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  Pediatric allergy-- principles and practice. Fourth edition.

  edited by Donald Y.M. Leung, Cezmi A. Akdis, Leonard B. Bacharier, Charlotte Cunningham-Rundles, Scott H. Sicherer, Hugh A. Sampson.

  Digital Access ClinicalKey 2020
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• Article

  Comparative study on antibody determination by different methods in sera of persons vaccinated with HDCS rabies vaccine.

  Kuwert EK, Thraenhart O, Marcus I, Werner J, Atanasiu P, Bahmanyar M, Bögel K, Cox JH, Schneider LG, Turner G, Wiktor TJ.

  Dev Biol Stand. 1978;40:221-9.

  The comparative studies undertaken by 7 laboratories in 6 countries show that the calculation of I.U.'s did not, as anticipated, minimize but actually enhanced the variability of results of rabies antibody estimations in the sera of HDCS vaccinees. The high biological variance in the method(s) may not have been considered by individual laboratories and any neglect of fundamental biostatistical laws unfortunately diminishes the theoretical advantage of using the "International Standard (I.S.)" as a "tertium comparationis". Perhaps the intrinsic variability of the I.S. should be re-evaluated and it is conceivable that a pure IgG fraction of rabies antiserum would show less variability. Intralaboratory variation might be reduced by agreeing that only a geometric mean of the I.S., and not a single value obtained in an individual test, should be used for calculation of I.U.'s. Application of the principles of biochemical and pharmacological methods, such as test-to-test control of the I.S. and its analytical variances might well enhance the reproducibility of the results. MNT, RFFIT, PRT and CFT were unable to detect antibodies in HDCS vaccinees until 7 days after the first vaccination. The establishment of methods for detecting early antibody requires further investigation.

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