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Basic
SPECIMEN
NM-123
Colon
carcinoma
123456789
Source:
• Carson F., Hladik C. HISTOTECHNOLOGY 3rd Edition
• Diagnostic Immunohistochemistry NORDICQC Krakow,
Poland, 12th-13th October 2015 (seminars)
• Dako’s Guidebook to Immunohistochemical Staining
Methods
In the clinical laboratory:
 a heavily used technique,
 for assisting the pathologist in making diagnosis,
Used to determine:
 the origins,
 prognosis,
 and treatment of a tumor
Rigorous quality control (QC)
 Accurate and consistent results
 Expected staining patterns
Trobbleshooting:
 Fixation
 Processing
 Tissue types
Grossing
Tissue processing
Embedding
Sectioning
Staining
HE/HC/IHC
Tissue sections
fixation
fixation
Diagnosis
• Fixation & tissue preparation
• Pre-treatment/epitope retrieval
(Appropriate and efficient epitope
retrieval)
• Primary antibody selection
(Appropriate choice & titre of
antibody/clone)
• Detection system s
pecific & sensitive detection system
• Appropriate choice of
control material
Important considerations
for IHC
START
IHC Images by Kornstein, MD, Medical College of Virginia
Abnormal 2+ Abnormal 3+
Normal 0
Normal
Normal 1+
Normal Abnormal low
amplification
Abnormal high
amplification
ALMOUST
THE END
Important considerations for IHC
Tissue preparation standards
1. PRELAB PITFALLS – 68%
2. FIXATION TIME: 6 - 48 h – PRECICION???
3. FORMALIN TEMPERATURE....
ROOM TEMPERATURE...WINTER//SUMMER???
4. FORMALIN pH !!! 7.0
5. FORMALIN VORTEXING
6. FRESH FORMALIN???...
Important considerations for IHC
LITTLE BIT OF HISTORY…
 The term “antibody” was coined by Paul Ehrlich in 1891.
 The principle of IHC has been known since the 1930s,
 It was not until 1942 that the first IHC study was reported…(Coons et al. used FITC-labeled antibodies to identify Pneumococcal
antigens in infected tissue).
 1974 Taylor and Burns developed IHC on routinely processed FFPE tissues
 1975 Köhler and Milstein presented the hybridoma technique to produce monoclonal antibodies (mAbs) by fusing an antibody-
producing B cell with a myeloma cell that is selected for its ability to grow in tissue culture
 1979 Peroxidase anti-peroxidase technique
 early 1980’s avidin & biotin complex
Since then, improvements have been made in protein conjugation, tissue fixation methods, detection labels and microscopy,
making immunohistochemistry a routine and essential tool in diagnostic and research laboratories
DAKO, seminars 2015
DAKO, seminars 2015
DAKO, seminars 2015
• Fixation & tissue preparation
• Pre-treatment/epitope retrieval
(Appropriate and efficient epitope
retrieval)
• Primary antibody selection
(Appropriate choice & titre of
antibody/clone)
• Detection system s
pecific & sensitive detection system
• Appropriate choice of control
material
Important considerations
for IHC
Fixation & tissue preparation
Fixation is a complex series of chemical events that differ for the
different groups of substance found in tissues.
• A fixative is described as a chemical substance which will
preserve the shape, structure, relationship and chemical
constituents of tissues and cells after death.
The aim of fixation according to IHC:
1- during fixation, hydrogen bonds are formed – which must be reserved to have successful
antibody binding to the antigen site.
Fixation & tissue preparation
– preservation of tissues in its original condition.
Aldehyde based
• 10% NBF
• 4% formaldehyde with PBS buffer
• 2% formaldehyde with picric acid and PBS
• Immersion v. transcardial perfusion
16
Fixation & tissue preparation
- factors affecting fixation good quality of IHC
• Formalin is best at 10% pH 7.2 (7.0 -7.4)
• Too high a concentration may adversely affect the
tissues and produce artefact similar to excessive
heat.
40% formaldehyde 250 ml
- Na2HPO4 x H2O 6,5 g
- NaH2PO4 4,0 g
- H2O dest. 750 ml
General principles of fixation
 Amount of fixing fluid should be approx. 20 times more than the volume of
tissue held in a container with a required fixation time.
Temperature has an important effect. ROOM TEMPARATURE: 21°C
A lower temperature retard fixation – reduce autolytic reaction.
 A higher temperature will decrease the required for fixation but will
increase autolysis.
• Formalin is best at 10% pH 7.2 (7.0 -7.4)
Fixation & tissue preparation
FIXATIVES FOR PARAFFIN-PROCESSED TISSUE
- new regulation regarding predictive marker staining  responsibility on the
clinical laboratory fo dokumenting the time of fixation
- Time: 6 - 48 h – standard: 24 h
The speed of fixation of most fixative is almost 1 mm/hour
(according to Medawar penetration index: 1 mm/ 1 godz.
d = k √ t (d = depth k = penetration index t = time (h)
Penetration time at K = 3.6( d = K x √t )
• 1 hour = 3.6 mm
• 4 hours = 7.2 mm (1.8 mm/hr)
• 16 hours = 14.4 mm (0.9 mm/hr)
• 64 hours = 28.8 mm (0.45 mm/hr)
• 256 hours = 57.6 mm (0.225 mm/hr)
(to double the depth takes 4x the time)
Fixation & tissue preparation
NORDICQC, seminars 20
100 % binding of formaldehyde after 24 hours at 25°C
50 % binding of formaldehyde after 100 min. at 25°C room temp.37˚C
Helander, KG. Kinetic studies of formaldehyde binding in tissue.
Biotechnique and Histochemistry. 1994; 69, 177 -179 NORDICQC, seminars 20
Am J Surg Pathol, Vol. 24, No. 7, 2000
Reaction!!!!!
− Penetration is just a part of the problem
− The main clue !!!!!  reaction!!!
− „GOLDEN HOUR” – first hour
is the most important during fixation
we can save or completly destroy the tissue
(IMMUNOREACTIVITY)
Appropriate tissue fixation and processing
• – Problem 1: Delayed fixation
• – Problem 2: Too short fixation in NBF
• – Problem 3: Other fixatives than NBF
• – Too long fixation in NBF is not a problem !!!??
Appropriate tissue fixation and processing
Fixation & tissue preparation
NORDICQC, seminars 20
• Because fixation varies markely from laboratory to laboratory
• Vimentin provides an excellent way of determinating when tissue has been
overfixed.
• Vimentin staining is usually excelent in paraffin sections of tissues that have
been optimally fixed in formalin but is progressively lost as the lenght of
time in the fixative increases.
• When the vimentin staining is completely negative  the tissues are
overfixed and all antibodies should be interpreted with caution.
• When the preservation of vimentin is uneven, then all immunostains should
be read in the area of most intense vimentin staining
Fixation & tissue preparation
DAKO, seminars 2015
Important considerations for IHC
Tissue preparation standards NEW ALTERNATIVE
TissueSafe – urządzenie, w którym tkanki możemy
opakować w folię, w próżni co eliminuje konieczność
utrwalenia jej w miejscu pobrania (np. blok
operacyjny).
- Urządzenie to pozwala również na transport
tkanek z miejsca pobrania do laboratorium
histopatologicznego.
- Tkanki przewożone są w temperaturze 4 °C.
- Otrzymaną tkankę utrwalamy dopiero po wyjęciu z
worka próżniowego, w laboratorium.
- Od początku możemy nadzorować proces
utrwalania materiału.
Important considerations for IHC
Tissue preparation standards NEW ALTERNATIVE
Ventana: System 2 + 2
1. Fresh tissue material – on ice – department of clinical pathomorphology
2. Cutting the fresh material
3. Placing the fresh thin tissue sections into 10% buffer formalin for 2 h in 4°c
4. Last step of fixation: 2 h in 45°c
Chafin D, Theiss A, Roberts E, Borlee G, Otter M, et al. (2013) Rapid Two-Temperature Formalin Fixation.
PLoS ONE 8(1): e54138. doi:10.1371/journal.pone.0054138
Important considerations for IHC
Tissue preparation standards NEW ALTERNATIVE
Important considerations for IHC
Tissue preparation standards
Important considerations for IHC
Tissue preparation standards
NORDICQC, seminars 2015
Estrogen receptor expression at
different delayed formalin fixation
times (0 minutes, 4 and 8 hours,
and overnight).
Note the decreased
number/percentage of positive cells
and the intensity of the stain with
increased time of delayed fixation.
Sectioning
• Paraffin
• Most commonly used
• Must heat and process through xylenes and alcohols – ruins some
antigens
• BEST if not stored more than two weeks – lose antigenicity after
that time
Fixation & tissue preparation
Sections usually 3-4µm
HER2 IHC = 4µm
Thinner sections 2-3µm required for:-
Bone marrow trephines
Lymph nodes
Renal biopsies
Thicker sections 6-20µm required for:-
Cases for amyloid (histochemistry)
(6-8µm)
Model A22
Zalecane do bardzo
cienkich sekcji w
krojeniu rutynowym i
badaniach
naukowych. Nadaje
się do tkanki
włóknistej, a także do
cięcia
wstążeczkowego.
Długość - 80mm;
Wysokość - 8 mm; Kąt
żyletki - 22°;
Model A35
Zalecane do bardzo
cienkich sekcji w
krojeniu rutynowym i
badaniach
naukowych. Nadaje
się zarówno do
tkanki miękkiej jak i
twardej .
Długość - 80mm;
Wysokość - 8 mm;
Kąt żyletki - 35°
Model C35
Zalecane wyłącznie
do skrawania w
kriostatach w celu
uzyskania bardzo
cienkich sekcji.
Jedyna żyletka
wykonana ze stali
węglowej.
Długość - 80mm;
Wysokość - 8 mm; Kąt
żyletki - 35°
Model R35
Zalecane do
skrawania
wstążeczkowego.
Nadaje się przede
wszystkim do tkanki
twardej, możliwe jest
jednak również
skrawanie materiału
miękkiego.
Długość - 80mm;
Wysokość - 8 mm; Kąt
żyletki - 35°
Model N35
Zalecane do
skrawania bardzo
twardych materiałów
w krojeniu
rutynowym.
Długość - 80mm;
Wysokość - 8 mm;
Kąt żyletki - 35°
Model N35HR
Zalecane do
skrawania bardzo
twardych i trudnych
materiałów zarówno
w skrawaniu
rutynowym jak i
wstążeczkowym.
Długość - 80mm;
Wysokość - 8 mm;
Kąt żyletki - 35°
Model S35L
Zalecane do
skrawania
rutynowego tkanek o
dużych wymiarach
zatopionych
w bloczku
parafinowym oraz
większych biopsji.
Długość - 120 mm;
Wysokość - 8 mm;
Kąt żyletki - 35°
Model S35LL
Zalecane do
skrawania
rutynowego tkanek o
bardzo dużych
wymiarach
zatopionych
w bloczku
parafinowym.
Długość - 180 mm;
Wysokość - 8 mm;
Kąt żyletki - 35°
Tissue preparation - sectioning
Tissue preparation - sectioning
H&E
Score lines visible on the
waterbath
David Muskett - SD/CP5 Microtomy
Tissue preparation - sectioning
This short ribbon of sections that was cut from a cold block shows considerable compression
(30–40%). In this case re-setting the knife tilt angle overcame the problem.
David Muskett - SD/CP5 Microtomy
Optimise knife tilt angle
Tissue preparation - sectioning
This block face has cracked because it was frozen to –15 °C in a freezer prior to cutting. The
cracks may make sectioning and flotation difficult because the wax is no longer bound to the
tissue. David Muskett - SD/CP5 Microtomy
Avoid freeze damaging
Tissue preparation - sectioning
David Muskett - SD/CP5 Microtomy
Carefully choose a section
Tissue preparation - sectioning
Tissue preparation - sectioning
Tissue preparation - sectioning
• Fixation & tissue preparation
• Pre-treatment/epitope retrieval
(Appropriate and efficient epitope
retrieval)
• Primary antibody selection
(Appropriate choice & titre of
antibody/clone)
• Detection system s
pecific & sensitive detection system
• Appropriate choice of
control material
Important considerations
for IHC
Pre-treatment/epitope retrieval
(Appropriate and efficient epitope retrieval)
two common categories of retrieval methods
1. HIER – HEAT-INDUCED EPITOPE RETRIEVAL
2. EIER – ENZYME-INDUCED EPITOPE ETRIEVAL
• Those methods are necessary to break down the hydrogen bonds,
formed during fixation
• Overfixation  results in in loss of immuneactivity  false negative
results
Important considerations
for IHC
Advantages in epitope retrieval:
- Ability to furthere dilute antibodies
- Exposure of epitopes sites not previously detectable
- More intense reactions with decreased incubation times
- More uniform staining
- Decreased background staining
- Possibility of better standarization
Pre-treatment/epitope retrieval
(Appropriate and efficient epitope retrieval)
Antigen retrieval Pre-treatment / Epitope retrieval:
Defined as an unmasking method
for ”re-storing” blocked antigens
in formaldehyde fixed tissue
The key to an optimal IHC reaction…
HIER Heat Induced Epitope Retrieval
Citrate 6.0//Tris-EDTA 9.0//EDTA 8.0 / 9.0
95°C 20 min.
IHC Procedure validation
Antibody dilution 1:25 1:50 1:100
Antigen retrieval 1. HIER low pH
2. HIER high pH
3. Enzyme
(protease)
1.HIER low pH
2.HIER high pH
3.Enzyme
(protease)
1.HIER low pH
2.HIER high pH
3. Enzyme
(protease)
Incubation 1. 30 min. 37°C
2. 1 h RT
3. 16 h 4°C
1. 30 min. 37°C
2. 1 h RT
3. 16 h 4°C
1. 30 min. 37°C
2. 1 h RT
3. 16 h 4°C
• Fixation & tissue preparation
• Pre-treatment/epitope retrieval
(Appropriate and efficient epitope
retrieval)
• Primary antibody selection
(Appropriate choice & titre of
antibody/clone)
• Detection system specific &
sensitive detection system
• Appropriate choice of control
material
Important considerations
for IHC
Monoclonal v. polyclonal
Antibodies monoclonals
• Mouse monoclonals - one clone
to one antigen determinant
• High specificity - low to high
sensitivity
• Mouse or rabbit hybridoma
Primary antibody selection
Rabbit polyclonals - more clones to more antigen determinants
• Low to high specificity - high sensitivity
• Polyclonal antibodies
• Many different species
• Tends to have more non-specific reactivity
• Can have very different
• avidity/affinity batch-to-batch
• Rabbit monoclonals -
• High specificity – high sensitivity
 Polyclonal antibodies reacting with various epitopes
 Each antibody is made by a different B-cell
Monoclonal v. polyclonal
Primary antibody selection
Antibody specifiacation sheet:
• The antibody specification sheet provided with a commercial antibody contains
valuable information regarding the antibody.
• The expiration date under recommended storage conditions
• Long-term//short-term storage temparatures (some antibodies require long-term
storage at -20°C. Measures to ensure that the antibody storage condition is optimal
will assist with antibody stability and maximum reactivity for the life of the antibody.
• The protein concentration and suggested working dilution ranges
• Pretreatment (antigen retrieval) solution; pH, and//or method if recommended
• Expected positive and negative tissue types INCLUDING NORMAL AND TUMOR
• Reference and publication list, and applications of antobody
• ANTIBODY TYPE: IN VITRO (IVD), RESEARCH USE ONLY (RUO), FOR RUTINE
DIAGNOSIS
Prediluted and concentrated antibodies
• Commercialy available – READY TO USE antibodies –
validated
• Concentrated antibodies – dilutions must be performed, to
find opitimal dilution for antigen detection
CONTROL REACTIONS – ANTIBODY VALIDATION
CONTROL REACTIONS – ANTIBODY VALIDATION
• EXAMPLE OF STANDARD LABORATORY PROTOCOL:
• Antigen retrieval - combination of heating method/
• - combination of time
• Peroxidase quenching – peroxidase block
• – combination of time
• Non-specific binding block – combination of time
• Detection system - universal polymer//HRP//AP
• Staining times: - primary antibody combination
• 30 minute//1 hour//16 hours
• - detection system//chromogen
• 20 minutes //1-10 minutes
Antibody specifiacation sheet:
v
Antibody specifiacation sheet:
Antibody specifiacation sheet:
Antibody specifiacation sheet:
Validated antibody
• IF v. IHC with fluorescence
• WB, ELISA, IP, etc.
Whole molecule or specific portion of epitope?
Primary antibody selection
Primary antibody selection
Primary antibody selection
1:800
1:400
1:50 1:100 1:200
IHC staining results of serially diluted Chromogranin A
antibody on pancreas.
Primary antibody selection rules
At 1:50, the Islet cells stain strongly but there is also a
strong background staining.
1:50
background staining
Islet cells
Primary antibody selection rules
At 1:800, there is no background staining but the Islet
cells stain very weak.
1:800
Primary antibody selection rules
At 1:200, there is good contrast and no background
staining, it is therefore the optimal working dilution.
1:200
Primary antibody selection rules
Primary antibody selection rules
Primary Antibody Incubation Time / Temparature
• Incubation time is inversely proportional to antibody concentration.
• Higher concentration of antibody allows shorter incubation time.
• 30 minutes 37°C // 1 hour RT // 16 hours 4°C
• Humidity chambers must be used when incubating at higher
temperature to prevent drying of tissue sections.
• 16 /4°C – allow sometines to better antibody penetration – used in
VALIDATION
IHC rules: Blocking
Background staining
• Specific
• Polyclonal antibodies – impure antigen used
• Inadequate fixation – diffusion of antigen – often worse in
center of large block
• Non-specific
• Endogenous enzymes peroxidases//AP
Structure of DAB
NH3
+
NH3
+
+H3
N
+H3
N 4Cl
-
DAB stained slides can be coverslipped with permanent organic
based mounting media.
In some IHC procedures, the dark brown reaction product can
be modified and intensified by adding metals (copper or
cobalt) to DAB solution.
Commonly used enzyme labels for IHC procedures include
horseradish peroxidase (HRP) HRP, from horseradish plant, is an enzyme that
catalyze the reduction of hydrogen peroxide (H2O2) to water and oxygen.
alkaline phophatase (AP)
Commonly used chromogens for HRP include
3-amino-9-ethylcarbazole (AEC)
3,3’-diaminobenzidine (DAB)
• Horse Radish Peroxidase (HRP)
• + high sensitivity
• + precise chromogenic reaction
• + can be amplified by metal (Cu/Ni)
•
• Alkaline Phosphatase (AP)
• + suitable for cryostate sections and cytology
(hematology)
• + double IHC staining
• - granular chromogenic reaction
• - relative low sensitivity
Enzyme
Control material can be categorized in different ways:
„
„
Reagent controls
– Positive reagent control is the actual reagent;
e.g. the primary antibody when tested on control material.
Testing is done during development and product validation to
ensure reagent specificity and sensitivity.
– Negative reagent control is a reagent substitute for the
primary antibody used to assess potential specificity
issues/false positive staining reaction
„
„
Tissue controls
– Positive tissue control is tissue with the specific antigen
at known, relevant and stable level.
Purpose is to docu-ment correct staining.
Control material can be categorized in different ways:
Negative tissue control
-is tissue without the specific antigen present – or not present in
specific regions.
- Purpose is to document specificity of the staining.
Tissue blocks/tissue microarrays,
- consisting of a few to several different
tissues that may serve as control material
for a range of antibodies
Control material can be categorized in different ways:
Internal tissue controls
– The presence of the target antigen (protein) within normal
elements of the tissue under investigation is an internal positive
control
„
„
Control material can be categorized in different ways:
„
„
Cell line controls
– Control material based on cultured cells with specific
antigenic characteristics. This type of control typically is made
for very specific purposes, in particular predictive assays (HER2)
Control material can be categorized in different ways:
Controls in Daily Routine Testing
On-slide positive tissue controls,
where specific controls are
placed on the same slide as the test
specimen are strongly preferred.
A) Illustration of the principle of
multi-core blocks. Tissue controls are
the cores in red, yellow, gray and
green. Patient sample is placed below
B) Example of on-slide tissue
controls. TMA
C) Example of cell line controls.
Controls in Daily Routine Testing
Tissue Controls
- both positive and negative tissue controls provide important information
and must be included in daily routine regardless of type of detection
system used.
- the tissues used for controls are carefully selected from normal or
cancer tissues previously analyzed in the laboratory.
- However, in some cases the actual patient tissue being tested can be
used as tissue control. HER2 - gastic
- For all tissue controls, if the staining does not perform as expected,
results from the respective test specimen should be considered invalid.
Controls in Daily Routine Testing
Positive tissue control
- The positive tissue control must contain the target
antigen at relevant, known and stable expression
level.
- It serves to document that proper staining has been
performed and confirms that the target retrieval procedure
has been carried out correctly.
- Thus, a positive tissue control assesses correct staining
protocol performance (temperature, time and correct
application of reagents).
Controls in Daily Routine Testing
Positive tissue controls
- are indicative of properly prepared tissue, they should
be as accurate as possible in the same manner as
the patient samples.
- Optimally, autopsy/biopsy/surgical specimens should be
fixed, processed and embedded as soon as
possible for best preservation of antigens.
- Generally, autopsy tissue is least preferred because of
inevitable delays before fixation (degradation of some
antigens)
Control material
On-slide positive tissue controls
-In the daily routine, positive tissue controls may be run on a
separate slide - as a batch control or daily control, or they
may be included on the same slides as the test specimens.
- on-slide positive controls, are
specific controls are placed
on the same slide as the test
specimen strongly preferred
Control material
More and more laboratories are using TMA cores as
on-slide controls.
-building a a few basic multi-tissue control blocks
- each containing a small number of control tissues to
cover most of the markers used in clinical
diagnostics.
Control material
The multi-tissue control blocks contains:
appendix, tonsil, pancreas and liver,
The reaction patterns are described for approximately 100 different
antibodies.
Control material
Tissue microarray
During immunohistochemistry:
Be focus on technical
calibration and controls for validation and verification.
Etapy reakcji IHC Odczynniki Warunki: Czas /Temperatura
Deparafinizacja
Bufor cytrynianowy – pH low
Bufor EDTA – high pH
Uwodnienie
Odkrywanie antygenów 20 min PT-link(95 - 99 °C)
Płukanie
Blokowanie endogennej peroxydazy
Płukanie
Woda redestyl//PBS
H2O2
PBS
2x // 10min
15 min RT wytrząsarka
10 min.
Blokowanie miejsc nieswoiście
wiążących przeciwciała
Roztwór BSA 5% 10 min, RT, komora wilgotna
Inkubacja z pierwszorzędowym
przeciwciałem
Płukanie
Rozcieńczenia:
1:250
PBS
16 godz., temp 4 °C, komora
wilgotna
10 min.
Inkubacja z drugorzedowym
przeciwciałem
płukanie
EnVision Anti-Mouse/Rabbit
FLEX HRP DAKO
PBS
20 min, 37 °C, komora wilgotna
10 min.
Inkubacja z substratem dla
peroksydazy
DAB Chromogen 2 min, RT, komora wilgotna
Step by Step IHC Staining Method
Remove paraffin wax and hydrate
tissue section.
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Deparaffinization and Rehydration
paraffin wax coated slide
Remove paraffin wax and hydrate
tissue section.
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Deparaffinization and Rehydration
tissue section
Step by Step IHC Staining Method
20:00
Wather bath for 20 minutes using
Antigen Retrieval Solution pH 9.0.
Rinse
Antigen Retrieval
Deparaffinization and Rehydration
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
3% hydrogen peroxide block solution for 5 minutes to
inactivate endogenous peroxidase activity.
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Rinse
Deparaffinization and Rehydration
Antigen Retrieval
Rinse
Step by Step IHC Staining Method
Thorough rinse in distilled water and
wash 2 times in PBS buffer.
Rinse
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
5% bovine serum albumin (BSA) to block nonspecific
staining.
Protein Block
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
Optimally diluted primary antibody for 20 minutes.
Primary Antibody
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
Wash 2 times in PBS buffer.
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Rinse
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
Secondary antibody for 20 minutes.
Secondary Antibody
Rinse
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
Wash 2 times in PBS buffer.
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
Rinse
Rinse
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
DAB chromogen for 1 minute.
DAB Chromogen
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
Rinse
Rinse
Rinse
Rinse
Rinse
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
rinse in water.
DAB Chromogen
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
Rinse
Rinse
Rinse
Rinse
Rinse
Step by Step IHC Staining Method
Counterstain in Mayer’s Hematoxylin
for 1 minute.
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
DAB Chromogen
Rinse
Rinse
Rinse
Rinse
Rinse
Hematoxylin Counterstain
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Step by Step IHC Staining Method
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
Thorough wash in tap water to “blue” the nuclei.
Hematoxylin Counterstain
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
DABChromogen
Rinse
Rinse
Rinse
Rinse
Rinse
Rinse
Step by Step IHC Staining Method
Step by Step IHC Staining Method
Coverslip using mounting medium.
Deparaffinization and Rehydration
Block Endogenous Peroxidase
Antigen Retrieval
Protein Block
Primary Antibody
Secondary Antibody
DAB Chromogen
Rinse
Rinse
Rinse
Rinse
Rinse
Hematoxylin Counterstain
Rinse
Mount
SPECIMEN
Lab
Vision
Corp.
NM-123
Colon
carcinoma
MS-1375
CEA
“Stronty formalinowe", albo
"hematyna kwaśnej formaliny".
Pigment ten tworzy się w środowisku
kwaśnej formaliny.
Hematyna powstaje z hemoglobiny,
reagującej z formaliną w środowisku
kwaśnym, stąd największe
nagromadzenie tego barwnika
obserwowane jest w preparatach
zawierających dużo krwinek.
Utrwalanie materiału tkankowego
Utrwalanie materiału tkankowego
Utrwalanie materiału tkankowego
Utrwalanie materiału tkankowego
Results of incomplete fixation
Results of incomplete fixation
Improving antibody penetration
 Need this for intracellular (cytoplasmic, nuclear) or
membrane components when epitope is inside cell
membrane
 Detergents most popular
 Triton-X
 Tween
 Also decreases surface tension – better coverage
 Can’t use for membrane proteins
 Acetone/Methanol
 Precipitate proteins outside cell membranes- more accessible
 Saponin
 Punches holes in cell membrane – holes close up when
removed

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IHC_PRINCIPLES.pdf

  • 2. Source: • Carson F., Hladik C. HISTOTECHNOLOGY 3rd Edition • Diagnostic Immunohistochemistry NORDICQC Krakow, Poland, 12th-13th October 2015 (seminars) • Dako’s Guidebook to Immunohistochemical Staining Methods
  • 3. In the clinical laboratory:  a heavily used technique,  for assisting the pathologist in making diagnosis, Used to determine:  the origins,  prognosis,  and treatment of a tumor Rigorous quality control (QC)  Accurate and consistent results  Expected staining patterns Trobbleshooting:  Fixation  Processing  Tissue types
  • 5. • Fixation & tissue preparation • Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval) • Primary antibody selection (Appropriate choice & titre of antibody/clone) • Detection system s pecific & sensitive detection system • Appropriate choice of control material Important considerations for IHC
  • 6. START IHC Images by Kornstein, MD, Medical College of Virginia Abnormal 2+ Abnormal 3+ Normal 0 Normal Normal 1+ Normal Abnormal low amplification Abnormal high amplification ALMOUST THE END Important considerations for IHC
  • 7. Tissue preparation standards 1. PRELAB PITFALLS – 68% 2. FIXATION TIME: 6 - 48 h – PRECICION??? 3. FORMALIN TEMPERATURE.... ROOM TEMPERATURE...WINTER//SUMMER??? 4. FORMALIN pH !!! 7.0 5. FORMALIN VORTEXING 6. FRESH FORMALIN???... Important considerations for IHC
  • 8. LITTLE BIT OF HISTORY…  The term “antibody” was coined by Paul Ehrlich in 1891.  The principle of IHC has been known since the 1930s,  It was not until 1942 that the first IHC study was reported…(Coons et al. used FITC-labeled antibodies to identify Pneumococcal antigens in infected tissue).  1974 Taylor and Burns developed IHC on routinely processed FFPE tissues  1975 Köhler and Milstein presented the hybridoma technique to produce monoclonal antibodies (mAbs) by fusing an antibody- producing B cell with a myeloma cell that is selected for its ability to grow in tissue culture  1979 Peroxidase anti-peroxidase technique  early 1980’s avidin & biotin complex Since then, improvements have been made in protein conjugation, tissue fixation methods, detection labels and microscopy, making immunohistochemistry a routine and essential tool in diagnostic and research laboratories
  • 12. • Fixation & tissue preparation • Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval) • Primary antibody selection (Appropriate choice & titre of antibody/clone) • Detection system s pecific & sensitive detection system • Appropriate choice of control material Important considerations for IHC
  • 13. Fixation & tissue preparation Fixation is a complex series of chemical events that differ for the different groups of substance found in tissues. • A fixative is described as a chemical substance which will preserve the shape, structure, relationship and chemical constituents of tissues and cells after death. The aim of fixation according to IHC: 1- during fixation, hydrogen bonds are formed – which must be reserved to have successful antibody binding to the antigen site.
  • 14. Fixation & tissue preparation – preservation of tissues in its original condition. Aldehyde based • 10% NBF • 4% formaldehyde with PBS buffer • 2% formaldehyde with picric acid and PBS • Immersion v. transcardial perfusion
  • 15.
  • 16. 16 Fixation & tissue preparation - factors affecting fixation good quality of IHC • Formalin is best at 10% pH 7.2 (7.0 -7.4) • Too high a concentration may adversely affect the tissues and produce artefact similar to excessive heat. 40% formaldehyde 250 ml - Na2HPO4 x H2O 6,5 g - NaH2PO4 4,0 g - H2O dest. 750 ml
  • 17. General principles of fixation  Amount of fixing fluid should be approx. 20 times more than the volume of tissue held in a container with a required fixation time. Temperature has an important effect. ROOM TEMPARATURE: 21°C A lower temperature retard fixation – reduce autolytic reaction.  A higher temperature will decrease the required for fixation but will increase autolysis. • Formalin is best at 10% pH 7.2 (7.0 -7.4)
  • 18. Fixation & tissue preparation FIXATIVES FOR PARAFFIN-PROCESSED TISSUE - new regulation regarding predictive marker staining  responsibility on the clinical laboratory fo dokumenting the time of fixation - Time: 6 - 48 h – standard: 24 h The speed of fixation of most fixative is almost 1 mm/hour (according to Medawar penetration index: 1 mm/ 1 godz. d = k √ t (d = depth k = penetration index t = time (h)
  • 19. Penetration time at K = 3.6( d = K x √t ) • 1 hour = 3.6 mm • 4 hours = 7.2 mm (1.8 mm/hr) • 16 hours = 14.4 mm (0.9 mm/hr) • 64 hours = 28.8 mm (0.45 mm/hr) • 256 hours = 57.6 mm (0.225 mm/hr) (to double the depth takes 4x the time) Fixation & tissue preparation NORDICQC, seminars 20
  • 20. 100 % binding of formaldehyde after 24 hours at 25°C 50 % binding of formaldehyde after 100 min. at 25°C room temp.37˚C Helander, KG. Kinetic studies of formaldehyde binding in tissue. Biotechnique and Histochemistry. 1994; 69, 177 -179 NORDICQC, seminars 20
  • 21. Am J Surg Pathol, Vol. 24, No. 7, 2000 Reaction!!!!! − Penetration is just a part of the problem − The main clue !!!!!  reaction!!! − „GOLDEN HOUR” – first hour is the most important during fixation we can save or completly destroy the tissue (IMMUNOREACTIVITY)
  • 22. Appropriate tissue fixation and processing • – Problem 1: Delayed fixation • – Problem 2: Too short fixation in NBF • – Problem 3: Other fixatives than NBF • – Too long fixation in NBF is not a problem !!!?? Appropriate tissue fixation and processing Fixation & tissue preparation NORDICQC, seminars 20
  • 23. • Because fixation varies markely from laboratory to laboratory • Vimentin provides an excellent way of determinating when tissue has been overfixed. • Vimentin staining is usually excelent in paraffin sections of tissues that have been optimally fixed in formalin but is progressively lost as the lenght of time in the fixative increases. • When the vimentin staining is completely negative  the tissues are overfixed and all antibodies should be interpreted with caution. • When the preservation of vimentin is uneven, then all immunostains should be read in the area of most intense vimentin staining Fixation & tissue preparation DAKO, seminars 2015
  • 24. Important considerations for IHC Tissue preparation standards NEW ALTERNATIVE
  • 25. TissueSafe – urządzenie, w którym tkanki możemy opakować w folię, w próżni co eliminuje konieczność utrwalenia jej w miejscu pobrania (np. blok operacyjny). - Urządzenie to pozwala również na transport tkanek z miejsca pobrania do laboratorium histopatologicznego. - Tkanki przewożone są w temperaturze 4 °C. - Otrzymaną tkankę utrwalamy dopiero po wyjęciu z worka próżniowego, w laboratorium. - Od początku możemy nadzorować proces utrwalania materiału. Important considerations for IHC Tissue preparation standards NEW ALTERNATIVE
  • 26. Ventana: System 2 + 2 1. Fresh tissue material – on ice – department of clinical pathomorphology 2. Cutting the fresh material 3. Placing the fresh thin tissue sections into 10% buffer formalin for 2 h in 4°c 4. Last step of fixation: 2 h in 45°c Chafin D, Theiss A, Roberts E, Borlee G, Otter M, et al. (2013) Rapid Two-Temperature Formalin Fixation. PLoS ONE 8(1): e54138. doi:10.1371/journal.pone.0054138 Important considerations for IHC Tissue preparation standards NEW ALTERNATIVE
  • 27. Important considerations for IHC Tissue preparation standards
  • 28. Important considerations for IHC Tissue preparation standards
  • 30. Estrogen receptor expression at different delayed formalin fixation times (0 minutes, 4 and 8 hours, and overnight). Note the decreased number/percentage of positive cells and the intensity of the stain with increased time of delayed fixation.
  • 31.
  • 32. Sectioning • Paraffin • Most commonly used • Must heat and process through xylenes and alcohols – ruins some antigens • BEST if not stored more than two weeks – lose antigenicity after that time Fixation & tissue preparation Sections usually 3-4µm HER2 IHC = 4µm Thinner sections 2-3µm required for:- Bone marrow trephines Lymph nodes Renal biopsies Thicker sections 6-20µm required for:- Cases for amyloid (histochemistry) (6-8µm)
  • 33.
  • 34.
  • 35. Model A22 Zalecane do bardzo cienkich sekcji w krojeniu rutynowym i badaniach naukowych. Nadaje się do tkanki włóknistej, a także do cięcia wstążeczkowego. Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 22°; Model A35 Zalecane do bardzo cienkich sekcji w krojeniu rutynowym i badaniach naukowych. Nadaje się zarówno do tkanki miękkiej jak i twardej . Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 35° Model C35 Zalecane wyłącznie do skrawania w kriostatach w celu uzyskania bardzo cienkich sekcji. Jedyna żyletka wykonana ze stali węglowej. Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 35° Model R35 Zalecane do skrawania wstążeczkowego. Nadaje się przede wszystkim do tkanki twardej, możliwe jest jednak również skrawanie materiału miękkiego. Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 35°
  • 36. Model N35 Zalecane do skrawania bardzo twardych materiałów w krojeniu rutynowym. Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 35° Model N35HR Zalecane do skrawania bardzo twardych i trudnych materiałów zarówno w skrawaniu rutynowym jak i wstążeczkowym. Długość - 80mm; Wysokość - 8 mm; Kąt żyletki - 35° Model S35L Zalecane do skrawania rutynowego tkanek o dużych wymiarach zatopionych w bloczku parafinowym oraz większych biopsji. Długość - 120 mm; Wysokość - 8 mm; Kąt żyletki - 35° Model S35LL Zalecane do skrawania rutynowego tkanek o bardzo dużych wymiarach zatopionych w bloczku parafinowym. Długość - 180 mm; Wysokość - 8 mm; Kąt żyletki - 35°
  • 37. Tissue preparation - sectioning
  • 38. Tissue preparation - sectioning
  • 39. H&E Score lines visible on the waterbath David Muskett - SD/CP5 Microtomy Tissue preparation - sectioning
  • 40. This short ribbon of sections that was cut from a cold block shows considerable compression (30–40%). In this case re-setting the knife tilt angle overcame the problem. David Muskett - SD/CP5 Microtomy Optimise knife tilt angle Tissue preparation - sectioning
  • 41. This block face has cracked because it was frozen to –15 °C in a freezer prior to cutting. The cracks may make sectioning and flotation difficult because the wax is no longer bound to the tissue. David Muskett - SD/CP5 Microtomy Avoid freeze damaging Tissue preparation - sectioning
  • 42. David Muskett - SD/CP5 Microtomy Carefully choose a section Tissue preparation - sectioning
  • 43. Tissue preparation - sectioning
  • 44. Tissue preparation - sectioning
  • 45.
  • 46.
  • 47. • Fixation & tissue preparation • Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval) • Primary antibody selection (Appropriate choice & titre of antibody/clone) • Detection system s pecific & sensitive detection system • Appropriate choice of control material Important considerations for IHC
  • 48. Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval) two common categories of retrieval methods 1. HIER – HEAT-INDUCED EPITOPE RETRIEVAL 2. EIER – ENZYME-INDUCED EPITOPE ETRIEVAL • Those methods are necessary to break down the hydrogen bonds, formed during fixation • Overfixation  results in in loss of immuneactivity  false negative results Important considerations for IHC
  • 49. Advantages in epitope retrieval: - Ability to furthere dilute antibodies - Exposure of epitopes sites not previously detectable - More intense reactions with decreased incubation times - More uniform staining - Decreased background staining - Possibility of better standarization Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval)
  • 50. Antigen retrieval Pre-treatment / Epitope retrieval: Defined as an unmasking method for ”re-storing” blocked antigens in formaldehyde fixed tissue The key to an optimal IHC reaction…
  • 51. HIER Heat Induced Epitope Retrieval Citrate 6.0//Tris-EDTA 9.0//EDTA 8.0 / 9.0 95°C 20 min.
  • 52. IHC Procedure validation Antibody dilution 1:25 1:50 1:100 Antigen retrieval 1. HIER low pH 2. HIER high pH 3. Enzyme (protease) 1.HIER low pH 2.HIER high pH 3.Enzyme (protease) 1.HIER low pH 2.HIER high pH 3. Enzyme (protease) Incubation 1. 30 min. 37°C 2. 1 h RT 3. 16 h 4°C 1. 30 min. 37°C 2. 1 h RT 3. 16 h 4°C 1. 30 min. 37°C 2. 1 h RT 3. 16 h 4°C
  • 53.
  • 54.
  • 55. • Fixation & tissue preparation • Pre-treatment/epitope retrieval (Appropriate and efficient epitope retrieval) • Primary antibody selection (Appropriate choice & titre of antibody/clone) • Detection system specific & sensitive detection system • Appropriate choice of control material Important considerations for IHC
  • 56. Monoclonal v. polyclonal Antibodies monoclonals • Mouse monoclonals - one clone to one antigen determinant • High specificity - low to high sensitivity • Mouse or rabbit hybridoma Primary antibody selection
  • 57. Rabbit polyclonals - more clones to more antigen determinants • Low to high specificity - high sensitivity • Polyclonal antibodies • Many different species • Tends to have more non-specific reactivity • Can have very different • avidity/affinity batch-to-batch • Rabbit monoclonals - • High specificity – high sensitivity  Polyclonal antibodies reacting with various epitopes  Each antibody is made by a different B-cell Monoclonal v. polyclonal Primary antibody selection
  • 58. Antibody specifiacation sheet: • The antibody specification sheet provided with a commercial antibody contains valuable information regarding the antibody. • The expiration date under recommended storage conditions • Long-term//short-term storage temparatures (some antibodies require long-term storage at -20°C. Measures to ensure that the antibody storage condition is optimal will assist with antibody stability and maximum reactivity for the life of the antibody. • The protein concentration and suggested working dilution ranges • Pretreatment (antigen retrieval) solution; pH, and//or method if recommended • Expected positive and negative tissue types INCLUDING NORMAL AND TUMOR • Reference and publication list, and applications of antobody • ANTIBODY TYPE: IN VITRO (IVD), RESEARCH USE ONLY (RUO), FOR RUTINE DIAGNOSIS
  • 59. Prediluted and concentrated antibodies • Commercialy available – READY TO USE antibodies – validated • Concentrated antibodies – dilutions must be performed, to find opitimal dilution for antigen detection CONTROL REACTIONS – ANTIBODY VALIDATION
  • 60. CONTROL REACTIONS – ANTIBODY VALIDATION • EXAMPLE OF STANDARD LABORATORY PROTOCOL: • Antigen retrieval - combination of heating method/ • - combination of time • Peroxidase quenching – peroxidase block • – combination of time • Non-specific binding block – combination of time • Detection system - universal polymer//HRP//AP • Staining times: - primary antibody combination • 30 minute//1 hour//16 hours • - detection system//chromogen • 20 minutes //1-10 minutes
  • 65.
  • 66. Validated antibody • IF v. IHC with fluorescence • WB, ELISA, IP, etc. Whole molecule or specific portion of epitope? Primary antibody selection
  • 69. 1:800 1:400 1:50 1:100 1:200 IHC staining results of serially diluted Chromogranin A antibody on pancreas. Primary antibody selection rules
  • 70. At 1:50, the Islet cells stain strongly but there is also a strong background staining. 1:50 background staining Islet cells Primary antibody selection rules
  • 71. At 1:800, there is no background staining but the Islet cells stain very weak. 1:800 Primary antibody selection rules
  • 72. At 1:200, there is good contrast and no background staining, it is therefore the optimal working dilution. 1:200 Primary antibody selection rules
  • 74. Primary Antibody Incubation Time / Temparature • Incubation time is inversely proportional to antibody concentration. • Higher concentration of antibody allows shorter incubation time. • 30 minutes 37°C // 1 hour RT // 16 hours 4°C • Humidity chambers must be used when incubating at higher temperature to prevent drying of tissue sections. • 16 /4°C – allow sometines to better antibody penetration – used in VALIDATION
  • 75. IHC rules: Blocking Background staining • Specific • Polyclonal antibodies – impure antigen used • Inadequate fixation – diffusion of antigen – often worse in center of large block • Non-specific • Endogenous enzymes peroxidases//AP
  • 76. Structure of DAB NH3 + NH3 + +H3 N +H3 N 4Cl - DAB stained slides can be coverslipped with permanent organic based mounting media. In some IHC procedures, the dark brown reaction product can be modified and intensified by adding metals (copper or cobalt) to DAB solution. Commonly used enzyme labels for IHC procedures include horseradish peroxidase (HRP) HRP, from horseradish plant, is an enzyme that catalyze the reduction of hydrogen peroxide (H2O2) to water and oxygen. alkaline phophatase (AP) Commonly used chromogens for HRP include 3-amino-9-ethylcarbazole (AEC) 3,3’-diaminobenzidine (DAB)
  • 77. • Horse Radish Peroxidase (HRP) • + high sensitivity • + precise chromogenic reaction • + can be amplified by metal (Cu/Ni) • • Alkaline Phosphatase (AP) • + suitable for cryostate sections and cytology (hematology) • + double IHC staining • - granular chromogenic reaction • - relative low sensitivity Enzyme
  • 78. Control material can be categorized in different ways: „ „ Reagent controls – Positive reagent control is the actual reagent; e.g. the primary antibody when tested on control material. Testing is done during development and product validation to ensure reagent specificity and sensitivity. – Negative reagent control is a reagent substitute for the primary antibody used to assess potential specificity issues/false positive staining reaction „ „
  • 79. Tissue controls – Positive tissue control is tissue with the specific antigen at known, relevant and stable level. Purpose is to docu-ment correct staining. Control material can be categorized in different ways:
  • 80. Negative tissue control -is tissue without the specific antigen present – or not present in specific regions. - Purpose is to document specificity of the staining. Tissue blocks/tissue microarrays, - consisting of a few to several different tissues that may serve as control material for a range of antibodies Control material can be categorized in different ways:
  • 81. Internal tissue controls – The presence of the target antigen (protein) within normal elements of the tissue under investigation is an internal positive control „ „ Control material can be categorized in different ways:
  • 82. „ „ Cell line controls – Control material based on cultured cells with specific antigenic characteristics. This type of control typically is made for very specific purposes, in particular predictive assays (HER2) Control material can be categorized in different ways:
  • 83. Controls in Daily Routine Testing On-slide positive tissue controls, where specific controls are placed on the same slide as the test specimen are strongly preferred. A) Illustration of the principle of multi-core blocks. Tissue controls are the cores in red, yellow, gray and green. Patient sample is placed below B) Example of on-slide tissue controls. TMA C) Example of cell line controls.
  • 84. Controls in Daily Routine Testing Tissue Controls - both positive and negative tissue controls provide important information and must be included in daily routine regardless of type of detection system used. - the tissues used for controls are carefully selected from normal or cancer tissues previously analyzed in the laboratory. - However, in some cases the actual patient tissue being tested can be used as tissue control. HER2 - gastic - For all tissue controls, if the staining does not perform as expected, results from the respective test specimen should be considered invalid.
  • 85. Controls in Daily Routine Testing Positive tissue control - The positive tissue control must contain the target antigen at relevant, known and stable expression level. - It serves to document that proper staining has been performed and confirms that the target retrieval procedure has been carried out correctly. - Thus, a positive tissue control assesses correct staining protocol performance (temperature, time and correct application of reagents).
  • 86. Controls in Daily Routine Testing Positive tissue controls - are indicative of properly prepared tissue, they should be as accurate as possible in the same manner as the patient samples. - Optimally, autopsy/biopsy/surgical specimens should be fixed, processed and embedded as soon as possible for best preservation of antigens. - Generally, autopsy tissue is least preferred because of inevitable delays before fixation (degradation of some antigens)
  • 87. Control material On-slide positive tissue controls -In the daily routine, positive tissue controls may be run on a separate slide - as a batch control or daily control, or they may be included on the same slides as the test specimens. - on-slide positive controls, are specific controls are placed on the same slide as the test specimen strongly preferred
  • 88. Control material More and more laboratories are using TMA cores as on-slide controls. -building a a few basic multi-tissue control blocks - each containing a small number of control tissues to cover most of the markers used in clinical diagnostics.
  • 89. Control material The multi-tissue control blocks contains: appendix, tonsil, pancreas and liver, The reaction patterns are described for approximately 100 different antibodies.
  • 90.
  • 93.
  • 94. During immunohistochemistry: Be focus on technical calibration and controls for validation and verification.
  • 95.
  • 96. Etapy reakcji IHC Odczynniki Warunki: Czas /Temperatura Deparafinizacja Bufor cytrynianowy – pH low Bufor EDTA – high pH Uwodnienie Odkrywanie antygenów 20 min PT-link(95 - 99 °C) Płukanie Blokowanie endogennej peroxydazy Płukanie Woda redestyl//PBS H2O2 PBS 2x // 10min 15 min RT wytrząsarka 10 min. Blokowanie miejsc nieswoiście wiążących przeciwciała Roztwór BSA 5% 10 min, RT, komora wilgotna Inkubacja z pierwszorzędowym przeciwciałem Płukanie Rozcieńczenia: 1:250 PBS 16 godz., temp 4 °C, komora wilgotna 10 min. Inkubacja z drugorzedowym przeciwciałem płukanie EnVision Anti-Mouse/Rabbit FLEX HRP DAKO PBS 20 min, 37 °C, komora wilgotna 10 min. Inkubacja z substratem dla peroksydazy DAB Chromogen 2 min, RT, komora wilgotna
  • 97. Step by Step IHC Staining Method Remove paraffin wax and hydrate tissue section. SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Deparaffinization and Rehydration paraffin wax coated slide
  • 98. Remove paraffin wax and hydrate tissue section. SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Deparaffinization and Rehydration tissue section Step by Step IHC Staining Method
  • 99. 20:00 Wather bath for 20 minutes using Antigen Retrieval Solution pH 9.0. Rinse Antigen Retrieval Deparaffinization and Rehydration SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 100. SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA 3% hydrogen peroxide block solution for 5 minutes to inactivate endogenous peroxidase activity. Deparaffinization and Rehydration Block Endogenous Peroxidase Rinse Deparaffinization and Rehydration Antigen Retrieval Rinse Step by Step IHC Staining Method
  • 101. Thorough rinse in distilled water and wash 2 times in PBS buffer. Rinse Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 102. 5% bovine serum albumin (BSA) to block nonspecific staining. Protein Block Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 103. Optimally diluted primary antibody for 20 minutes. Primary Antibody Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 104. Wash 2 times in PBS buffer. Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Rinse Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 105. Secondary antibody for 20 minutes. Secondary Antibody Rinse Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 106. Wash 2 times in PBS buffer. Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody Rinse Rinse Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 107. DAB chromogen for 1 minute. DAB Chromogen Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody Rinse Rinse Rinse Rinse Rinse SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 108. SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA rinse in water. DAB Chromogen Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody Rinse Rinse Rinse Rinse Rinse Step by Step IHC Staining Method
  • 109. Counterstain in Mayer’s Hematoxylin for 1 minute. Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody DAB Chromogen Rinse Rinse Rinse Rinse Rinse Hematoxylin Counterstain SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Step by Step IHC Staining Method
  • 110. SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA Thorough wash in tap water to “blue” the nuclei. Hematoxylin Counterstain Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody DABChromogen Rinse Rinse Rinse Rinse Rinse Rinse Step by Step IHC Staining Method
  • 111. Step by Step IHC Staining Method Coverslip using mounting medium. Deparaffinization and Rehydration Block Endogenous Peroxidase Antigen Retrieval Protein Block Primary Antibody Secondary Antibody DAB Chromogen Rinse Rinse Rinse Rinse Rinse Hematoxylin Counterstain Rinse Mount SPECIMEN Lab Vision Corp. NM-123 Colon carcinoma MS-1375 CEA
  • 112.
  • 113.
  • 114.
  • 115.
  • 116.
  • 117.
  • 118.
  • 119.
  • 120. “Stronty formalinowe", albo "hematyna kwaśnej formaliny". Pigment ten tworzy się w środowisku kwaśnej formaliny. Hematyna powstaje z hemoglobiny, reagującej z formaliną w środowisku kwaśnym, stąd największe nagromadzenie tego barwnika obserwowane jest w preparatach zawierających dużo krwinek.
  • 121.
  • 122.
  • 128.
  • 130.
  • 131. Improving antibody penetration  Need this for intracellular (cytoplasmic, nuclear) or membrane components when epitope is inside cell membrane  Detergents most popular  Triton-X  Tween  Also decreases surface tension – better coverage  Can’t use for membrane proteins  Acetone/Methanol  Precipitate proteins outside cell membranes- more accessible  Saponin  Punches holes in cell membrane – holes close up when removed