Krog Grethe Risum, Lorenzen Henriette, Clausen Frederik Banch, Dziegiel Morten Hanefeld
Department of Clinical Immunology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
Faculty of Health, University College Copenhagen, Copenhagen, Denmark.
Vox Sang. 2023 May;118(5):402-406. doi: 10.1111/vox.13420. Epub 2023 Mar 9.
Identification of antibody characteristics and genetics underlying the development of maternal anti-A/B linked to inducing haemolytic disease of the foetus and newborn could contribute to the development of screening methods predicting pregnancies at risk with high diagnostic accuracy.
We examined 73 samples from mothers to 37 newborns with haemolysis (cases) and 36 without (controls). The secretor status was determined by genotyping a single nucleotide polymorphism in FUT2, rs601338 (c.428G>A).
We found a significant association between secretor mothers and newborns developing haemolysis (p = 0.028). However, stratifying by the newborn's blood group, the association was found only in secretor mothers to blood group B newborns (p = 0.032). In fact, only secretor mothers were found in this group. By including antibody data from a previous study, we found higher median semi-quantitative levels of IgG1 and IgG3 among secretor mothers than non-secretor mothers to newborns with and without haemolysis.
We found that the maternal secretor status is associated with the production of anti-A/B, pathogenic to ABO-incompatible newborns. We suggest that secretors experience hyper-immunizing events more frequently than non-secretors, leading to the production of pathogenic ABO antibodies, especially anti-B.
识别与胎儿及新生儿溶血病相关的母体抗A/B抗体产生的特征及遗传学因素，有助于开发具有高诊断准确性的预测妊娠风险的筛查方法。
我们检测了73例母亲的样本，这些母亲所生的新生儿中37例有溶血（病例组），36例无溶血（对照组）。通过对FUT2基因中的单核苷酸多态性rs601338（c.428G>A）进行基因分型来确定分泌型状态。
我们发现分泌型母亲与发生溶血的新生儿之间存在显著关联（p = 0.028）。然而，按新生儿血型分层后，这种关联仅在分泌型母亲与B血型新生儿中发现（p = 0.032）。事实上，该组中仅发现了分泌型母亲。通过纳入一项先前研究的抗体数据，我们发现，无论新生儿有无溶血，分泌型母亲体内IgG1和IgG3的半定量水平中位数均高于非分泌型母亲。
我们发现母体分泌型状态与产生对ABO血型不相容新生儿具有致病性的抗A/B抗体有关。我们认为，分泌型个体比非分泌型个体更频繁地经历超免疫事件，从而导致产生致病性ABO抗体，尤其是抗B抗体。
