Ronald Finn

Experimental Studies on the Prevention of Rh Haemolytic Disease

In the context of haemolytic disease of the newborn, ABO incompatibility means that the father’s blood is unsuitable for transfusion into the mother, and our interest in this stems from the work of Levine (1943), who noted a deficiency of such mating types in the parents of affected children. He deduced, therefore, that ABO incompatibility affords a degree of protection against Rh haemolytic disease, and this has been confirmed by many workers. Of particular interest are the experiments of Stern et al. (1956), who showed that male volunteers could be much more easily sensitized to Rh if the injected blood were ABO compatible.

Immunological Responses in Pregnancy and Survival of Fetal Homograft

Immunological responses were studied in pregnant women and controls using as tests phytohaemagglutinin-induced lymphocyte transformation and the tuberculin reaction. Significantly reduced responses were found to both tests in the pregnant women. These results suggest that a reduction in T-cell activity during pregnancy may help protect the fetus from rejection by its mothers immunological mechanisms.

Depression of Cellular Immunity in Pregnancy due to a Serum Factor

Lymphocytes from pregnant women and non-pregnant individuals were cultured under the stimulus of phytohaemagglutinin in the presence of their own and heterologous (allogeneic) sera. The results indicate that heterologous sera have an inhibitory effect on the lymphocyte transformation rate and suggest that the inhibitory property is more powerful in pregnant and fetal sera. Conversely, the addition of heterologous non-pregnant sera to cultures of pregnant lymphocytes increases their transformation rate. These findings suggest that there is a serum inhibitor in pregnancy and this finding may be relevant to the survival of the fetal allograft.

Prevention of Rh-Haemolytic Disease: A Third Report

In two papers (Finn et d., 1961; Clarke it al., 1963) we described experiments which were successful in preventing Rh immunization in Rh-negative male volunteers. The basis of the procedure was to remove rapidly from the circulation previously injected chromium-tagged Rh-positive red cells by giving hightitre incomplete anti-D either as an infusion of plasma or as gamma3-globulin. In our second paper we stated that the next steps should be to find out whether foetal red cells could be cleared equally well as adult and whether female volunteers could be protected in the same way as men. The results of experiments to test these points form the first part (I) of the present paper. The second part (II) concerns two factors of great importance in the application of the technique to preventing Rh immunization due to pregnancy. These are the frequency with which transplacental haemorrhage from foetus to mother occurs during pregnancy as distinct from at delivery, and the relation of the production of immune antibodies to the size of transplacental haemorrhage assessed after delivery. In the third part of the paper (III) we discuss some of the details of the clinical trial, recently started in Liverpool, of anti-D gamma2-globulin injection given to Rh-negative Women after delivery.

FOOD ALLERGY: FACT OR FICTION?

Six patients with longstanding physical and mental symptoms who had not been helped by many years of conventional medical investigation and treatment experienced immediate relief of symptoms when they avoided certain foodstuffs. This clinical study supports the view that some foods may cause widespread and disabling symptoms in people who are sensitive to them.

FETO-MATERNAL BIDIRECTIONAL MIXED LYMPHOCYTE REACTION AND SURVIVAL OF FETAL ALLOGRAFT

Maternal and fetal lymphocytes were tolerant of each other in the bidirectional mixed lymphocyte reaction. This seems to be the principal reason why the mother does not reject the fetal allograft. Tolerance between maternal and fetal cells must be largely due to a genetic mechanism, because the bidirectional mixed lymphocyte reaction between parents and older children was much reduced compared with that between randomly selected pairs of controls. This weak reaction disappeared when immunosuppressive agents were given to one member of the parent/child pair, whereas the mixed lymphocyte reaction between unrelated individuals was not abolished by similar immunosuppression. It is suggested that this genetic mechanism is distinct from the HLA system. Tolerance between maternal and fetal cells was not demonstrated in the unidirectional mixed lymphocyte reaction, suggesting that this tolerance requires the viability of the two cell populations.

Possible role of laxatives in analgesic nephropathy.

Eight out of ten of patients with analgesic nephropathy were regular and usually heavy laxative takers compared with 12 out of 200 controls from the general population and four out of 70 patients attending a renal clinic. The finding that regular laxative taking was greatly increased in patients with analgesic nephropathy suggests that this condition may often be due to the combined abuse of both laxatives and analgesics. In a series of 40 patients with rheumatoid arthritis all were found to have normal renal function and no patient took laxatives regularly. This finding would explain why analgesic nephropathy is so uncommon in patients with rheumatoid arthritis despite the fact that they are regular and heavy analgesic takers.

Data on linkage in man: ovalocytosis, sickling and the Rhesus blood group complex

1. Two families are reported in which linkage between the gene controlling ovalocytosis and that of the Rhesus blood group complex is present. In those individuals where cross‐overs could have been detected none was in fact found in either family.

Association between Previous Tuberculous Infection and Cerebal Glioma.

An increased incidence of previous infection with tuberculosis has been found in a series of patients with cerebral gliomas, and it is suggested that such an association may be due to defective immunity acting as a common aetiological factor.

SURVIVAL OF THE GENETICALLY INCOMPATIBLE FETAL ALLOGRAFT

A hypothesis is put forward to account for the non-rejection of the fetal allograft, based on shared surface-repellent molecules (S.R.M.s) which prevent close apposition of maternal and fetal immunocompetent cells. This hypothesis is shown to be compatible with the major theoretical requirements of the immune system. Thus it provides possible explanations for the self/not-self recognition process, tolerance to organ transplants, the development of autoimmune disease, and high and low zone tolerance. It is also argued that the recognition of self is important with reference to cellular antigens, but may not be essential for humoral antigens.