Evaluation of anti-C1q capture assay for detecting circulating immune complexes and comparison with polyethylene glycol-immunoglobulin G, C1q-binding, and Raji cell methods.

An anti-C1q capture method kit (C1q-immunoglobulin G [IgG]) (Ortho Diagnostics, Inc., Raritan, N.J.) for measuring circulating immune complexes (CIC) was evaluated. The kit showed poor diagnostic sensitivity (P less than 0.005) for identifying CIC in patients with systemic lupus, rheumatoid arthritis, and bacterial endocarditis, as compared with polyethylene glycol-IgG and Raji cell tests (12, 24, and 24 positive, respectively, of 31 patients). Of the patients who were positive with the C1q-IgG test, 25% showed discrepancies when their results were compared with the polyethylene glycol-IgG and C1q-binding test results. Gel filtration chromatography of two of these discrepant sera showed the only peak of C1q-IgG activity to be associated with monomeric IgG (molecular weight, less than 200,000). We concluded that the kit method may be measuring substances other than CIC in some sera, because molecules of C1q attached to IgG should exhibit a molecular weight of greater than 500,000.

Inaccurate measurement of a polymeric IgA myeloma protein by nephelometric and fluorometric instrumentation.

The concentration of IgA in a serum was 5.99 g/L as assayed nephelometrically with reagent from one company, but varied between 5 and 3 g/L (for sixfold and 36-fold dilutions, respectively) without giving a definitive answer when assayed with reagent from another source. Immunofixation electrophoresis indicated an IgA lambda monoclonal protein of 45 g/L. Radial immunodiffusion showed two components, having a total concentration of 41 g/L. By fluorometry the IgA was 3.1 g/L. Increasing the dilution caused the (dilution-corrected) lower values to increase. Although the most frequent cause of such discrepant findings is an IgA2 myeloma, which occurs in about one of every 100 myeloma cases, Ouchterlony double diffusion indicated the major component to be IgA1. A polymer, Mr 670,000, was identified by column chromatography. Contrary to the usual behavior of polymers assayed with radial immunodiffusion, which underestimates their concentration, this polymer reached equivalency in agreement with its true concentration as assayed by the Mancini-Heremans technique.

Anti-IgG binding test to assay circulating IgG-containing immune complexes from polyethylene glycol precipitates.

We describe a simple approach for assaying immune complexes from serum by using anti-IgG as the indicator after a three-step extraction procedure with polyethylene glycol. Analysis of the data indicates that assays of such extracts for immune complexes by absorbance nephelometry, kinetic light scatter, and immunoradiometric techniques correlate well. For 116 samples, results by absorbance nephelometry correlated (r = 0.86) with those by the C1q-binding test. The present assay and the Raji cell test were more sensitive than the C1q-binding test (p less than 0.001) for detecting increased concentrations of immune complexes in 29 samples from patients with immune-complex-type diseases. The basic approach we describe may lend itself to broad applications for use with various immunoassay techniques.