Antiglobulin

Oxyphenbutazone (712), y-hydroxyphenylbutazone and kebuzone (715) are metabolites of phenylbutazone in liver. The first cited is an equally potent antiinflammatory agent but slightly less toxic. Compounds (711) and (712) are rarely used as analgesics and antipyretics because of their toxicities. The first one is used in therapy of rheumatoid disorders characterized by a lack of detectable antiglobulin and antinuclear antibodies in the serum. The y-hydroxyphenylbutazone has marked uricosuric activity but little antirheumatic effect. Kebuzone (715) is an antiinflammatory agent still widely used in Europe. 

Arndt, P.A., Leger, R.M., and Garratty, G., Serology of antibodies to second- and third-generation cephalosporins associated with immune hemolytic anemia and/or positive direct antiglobulin tests, Transfusion, 39, 1239, 1999. 

Romano EL, Stolinski C, Hughes-Jones NC. An antiglobulin reagent labeled with colloidal gold for use in electron microscopy. Immunochemistry 1974 11 521-522. 

Kleinman, S., Nelson, R., Smith, L. and Goldfinger, D. (1984). Positive direct antiglobulin tests and immune hemolytic anemia in patients receiving procainamide. New Engl. J. Med. 311 809-812. 

Secondary antibody affinity-purified fluorescent antiglobulin conjugate reactive with the species globulin of the first step, e.g., affinity-purified rhodamine-con-jugated goat antimouse IgG(H + L chains) (Jackson ImmunoResearch, West Grove, PA), diluted to 25 pg/mL in BSA-PBS. Can be stored at-70°C and reused (see Notes 3 and 4). 

H9. Houba, V., and Allison, A. C., M-antiglobulins rheumatoid-factor-like globulins and other gamma globulins in relation to tropical parasite infections. Lancet i, 848-S52 (1966). 

Another use of the RIA is to measure the quantities of serum IgE antibodies specific for various allergens in a patient s serum, in which case it is called a Radio Allergo Sorbent Test (RAST) (Nalebuff 1985). In this case, the test is performed similar to an ELISA for Ab, using radiolabeled antiglobulins specific for IgE, rather enzyme-labeled antiglobulins. However, this test has been almost completely replaced by ELISA. 

Fanger, M.W., Hart, D.A., Wells, J.V., Nisonoff, A. (1970). Requirement for cross-linkage in the stimulation of transformation of rabbit peripheral lymphocytes by antiglobulin reagents. J. Immunol. 105, 1484-1492. 

The most important diagnostic features of HS are as follows (1) congenital hemolytic anemia (2) microspherocytosis on the peripheral blood film (3) increased osmotic fragility, particularly in incubated red cells and (4) negative antiglobulin (Coombs) test. 

In principle, the RAST is similar to the red-cell-linked antigen-antiglobulin reaction (RCLAAR) and the test sequence is summarized as follows ... 

Protein A, a structural component of certain strains of staphylococci, has been used successfully in the place of the second antibody in radioimmunoassay techniques, as well as the solid phase adsorbent of antibody (mentioned in the section Solid Phase Materials). This protein can be heavily labeled with and is, therefore, a reasonable alternative for the use of labeled antiglobulins in immunoassays. 

Biological products were developed traditionally, before recombinant proteins, as extracts or derivatives of the actual protein from the human body or nature. This approach continues today and Table 15 lists 18 such products, mostly blood derivatives for therapeutic use. Albumin is obtained for cardiovascular volume conditions. A fish protein is harvested for osteoporosis. Igs extracted from blood are available for immunodeficiency conditions, viral infections (hepatitis-B and vaccinia), hemolytic anemia in newborns, and idiopathic thrombocytopenic purpurea. Antihemophilic products are still derived from blood. An antiglobulin is produced for kidney transplant rejection. A collagen product and two botulinum toxin products are used for various facial wrinkle problems and cervical dystonia. A bacterial antigen is formulated to enhance immunity to treat a cancer. 

Immune hemolytic anemia has been reported in a 67-year-old man taking mercaptopurine for chronic myelomonocytic leukemia (17). Serology showed a positive direct antiglobuhn test and confirmed the presence of mercaptopurine drug-dependent antibodies. He improved and the direct antiglobulin test was no longer positive 20 days after mercaptopurine withdrawal. 

Garratty G. Review Immune hemolytic anemia and/or positive direct antiglobulin tests caused by drugs. Immunohematol 1994 10(2) 41-50. 

Williams ME, Thomas D, Harman CP, Mintz PD, Donowitz GR. Positive direct antiglobulin tests due to clavulanic acid. Antimicrob Agents Chemother 1985 27(l) 125-7. 

Lutz P, Dzik W. Very high incidence of a positive direct antiglobulin test (-I-DAT) in patients receiving Unasyn. Transfusion 1992 32 23. 

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