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We have tested 10 bone marrow transplant donors and recipients for ABH and Lewis antigens and ABH antibodies. Two group A2 recipients stably engrafted with group O marrow produced anti-A1. Small quantities of recipient-type ABH substance were found on the posttransplant erythrocytes in cases where the recipient was a secretor but not in a single nonsecretor recipient. Lewis antigens were always of recipient type. The incidence of graft-versus-host disease and graft rejection were similar in 41 patients who received ABO-mismatched and 61 patients who received ABO-matched grafts.

Haemagglutination-inhibition studies showed that several different allergenic preparations exhibit A and B blood group activity. Most products displayed A-specificity, less often B-specificity; the inhibition titers were usually low. No correlation was evident between isoagglutination-inhibition titers and the complement-consuming capacity or skin-reactivity of the allergens. Absorption of A- and B-isoagglutinins from human serum did not affect the complement consumption by house dust allergens. Hapten-inhibition studies confirmed the non-participation of blood group antibodies in allergen-induced complement consumption. The observed inhibition by D-glucosamine is attributed to a partial structural homology with the lysine-sugar site on house dust allergens.

A review is given of the ante- and peri-natal immunohaematological problems arising when ‘non-Rhesus’ irregular red-cell antibodies, especially those reacting with ‘public’ antigens, are encountered in pregnancy, and a case of anti-Ve in pregnancy is reported. The antibody did not cause haemolytic disease of the newborn. The direct Coombs test was negative, and no maternal antibody was present in the infant's serum. The results of the serological and immunological investigations are discussed in relation to the condition of the newborn infant, and the difficulty in assessing whether an infant is likely to be affected when such antibodies are present in pregnancy is stressed.

The properties of four albumin-agglutinating sera demonstrating a spectrum of reactivities are reported. All cause pan- and auto-agglutination in albumin. Direct and indirect reacting caprylate-dependent agglutinins are described, as are two sera with undefined specificity not related to the presence of caprylate stabilizer in the albumin. Immunoelectrophoretic evidence was obtained to support the concept of albumin-immunoglobulin complex formation in the genesis of albumin agglutination. Most albumin agglutinins react only with albumin stabilized by short-chain fatty acids; however, other specificities may be represented. Albumin agglutinins should be clearly identified in the blood bank to prevent confusion with blood group antibodies.

Antiglobulin sera, from nine different manufacturers, have been tested over a two-year period for their ability to detect different nonagglutinating, IgG and IgM blood group antibodies and for the presence of undesirable antibodies that cause the agglutination of nonglobulin coated red blood cells. There are not so many differences in anti-IgG levels among the sera as there are differences in anticomplement levels. Over the two-year period, there have been, in general, increases in the amounts of anti-IgM antibodies in the sera tested. Several of the sera, apparently prepared by dilution of raw rabbit serum and not by adsorption, contain antibodies that cause the agglutination of red blood cells not coated with IgG, IgM, or any of the components of complement.

IN a previous report1 we showed that ganglioside, a class of complex sphingolipids isolated from brain tissue, inhibited several blood group antibodies, namely, anti-A, anti-M and anti-Rh0 (D). Since then2 we have found that anti-I and anti-O also were inhibited by gangliosides although anti-H was not. It has recently been found that anti-H (lectin) was less easily inhibited by gangliosida than human anti-H. In an extensive study of the association between ABH (O) and I, Gold3 found a parallel between the agglutinability of cells by anti-O, anti-A1, and anti-I. Schmidt and McGinniss4 demonstrated that the serological similarity between anti-O and anti-I sera does not extend to anti-H reagents and suggested establishing this blood group system as the OI rather than the HI system.

Ten commercial “broad-spectrum” antiglobulin sera, which had satisfied NIH standards, were evaluated and compared with six antiglobulin sera of varying specificities prepared in the authors' laboratories. The majority of the commercial antisera had adequate anti-IgG, although four were definitely weaker and failed to detect weak IgG antibodies. Most of the commercial antiglobulin sera had inadequate anticomplement, eight failing to react with cells strongly sensitized with complement, from patients with hemolytic anemia. Most of the commercial antiglobulin sera reacted poorly with cells weakly or moderately sensitized with complement-binding blood group antibodies, such as anti-Lewis. Evidence that adequate anticomplement activity should be present in routinely employed antiglobulin sera is discussed.

Pregnant cows can be successfully immunized with different proteins and subsequently deliver large volumes of potent antisera in their colostrum. An anti-human immunoglobulin has been prepared in this way which is excellently suited for the demonstration of incomplete blood group antibodies of the IgG class. At a dilution of 1:50 it was equivalent to a commercial antiglobulin serum of high quality. Anti-complementary antibodies were also present but at a considerably lower concentration than the antibodies against IgC.

THE PRESENT case was deemed worthy of report for three reasons: (1) the occurrence of acquired hemolytic anemia subsequent to transfusion incompatibility in a patient with acute disseminated lupus erythematosus; (2) the occurrence and demonstration of blood group antibodies, anti-C, anti-A 1 , and a third incompletely identified atypical hemagglutinin, subsequent to multiple whole blood transfusions; (3) the use of exchange transfusion as a therapeutic agent during the most acute phase of intravascular hemolysis. REPORT OF CASE The patient, a 15-year-old white girl, was admitted to the hospital for the first time on July 9, 1949, with complaints of generalized weakness and fatigability and of migratory joint swellings. Her first difficulties began seven months prior to admission with a brief episode of low-grade fever and widespread joint pains which subsided until six weeks before admission, when fever and alternate warm painful swellings of the finger, elbow, and knee points again developed.

Summary From the known effect of pH, temperature, antigen and salt concentration on the reaction between an example of anti-D and red cells, it has been found possible to suggest optimum conditions for the detection of other antibodies by the antiglobulin test. By lowering the salt concentration of the suspending medium the rate of association of antibody and red cells is considerably increased, so that the incubation time can be reduced from 1 hour to 5 minutes. Performance of the antiglobulin test under these conditions has been found to enhance the titre of antibodies against the following antigens: A, c. D, e, E, M, K, Lea, Fya, Jka. Using 131I-labelled anti-D it was estimated that approximately 500 molecules of blood group antibody on the surface of each red cell would give a just detectable agglutination reaction with antiglobulin serum under standard conditions. Resume Connaissant l'effet du pH, de la temperature, de la concentration en antigene et en sel sur la reaction entre l'anti-D et les erythrocytes, il nous a semble possible de trouver les conditions optimales permettant de detecter d'autres anticorps au moyen du test a l'anti-globuline. En diminuant la concentration en sel du milieu de suspension, le taux d'association de l'anticorps avec les erythrocytes est considerablement augmente, si bien que le temps d'incubation peut etre reduit de 60 minutes a 5 minutes. La pratique du test a l'anti-globuline dans ces conditions a demontre une augmentation du titre de l'anticorps contre les antigenes suivants: A, c, D, e, E, M, K, Lea, Duffya, Jka. Lorsqu'on utilise de l'anti-D marque au 131I, on a pu estimer que, approximativement, 500 molecules d'anticorps de groupe sanguin fixes a Ia surface de chaque erythrocyte donnent une reaction d'agglutination aisement decelable avec le scrum anti-globuline dans des conditions standard. Zusammenfassung Anhand der bekannten Beeinflussung der Reaktion eines Anti-D-Antikurpers mit Erythrozyten durch das pH, die Temperatur, die Antigen- und Salzkonzentration wurden die optimalen Bedingungen fur den Nachweis anderer Antikurper mittels des Antiglobulintestes ermittelt. Durch Herabsetzung der Salzkonzentration der Aufschwemmungsflussigkeit gelang es die Geschwindigkeit der Antikurperbindung an die Erythrozyten derart zu beschleunigen, das die Inkubationszeit von 1 Stunde auf 5 Minuten herabgesetzt werden konnte. Bei Innehaltung dieser Bedingungen gelang es im Antiglobulintest den Titer der Antikurper gegen folgende Antigene zu erhuhen: A, c, D, e, E, M, K, Lea, Fya, Jka. Mittels 131I-markierten Anti-D-Antikurpern gelang es zu zeigen, das unter Standardbedingungen 500 Antikurpermolekule pro Erythrozyt eben ausreichen, um im Antiglobulintest eine positive Agglutination auszulusen.

Eight human Lewis blood group antibodies were characterized for their fine specificity by the use of specific immunoadsorbents and a kinetic enzyme-linked immunosorbent assay technique. Examination of sera following immunoglobulin fractionation showed IgM anti-Le(a) exhibiting broad cross-reactivity with structures biochemically related to the Lewis antigens. IgG anti-Le(a) binding was restricted to Le(a) and Le(b) These findings are consistent with the concept of affinity maturation of the immune response, which has been previously demonstrated only in animal model systems.

Fifty-two sterile couples, characterized by persistent and unexplained incompatibility between spermatozoa and cervical mucus, without any other evident factor to explain their sterility, were investigated for the possible role of blood group incompatibility as a cause of their sterility. After a study of the distribution of blood groups in sterile and fertile couples, the distribution of blood group substances in pairs of husbands and wives, and the effect of blood group antibodies on sperm migration, it seems highly unlikely that blood group incompatibility contributes significantly to cervical hostility and the resulting sterility.

Excerpt In an earlier study of experimental transfusion of donor plasma containing blood group antibodies into incompatible normal human recipients, a single ACD plasma containing exceptional anti-...

IT HAS BEEN well established that blood group antigens, substances A and B, are genetically determined and develop during intrauterine life. 1,2 In contrast, the blood group antibodies, the so-called "natural" isohemagglutinins, are believed by most authors to appear first, three to six months after birth. 3,4 Whether these isohemagglutinins are inborn or the result of an antigenic stimulus has been a subject of experimentation and long debate. The theory that isohemagglutinin production takes place after birth from exposure to group A and B antigens found normally in ingested food and in the developing intestinal flora has many proponents. 5-7 However, the presence of isohemagglutinins in neonatal sera 8 has been demonstrated, and it is thought that these are maternal in origin and transferred through the placenta. 4,9 Nevertheless, in recent years it has been well documented that the fetus produces small amounts of γM-globulins 10 and is capable of

The anti-Rh antibody first found in human serum was an agglutinin active, like other agglutinins, against erythrocytes suspended in saline, but, unlike most other blood group antibodies, more active at 37 C, than at lower temperatures. It can be absorbed by red cells and eluted from them, and apart from the complicated specificities involved, does not differ particularly from other antibodies. 1 In addition to the saline agglutinin, there is a type of antibody incapable of agglutinating erythrocytes suspended in saline, but combining with cells containing the proper receptor, and thus rendering them insusceptible to agglutination by the ordinary saline agglutinins. These antibodies were therefore first referred to as "blocking" or "coating" antibodies. The presence of anti-Rh antibodies on the red cells somehow causes them to be removed from the circulation and destroyed earlier than normally. 2 The red cells appear normal in the test tube, and even on microscopic