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IgG and Fab fragments were prepared from the plasma of two haemophilia A patients whose anti- V111 : C titres were 2,000 and 400 Bethesda U./ml. 125-I-IgG and Fab specific for VIII :CAg were purified by a solid phase procedure and the reactivity of these two antibodies with VIII: CAg was studied by immunoprecipitation in agarose. With double diffusion and autoradiographic methods, both the IgG and Fab antibodies showed a precipitin line against normal plasma, serum, haemophilia A+ plasma, cryopre ci pi t ate , purified F.VIII/vWF or VIII: C free of vWF. No precipitin line was observed in haemophilia A- or severe von Willebrand’s disease. With electroimmunoassay (radi o-Laurell) using both IgG and Fab antibodies, results of VIII: C A g were in agreement in all samples with those obtained by immunoradiometric assay using the same antibodies. The specificity of the immunoprecipitation observed in agarose with IgG or Fab fragments was assessed by modifying the pH (7.5 to 9.5) of the buffer, the ionic composition (0.15, 0.5 and 1M sodium chloride, 0.15 and 0.5M potassium iodide, 0.15 and 0.5M sodium thiocyanate) of the washing fluid,or by carbamy1ation of the anti-VIII: CAg IgG. In all cases, specific precipitation was observed. In addition, 125-I-IgG or Fab isolated by the same technique from normal plasma gave no precipitinline with VIII: CAg. This study demonstrates that, contrary to previous evidence, 1) human anti-VIII: CAg antibodies are both precipitating as well as neutralizing when studied by highly sensitive techniques; and 2) monovalent Fab can also precipitate VIII: C Ag. The results of this study raise some questions about the lattice theory of immunoprecipitation.

Specific Precipitating Antibodies To VIII: CAg In Two Patients With Haemophilia