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Chimerism. 2013 Oct-Dec;4(4):119-25. doi: 10.4161/chim.26912. Epub 2013 Nov 6.

Chimerism in transfusion medicine: the grandmother effect revisited.

Author information

1
Department of Pathology; The Johns Hopkins Hospital; Baltimore, MD USA.

Abstract

Transfusion therapy is complicated by the production of alloantibodies to antigens present in the donor and lacking in the recipient through the poorly-understood but likely multi-factorial process of alloimmunization. The low prevalence of alloimmunization in transfused patients (6.1%) (1) suggests that processes central to immunologic tolerance may be operating in the vast majority of transfused patients who do not produce alloantibodies. Using RhD as a prototype, evidence is reviewed that the ability to make antibodies to red blood cell (RBC) antigens may result in part from immunologic tolerance acquired in utero. These ideas are extended to other examples of maternal microchimerism (MMc) of other non-inherited maternal antigens (NIMA). An evolutionary argument is offered that multi-generational immunity supports the hypothesis that MMc may partly explain the "non-responder" phenotype in RBC alloimmunization.

KEYWORDS:

Rh; alloimmunization; pregnancy; tolerance; transfusion

PMID:
24196285
PMCID:
PMC3921192
DOI:
10.4161/chim.26912
[Indexed for MEDLINE]
Free PMC Article

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