How does anti-D prevent hemolytic disease of the fetus and newborn? Lessons from a mouse model

What is this research about?

Antibodies are critical elements of an immune response to combat pathogens such as harmful bacteria and viruses. Interestingly, certain antibodies can also stop an immune response - a phenomenon known as antibody-mediated immune suppression (AMIS). AMIS is used in transfusion medicine to prevent an unwanted immune response, for example, the immune response that leads to hemolytic disease of the fetus and newborn (HDFN). HDFN occurs when there is an incompatibility between a mother and her fetus’ blood type — for example, when the mother is Rh-negative and the fetus is Rh-positive. If, during the pregnancy, the mother is exposed to fetal red blood cells, her immune system recognizes the Rh-antigen as foreign and produces antibodies against it. These antibodies cross the placenta and bind to the Rh-antigen on the fetal red blood cells, triggering their destruction. HDFN can be life-threatening for the fetus or newborn. HDFN can be prevented through AMIS with an anti-D drug that suppresses the mother’s immune response against the fetal Rh-antigen. However, this treatment has limitations.

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