The development of an enzyme-linked immunosorbent assay (ELISA) for anti-albumin autoantibodies (AAA), using immobilized monomeric or glutaraldehyde-polymerized human, bovine or egg albumin, is described. Major problems in detection by the ELISA of AA against human albumin (HSA) were due to high 'non-specific' binding with the commercial anti-human immunoglobulin antisera used and to interference by IgM/HBs circulating complexes. However, it was found that AAA are not species-specific and that these problems may be overcome using immobilized bovine (BSA) or egg (EggA) albumin. AAA were found to have a similar affinity for BSA as for HSA but slightly lower for EggA, while AAA affinities for the monomeric forms were lower than for the corresponding polymeric albumins. All sera from the 28 normal subjects tested were found to contain both IgM- and IgG-AAA. Patients with acute hepatitis B (n = 23) had significantly lower titres of IgM-AAA than normal subjects, as did chronic HBV carriers with (n = 33) or without (= 17) underlying liver disease, while IgG-AAA titres were reduced only in the acute hepatitis patients. These findings support the concept that AAA have a normal physiological function (probably for removal of effete albumin molecules) and that, in HBV infection, there is a decrement in titres that may be related to the clearance of the virus.
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