Alvin Zipursky

The pathogenesis and prevention of Rh immunization

RH immunization of Rh-negative women during or subsequent to pregnancy is a response to the presence of fetal red cells in the mother. It has been the goal of several groups, including our own, to define this process of isoimmunization in Rh-negative women and to develop a rational program for its prevention.

Fœtal Erythrocytes in the Maternal Circulation

Kleihauer et al. (1957) recently reported that the haemoglobin of adult red cells in a fixed smear was readily eluted by an acid phosphate buffer whereas the haemoglobin of foetal cells was not. We have applied this observation to the detection of small numbers of foetal cells in the blood of newly delivered women.

Shunt bilirubin: evidence for two components.

Studies with C14-labeled glycine and δ-aminolevulinic acid as heme-bilirubin precursors in man indicate that the early labeled or shunt bilirubin consists of two fractions. Fraction 1 requires 1 to 24 hours for maximum synthesis, is not dependent on marrow erythropoietic heme synthesis, and is possibly of anabolic origin (formed by a direct pathway from heme precursors). Fraction 2 requires 3 to 4 days for maximum production, is dependent on heme synthesis, and probably has its origin in the bone marrow, as a degradation product of red-cell heme.