Lessons learnt from many years of experience using anti-D in humans for prevention of RhD immunization and haemolytic disease of the fetus and newborn

For 40 years prophylactic anti-D has been given to D-negative women after parturition to prevent haemolytic disease of the fetus and newborn. Monoclonal or recombinant anti-D may provide alternatives to the current plasma-derived polyclonal IgG anti-D, although none of them have yet proved as effect...

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Bibliographic Details
Published in:Clinical and experimental immunology 2008-10, Vol.154 (1), p.1-5
Main Author: Kumpel, B.M
Format: Article
Language:English
Subjects:
Analytical, structural and metabolic biochemistry
anti-D
Biological and medical sciences
clinical trials
Clinical Trials as Topic
Erythroblastosis, Fetal - prevention & control
Female
Fetus - immunology
Fundamental and applied biological sciences. Psychology
Humans
Infant, Newborn - immunology
Isoantibodies - administration & dosage
monoclonal antibody
Pregnancy - immunology
red cell clearance
Review
Rh Isoimmunization - drug therapy
Rh-Hr Blood-Group System - immunology
RhD haemolytic disease
Rho(D) Immune Globulin
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Summary:For 40 years prophylactic anti-D has been given to D-negative women after parturition to prevent haemolytic disease of the fetus and newborn. Monoclonal or recombinant anti-D may provide alternatives to the current plasma-derived polyclonal IgG anti-D, although none of them have yet proved as effective in phase 1 clinical trials. The variation in efficacy of the antibodies may have been influenced by heterogeneity in glycosylation of anti-D produced from different cell lines. Some aspects of the conduct of the human studies, most notably the use of low doses of anti-D and target D positive red cells in vivo, may aid the design of the clinical development of other immunomodulatory drugs in order to minimize adverse effects.
ISSN:0009-9104
1365-2249
DOI:10.1111/j.1365-2249.2008.03735.x