Antihuman Globulin (AHG) ReagentsWhen RBCs become coated with antibody or complement orboth but do not agglutinate in regular testing, specialreagents are needed to produce agglutination. The direct antihuman globulin (AHG) test is designed to determine if RBCs are coated with antibody or complement or both. Polyspecific AHG can determine if RBCs have been sensitized with IgGantibody or complement (components C3b or C3d) or both.Monospecific AHG reagents react only with RBCs sensitizedwith IgG or complement.21 Some AHG reagents are manufactured by injecting animals, usually goats or rabbits, with human globulin, which in turn makes antihuman antibodies against the foreign human protein. For the manufacture of polyspecific AHG, both the gamma (IgG) and beta (C3b and C3d) globulin fractions of plasma are processed. For monospecific AHG, animals are injected only with IgG and produce antibodies directed against the gamma heavy chain. Blood bank reagents can be either polyclonal or monoclonal in source and are discussed in greater detail in this chapter. In the indirect antiglobulin test, the same AHG reagents are used to detect antibodies or complement that have attached to RBC membranes but with a prior incubation step with serum (or plasma). If the antibodies present in serum cannot cause RBC agglutination but only sensitize the RBCs, then the AHG reagents will allow for agglutination to occur by cross-linking the antibodies on the RBCs. The use of AHG re ...
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