Levine's Hypothesis of Maternal Iso-immunization

Abstract

MY recent letter on "Mutation and the Rhesus Reaction"¹ has provoked two replies. In one of them², Prof. J. B. S. Haldane raises an objection with which I hope to deal elsewhere at length when pressure of official duties is less exacting. In the course of the other³, Prof. R. A. Fisher, R. R. Race and Dr. G. L. Taylor say that they "dissociate ourselves from the statement that 'Levine's hypothesis postulates a form of adverse selection . . .'". Levine's hypothesis postulates that the blood of an Rh(–) mother who bears Rh(+) offspring by an Rh(+) father produces an antibody which plays havoc with the red cells of the fœtus. The result may be miscarriage, stillbirth or neonatal hæmolytic anæmia with possibly fatal consequences. Since such offspring are necessarily heterozygous, the hypothesis that erythroblastosis fœtalis, a condition lethal in a certain percentage of cases, is due to maternal iso-immunization also implies the existence of the adverse form of selection with which Haldane's letter mainly deals, as does the article of Wiener cited therein. Owing to present difficulties arising from dispersal of libraries for safe storage, I was not aware of the existence of Haldane's paper⁴ in which he develops several conclusions which I have derived independently, though it now appears later. Otherwise I should have cited his own prior treatment of the type of adverse selection implicit in Levine's hypothesis.