Red cell antibodies and low ionic strength: a study with enzyme-linked antiglobulin test

Alloantibody uptake on red blood cells was quantified with an accurate and reproducible enzyme-linked antiglobulin test. The uptake of anti-D, anti-Fy2 and anti-JK3 was markedly accelerated by low ionic strength salt solution (LISS) with a final ionic strength of 0.05 M. Near maximum uptake occurred within ten minutes at room temperature which corresponded to 60 minutes in saline at 37 C. Papain treatment of red blood cells increased the amount of anti-D bound, and there was no difference whether or not the papain-treated cells were suspended in LISS. In contrast, the uptake of IgG anti-A and anti-Leb was not accelerated by LISS, nor did LISS increase the rate of binding of antiblogulin to IgG antibody-coated red blood cells. We suggest this may be explained by the fact that the ABH and Lewis antigens (as well as bound IgG antibodies) extend beyond the "ionic cloud" surrounding the red blood cell. Antibody binding in the presence of albumin was approximately the same as in saline; but if the albumin was first dialyzed against LISS, the reaction was markedly accelerated and the final antibody uptake somewhat higher than in LISS alone.