key: cord-0050745-3yuu5d2w authors: Hitoshi, OHTO title: Extension of Homo Sapiens Adapting to Every Environment with Divertgent Phenotypes: Blood Type Incompatible in Pregnancy as an Abaxial Phenomenon date: 2020-09-28 journal: Transfus Apher Sci DOI: 10.1016/j.transci.2020.102943 sha: 6c1e3fe9a04f2eec16828b47f0f830c5e4f4b4c0 doc_id: 50745 cord_uid: 3yuu5d2w nan Since the genesis of living organisms, the selection pressure or survival competition of any species has emerged through continuous, uncountable mutations. Prior to the emergence of Homo sapiens from subhuman primates, many pathogens, such as malaria species, have long and severely affected them (1) . Beginning 100,000 to 40,000 years ago, modern humans migrated from Africa and adapted their cultures and phenotypes to extremes of altitudes, temperature, and humidity throughout the planet. Various erythrocyte mutations are thought to have emerged with a survival neutrality, disadvantages, or advantages in avoiding death before reproductive ages, such as hemoglobinopathies and the distribution of blood groups. The most common allele of group O (O01) is derived primarily from the group A allele (A01) with a single base deletion resulting in failure to produce a functional A transferase. Subsequently, O individuals have manifested an immune response to produce strong anti-A and anti-B isoantibodies, which may provoke intrauterine fetal demise or severe postpartum morbidity. In modern humans, however, a reduction of A and B antigen sites on neonatal red cells to about one-third, combined with diminished branching of A and B chains, improve fetal and neonatal outcomes in the context of maternally-derived cognate antibodies(2). This Theme Section offers guidance to readers who have been and those who will be making efforts for mothers and infants associated with blood group incompatible pregnancy and related issues. The fetus is immunocompetent and acquires the ability to generate an immune response and also specific tolerance as it is exposed to genetically foreign and noninherited maternal antigens (3) . At birth, the immune system does not attack nor harm maternal tissues. Hyland and others state that non-invasive prenatal testing (NIPT) fetal genotyping for atypical (other than RhD) blood group antigens presents more challenges as most arise from a single nucleotide variant. Recent studies show potential for genomic and digital technologies to provide a personalised medicinal approach with NIPT to assess fetal blood group status for women with other (non-D) red cell antibodies to manage the risk for HDFN (6) . This guest editor is deeply grateful for all contributors to this Theme Section. The genetic inheritance of Homo sapiens is a matter of natural selection, but our cultural and intellectual inheritance is a matter of volition. Among those readers, we dare to imagine those who will further advance fetomaternal care for generations to come. Biography of Professor Emeritus OHTO Hitoshi, the Guest Editor for this theme section, "Maternofetal interaction, blood group incompatibility and its interventions" initiatives. In 1989, FMU was the first institution in the world to introduce universal irradiation to prevent transfusion-associated graft-versus-host disease (TA-GVHD). [5] Widely shared HLA phenotypes make the Japanese population especially vulnerable to TA-GVHD, so this FMU standard was soon adopted nationally. With other interests in transfusion safety, such as bidirectional maternofetal micro-transfusion and it's infectious disease, alloimmune, and other consequences to mother and infant [6, 7] , Prof. OHTO has contributed to more than 220 peer-reviewed articles in English, and another The ABO blood group system and Plasmodium falciparum malaria Fetal and neonatal allo-immune response Erythrocyte alloimmunity and genetic variance: results from the collaborative study of Alloimmunity to Antigen Diversity in Asian Populations (All ADP) Immunohematologic aspects of alloimmunization and alloantibody detection: a focus on pregnancy and hemolytic disease of the fetus and newborn Non-invasive prenatal testing for management of haemolytic disease of the fetus and newborn induced by maternal alloimmunization The Rhesus incompatible pregnancy and its consequence for affected fetuses and neonates Three non-classical mechanisms for anemic disease of the fetus and newborn, based on maternal anti-Kell, anti-Ge3, anti-M, and anti-Jr a cases RhIg for the prevention Rh immunization and IVIG for the treatment of affected neonates Infectious complications in neonatal transfusion: narrative review and personal contribution Umbilical cord blood current uses for transfusion and regenerative medicine Efficient and safe stem cell apheresis Platelet preservation: Past, present, and future What we have learnt from past disasters, how to prepare for future calamities? Progenitor/Stem Cell Apheresis and its Related Issues Survey of transfusion-associated graft-versus-host disease in immunocompetent recipients Transmission of Hepatitis C virus from mothers to infants Low frequency of observed anti-HLA among transfused preterm infants Suicide rates in the aftermath of the 2011 earthquake in Japan