2. basic immunologic procedures terry kotrla, ms, mt(ascp)bb fall 2005

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2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

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Page 1: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

2. Basic Immunologic Procedures

Terry Kotrla, MS, MT(ASCP)BB

Fall 2005

Page 2: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Introduction

Detection of antigen/antibody reactions difficult

Sensitization is the binding of a specific antibody to its’ specific antigen

Cannot be visualized Multitude of laboratory methods have been

developed to make this visible

Page 3: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Three Distinct Phases of Antigen/Antibody Reactions Primary Phenomenon – Sensitization Secondary Phenomenon – Lattice formation Tertiary Phenomenon – Detected by affect on

tissues or cells.

Page 4: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Primary phenomenon Sensitization – binding of antibody to antigen – not

visible

Page 5: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Secondary Phenomenon

Lattice Formation The Fab portion of the Ig molecule attaches to antigens on 2

adjacent cells-visible results in agglutination If both antigen and antibody are SOLUBLE reaction will become

visible over time, ie, precipitation http://www.cehs.siu.edu/fix/medmicro/agabx.htm

Page 6: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Tertiary Phenomenon

Reaction not visible, detected by affect of reaction on tissues or cells.

http://www.cellsalive.com/mac.htm

Page 7: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Phagocytosis

Page 8: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Secondary Phenomena Most Frequently Utilized Precipitation – soluble antibody reacts with

soluble antigen Agglutination – particulate antigens bound

together by antibody Complement Fixation – antibody binding to

antigen triggers activation of complement

Page 9: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Antigen-Antibody Binding

Affinity Avidity Law of Mass Action

Page 10: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Affinity

Antibody affinity is the strength of the reaction between a single antigenic determinant and a single combining site on the antibody.

It is the sum of the attractive and repulsive forces operating between the antigenic determinant and the combining site .

Affinity is the equilibrium constant that describes the Ag-Ab reaction as illustrated in Figure 3. Most antibodies have a high affinity for their antigens.

Page 11: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Affinity

Page 12: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Avidity

Avidity is a measure of the overall strength of binding of an antigen with many antigenic determinants and multivalent antibodies.

Affinity refers to the strength of binding between a single antigenic determinant and an individual antibody combining site whereas avidity refers to the overall strength of binding between multivalent antigens and antibodies.

Avidity is influenced by both the valence of the antibody and the valence of the antigen.

Avidity is more than the sum of the individual affinities.

Page 13: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Avidity

Page 14: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Law of Mass Action

Governs the reversibility of the antigen-antibody reaction.

Reversible reaction, visible reaction occurs when the rate of binding exceeds the rate of dissociation.

Page 15: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Precipitation Curve

Prozone – antibody excess, many antibodies coat all antigen sites- results in false negative

Postzone – antigen excess, antibody coats antigen but cannot get lattice formation, results in false negative

Zone of Equivalence – antigen and antibody present in optimal proportions to bind and give visible reaction

Page 16: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005
Page 17: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Precipitation Curve

Page 18: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Precipitation Curve

Page 19: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Measurement of Precipitation by Light

Antigen-antibody complexes, when formed at a high rate, will precipitate out of a solution resulting in a turbid or cloudy appearance.

Turbidimetry measures the turbidity or cloudiness of a solution by measuring amount of light directly passing through a solution.

Nephelometry indirect measurement, measures amount of light scattered by the antigen-antibody complexes.

Page 20: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Precipitation/Flocculation

When soluble antibody binds to soluble antigen (sensitization) there will come a point where lattice formation will occur resulting in precipitation occurring resulting in a visible reaction

These immune complexes have fallen out of solution. The Ab at the bottom in the illustration at right is still in the soluble phase.

Page 21: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Turbidimetry

Measures turbidity or cloudiness of a solution by measuring the amount of light PASSING THROUGH the solution.

Soluble antigen and antibody join and once they join in sufficient amounts precipitate, results in cloudiness.

The more cloudy the solution, the less light can pass through.

Page 22: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Nephelometry

Measures SCATTERED light bouncing off antigen-antibody complexes.

Page 23: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Nephelometry

Page 24: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Passive Immunodiffusion

Reactions in gels Migrate towards each other and where they

meet in optimal proportions form a precipitate. http://perso.wanadoo.fr/svt.ronsard/

svt.ronsard/travaux/exper/albumine/anim1.gif

Page 25: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Four Methodologies

Single diffusion, single dimension Single diffusion, double dimension Double diffusion, single dimension Double diffusion, double dimension

Page 26: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouidin Single Diffusion, Single Dimension

Page 27: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Oudin Precipitation

Solution of antibody is carefully layered on top of a solution of antigen, such that there is no mixing between the two. 

With time at the interface where the two layers meet, antigen-antibody complexes form a visible precipitate.  The other two tubes are negative controls, containing only antibody or only antigen plus an irrelevant protein in the second layer. 

Page 28: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radial Immunodiffusion

Page 29: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Standard Curve

Page 30: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

RADIAL IMMUNODIFFUSION

Standard Curve

Precipitin Rings A B C

a b c

Standards Samples

Page 31: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony Gel Diffusion

Holes punched in agar. Known antibody or antigen added to center

well. Known sample added to outer well. Unknown sample added to outer well next to

unknown sample. Wait for bands to form.

Page 32: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony Immunodiffusion

Page 33: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony - Identity

The precipitation appears as a continuous line in the form of an angle between those two wells and the C well. There are no spurs at the angle and this type of reaction is termed a band of identity.

Page 34: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony – Partial Identity FIGURE 2:

If a solution with antigens X and Y is placed in well 1, a solution with antigen X only is placed in well 2, and antiserum containing antibodies specific for both X and Y is placed in well 3, a reaction similar to that appearing in Fig. 2 will occur. Notice that there is a spur reaction towards the XY well. This indicates that the two antigenic materials in wells 1 and 2 are related, but that the material in well 1 possesses an antigenic specificity not possessed by the material in well 2. Such a reaction with spur formation indicates partial identity

Page 35: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony – Non-Identity

If the material in wells 1 and 2 do not possess common antigens and the antiserum in well 3 possesses specificities for both materials, the reaction will appear as two crossed lines as in Fig. 3

Page 36: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Ouchterlony-Interpret

Determine which interpretation fits for samples 1, 2 and 3.

Page 37: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Electrophoretic Techniques

Immunodiffusion can be combined with electrical current to speed things up.

Page 38: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Rocket Immunoelectrophoresis

Antigen is electrophoresed into gel containing antibody. The distance from the starting well to the front of the rocket shaped arc is related to antigen concentration.

Page 39: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Rocket Electrophoresis

Page 40: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunoelectrophoresis

Page 41: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunoelectrophoresis

Two-dimensional immunoelectrophoresis. Antigens are separated on the basis of electrophoretic mobility. The second separation is run at right angles to the first which drives the antigens into the antiserum-containing gel to form precipitin peaks; the area under the peak is related to the concentration of antigen.

Page 42: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunoelectrophoresis-Antivenom Each antibody molecule can bind two separate sites on an antigen

molecule (venom toxin), consequently antibodies have the ability to cross link many antigen molecules simultaneously.    This cross-linking causes the antibody antigen-complex to become insoluble and precipitate out from the solution.

The immunoelectrophoresis technique makes use of this capability of the antibodies to form giant insoluble complexes with their respective antigens.    The antigen-antibody precipitate which forms can be visualised by specific staining techniques, or quantified by various means.

Page 43: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunofixation Electrophoresis

Immunofixation Electrophoresis (IFE) combines zone electrophoresis with immunoprecipitation.

This technique may be used to identify and characterise serum proteins.

In IFE, proteins of sample are first separated by electrophoresis on a support (agarose) according to their charge and after that the medium is overlaid with monospesific antiserá reactive with specific protein - antigen.

If the antigen is present a characteristic immunoprecipitin band will be formed.

Page 44: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunofixation Electrophoresis

Page 45: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunofixation Electrophoresis

Page 46: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Enhancement of Agglutination

Additive to neutralize charge Viscosity Treatment with enzymes Agitation and centrifugation Temperature pH

Page 47: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Direct Agglutination

Antigen found naturally on particle. Blood Grouping is an example, antigen on

cell

Page 48: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

ABO Blood Grouping

Page 49: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Passive Agglutination

Employs particles that are coated with antigens, ie , RBCs, polystyrene latex, bentonite or charcoal.

Page 50: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Reverse Passive Agglutination

Antibody attached to carrier particle instead of antigen.

Serologic Typing of Shigella: Positive Test

Page 51: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Agglutination Inhibition

Based on competition between particulate and soluble antigens for limited antibody combining sites.

Patient sample added to reagent antibody specific for antigen being tested, if antigen is present it binds to reagent antibody.

Reagent particles (latex or RBCs) coated with the same antigen are added, if antigen was present in the sample all reagent antibody binds to it so no antibody is present to react with antigens coating the particles

Page 52: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Agglutination Inhibition

In row A wells 1-8 are positive.

Page 53: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Coagglutination

Name given to systems using bacteria as the inert particles to which antibody is attached.

Page 54: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Labeled Immunoassays

Some antigen/antibody reactions not detected by precipitation or agglutination.

Measured indirectly using a labeled reactant. Referred to as receptor-ligand assays. Ligand is the substance to be measured and is

defined as a molecule that binds to nother molecule of a complementary configuration,

usually it binds to the substance the test is trying to detect.

The receptor is what binds the specific target molecule.

Page 55: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Labeled Immunoassays

Ligand – substance to be measured. Receptor – binds the specific target molecule Sandwich technique Next slide - example

Page 56: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

“Sandwich” Technique ELISA

Page 57: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Labels

Used to detect reaction which has occurred. Radioactive, fluorescent, chemiluminescent

and enzymes. Competitive or non-competitive Heterogenous or homogeneous

Page 58: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Standards or Calibrators

Substance of exact known concentration. Usually run for each new lot number Based on results create standard curve. Standard curve used to “read” results or built

into machine to provide results.

Page 59: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Competitive Binding

Add known labeled antigen Add unknown antigen Will compete with each other for sites on

bound antibody molecule. Must wash off unreacted substances. Type of label on known antigen will determine

method of detection.

Page 60: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Competitive Binding

Page 61: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radioimmunoassay

http://www.castleviewuk.com/Frameless/Forensics/Presumptive_Tests/Drugs/ria/ria.htm

Page 62: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radioimmunassay (RIA)

Competitive binding Uses Iodine 125 (I 125) as label Radioactive label competes with patient for

sites High radioactivity, small amount of patient

substance Low radioactivity high amount of patient

substance Textbook page 159 figure 11-2

Page 63: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005
Page 64: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radioimmunassay

Page 65: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radioimmunoassay Competitive A plasma (or urine) sample that contains ADH is mixed with the

antibodies. A known amount of "standard" ADH that has been tagged with

radioactivity is added to the antibody mixture. The "standard" ADH is something that has already been measured and

that can be used to compare the unknown quantity of natural ADH. A radioactive tag is added to the standard ADH so that it can be

distinguished from the natural ADH that is in the plasma. As the antibodies, the standard radioactive ADH, and the plasma are

mixed, one main requirement must be met: there must be too little antibody to bind completely to both the radioactive hormone and the natural hormone in the fluid to be assayed.

Therefore, the natural hormone in the plasma and the radioactive standard hormone compete for the binding sites on the antibody (next slide)

Page 66: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Radioimmunoassay Competitive

Page 67: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunoradiometric Assay (IRMA)

Labeled antibody plus patient antigen Solid phase antigen added to bind excess

antibody Spin down to separate Labeled antibody/antigen remain in solution. Measure radioactivity Textbook page 160 fig 11-3

Page 68: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Enzyme Immunoassay

Advantages Reason for choosing enzyme as label Enzymes used Two classifications:

Heterogenous – separation of reactants must be done

Homogeneous – no separation step Two types:

Competitive – known and unknown compete Noncompetitive – only unknown reacts

Page 69: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Enzyme Immunoassay

http://www.castleviewuk.com/Frameless/Forensics/Presumptive_Tests/Drugs/elisa/elisa.htm

http://tinyurl.com/ckdaz

Page 70: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Heterogenous Enzyme Assays

Competitive ELISA Noncompetetive ELISA Immunoenzymometric Assay Sandwich or capture assays

Page 71: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Competitive ELISA

Unknown antigen competes with labeled known antigen

Enzyme produces color reaction

Page 72: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Noncompetitive ELISA

Referred to as “Indirect” ELISA Antigen bound to solid phase Add patient, antibody will bind if present Add known labeled antibody Measure enzyme label Textbook page 161 figure 11-4 Disadvantage more manipulation of test

Page 73: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Immunoenzymometric Assay

Noncompetitive ELISA Detects unknown antigen by means of excess

labeled antibody Textbook page 162 figure 11-5

Page 74: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Sandwich or Capture Assays

Used for antigens with multiple epitopes, ie, HCG

Antibody to one epitope fluid, antibody to second epitope fixed.

Enzyme label used to detect reaction Textbook page 163 figure 11-6

Page 75: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Homogeneous Enzyme Assay

Labeled reagent antigen and patient sample added.

Compete for bound antibody Antibody binds to patient antigen causing

inactivation of enzyme Competitive Assay Enzyme activity proportional to concentration

of patient antigen

Page 76: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Fluorescence Immunoassay

Page 77: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Markers

Fluorophores or fluorochromes Ability to absorb energy and emit light Two most commonly used:

Fluorescein – green Tetramethylrhodamine – red

Page 78: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Fluorescence

Page 79: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Fluorescence

Antibodies and bacteria are fixed on a glass-plate. The surplus i.e. non-bounded antibodies are washed out,

antibody-bacteria-complexes ("sandwiches") remain. The "sandwich" becomes visible by adding fluorescent anti

bovine immunoglobulin which can be seen as green light in the fluorescence microscope.

Page 80: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Fluorescent Immunoassay

Direct immunofluorescence Tagged antibody added to unknown antigen

fixed to slide Indirect immunofluorescence

Patient plus known fixed antigen Add tagged anti-antibody Fluorescence

Page 81: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005
Page 82: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Positive

Page 83: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Heterogeneous Fluorescent Immunoassays

Page 84: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Homogenous Assays

Page 85: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

Fluorescence Polarization Immunoassay

http://www.castleviewuk.com/Frameless/Forensics/Presumptive_Tests/Drugs/fpia/fpia.htm

Page 86: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

References

http://web.indstate.edu/thcme/PSP/labtests/precip.htm http://www.gla.ac.uk/departments/immunology/education/nursing/lectures/antibo

dy.htm http://www.cellsalive.com/mac.htm http://jeeves.mmg.uci.edu/immunology/Assays/Assays.htm http://www.medschool.lsuhsc.edu/microbiology/DMIP/dmex03.htm http://www.tulipgroup.com/Common/html/TurbidTech.pdf http://departments.oxy.edu/biology/Franck/Bio222/Lectures/Feb1lecture.htm http://www.mercodia.se/global/mainpage.asp?page_id=41 ELISA http://www.clinprointl.com/technical.htm ELISA

http://www.nsbri.org/HumanPhysSpace/focus4/sf-hormonal.html http://ccm.ucdavis.edu/cpl/Tech%20updates/TechUpdates.htm

molecular diagnostics

Page 87: 2. Basic Immunologic Procedures Terry Kotrla, MS, MT(ASCP)BB Fall 2005

References (Continued)

http://www.liv.ac.uk/~agmclen/Medpracs/practical_5/theory_5.html http://www.fao.org/docrep/W0049E/w0049e06.htm