Christensen Robert D, Bahr Timothy M, Ilstrup Sarah J, Dizon-Townson Donna S
Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA.
Obstetric and Neonatal Operations, Intermountain Health, Salt Lake City, UT, USA.
J Perinatol. 2023 Dec;43(12):1459-1467. doi: 10.1038/s41372-023-01785-3. Epub 2023 Oct 17.
Hemolytic disease of the fetus and newborn (HDFN) can occur when a pregnant woman has antibody directed against an erythrocyte surface antigen expressed by her fetus. This alloimmune disorder is restricted to situations where transplacental transfer of maternal antibody to the fetus occurs, and binds to fetal erythrocytes, and significantly shortens the red cell lifespan. The pathogenesis of HDFN involves maternal sensitization to erythrocyte "non-self" antigens (those she does not express). Exposure of a woman to a non-self-erythrocyte antigen principally occurs through either a blood transfusion or a pregnancy where paternally derived erythrocyte antigens, expressed by her fetus, enter her circulation, and are immunologically recognized as foreign. This review focuses on the genetics, structure, and function of the erythrocyte antigens that are most frequently involved in the pathogenesis of alloimmune HDFN. By providing this information we aim to convey useful insights to clinicians caring for patients with this condition.
当孕妇体内存在针对其胎儿所表达的红细胞表面抗原的抗体时，可发生胎儿和新生儿溶血病（HDFN）。这种同种免疫性疾病仅限于母体抗体经胎盘转移至胎儿，并与胎儿红细胞结合，从而显著缩短红细胞寿命的情况。HDFN的发病机制涉及母体对红细胞“非自身”抗原（即她自身不表达的抗原）的致敏。女性接触非自身红细胞抗原主要通过输血或怀孕，在怀孕时，由其胎儿表达的父源性红细胞抗原进入她的循环系统，并被免疫识别为外来物质。本综述重点关注同种免疫性HDFN发病机制中最常涉及的红细胞抗原的遗传学、结构和功能。通过提供这些信息，我们旨在为照料患有这种疾病的患者的临床医生提供有用的见解。
