the pathogenesis of fetal anemia.
Authors:
Patrick Lambin; Martine Debbia; Philippe Puillandre; Yves Brossard
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  42     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-10     Completed Date:  2003-03-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1537-46     Citation Subset:  IM    
Affiliation:
Immunology Transfusion Unit, National Institute of Blood Transfusion, Paris, France. plambin@ints.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Transfusion, Intrauterine
Enzyme-Linked Immunosorbent Assay
Erythroblastosis, Fetal / blood,  etiology,  immunology*
Erythrocytes / immunology*
Female
Humans
Immunoglobulin G / blood*,  classification
Immunoglobulin Isotypes / blood*
Infant, Newborn
Mothers
Pregnancy
Rho(D) Immune Globulin / blood*
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Immunoglobulin G; 0/Immunoglobulin Isotypes; 0/Rho(D) Immune Globulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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