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Immunologic Methods
Part 2
Basic Methods
CLS 420 Clinical Immunology &
Molecular Diagnostics
Objectives
• Explain the principle of each method presented, and give
a clinical use for each.
• Contrast precipitation, agglutination and flocculation,
including:
– Reaction time and conditions
– Antigen state
– Immunoglobulin class
– Lattice formation
• Describe heat inactivation of patient serum, including
method and purpose.
• Discuss general reasons for performing immunologic
tests.
Precipitation Based Methods
Soluble antigen combines with
antibody to form aggregates
which precipitate out of solution.
Nephelometry
• Antibody reagent is
combined with patient
sample.
• If antigen is present in
the patient’s sample,
Ag/Ab complexes will
form and precipitate
out of solution.
Y
Y
Y
Click on image at right wait for animation to begin.
Nephelometry
• When light is passed
through the solution, the
precipitates cause the
light to scatter at various
angles.
• The light that is scattered
at a particular angle is
measured. This
corresponds to the level
of antigen in the sample.
Light
source
Detector
Flocculation
Negative test Positive test
Uses fine particles of antigen to detect
antibody in patient’s serum.
Click on images above wait for animation to begin.
Double Immunodiffusion
Ouchterlony Method
• Testing performed in
agar gel.
• Antigen is placed in
one well.
• Antibody is place in
other well.
• Each diffuses
through gel.
• If antibody is specific
to that antigen, a
precipitin line will
form where the 2
meet.
AG
AB
Double Immunodiffusion
Identity
Click on image above wait for animation to begin.
Double Immunodiffusion
Nonidentity
Click on image above wait for animation to begin.
Double Immunodiffusion
Partial Identity
D
AG
Anti-D
Da
AG
Da Db
DdDc
D antigen
Immunofixation Electrophoresis
• Proteins separated by electrophoresis
• Antiserum (antibody) is applied to the gel.
• Ag/Ab complexes form in the gel.
• The gel is stained to reveal precipitin bands.
Anode Patient serum Cathode
(+ electrode) (- electrode)
Application point
IFE stained gels
= Serum application point
SPE Anti-IgG Anti-IgA Anti-IgM Anti-Kappa Anti-Lambda
Western Blot
Negative Patient Positive
Control specimen Control
No bands Patient bands compared to Pos Control
p24
gp 41
gp120/160
Agglutination Based Methods
Antibodies cause the cross-linking
of particulate antigen, usually
found on a cell.
Direct Agglutination
• The antigen is a natural
part of the solid’s surface.
• Often performed at room
temperature.
• May use centrifugation to
bring antigen and
antibody into closer
proximity.
• Can be used to detect
antigen or antibody
Click on image at right wait for animation to begin.
Passive Agglutination
Antigens on a carrier molecule, such as latex,
combine with patient’s sample for antibody detection.
Click on image above wait for animation to begin.
Reverse Passive Agglutination
Antibody is bound to the carrier molecule, which is
then mixed with patient’s sample to detect antigen.
Click on image above wait for animation to begin.
Inhibition of Agglutination
• Antibody reagent is combined
with patient’s specimen.
• If patient’s specimen contains
the antigen for that antibody,
they will react.
• Reagent antigen is added.
• A positive reaction will show
no agglutination, because the
antibodies were bound to the
patient antigen before the
reagent antigen was added.
• A negative reaction shows
agglutination between reagent
antibodies and antigen.
Y
Y
Y
Y
Y
Y
Click on images at right wait for animation to begin.
Other Methods
Neutralization
Positive Test Negative Test
The presence of an antibody prevents the
antigen from functioning correctly.
Click on images above wait for animation to begin.
Complement Fixation
• The patient’s serum is heated at 56o
C for 30 minutes to
inactivate any complement present.
• Patient’s treated serum is incubated with known antigen
and a known quantity of guinea pig complement.
• If the patient has an antibody to the antigen, they will
react and the complement will bind to the Fc pieces of
the antibodies.
• Sheep RBCs that are coated with hemolysin are added.
• The test is incubated, centrifuged and read for
hemolysis.
• In a positive test, the complement will have been used
up by the patient’s antibody, and no hemolysis will be
present.
Complement Fixation
Negative test Positive test
Click on images above wait for animation to begin.
“Labeled” Methods
Attaches a “tag” to either the
antigen or antibody. This “tag”
can be detected and measured.
Parts of a labeled assay
• Analyte (labeled and unlabeled)
• Specific antibody
• Separation of bound and free
components
• Detection of label
• Standards/calibrators
Classification
• Heterogeneous: Method that requires a
step that separates bound analyte from
unbound analyte.
• Homogeneous: Method that does not
require a separation step.
Competitive EIA
• Enzyme labeled
antigen competes with
unlabeled patient
antigen for binding
sites on fixed
antibodies.
• A chromogen is added
that reacts with the
enzyme.
• The level of color
development is
inversely proportional
to the level of patient
antigen.
Click on image at right wait for animation to begin.
Capture (Sandwich) EIA
• Patient’s sample is
incubated with bound
antibody.
• Following a wash, a
second antibody that is
labeled with a
chromogen is added.
• The level of color
development
corresponds with the
amount of antigen
“captured”.
Click on image at right wait for animation to begin.
Enzyme-multiplied Immunoassay
Technique (EMIT)
Y Y Y Y
•This is a homogeneous competitive binding assay.
•Color development is _______proportional to the
concentration of antigen.
Direct Fluorescence
Negative test Positive test
Fluorescently labeled antibody is used to detect
antigen fixed to a slide.
Click on images above wait for animation to begin.
Indirect Fluorescence
Positive Test Negative Test
•Known antigen fixed to slide
•Patient’s serum added (unknown antibody)
•Incubation & wash
•Fluorescently labeled anti-human globulin reagent added.
Click on images above wait for animation to begin.
Microparticle Capture
• Uses microbeads coated with known
antigen or antibody.
• The beads are incubated with a
fluorescently labeled analyte and the
patient’s sample.
• The test mixture is centrifuged (or
magnetized) to collect the beads, which
are then analyzed for fluorescence.
Fluorescent Polarization
• Free labeled antigen excited
by polarized light emits
unpolarized light.
• Labeled antigen/antibody
complexes excited by
polarized light emit polarized
light.
• FPIA is a competitive binding
assay in which labeled antigen
competes with unlabeled
(patient) antigen for antibody
binding sites.
• The more labeled antigen that
is bound to antibody, the more
polarized light is emitted.
Y
Chemiluminescence
• Uses chemical labels that, when
oxidized, produce a substance of a
higher energy level.
• When this substance decays to its
original state, it emits energy in the form
of light.
– Common label materials include:
• Luminol
• Acridium esters
• Peroxyoxalates
Comparing Antibody
Quantities
Antibody titers
Antibody Titer
• An antibody titration can help determine
antibody concentration levels.
• Twofold serial dilutions of serum
containing an antibody are made, then
tested against cells possessing the target
antigen.
• The titer is the reciprocal of the greatest
dilution in which agglutination is observed.
Two-fold Serial Dilutions
Tube 1 2 3 4 5 6 7 8 9 10 11 12
Saline
0 0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
0.2
ml
Serum
0.2
ml
0.2
ml
0.2
ml of
tube
2
0.2
ml of
tube
3
0.2
ml of
tube
4
0.2
ml of
tube
5
0.2
ml of
tube
6
0.2
ml of
tube
7
0.2
ml of
tube
8
0.2
ml of
tube
9
0.2
ml of
tube
10
0.2
ml of
6%
BSA
RBC
Suspe
nsion
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
0.1
ml
Final
Dilutio
n
1:1 1:2 1:4 1:8 1:16 1:32 1:64 1:128 1:256 1:512 1:1024 control
Results
• Titers provide more valuable information
when tested in parallel with a previous titer
specimen.
• A comparison of the current specimen’s
results and previous specimen’s current
results should be made.
• A change in titer of 2 or more tubes is
considered to be significant.
Reasons to perform a titer
• Acute and convalescent
• Prenatal
• Verify past infection
• Confirm vaccination
Primary vs. Secondary Humoral
Response
First
exposure
Second
exposure
IgM
IgM
IgG
IgG
Congratulations
You have finished
Immunology Student Lab
Lectures!
Good Luck on your exam!

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Immunologic methods basic methods

  • 1. Immunologic Methods Part 2 Basic Methods CLS 420 Clinical Immunology & Molecular Diagnostics
  • 2. Objectives • Explain the principle of each method presented, and give a clinical use for each. • Contrast precipitation, agglutination and flocculation, including: – Reaction time and conditions – Antigen state – Immunoglobulin class – Lattice formation • Describe heat inactivation of patient serum, including method and purpose. • Discuss general reasons for performing immunologic tests.
  • 3. Precipitation Based Methods Soluble antigen combines with antibody to form aggregates which precipitate out of solution.
  • 4. Nephelometry • Antibody reagent is combined with patient sample. • If antigen is present in the patient’s sample, Ag/Ab complexes will form and precipitate out of solution. Y Y Y Click on image at right wait for animation to begin.
  • 5. Nephelometry • When light is passed through the solution, the precipitates cause the light to scatter at various angles. • The light that is scattered at a particular angle is measured. This corresponds to the level of antigen in the sample. Light source Detector
  • 6. Flocculation Negative test Positive test Uses fine particles of antigen to detect antibody in patient’s serum. Click on images above wait for animation to begin.
  • 7. Double Immunodiffusion Ouchterlony Method • Testing performed in agar gel. • Antigen is placed in one well. • Antibody is place in other well. • Each diffuses through gel. • If antibody is specific to that antigen, a precipitin line will form where the 2 meet. AG AB
  • 8. Double Immunodiffusion Identity Click on image above wait for animation to begin.
  • 9. Double Immunodiffusion Nonidentity Click on image above wait for animation to begin.
  • 11. Immunofixation Electrophoresis • Proteins separated by electrophoresis • Antiserum (antibody) is applied to the gel. • Ag/Ab complexes form in the gel. • The gel is stained to reveal precipitin bands. Anode Patient serum Cathode (+ electrode) (- electrode) Application point
  • 12. IFE stained gels = Serum application point SPE Anti-IgG Anti-IgA Anti-IgM Anti-Kappa Anti-Lambda
  • 13. Western Blot Negative Patient Positive Control specimen Control No bands Patient bands compared to Pos Control p24 gp 41 gp120/160
  • 14. Agglutination Based Methods Antibodies cause the cross-linking of particulate antigen, usually found on a cell.
  • 15. Direct Agglutination • The antigen is a natural part of the solid’s surface. • Often performed at room temperature. • May use centrifugation to bring antigen and antibody into closer proximity. • Can be used to detect antigen or antibody Click on image at right wait for animation to begin.
  • 16. Passive Agglutination Antigens on a carrier molecule, such as latex, combine with patient’s sample for antibody detection. Click on image above wait for animation to begin.
  • 17. Reverse Passive Agglutination Antibody is bound to the carrier molecule, which is then mixed with patient’s sample to detect antigen. Click on image above wait for animation to begin.
  • 18. Inhibition of Agglutination • Antibody reagent is combined with patient’s specimen. • If patient’s specimen contains the antigen for that antibody, they will react. • Reagent antigen is added. • A positive reaction will show no agglutination, because the antibodies were bound to the patient antigen before the reagent antigen was added. • A negative reaction shows agglutination between reagent antibodies and antigen. Y Y Y Y Y Y Click on images at right wait for animation to begin.
  • 20. Neutralization Positive Test Negative Test The presence of an antibody prevents the antigen from functioning correctly. Click on images above wait for animation to begin.
  • 21. Complement Fixation • The patient’s serum is heated at 56o C for 30 minutes to inactivate any complement present. • Patient’s treated serum is incubated with known antigen and a known quantity of guinea pig complement. • If the patient has an antibody to the antigen, they will react and the complement will bind to the Fc pieces of the antibodies. • Sheep RBCs that are coated with hemolysin are added. • The test is incubated, centrifuged and read for hemolysis. • In a positive test, the complement will have been used up by the patient’s antibody, and no hemolysis will be present.
  • 22. Complement Fixation Negative test Positive test Click on images above wait for animation to begin.
  • 23. “Labeled” Methods Attaches a “tag” to either the antigen or antibody. This “tag” can be detected and measured.
  • 24. Parts of a labeled assay • Analyte (labeled and unlabeled) • Specific antibody • Separation of bound and free components • Detection of label • Standards/calibrators
  • 25. Classification • Heterogeneous: Method that requires a step that separates bound analyte from unbound analyte. • Homogeneous: Method that does not require a separation step.
  • 26. Competitive EIA • Enzyme labeled antigen competes with unlabeled patient antigen for binding sites on fixed antibodies. • A chromogen is added that reacts with the enzyme. • The level of color development is inversely proportional to the level of patient antigen. Click on image at right wait for animation to begin.
  • 27. Capture (Sandwich) EIA • Patient’s sample is incubated with bound antibody. • Following a wash, a second antibody that is labeled with a chromogen is added. • The level of color development corresponds with the amount of antigen “captured”. Click on image at right wait for animation to begin.
  • 28. Enzyme-multiplied Immunoassay Technique (EMIT) Y Y Y Y •This is a homogeneous competitive binding assay. •Color development is _______proportional to the concentration of antigen.
  • 29. Direct Fluorescence Negative test Positive test Fluorescently labeled antibody is used to detect antigen fixed to a slide. Click on images above wait for animation to begin.
  • 30. Indirect Fluorescence Positive Test Negative Test •Known antigen fixed to slide •Patient’s serum added (unknown antibody) •Incubation & wash •Fluorescently labeled anti-human globulin reagent added. Click on images above wait for animation to begin.
  • 31. Microparticle Capture • Uses microbeads coated with known antigen or antibody. • The beads are incubated with a fluorescently labeled analyte and the patient’s sample. • The test mixture is centrifuged (or magnetized) to collect the beads, which are then analyzed for fluorescence.
  • 32. Fluorescent Polarization • Free labeled antigen excited by polarized light emits unpolarized light. • Labeled antigen/antibody complexes excited by polarized light emit polarized light. • FPIA is a competitive binding assay in which labeled antigen competes with unlabeled (patient) antigen for antibody binding sites. • The more labeled antigen that is bound to antibody, the more polarized light is emitted. Y
  • 33. Chemiluminescence • Uses chemical labels that, when oxidized, produce a substance of a higher energy level. • When this substance decays to its original state, it emits energy in the form of light. – Common label materials include: • Luminol • Acridium esters • Peroxyoxalates
  • 35. Antibody Titer • An antibody titration can help determine antibody concentration levels. • Twofold serial dilutions of serum containing an antibody are made, then tested against cells possessing the target antigen. • The titer is the reciprocal of the greatest dilution in which agglutination is observed.
  • 37. Tube 1 2 3 4 5 6 7 8 9 10 11 12 Saline 0 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml 0.2 ml Serum 0.2 ml 0.2 ml 0.2 ml of tube 2 0.2 ml of tube 3 0.2 ml of tube 4 0.2 ml of tube 5 0.2 ml of tube 6 0.2 ml of tube 7 0.2 ml of tube 8 0.2 ml of tube 9 0.2 ml of tube 10 0.2 ml of 6% BSA RBC Suspe nsion 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml 0.1 ml Final Dilutio n 1:1 1:2 1:4 1:8 1:16 1:32 1:64 1:128 1:256 1:512 1:1024 control
  • 38. Results • Titers provide more valuable information when tested in parallel with a previous titer specimen. • A comparison of the current specimen’s results and previous specimen’s current results should be made. • A change in titer of 2 or more tubes is considered to be significant.
  • 39. Reasons to perform a titer • Acute and convalescent • Prenatal • Verify past infection • Confirm vaccination
  • 40. Primary vs. Secondary Humoral Response First exposure Second exposure IgM IgM IgG IgG
  • 41. Congratulations You have finished Immunology Student Lab Lectures! Good Luck on your exam!

Editor's Notes

  1. May use known antigen as a reagent to look for antibodies in a patient’s specimen.
  2. Light scattered at 90 degrees in commonly measured. Endpoint – reaction is allowed to go to completion. Problems with precipitate settling out, reducing the amount of scatter. Rate – measures rate that scatter increases following addition of reagent. Nephelometry can be used to quantitate serum protein levels. Nephelometry can be used to detect serum proteins.
  3. Most common application is testing for syphilis, detecting antibodies to reagin. Patient’s serum is placed within a ring on a slide or card. A measured volume of reagent containing antigen is placed in the ring. The slide or card is rotated to mix the sample and reagent. The reaction is examined for fine precipitates, which indicate a positive test.
  4. Known antibody with multiple specificities is placed in center well. Known antigen is placed in an outside well. Patient specimen containing antigen is placed in other outside well. The pattern of precipitin lines is interpreted. This test may be used to identify fungal antigens and antibodies to nuclear antigens.
  5. Electrophoresis used to separate proteins on a gel according to size and electrical charge. If the antibody applied to the gel is directed against a particular protein, precipitin bands form where Ag/Ab complexes have been trapped in the gel. The gel is washed to remove any unprecipitated proteins, then stained to reveal the bands.
  6. Example of an IgG monoclonal antibody with kappa light chains SPE = Serum Protein Electrophoresis
  7. Modification of IFE Known antigens are electrophoresed to separate them. The separated components are transferred to nitrocellulose paper by blotting the gel. The patient’s serum is applied to the paper. If the patient has antibodies to any of the antigens on the paper, it will form a precipitate. Paper is washed and stained. If antibody to more than one antigen of an organism is detected in the patient’s serum, infection with that particular organism is highly likely.
  8. Bacterial antigens/antibodies RBC antigens/antibodies (hemagglutination)
  9. Uses include ID of bacteria, measuring hormone and drug levels, and measuring levels of some proteins.
  10. Applications include ASO titers and anti-DNase B titers.
  11. Hemolysin = antibodies known to activate complement and cause hemolysis. This test is not used frequently, but has been used to detect antibodies to viruses, fungus and rickettsia.
  12. Tests are fast, sensitive and specific.
  13. Radioactivity, fluorescence, chemiluminous materials and enzymes have all been used as tags.
  14. Often a wash step removes the unbound analyte. Other separation methods include adsorption coupled with centrifugation or filtration, magnets, or chemically modifying the test medium so that bound analytes remain in solution while Ag/Ab complexes fall out of solution.
  15. When antibody binds to the labeled antigen, it blocks enzymatic activity, reducing the amount of color development. The more patient antigen that binds to the antibody, the more enzyme-tagged antigen remains free to react with the chromogen. Commonly used to test for drugs.
  16. This test has been used for detection of Chlamydia, Legionella, RSV, and other antigens.
  17. Anti-Human Globulin (AHG) is antibody to human antibodies. The Fab portion of AHG is directed at the Fc portion of the human immunoglobulin. Clinical applications of indirect fluorescence include detection of viral, treponemal, and antinuclear antibodies.
  18. Microbeads may be made of polysaccharides, polyacrylamide or magnetizable cellulose.
  19. Free antigen can rotate when hit by polarized light whereas Ag/Ab complexes are too large to turn that quickly. The degree of polarization is inversely proportional to the level of patient antigen. Used to measure hormones and therapeutic drugs.
  20. Requires sophisticated instrumentation that is specific to the chemical being used. This labeling technique can be applied to heterogeneous or homogenous assays, and may detect antigens or antibodies. Clinical applications include detection of drugs, hormones, and viral antigens.
  21. Twofold dilutions are the most common, however other dilutions may be used.
  22. Change of 2 tubes = 4-fold dilution