Quantitation of red blood cell-bound C3d in normal subjects and random hospitalized patients

A sensitive radiolabelled anti-antiglobulin method was devised and applied to quantitating red blood cell-bound C3d (RBC-C3d) in samples from 174 normal blood donors. C3d was demonstrable on all RBC examined; 98% of values fell over a broad range, with the highest values being approximately 3.5 X the lowest values (equivalent to 50-160 molecules of C3d per cell). RBC-C3d did not correlate with sex or age (over 18-65 years); indirect evidence suggests that values for the paediatric age group will fall in the same normal range. Studies on samples obtained weekly for 10-12 weeks from six adult males and six adult females indicated stable levels of RBC-C3 for individual subjects; i.e. high normals, mid normals and low normals remained in their characteristic range levels over the period of observation. For comparison, RBC-C3d was measured in samples from 313 randomly selected hospitalized adult patients. 33% of the values were above the normal range; 8% were elevated to a level likely to have been detectable by a direct anti-C3d antiglobulin test. The great majority of elevated values occurred in patients not ordinarily considered to have autoimmune conditions. The results provide background for studies of the aetiology and significance of RBC-C3d in health and disease.