Biomedical subjects
Publications and source records attributed to H Chaplin.
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Hydroxyethyl starch (HES), which is licensed for human use as a plasma volume expander, has red blood cell sedimenting properties similar to high molecular weight dextran (HMWD). The present studies document the effectiveness of commercially available HES in preparing leukocyte-poor red blood cell suspensions (L-PRBCs) from donor whole blood and packed red blood cells stored in CPD up to 120 hours prior to processing. The effect of HES sedimentation on final white blood cell count, on erythrocyte p50 and 2,3-DPG concentration, and on short- and long-term in vivo survival of 72-hour stored donor red cells are described, along with favorable clinical experience with over 300 transfusions of HES-sedimented L-PRBCs. Since the method requires no special equipment, it is immediately available for widespread use.
A method is described for the preparation of C3d from fresh-frozen CPD plasma. A redissolved EDTA euglobulin precipitate formed from defibrinated plasma is chromatographed on DEAE cellulose. The C3-rich peak is further chromatographed by stepwise elution from hydroxy-apatite. The highly purified C3 and C3b so obtained are then treated with commercial C3b inactivator. G-200 sephadex filtration of this material produces a low molecular weight peak containing C3d greater than 95 per cent purity. The purified C3d, which contains negligible carbohydrate, has a molecular weight of 28,000 (based on SDS polyacrylamide gel electrophoresis). When added at a final concentration of less than 70 mug per ml, it completely inhibits the anti-C3d hemagglutinin reactivity of a potent anti-C3d antiglobulin serum but does not inhibit sera with reactivities against C3c, C4b, and C5b. Two of three rabbits hyperimmunized with purified C3d produced antisera exhibiting only anti-C3d precipitin activity. After absorption of heterologous antibodies, the antisera strongly agglutinated C3d-coated RBC, failed to agglutinate RBC glutinated C3d-coated RBC, failed to agglutinate RBC coated only with C4, and reacted weakly against strongly anti-Rh coated RBC. The latter reactivity was readily absorbed by whole IgG. Preliminary studies with 125I-labeled C3d indicate its potential value in assessing potency of anti-C3d reagents.
Test erythrocytes (E) used to evaluate anti-complement (C') antiglobulin sera have not been adequately standardized. This report describes a previously unrecognized C4-derived antigen (temporarily called X-Ag) found on E generally believed to be coated only with the C3d subcomponent of C3, X-Ag occurred on all E coated in vitro with C' by low ionic strength-sucrose or cold agglutinin methods and on E from ten of ten patients whose cells had been C' coated in vivo. It was not removed by incubating these cells with trypsin or fresh compatible serum. This antigen was found on "C4-only-coated" red blood cells made with normal or congenitally C2-deficient serum but not on cells similarly prepared with congenitally C4-deficient serum. It was not identified on E coated with C' via the alternate pathway, normal trypsinized cells, nor cells coated only with IgG. Absorption experiments utilizing purified complement components and subcomponents and G200 Sephadex fractions of normal human serum strongly suggest that X-Ag is a subcomponent of C4(C4d). These results show that at least one C' subcomponent other than C3d occures on both in vitro and in vivo C3d-coated erythrocytes and must be taken into account when such cells are used to evaluate antiglobulin reagents.
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A simple method for preparing relatively pure C3c fragment from serum-reacted zymosan is described. Although hyperimmunization studies indicate contamination of the "C3c" product by C3d and immunoglobulin antigenic materials, these are present in such small amounts that they do not impair the effectiveness of the product as a reagent for absorbing anti-C3c reactivity from polyspecific antisera. Furthermore, two of the three hyperimmune sera contained such weak anti-C3d that they could serve as monospecific anti-C3c antiglobulin reagents if used at moderate dilution. Neutralization of accompanying anti-IgG and weak anti-IgM is easily accomplished with readily available purified immunoglobulins. Preliminary studies indicate that the C3c product should be adaptable to quantitative radioimmunoassay of anti-C3c antibody concentrations and equilibrium constants.
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The study was undertaken to assess the potential of a labeled C3d radioimmunoassay method as a standardization criterion for antiglobulin reagents containing anti-C3d reactivity. Over an 18-month interval, four different lots of broad-spectrum antiglobulin reagents were purchased from each of seven United States manufacturers. Anti-C3d antibody concentration and Ko in each lot were assayed initially and at four-month intervals over 16 to 21 months storage at 4 degrees C. The results permitted 1) comparison of anti-C3d antibody concentrations among different manufacturers, 2) comparison among different lots from the same manufacturer, and 3) assessment of stability of anti-C3d during storage. In addition, serial dilutions of reagents in each manufacturer's diluent were compared for their anti-C3d agglutinating properties by the spin-antiglobulin method against red blood cells (RBC) coated by C3d in vitro and against in vivo C3d-coated RBC from 16 patients. Most reagents were shown also to contain anti-C3c, anti-C4c and anti-C4d reactivities when tested against suitably coated RBC. Anti-C3d antibody concentrations ranged from approximately 1 to 3.5 microgram/ml for 27 of the 28 reagents and were stable over 16 to 21 months of storage. Anti-C3d agglutination titer scores showed a general correlation with anti-C3d antibody concentrations when tested against in vitro C3d-coated RBC; correlations were less good against C3d-coated cells from patients. The radioimmunoassay provided reproducible objective measurements and appeared to have merit as a standardization criterion.