The titration of tetanus antitoxin I. Factors affecting the sensitivity of the indirect haemagglutination test.

Various factors affecting the indirect HA test for the titration of tetanus antitoxin have been evaluated with a view to obtaining maximum sensitivity in tests using unfixed sheep erythrocytes and sheep erythrocytes fixed with glutaraldehyde, formaldehyde and pyruvic aldehyde. The optimal concentration of tannic acid has been found to be 1/40 000 for tanning both fixed and unfixed sheep erythrocytes. Tanned sheep erythrocytes sensitized with 50 Lf/ml of tetanus toxoid at pH 7.2 for one hour were the most sensitive. Although the optimal temperature of sensitization was found to be 56 degrees C, unfixed cells tended to clump and lyse at this temperature. Thus a temperature of 37 degrees C was used to sensitize unfixed sheep erythrocytes. Sheep erythrocytes from different animals and the final concentration of sensitized sheep erythrocytes both had great effects on sensitivity. A final concentration of 0.5% of sensitized sheep erythrocytes was found suitable as a compromise between sensitivity and readability. The loss of sensitivity of fixed and sensitized erythrocytes was investigated by storing these cells at 4-8 degrees C for six to nine months.