Enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to protein-reactive drugs and metabolites: criteria for identification of antibody activity. Detection and hapten specificity of anti-DNP, anti-captopril and anti-sulphanilamidobenzoic acid.

Certain hypersensitivity reactions to drugs are thought to depend on coupling of reactive species (the drug itself or a metabolite) to macromolecules, leading to the formation of hapten-carrier conjugates. In assays for the detection of antibodies directed against such reactive species the drug or metabolite must be used in conjugated rather than free form. We describe ELISAs for the detection of anti-dinitrophenyl (DNP), anti-captopril (CP) and anti-sulphanilamidobenzoic acid (SABA) antibodies, in which the wells of microtitre plates are coated with hapten conjugated to protein. We define coating conditions and the following 3 criteria for identification of anti-hapten activity: Immunoglobulin in the test sample binds to the immobilised hapten-protein conjugate, but not to the immobilised protein alone. Binding is inhibited by preincubation of the test sample with protein conjugates incorporating the test hapten, but not by preincubation with the same unconjugated proteins, nor protein conjugates incorporating haptenic groups unrelated to the test hapten. The inhibitory hapten-protein conjugates are shown to be inactive in unrelated antigen-antibody interactions. Binding is blocked by preincubation of the test sample with low molecular weight chemical derivatives of the reactive hapten. The inhibitory derivatives must be shown to be inactive in unrelated antigen-antibody interactions. On the basis of these criteria, IgG anti-DNP and IgG anti-CP were detected in the sera of immunized rabbits. The IgG anti-DNP antibody recognised protein-conjugated DNP, DNP-lysine, N-acetyl-DNP-lysine and DNP-S-glutathione, whereas the IgG anti-CP antibody recognised CP-S-S-protein and CP-S-S-CP. By the same criteria IgG anti-SABA was detected in the sera of immunized mice. The antibody recognised free and protein-conjugated SABA, but not free sulphanilamide.