Agglutinating Activity of a Healthy Donor Serum in the Presence of Albumin¹

Abstract

In 1956, WEINER et al. [l] described the reactions of some unusual human sera which showed apparently non-specific auto-agglutination of red cells only in the presence of bovine serum albumin (BSA).In the present case, the serum of a group 0 donor, a 24-year-old male of Hawaiian-Caucasian-Chinese extraction, was found to agglutinate his own red cells. as well as random group 0 cells, in the presence of BSA at room temperature. No agglutination occurred when the saline and indirect antiglobulin methods were performed. The direct antiglobulin test was negative. The donor had given blood three times during the previous year, and the blood had been used for transfusion without any untoward reaction. Also, until the fourth blood donation, no incompatibility had been found by the albumin method. The present study was carried out to determine the properties of the donor's serum, and t o identify by immunochemical analysis the specific serum fraction probably involved in this phenomenon.Two blood samples were obtained from the donor at an interval of two months. One hundred and twenty group 0 blood samples from healthy donors ranging in age from 18 to 55 years and twenty group O cord blood samples were used. Two percent cell suspensions were prepared in two ways: (1) in homologous serum and (2) after three washings, in physiological saline. An equal volume of each cell suspension was mixed with the donor's serum in test tubes. An identical set of the mixtures was prcpared and 30% BSA was added. All test tubes were incubated for 30min a t 5"C, 25°C and 37°C respectively. The agglutination, with and without BSA, was This work was supported by the Memorial Fund for Mrs. LOIS A. MAYERS.

Mechanism of the Albumin Agglutination Phenomenon

“…This view is supported by other studies [2] and can explain the two reported cases of transplacental passage of the factor [3,8]. An albumin agglutinating serum has been reported, however, in which activity was found only in the yM globulin fraction after column separation with DEAE [9]. The mechanism whereby albumin is inactivated by 2-mercaptoethanol is uncertain, but the occurrence emphasizes the need for caution in using this test to characterize an antibody.…”

“…The common property of these albumin agglu tinating sera is the ability to cause agglutination of all red blood cells, including auto-agglutination, in an albumin medium. Previous studies have shown that the property does not have the characteristics of a blood group antibody, there is no reactivity with colloids other than albumin, the direct Coombs test is negative, and the reaction is not complement dependent [1][2][3][4][5][6][7][8][9]. Individuals with this abnormality are usually identified when transfusion is anticipated and an albumin crossmatch is performed.…”

Another Example of an Albumin Auto-Agglutinin

“…The albumin auto-agglutinating phenomenon, first described by Weiner [12,13] and his associates, must be of infrequent occurrence, for although albumin is frequently used as a suspending medium for test cells, only a few further examples of this phenomenon have been recorded [1,2,3,4,5,6,8,11,14], The property is characterized by the ability of the patients' sera to react with their own and all other red cells but only when the cells are suspended in an albumin medium.…”

Anti-I Autoantibody Acting Preferentially in Albumin

“…[ 5,6] and that the antibody responsible, which may be IgG [5,7] or IgM, [13,19] is directed at a conformational determinant imparted to albumin by sodium caprylate. An antigen-antibody complex is formed which combines with red cells.…”