Specificity and Possible Origin of Anti‐N Antibodies Developed by Patients Undergoing Chronic Haemodialysis

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Abstract
Studies were performed on 2 anti-N sera from patients who formed anti-N antibodies during their period of hemodialysis. No specific inhibition of these antibodies was obtained by extracts prepared from a new and a used dialysis unit. There was no evidence of a compound in the units which would stimulate production of the anti-N. The specificity of the anti-N was against a precursor of MN antigens, since all activity in the sera could be removed by neuraminidase-treated M cells which expressed MN precursor. Since the anti-N would react with untreated N cells only at 4.degree. C, but with formaldehyde-treated cells at 4, 25 and 37.degree. C, the specificity of the anti-N was probably directed against an antigen developed by red cells after formaldehyde treatment. The production of the anti-N antibodies is apparently stimulated by formaldehyde-treated red cells passing into the patient during re-use of a dialysis unit sterilized with formaldehyde.