It is my understanding that, while resistant, it is not totally unaffected and can even be enhanced due to cleavage. From the internet search: Rh Antigens and Papain: While intact Rh-positive red blood cells treated with papain may not show a change in the size of the Rh-containing polypeptides, sequential treatment with phospholipase A2 followed by papain does result in cleavage of a 35-Kd protein band to a 30-Kd band, suggesting some effect on the Rh-related polypeptides. Increased Agglutination: Interestingly, papain treatment often leads to enhanced agglutination (clumping) of red blood cells by anti-D antibodies. This suggests that while the D antigen itself might not be entirely destroyed, the changes in the red cell membrane caused by papain somehow make the antigen more accessible to the antibody or enhance the agglutination process. One theory is that papain modifies the red cell surface, reducing its electronegativity and exposing hidden antigens. Here's a couple of articles discussing: https://www.sciencedirect.com/science/article/pii/S0006497120626842 https://www.sciencedirect.com/science/article/pii/S0006497120858455#:~:text=studies%20described%20here.-,RESULTS,produce%20other%20detectable%20cleavage%20products. Very interesting ... thank you!
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