Anti-D: Birth of the breakthrough

Before anti-D, until the 1960s, there was no method available to prevent Rh immunization during Rh-incompatible pregnancies. Passive antibody immunosuppression is an immunologic phenomenon. It had been observed by generations of immunologists since it was first reported in 1900.16 In passive antibody immunosuppression, an active immune response is prevented by the passive administration of antibodies directed to the stimulus.

ANTI-D IMMUNOGLOBULIN

Based on this phenomenon two research groups worked on it. They were Finn and Clarke et al in England, and Freda, Gorman, and Pollack in the United State. In the 1960s they independently suggested the use of passively administered anti-D immunoglobulin for the prevention of immunization.17,18 With the passive antibody immunosuppression concept in mind, these two groups tested two different anti-D preparations in male volunteers. The US investigators used an IgG preparation derived from immune plasma subjected to cold alcohol fractionation. One thing was the same in each study. Rh-negative males received Rh-positive blood followed by an injection of the anti-D preparations. Both preparations significantly reduced Rh immunization of these volunteers. 17,19,20

16    Uhr JW, Baumann JB. Antibody formation. I. The suppression of antibody formation by passively administered antibody. J Exp Med. 1961;113:935-57.
17    Freda VJ, Gorman JG, Pollack W. Successful prevention of immunization to Rh. with an experimental anti-Rh, gamma2-globulin antibody preparation. Fed Proc. 1963;22:374.
18.     Finn R, Clarke CA, Donohoe WTA, et al. Experimental studies on the prevention of Rh. haemolytic disease. BMJ. 1961;1:1486-90. Dungern EV. Beiträge zur immunitätslehre. Münch Med Wochenschr.1900;47:677-680.
19    Clarke CA, Donohoe WTA, McConnell RB, et al. Further experimental studies on prevention of Rh haemolytic disease. BMJ. 1963;1:979-984.
20.     Freda VJ, Gorman JG, Pollack W. Successful prevention of experimental. Rh sensitization in man with an anti-Rh gamma globulin antibody preparation: a preliminary report. Transfusion. 1964;4:26-32.