[Erythrocyte blood groups and geographic pathology (author's transl)]

Abstract

Blood groups are an obstacle to reproduction, transfusion and transplantation. There are immunological abortions due to the antibodies of "p" phenotype women; and Rh haemolytic disease of the new-born is in direct proportion to the frequency of the "r" gene in a given population; the problem of transfusional allo-immunisation is completely parallel. Certain membrane anomalies (due to exceptional erythrocyte blood groups--Rh null, Rh mod or McLeod, for example), can provoke hemolytic anaemias, but in these cases the subjects are scattered throughout the world. An important problem is that of the relationships between Duffy antigens and malaria: from what is known about plasmodium Knowlesi, Fya and Fyb antigens are related to the erythrocyte receptors for this plasmodium: the Fy(a-b-) red cells, even of exceptional non-blacks, are not infested with parasites. Two kinds of receptors are postulated: one for adherence and another for penetration. In contrast, plasmodium falciparum does not recognise the same receptors as plasmodium Knowlesi. Experiments carried out on man have led to the conclusion that plasmodium vivax also used Fya and Fyb antigens to penetrate the red cell. These recent facts give rise to the problem of a possible natural selection by plasmodium vivax, which would eradicate polymorphism, whilst until now, the facts concerning plasmodium falciparum have explained the balance of polymorphism.