Detection by radioimmunoassay of IgM class antibody to hepatitis B core antigen: a comparison of two methods

A solid-phase radioimmunoassay (RIA) for IgM anti-HBc is described. The assay (anti-mu RIA) is based on the adsorption of IgM to a tube coated with sheep antibody to the human IgM mu-chain. The adsorbed immunoglobulin is assayed for anti-HBc activity. Positive reactions in the test are shown to be due to IgM antibody, and a confirmation blocking test is described. Reactivity of test sera can be quantitated by comparison with standard sera containing known levels of IgM anti-HBc. Sera assayed for IgM anti-HBc by both the anti-mu RIA and a method employing serum fractionation and competitive RIA gave similar results. Rheumatoid factor (RF) alone did not react in the anti-mu RIA, but reactivity could be generated in the presence of RF and preformed aggregates of IgG anti-HBc.

The role of rheumatoid factor in an electron microscope study of hepatitis B antigens

An immune electron microscopic (IEM) study of the hepatitis B e antigen (HBeAg) system has shown that rheumatoid factor (RE) can be an important complicating factor when examining preparations containing multiple antigenic specificities. For example, in the presence of RF, mixed immune complexes were produced that suggested HBeAg might be antigenically related to either Dane particles or cores. When RF was removed, however, the putative HBeAg--anti-Hbe complexes showed no relationship with any other hepatitis B component. It has been shown that RF can have a positive practical application in IEM by using it to link preformed marker complexes to immune complexes which do not contain morphologically recognizable antigen.

Contrasting patterns and frequency of antibodies to the surface, core, and e antigens of hepatitis B virus in blood donors and in homosexual patients

An attempt was made to assess the significance of the relatively frequent low-titre positive reactions in radioimmunoassays for antibody to hepatitis B surface antigen. Serum specimens negative for surface antigen were assayed for antibodies to the surface, core, and e antigens of the Hepatitis B virus. Two populations were studied - one of low hepatitis B incidence (2000 blood donors) and one of high incidence (200 male patients attending a clinic for sexually transmitted diseases). The validity of some singly occurring low-titre anti-HBs and anti-HBc reactions is questioned, and the occurrence of positive reactions unrelated to previous hepatitis B infection inferred.

Characterization of 'e' antigen associated with hepatitis B

Hepatitis B 'e' antigen (HBe) from the serum of a chronic carrier of HBsAg has been partially purified and characterized. It behaves as an acidic protein, pI 4.5--5.0, which is thermolabile and sulphydryl-sensitive. In serum it usually has a flotation density 1.3 g/cm3, but is sometimes found at density 1.15 g/cm3 because of its association with lipid. HBe from serum is polydisperse on gel filtration although most antigen is recovered with a nominal molecular weight of 3 x 10(5) Daltons. In contrast, in the presence of chaotropic ions, the bulk of serum HBe is found as a species of 3 X 10(4) Daltons previously detected in small amounts under non-dissociating conditions. This suggests that the larger material is formed by non-covalent association of the 3 X 10(4) Dalton species either with itself or other serum components. This would include IgG, although there is no evidence that HBe itself bears immunoglobulin determinants. Analysis of HBe precipitins by polyacrylamide gel electrophoresis under reducing and dissociating conditions suggests that its component polypeptide chains are about 1.7 X 10(4) Daltons.

Liver enzyme concentrations as measure of possible infectivity in chronic asymptomatic carriers of hepatitis B

Fifty-two British-born blood donors who were chronic carriers of hepatitis B surface antigen (HBsAg) were tested for the presence of hepatitis B e antigen (HBeAg) and antibody to HBeAg by an immunoradiometric assay. The presence of HBeAg was closely associated with a slight rise in serum liver enzyme concentrations, a high HBsAg titre, and male sex. We suggest that the finding of persistently raised serum liver enzyme concentrations in an asymptomatic HBsAg carrier might be useful as a likely indicator of HBeAg and high infectivity.

Testing for e antigen and e antibody by immunodiffusion

A rapid and reproducible micro e-ID test is described which allows two out of three HBsAg carriers to be classified as e-Ag or e-Ab. The majority of the remaining one-third of carriers are e-Ab as shown by e-RIA though a few will be e-Ag positive carriers by e-RIA.

A non-invasive test for receptor binding applied to nephrogenic diabetes insipidus

Studies in animals have determined the importance of specific receptors to the action of many hormones and drugs. In man, a non-invasive external counting technique has been used and absence of receptor function has been demonstrated in a patient with nephrogenic diabetes insipidus using radioactively labelled arginine vasopressin. This is in contrast to the findings in a patient with pituitary diabetes insipidus and a normal control. These results suggest a model for the study of hormone and drug kinetics in man avoiding multiple samplings of biological fluids.

Prostaglandins and complement changes in some conditions related to inflammation

Exposure to ionizing radiation produces several systemic and local reactions which could be mediated by prostaglandins. Prostaglandin levels were therefore studied in blood and tissues of mice which had been exposed to x-rays. Significant increases were found in spleens after 200 to 700 R, and in lungs after 600 to 700 R. These changes were most pronounced 4-7 days after irradiation. Ionizing radiation promptly and potently reduced the activity of prostaglandin dehydrogenase in the spleen, whereas prostaglandin synthesis was less affected. Evidence was obtained for the activation and consumption of haemolytic complement in serum in the course of heart-lung operations involving extracorporeal circulation. Activation involved primarily the classical pathway, and only slightly the alternate pathway.

Changes in intra-vascular complement and anti-treponemal antibody titres preceding the Jarisch-Herxheimer reaction in secondary syphilis

Six patients with secondary syphilis and one control subject were observed over a period of up to 8 hr following the administration of either penicillin or erythromycin. Serial clinical observations were made and blood samples obtained for complement and serological analysis. The patients showed Jarisch-Herxheimer reactions (JHR) of varying intensity which were found to be preceded by and to parallel in degree certain changes in complement and syphilitic antibody titres. Falls in total haemolytic complement, in C4, C3, C6 and C7 and a marked drop in C1INH were observed. There was no change in total GBG/GGG or evidence of conversion of GBG to GGG. Associated falls occurred in the titres of the QFTA and the QTPHA antibodies but not of the QVDRL or QTPI antibodies. C3 conversion was found in the two patients that suffered severe reactions. Immune complexes were not detected and it is suggested that complement activation occurred in the extra-vascular body compartment. The significance of these changes in relation to other plasma enzyme systems and to the development of the full clinical picture of the JHR is discussed.

Effects on serum complement of normal and pre-eclamptic pregnancy and of oral contraceptives

The complement system was studied in normal gestation and puerperium, in pre-eclampsia and in women taking oral contraceptives. In 12 normal pregnancies, CH50 titres, C4, C3, C6 and C7 were increased throughout pregnancy; the serum concentration of C1 inhibitor was decreased in the last 2 quarters but greatly raised after delivery. Oral oestrogen-progestogen contraceptives also raised C3 but in contrast to pregnancy lowered CH50, C6 and C7. The different effects of pregnancy and of oral contraceptives may be due to materno-foetal immune reactions. In 9 patients with pre-eclamplsia, complement levels showed a wider scatter and a significantly higher C3 level than in normal pregnancy. Conversion of C3 to C3i was found in 2 of these patients.