Heterophile antibodies. Part I. The specificity of agglutinating and hemolytic sheep red blood cell antibodies in human sera.
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Biomedical subjects
Publications and source records attributed to G H Vos.
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This study shows that some substances in human secretions can inhibit the agglutination of sheep red blood cells by human antibodies. When present in adequate concentrations, they can also inhibit the reaction of the donor's own sheep red blood cell antibody activity in vito. The subjects in whom this phenomenon was found almost always had low agglutinating antibody titers to sheep red blood cells. The inhibiting activity of saliva for sheep red blood cell antibodies was influenced by the ABH secretor status. Substances reacting against sheep red blood cell antibodies occur in the secretions in considerably smaller quantities than ABH substances.
Group A, B and O subjects who produce immune antibodies to group A1 or B red blood cells also produce high titer antibodies to sheep red blood cells. Sheep red blood cells appear to possess AB-like as well as non-AB determinants on their surface membranes, each capable of producing and reacting with antibodies of their respective specificities. The antibodies against AB-like determinants preferentially agglutinate A or B cells whereas non-AB-like determinants preferentially stimulate hemolytic antibodies. Human antibodies reacting with these two kinds of determinants on sheep red blood cells may be produced in response to microorganisms possessing very similar factors on their membranes. Individuals who possess AB-like determinants in their secretions, similar to the determinants present on sheep red blood cells (or microorganisms), often make weaker antibodies to these red blood cells. Subjects lacking corresponding anti-sheep inhibitors in their secretions generally produce stronger sheep red blood cell antibodies. There is a positive correlation between the formation of antibodies to HBsAg and strong agglutinating antibodies to sheep red blood cells, indicating that similar determinants may be found on HBsAg virus and on sheep red blood cells. No such correlation was found for anti-tetanus antibodies.
In order to establish the role of fetomaternal ABO incompatibility as a cause of overall neonatal jaundice, its relationship to the degree of jaundice, and its etiologic contribution to severe jaundice necessitating exchange transfusion in South African blacks, a retrospective analysis of both laboratory and clinical data was undertaken. Two thousand forty-two blood samples were submitted for laboratory investigation from mothers and their jaundiced newborn infants and categorized according to ABO blood groups and levels of serum bilirubin. At levels of serum bilirubin below 301 mumol/l, ABO incompatible combinations occurred as frequently as ABO compatible combinations. However, at serum bilirubins above 301 mumol/l, ABO incompatibility was a major cause of jaundice in almost 58 per cent of infants. In the nursery-based clinical studies, ABO incompatibility accounted for 41.7 per cent of those severely jaundiced (greater than 301 mumol/l) and 44.4 per cent of newborn infants who had exchange transfusions. ABO incompatible combinations however did not assume a significant role in the cause of overall neonatal jaundice. Both laboratory and clinical findings therefore confirm the importance of fetomaternal ABO incompatibility as a cause of severe jaundice and an unimportant cause of overall jaundice in newborn black babies.
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