[Current situation and problems in the estimation of circulating immune complexes].

Some methods employing murine monoclonal antibodies have been developed for the estimation of circulating immune complexes (ICs). In the assays using monoclonal antibodies to C1q and C3d, ICs attached by reaction of C1q or C3d with the corresponding antibodies are detected by enzyme-labelled anti-IgG antibody. The murine monoclonal rheumatoid factor (RF) of IgG class is employed in the assay for detection of ICs. ICs reacted with the RF on the solid phase are further detected by the reaction with the second anti-IgG antibody labelled with the enzyme. The anti-C1q antibody in the sera as well as ICs produces positive reactions in the solid phase C1q assay, the assays using monoclonal antibodies are recommended for use in the detection of circulating ICs. In the pretreatment of serum samples, heating at 56 degrees C induces aggregation of IgG to produce a positive reaction by these sensitive assays, and the addition of EDTA-Na2 increases free C1q detached from C1 to induce increased binding to IgG. Reactions of aggregated IgG with RF and C1q in the fluid phase inhibit the following binding of monoclonal RF and anti-C1q antibody on the solid phase. Sera of patients with SLE were examined for CH50, anti-DNA antibody and ICs. The levels of ICs determined by the anti-C1q and C3d antibody assay did not correlate with other parameters. Positivity of ICs was unexpectedly lower in SLE sera. To evaluate the significance of the estimation of ICs, more data must be analyzed by these methods.