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

• Published in: Clinical and experimental immunology Vol. 154; no. 1; pp. 1 - 5
• Main Author: Kumpel, B.M
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.10.2008; Blackwell Publishing Ltd; Blackwell; Blackwell Science Inc
• 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; Human; RhD haemolytic disease; Immunization; Vaccination; Red blood cell; Biochemistry; Monoclonal antibody; Clearance; Prevention; Blood cell; Newborn; anti-D; red cell clearance; Clinical trial; Fetus; Rh-System; clinical trials
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1111/j.1365-2249.2008.03735.x

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.