Abstract
Anti-neutrophil antibodies (ANA) have been demonstrated in the serums of recipients of multiple transfusions, mothers of infants with transient neonatal neutropenia, and in some patients with idiopathic neutropenia. Ingestion of sensitized neutrophils by other phagocytic cells has been observed, but direct evidence of membrane alteration of polymorphonuclear leukocytes (PMNS) by ANA is limited. We have used cell elastimetry to explore the problem. This technique measures, under direct visualization, the negative pressure required to aspirate PMNS into small pored pipettes. We have previously shown that the assay primarily reflects rigidity or deformability of the cell membrane. When incubated with normal PMNS, eight of nine serums from patients with known ANA significantly decreased membrane deformability -- i.e. cells became more rigid. The mean negative pressure required to aspirate PMNS incubated in normal plasma was 11.4 ± 3.6 (2 S.D.) cm Hg. PMNS incubated in the various ANA positive serums ranged from 25.9 to >43 cm Hg negative pressure required for aspiration. To insure objectivity, the study was conducted in an entirely blind fashion. Randomly coded serums from patients and controls were studied for deformability by observers unaware of the code. We conclude: 1) Elastimetry is a reliable and sensitive probe for the detection of ANA; 2) A primary effect of ANA upon PMN membranes has been demonstrated.
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