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Treatments involving Anti-D antibodies are given to pregnant women carrying Rh+ fetuses when the mother has an Rh- blood type in order to prevent Hemolytic Disease of the Newborn during the 2nd pregnancy. The anti-D antibodies are injected during later stages of pregnancy and right after birth in order to eliminate any Rh+ blood cells in the mother before D-antigen antibodies are produced naturally by the mother. If antibodies do not attack cells directly, what stops the mother's macrophages from engulfing the antibody bound Rh+ blood cells, becoming an antigen presenting cell and hence initiating the process of producing antibodies and saving the antigen in memory cells? Are the Fc receptors on the macrophages not compatible with the injected anti-D antibodies?

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  • $\begingroup$ I think you've misunderstood some of this. The treatment doesn't involve giving someone anti-D antibodies to destroy Rh+ cells - indeed, those antibodies would cross through the placenta and potentially cause the disease in the newborn. An antibody treatment based on Rho(D) immune globulin does exist, but this functions by preventing the immune response which would otherwise cause the production of anti-D antibodies. $\endgroup$ Nov 19 '20 at 9:27
  • $\begingroup$ Hmm, it seems even I was wrong in part - the treatment involves "a solution of gamma globulin containing anti-D" according to Rudmann's textbook (p439) $\endgroup$ Nov 19 '20 at 9:40
  • $\begingroup$ @Astrid_Redfern Thank you very much for your input. Still, if the gamma globulin contains anti-D, then my question is still relevant right? $\endgroup$
    – JulianS
    Nov 19 '20 at 17:27
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    $\begingroup$ Related: biology.stackexchange.com/questions/35531/… $\endgroup$
    – MattDMo
    Nov 20 '20 at 3:04
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    $\begingroup$ Made a bit of progress by learning that antibodies can either be of a neutralizing or non-neutralizing nature: en.wikipedia.org/wiki/Neutralizing_antibody "Neutralizing antibodies on the other hand can neutralize the biological effects of the antigen without a need for immune cells" The anti-D antibodies in Rh Immune Globulin are of a neutralizing nature: sciencedirect.com/science/article/pii/B978012374432600035X Could it be that sensitization is avoided because the Rh Immune Globulin does not tag the Rh+ blood cell for phagocytosis by macrophages? $\endgroup$
    – JulianS
    Nov 20 '20 at 22:12

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