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IMMUNOFLUORESCENCE 
Dr Rania Abo-Shady 
ASS.Prof. of Clinical Pathology 
Ain Shams University
Immunofluorescence assay 
• Immunofluorescence is a technique allowing the 
visualization of a specific protein or antigen in tissue 
sections by binding a specific antibody chemically 
conjugated with a fluorescent dye such as fluorescein 
isothiocyanate (FITC). 
• The specific antibodies are labeled with a compound 
(FITC) that makes them glow an apple-green color 
when observed microscopically under ultraviolet 
light.
• Fluorescence is the property of certain molecules 
or fluorophores to absorb light at one wave length 
and emit light at longer wave length (emission 
wavelength) when it is illuminated by light of 
a different wavelength (excitation wavelength). 
• The incident light excites the molecule to a higher 
level of vibrational energy. As the molecules return 
to the ground state, the excited fluorophore emits 
a photon(= fluorescence emission ).
Principle of the Test
There are two major types of 
immunofluorescence staining methods: 
• 1) direct immunofluorescence: staining in 
which the primary antibody is labeled with 
fluorescence dye, 
• 2) indirect immunofluorescence: staining in 
which a secondary antibody labeled with 
fluorochrome is used to recognize a primary 
antibody.
Advantages of indirect: 
(1). Gives an amplification effect -- more tag or label ('signal') 
per molecule of target protein. 
(2). Requires only one labeled antibody to identify many 
proteins. Same labeled secondary antibody can be used to bind 
to ("light up") many different proteins. (Preparation of labeled 
antibody is difficult and expensive.) 
(a). A different primary antibody is used for each target protein. 
(Not labeled -- no tag.) Variable part of primary antibody binds 
to specific part of target protein. 
(b). The secondary antibody binds to the constant part of the 
primary antibody. Therefore a sample of the same (labeled or 
tagged) batch of secondary antibody can bind to many different 
(unlabeled) primary antibodies
• Indirect immunofluorescence uses two 
antibodies; the first (the primary antibody) 
recognises the target molecule and binds to it, 
and the second (the secondary antibody), 
which carries the fluorophore, recognises the 
primary antibody and binds to it.
• For the determation of autoantibodies, tissue 
sections are used as antigen substrates. 
• If the sample is positive, specific antibodies in 
the diluted serum sample attach to the 
antigens coupled to a solid phase. 
• In a second step, the attached antibodies are 
stained with fluorescein-labelled anti-human 
antibodies and visualized with the 
fluorescence microscope.
Indirect immunofluorescence assay: 
A laboratory test used to detect antibodies in serum 
or other body fluid. 
Examples of autoantibodies: 
– Anti-dsDNAAbs. 
– ANA . 
– APA. 
– ASMA. 
– AMA. 
– Anti LKM. 
– ANCA. 
– Antithyroid Abs.
Indirect immunofluorescence is considered the 
standard technique for detection of autoantibodies. 
It offers unique advantages: 
• A negative result excludes the presence of all these 
antibodies. 
• For every antibody there is a characteristic 
fluorescence pattern. 
• High specificity through visual discrimination: 
Antibodies are localized morphologically in exactly 
the same spots as their corresponding antigens. 
• The combination of different substrates in one test 
field is highly suitable for determining autoantibody 
profiles (mouse –stomach –kidney substrate CT3 )
Autoantibodies are detected on 
specific substrates 
– Anti-dsDNAAb Crithedia Lucilae substrate 
– ANA on Hep-2 substate 
on mouse stomach kidney substrate 
– APA. 
– ASMA. on mouse stomach kidney substrate(CT2) 
(CT2) 
– AMA. 
– Anti LKM on mouse liver stomach kidney (CT3) 
– ANCA on neutrophil substrate 
– Antithyroid Abs on Thyroid tissue
Advantage of Hep2 cells over rodent tissue 
i. Higher sensitivity (greater Ag expression) 
ii. Human origin ensure better specificity 
iii. Cell division rates are higher so cell cycle 
dependent Ab are easily identified 
iv. Nucleus are much larger ,visible & complex 
nucleolar detail can be seen 
v. Ags distribution are uniform not obscuring 
intercellular matrix
Antinuclear antibodies (ANA) 
• Are autoantibodies directed against various nuclear antigens, 
and are used to report the titer of the ANA and the pattern of 
nuclear staining of the ANA. 
• Comment on : 
-Type of substrate 
-Autoantibody (positive/negative) 
-Pattern
• STAINING PATTERNS 
• Diffuse / homogeneous: antibodies to histone 
• Rim: antibodies to nuclear envelope proteins 
and to double-stranded (ds) DNA 
• Speckled: antibodies to Sm, RNP, Ro/SS-A, 
La/SS-B, and other antigens 
• Nucleolar: associated with diffuse scleroderma 
• Centromeric: highly specific for the CREST 
syndrome
Patterns of ANA
Negative ANA on Hep2
ANA (Homogenous pattern)
ANA( Speckled)
ANA (Nucleolar)
ANA(Rim pattern)
ANTIBODIES TO DOUBLE-STRANDED DNA 
(Positive anti dsDNA)
Negative Anti-ds DNA
Anti-neutrophil cytoplasmic Abs 
(ANCA)
P-ANCA
Antithyroid Abs (anti-microsomal)
Antithyroid Abs (anti-thyroglobulin)
Mouse stomach-kidney 
substrate
AMA onMouse stomach-kidney 
substrate
AMA (renal tubules)
ASMA on Mouse stomach-kidney 
substrate
ASMA (blood vessel )
APCA
Anti-LKM on mouse liver stomach 
kidney substrate(CT3) 
• The pattern was consistently found to be that of a 
typical LKM antibody without any evidence of a 
mitochondrial antibody pattern is as follows; 
Liver – strong positive cytoplasmic stain 
Kidney – strong positive cytoplasmic stain in inner 
proximal tubules, negative distal tubules. 
Stomach – negative
LKM bright liver, negative stomach
LKM close up of proximal renal tubule 
staining
THANK YOU

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Immunofluorescence 130125142023-phpapp02

  • 1. IMMUNOFLUORESCENCE Dr Rania Abo-Shady ASS.Prof. of Clinical Pathology Ain Shams University
  • 2. Immunofluorescence assay • Immunofluorescence is a technique allowing the visualization of a specific protein or antigen in tissue sections by binding a specific antibody chemically conjugated with a fluorescent dye such as fluorescein isothiocyanate (FITC). • The specific antibodies are labeled with a compound (FITC) that makes them glow an apple-green color when observed microscopically under ultraviolet light.
  • 3. • Fluorescence is the property of certain molecules or fluorophores to absorb light at one wave length and emit light at longer wave length (emission wavelength) when it is illuminated by light of a different wavelength (excitation wavelength). • The incident light excites the molecule to a higher level of vibrational energy. As the molecules return to the ground state, the excited fluorophore emits a photon(= fluorescence emission ).
  • 5.
  • 6. There are two major types of immunofluorescence staining methods: • 1) direct immunofluorescence: staining in which the primary antibody is labeled with fluorescence dye, • 2) indirect immunofluorescence: staining in which a secondary antibody labeled with fluorochrome is used to recognize a primary antibody.
  • 7.
  • 8. Advantages of indirect: (1). Gives an amplification effect -- more tag or label ('signal') per molecule of target protein. (2). Requires only one labeled antibody to identify many proteins. Same labeled secondary antibody can be used to bind to ("light up") many different proteins. (Preparation of labeled antibody is difficult and expensive.) (a). A different primary antibody is used for each target protein. (Not labeled -- no tag.) Variable part of primary antibody binds to specific part of target protein. (b). The secondary antibody binds to the constant part of the primary antibody. Therefore a sample of the same (labeled or tagged) batch of secondary antibody can bind to many different (unlabeled) primary antibodies
  • 9. • Indirect immunofluorescence uses two antibodies; the first (the primary antibody) recognises the target molecule and binds to it, and the second (the secondary antibody), which carries the fluorophore, recognises the primary antibody and binds to it.
  • 10.
  • 11. • For the determation of autoantibodies, tissue sections are used as antigen substrates. • If the sample is positive, specific antibodies in the diluted serum sample attach to the antigens coupled to a solid phase. • In a second step, the attached antibodies are stained with fluorescein-labelled anti-human antibodies and visualized with the fluorescence microscope.
  • 12.
  • 13. Indirect immunofluorescence assay: A laboratory test used to detect antibodies in serum or other body fluid. Examples of autoantibodies: – Anti-dsDNAAbs. – ANA . – APA. – ASMA. – AMA. – Anti LKM. – ANCA. – Antithyroid Abs.
  • 14. Indirect immunofluorescence is considered the standard technique for detection of autoantibodies. It offers unique advantages: • A negative result excludes the presence of all these antibodies. • For every antibody there is a characteristic fluorescence pattern. • High specificity through visual discrimination: Antibodies are localized morphologically in exactly the same spots as their corresponding antigens. • The combination of different substrates in one test field is highly suitable for determining autoantibody profiles (mouse –stomach –kidney substrate CT3 )
  • 15. Autoantibodies are detected on specific substrates – Anti-dsDNAAb Crithedia Lucilae substrate – ANA on Hep-2 substate on mouse stomach kidney substrate – APA. – ASMA. on mouse stomach kidney substrate(CT2) (CT2) – AMA. – Anti LKM on mouse liver stomach kidney (CT3) – ANCA on neutrophil substrate – Antithyroid Abs on Thyroid tissue
  • 16. Advantage of Hep2 cells over rodent tissue i. Higher sensitivity (greater Ag expression) ii. Human origin ensure better specificity iii. Cell division rates are higher so cell cycle dependent Ab are easily identified iv. Nucleus are much larger ,visible & complex nucleolar detail can be seen v. Ags distribution are uniform not obscuring intercellular matrix
  • 17. Antinuclear antibodies (ANA) • Are autoantibodies directed against various nuclear antigens, and are used to report the titer of the ANA and the pattern of nuclear staining of the ANA. • Comment on : -Type of substrate -Autoantibody (positive/negative) -Pattern
  • 18. • STAINING PATTERNS • Diffuse / homogeneous: antibodies to histone • Rim: antibodies to nuclear envelope proteins and to double-stranded (ds) DNA • Speckled: antibodies to Sm, RNP, Ro/SS-A, La/SS-B, and other antigens • Nucleolar: associated with diffuse scleroderma • Centromeric: highly specific for the CREST syndrome
  • 22.
  • 24.
  • 27. ANTIBODIES TO DOUBLE-STRANDED DNA (Positive anti dsDNA)
  • 31.
  • 32.
  • 38. ASMA on Mouse stomach-kidney substrate
  • 40. APCA
  • 41. Anti-LKM on mouse liver stomach kidney substrate(CT3) • The pattern was consistently found to be that of a typical LKM antibody without any evidence of a mitochondrial antibody pattern is as follows; Liver – strong positive cytoplasmic stain Kidney – strong positive cytoplasmic stain in inner proximal tubules, negative distal tubules. Stomach – negative
  • 42. LKM bright liver, negative stomach
  • 43. LKM close up of proximal renal tubule staining