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Sayeed Ismail Khatib

Lecturer Microbiology & Immunology Ibn Sina National College for Medical Studies


The complement fixation test (CFT) was extensively used in syphilis serology after being introduced by Wasserman in 1909. Complement is a protein (globulin) present in normal serum. Whole complement system is made up of nine components: C1 to C9 Complement proteins are heat labile and are destroyed by heating at 56C for 20 30 minutes. Complement binds to Ag-Ab complex When the Ag is an RBC it causes lysis of RBCs.


Complement takes part in many of the immunological reactions. It gets absorbed during the combination of antigens and antibody.

This property of antigenantibody complex to fix the complement is used in complement fixation test for the identification of specific antibodies.
The haemolytic system containing sheep erythrocytes (RBC) and its corresponding antibody (amboceptor) is used as an indicator which shows the utilization or availability of the complement. If the complement is fixed then there will be no lysis of sheep erythrocytes, thus denoting a positive test. If the complement is available then there will be haemolysis which is a property of complement, denoting a negative test.

The test requires five reagents and is carried out in two steps.

Components of CFT
Test System Antigen: It may be soluble or particulate.

Antibody: Human serum (May or may not contain Antibody towards specific Antigen)
Complement: It is pooled serum obtained from 4 to 5 guinea pigs. It should be fresh or specially preserved as the complement activity is heat labile (stored at -30 C in small fractions). The complement activity should be initially standardized before using in the test.

Indicator System (Haemolytic system) Erythrocytes: Sheep RBC

Amboceptor (Hemolysin): Rabbit antibody to sheep red cells prepared by inoculating sheep erythrocytes into rabbit under standard immunization protocol.

Positive Test

Step 1:
At 37C Complement gets fixed

Antigen + Antibody + Complement (from serum) 1 Hour

Step 2:
At 37C No Haemolysis (Test Positive)

Fixed Complement complex + Haemolytic system 1 Hour

Negative Test

Step 1:
At 37C Complement not fixed 1 Hour

Antigen + Antibody absent + Complement

Step 2:
At 37C Haemolysis (Test Negative)

Free Complement + Haemolytic system 1 Hour

Results and Interpretations:

No haemolysis is considered as a positive test. haemolysis of erythrocytes indicative of a negative test. 1 2 3 4 A

Microtiter plate showing Haemolysis (Well A3, A3 and B4) and No Haemolysis (Well