ABH secretion and natural selection

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Abstract
The secretor gene, which determines secretion of the ABH blood group antigens into saliva and other fluids, has widely varying frequencies in different heathly populations. Its frequency in patients suffering from certain diseases also differs from that in healthy persons. Frequencies of the gene are to some extent the results of natural selection. One means of selection is through hemolytic disease of the newborn. Women, mostly of group O, become immunized to the A or B antigen of a fetus, and this or subsequent fetuses are at risk from hemolytic disease of the newborn. Affected fetuses are preponderantly secretors; this is probably a genetic consequence of all or most immunizing fetuses being secretors. Selection against the secretor factor as well as against blood groups A and B is thus liable to occur. Similar processes of selection seem to operate through fetal loss by early abortion. Counter-selection favoring secretors may result from certain epidemic infectious diseases.

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