An ELISA technique for the quantitation of platelet-bound IgG and C3 is described. This is an antiglobulin consumption assay using commercial horseradish peroxidase conjugated anti-IgG and anti-C3 antisera. The greater the amount of antiglobulin consumed by the reaction with platelets the less is available to bind to an immune adsorbent in the form of human serum-coated polystyrene balls. This test can be calibrated by adding known quantities of IgG of C3 to the specific enzyme-linked antibody and the unbound fraction of antiserum is quantitated by allowing it to react with a chromogenic substrate for the enzyme and measuring the intensity spectrophotometrically, thus establishing an inverse relationship with the amount of antigen. Platelets from normal donors and those with non-immunological thrombocytopenia gave values of 1.3--15.5 ng IgG/10(6) platelets and 0.22--0.96 ng C3/10(6) platelets which are in accordance with the normal ratio of these proteins in normal serum. Fifteen patients in whom immune destruction of platelets weas suspected had excess platelet-bound IgG ranging from 30 to 450 ng IgG/10(6) platelets. In none of these patients could excess platelet-bound C3 be demonstrated. Compared to the antiglobulin consumption test we have found this test to be superior both technically and in terms of sensitivity and reproducibility.

Elevated levels of platelet-bound IgG (PA-IgG) are a feature of autoimmune thrombocytopenia (ATP), but it is well documented that this does not occur in all cases. This has led us to investigate the role of platelet-bound IgM (PA-IgM) in these patients using a quantitative enzyme-linked immunosorbent assay (ELISA). Forty-five determinations of PA-IgM and PA-IgG were done on 24 patients with ATP. Elevated levels of PA-IgM were found in 93.3% of the determinations, while PA-IgG was elevated in only 71.7%. In 64.4% of determinations, both were elevated. Elevated PA-IgM or PA-IgG alone occurred in 28.9% and 6.7% of determinations, respectively. These results show the hitherto unrecognized frequent involvement of PA-IgM in ATP and suggests that a complex interrelationship exists between the two immunoglobulin classes in ATP. Some of the possibilities that might explain this interrelationship are discussed.

Elevated levels of platelet-bound IgG (PA-IgG) are a feature of autoimmune thrombocytopenia (ATP), but it is well documented that this does not occur in all cases. This has led us to investigate the role of platelet-bound IgM (PA-IgM) in these patients using a quantitative enzyme-linked immunosorbent assay (ELISA). Forty-five determinations of PA-IgM and PA-IgG were done on 24 patients with ATP. Elevated levels of PA-IgM were found in 93.3% of the determinations, while PA-IgG was elevated in only 71.7%. In 64.4% of determinations, both were elevated. Elevated PA-IgM or PA-IgG alone occurred in 28.9% and 6.7% of determinations, respectively. These results show the hitherto unrecognized frequent involvement of PA-IgM in ATP and suggests that a complex interrelationship exists between the two immunoglobulin classes in ATP. Some of the possibilities that might explain this interrelationship are discussed.

Renal stone formation can be caused by many different and varied disturbances, some of which are poorly understood. The relationship between urinary infection and renal stone formation has not been completely clarified. It is argued that renal stones form primarily as a consequence of the hydrolysis of urea by the bacterial enzyme urease. However, no explanation is given for microorganisms that produce urease only occasionally or not at all. The question arises as to whether the infection-induced microorganisms might not be playing a double role in renal stone formation by not only producing urease, but also by affecting in vivo urokinase (UK) and sialidase (SA) activity. With this in mind, the effect of Escherichia coli on renal UK and SA activity has been studied in male rats with a normal diet. The renal UK (P = 0.208) and SA (P = 0.2135) activities did not differ significantly between the two kidneys of the same rat. In contrast, when drainage from one kidney of a rat was externally obstructed, the UK and SA activities differed significantly between kidneys (P < 0.015). An increase in UK (r = 0.6456, P < 0.0001) and SA (r = 0.7507, P < 0.0001) activity was observed over time in the obstructed kidney. Subcutaneous injections with E coli reduced the UK activity of the obstructed kidney significantly (p = 0.017). However, the SA activity remained the same (P = 0.3929).(ABSTRACT TRUNCATED AT 250 WORDS)