Autoimmune Complement-fixation Reaction in 1,014 Patients

1957, 1958), and Mackay and Gajdusek (1958) reported that fixation of complement occurred when sera from certain hospital patients were incubated with simple saline extracts of various human organs.They called this the " autoimmune complement-fixation reaction" (A.I.C.F.).It had no strict organ specificity, and it occurred most often in cases of liver disease, diffuse " collagen " disease, and macroglobulinaemia.Gajdusek (1958) gave his reasons for regarding the reaction as one between antibody and antigen, and for adopting the view that it is an "autoimmune" phenomenon.We have looked for this A.I.C.F.reaction in the sera of 1,014 medical patients in the Royal Adelaide Hospital, and report the results, together with a discussion of some possible interpretations of the reaction other than on a basis of autoimmunity. Materials and Methods Source of SeraBlood was taken as a routine from patients admitted to the beds of the professorial unit of the Royal Adelaide Hospital.Other sera were obtained from time to time from large groups of patients in other medical clinics of the hospital.A few specimens were taken selectively from cases of syphilis, yaws, cirrhosis, diffuse " collagen " disease, or from cases known to have abnormal serum protein electrophoretic patterns.Usually only one test was made on each patient, and this was soon after admission or in an acute phase of the disease, when diagnosis or management was under active consideration.Every one of the 1,014 cases was later reviewed and a diagnosis assigned without reference to the A.I.C.F.results, which were recorded separately. Complement-fixation TestComplemenit.Pooled guinea-pig serum was stored in small amounts at -20° C.Antigens.-Freshorgans, obtained surgically or at necropsy, were homogenized to a 10%,' suspension in physiological saline in a Waring blender, then centri- fuged three times at 3,000 r.p.m. for 10 minutes at +4° C. and the sediments discarded.The supernatant solution was the antigen, and was stored in small con- tainers at -20° C. for up to three months.Antigens were prepared from normal liver, kidney, lung, adrenal, and thyroid gland.Diliuenit.Calciummagnesium saline was used throughout the test (Mayer et al., 1946).