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Targeting rhd molecules on fetal red blood cells

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Reference no: EM131353225

Anakin with a genotype of A/O RhD+/- has fraternal twins (Luke and Leia) with Padme, whose genotype is A/O RhD-/-. Luke and his uncle Owen have never had their blood type tested. Leia has her blood typed and it is A RhD+. Luke is an HLA-A1/HLA-A2 heterozygot. Leia is an HLA-A2/HLA-A3 heterozygot. Owen is an HLA-A1/HLA-A3 heterozygot. Define the following statements (1-15) concerning various hypothetical scenarios related to this family situation as either factually correct (true) or incorrect (false):

1. Any future children Padme has with Anakin will develop erythroblastosis fetalis.

2. Erythroblastosis fetalis is typically caused by maternal IgM antibodies targeting RhD molecules on fetal red blood cells.

3. During her pregnancy (and knowing that Anakin is the father), Padme could be given an intramuscular injection of Rhogam (also spelled RhoGAM) at about 28 weeks of pregnancy to minimize the risk of RhD alloimmunization.

4. During her pregnancy (and knowing that Anakin is the father) Padme should be treated with Rhogam even if the fetus is known to be RhD-negative

5. If Leia ever receives a kidney transplant from Luke, without any immunosuppression, she may reject it faster than Luke would reject (without any immunosuppression) a kidney transplant from Leia.

6. If Leia ever receives a kidney transplant from Luke, without any immunosuppression, she may reject it faster than Luke would reject (without any immunosuppression) a kidney transplant from Leia, even if Luke and Leia would be perfectly MHC-matched.

7. If Luke ever receives a kidney transplant from Leia, without any immunosuppression, he may reject it faster than Leia would reject (without any immunosuppression) a kidney transplant from Luke.

8. If Luke ever receives a kidney transplant from Leia, without any immunosuppression, he may reject it faster than Leia would reject (without any immunosuppression) a kidney transplant from Luke, even if Luke and Leia would be perfectly MHC-matched.

9. Even if Luke and Leia would be perfectly MHC-matched (currently they are at least HLA-A- mismatched), Luke may reject a kidney transplant from Leia due to H-Y-antigen incompatibility. 10. Even if Luke and Leia would be perfectly MHC-matched (currently they are at least HLA-A- mismatched), Leia may reject a kidney transplant from Luke due to H-Y-antigen incompatibility. 11. To determine whether Leia would be likely to develop graft-versus-host disease (GVHD) after receiving allogeneic hematopoietic stem cells (HSCs) from either Luke or Owen, Luke's and Owen's lymphocytes could mixed together ex vivo and the results of this so-called mixed lymphocyte reaction (MLR) could predict the likelihood of this GVHD.

12. If Leia developed leukemia and her MHC class I ligands for Luke's inhibitory KIRs were more present on her cells than her MHC class I ligands for Owen's inhibitory KIRs and the level of the overall Leia-versus-Luke MHC incompatibility (tested and retested in multiple MLRs) was about the same as the level of the Leia-versus-Owen MHC incompatibility, then the graft-versus- leukemia effect would be expected to be stronger, if Leia received allogeneic HSCs from Luke rather than from Owen.

13. If Leia developed leukemia and her MHC class I ligands for Luke's inhibitory KIRs were more present on her cells than her MHC class I ligands for Owen's inhibitory KIRs and the level of the overall Leia-versus-Luke MHC incompatibility (tested and retested in multiple MLRs) was about the same as the level of the Leia-versus-Owen MHC incompatibility, then the graft-versus- leukemia effect would be expected to be weaker, if Leia received allogeneic HSCs from Luke rather than from Owen.

14. If Leia developed leukemia and her MHC class I ligands for Luke's inhibitory KIRs were more present on her cells than her MHC class I ligands for Owen's inhibitory KIRs and the level of the overall Leia-versus-Luke MHC incompatibility (tested and retested in multiple MLRs) was about the same as the level of the Leia-versus-Owen MHC incompatibility, then the graft-versus- leukemia effect would be about the same regardless of the source of allogeneic HSCs (Luke or Owen).

15. If Leia develops leukemia and needs bone marrow transplantation, Luke or Owen will be more suitable donors of HSCs than Anakin or Padme.

Reference no: EM131353225

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