Dr. M. Alzaharna 2015 LABELED IMMUNOASSAY Lab. 2.

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Dr. M. Alzaharna 2015 LABELED IMMUNOASSAY Lab. 2

Transcript of Dr. M. Alzaharna 2015 LABELED IMMUNOASSAY Lab. 2.

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Dr. M. Alzaharna 2015

LABELED IMMUNOASSAY

Lab. 2

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Immunoassay• An immunoassay is a test that uses antibody and antigen complexes as a mean of generating a measurable result

• Immuno refers to an immune response that causes the body to generate antibodies,

• and assay refers to a test

• An antibody-antigen complex is also known as an immuno-complex

• The assay takes advantage of the specific binding of an antibody to its antigen

• The antibodies used must have a high affinity for the antigen

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Immunoassays

• Immunoassays derive their unique specificity, sensitivity, and flexibility from three important properties of antibodies:• Their ability to bind to an extremely wide range of

natural and man-made chemicals, biomolecules, cells, and viruses

• Exceptional specificity for the substance to which each antibody binds.

• The strength of the binding between an antibody and its target

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Immunoassay

• Both the presence of antigen or antibody can be measured• For measuring hormones such as insulin, the insulin

acts as the antigen• When detecting infection the presence of antibody

against the pathogen is measured

• For numerical results the response of the object being measured must be compared to standards of a known concentration

• This is usually done through the plotting of a standard curve on a graph paper, and then the quantity of the unknown is found from the curve

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Types of Tests

• Many methods of varying sophistication are used for immunodiagnostic studies

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Visible Change Observable Reaction Name of Test

Clumping Particulate antigen reacts with corresponding antibody; antigen may be in form of RBCs (hemagglutination, latex, or charcoal coated with antigen).

Agglutination

Precipitates Soluble antigen reacts with corresponding antibody Precipitation

Complement activation, hemolysis

Competition between two antigen-antibody systems (test and indicator systems)

Complement fixation (CF)

Visible microscopic fluorescence

Fluorescent-tagged antibody reacts with antigen-antibody complex in the presence of ultraviolet light.

Immunofluorescence

Color change indicates enzyme substrate reaction.

Indirect EIA for quantification of an antigen or antibody enzyme and substrate

Enzyme-linked immunosorbent assay

(ELISA)

Detection of antibodies of specific mobility

Electrophoresis separation of antigen subspecies Immunoblot (eg, Western blot [WB])

Light scatter proportionately increases as numbered size of immune complexes increases.

Measures either antigen or antibody in solution through the scattering of a light beam; antibody reagent used to detect antigen IgA, IgG, IgM; concurrent controls are run to establish amount of background scatter in reagents and test samples.

Rate nephelometry

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Types of Tests

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Rate nephelometry

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Antigen-antibody interaction• Antigens are substances that stimulate and subsequently

react with the products of an immune response. They may be:• Enzymes, • Toxins, • Microorganisms (eg, bacterial, viral, parasitic, fungal), • Tumors, • Autoimmune factors

• Antibodies are proteins produced by the body's immune system in response to an antigen or antigens.

• The antigen-antibody response is the body's natural defense against invading organisms

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SSSS

Light Chain

Light ChainSS

SS

Antibody Structure

Constant Constant

Constant Constant

VV

V

V

Antigen binding site

Antigen binding site

Heavy Chains

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Antigen Binding

Variable

Light

Variable

Heavy

Antigen 1Antigen 3

Antigen 2

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History

• In the year 1959, Drs. Rosalyn Yalow & Soloman Berson invented the radioimmunoassay (RIA)

• Applied the use of radioisotopes in the measurement of insulin

• The RIA is the predecessor of modern immunoassays Dr. Rosalyn Yalow became the first

female to win a Nobel Prize withher work on the radioimmunoassay

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Current Situation• There are now hundreds of immunoassays for dozens of

analytes including:

• covering the fields of:

• Developments in antibodies, labels, and automation have resulted in highly specific and sensitive assays

• Hormones • Tumor markers • Antibodies

• Drugs • Cardiac markers

• Endocrinology • Oncology • Hematology

• Toxicology • Immunology • Infectious diseases

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Constituents of a Labeled Immunoassay

• For detection of an analyte, the following are usually a part of the assay:

1. Labeled analytes

2. Specific antibody

3. Standards or calibrators

4. A method to separate the bound from free components

5. A method for detection of the label

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1- Labeled Analytes• A labeled analyte is used to detect whether or not specific

binding has taken place• The label used in immunoassay:

• must not alter the reactivity of the molecule• and it should remain stable for the shelf life of the reagent

• Labels attached to analytes and antibodies can be:• Radioactive

• usually iodine-125 (radioimmunoassay),

• Enzymes • such as alkaline phosphatase and horseradish peroxidase, (enzyme

immunoassay or enzyme-linked immunosorbent assay [ELISA]),

• Chemiluminescent • e.g. acridinium ester

• Fluorescent • e.g. fluorscein

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Methods of coupling indicator labels to antigen or antibody

• The Methods include:

A. Binding to amino acids• The radioactive isotope iodine is

covalently linked to tyrosine residues present on antibodies and most antigens

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Methods of coupling indicator labels to antigen or antibody

B. Using glutaraldhyde • It is a bifunctional reagent

that covalently cross links two aminoacids together, reacts with amine groups

• Fluorochromes or enzymes may be coupled to antigens or antibodies using glutaraldhyde

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Methods of coupling indicator labels to antigen or antibody

C. Biotin-Streptavidin system• Biotin is a vitamin that can bind tightly to either avidin or

streptavidin (proteins) • The natural attraction of biotin to these two proteins is a

property that has been exploited to facilitate coupling of indicator molecules to antigens or antibodies

• At the end of the assay, a conjugate of streptavidin linked to a signal-generating substance is added• Examples of suitable conjugates are streptavidin-alkaline phosphatase,

streptavidin-HRP, streptavidin-125I, streptavidin fluorescein

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The biotin-Streptavidin indicator label system

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2- Production of Antibodies

• The production of antibodies is an important process in the use of immunoassays because it is the antibody-antigen complexes that form the basic

• Antibodies can be called depending upon the technique used to produce them either:a) Monoclonal or

b) Polyclonal

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a) Polyclonal Antibodies

• May be produced in mammals such as rabbits or sheep

• When a foreign substance enters the body, it stimulates the immune system to produce antibodies to the substance

• Using this natural reaction, an analyte in as pure form as possible is injected into the animal stimulating the production of antibodies

• Antiserum usually contains a mixture of antibodies that recognize and bind to the same antigen, but they may attach to different epitopes

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a) Polyclonal Antibodies

Ag Ag

Multivalent Antigen complex

Polyclonal Antibodies Antibody-Antigen complex

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b) Monoclonal Antibodies

• Monoclonal antibodies production result in very specific antibodies that bind only to one antigen epitope, which in turn reduces the occurrence of false positives in the immunoassay

Multivalent Antigen complex

Monoclonal Antibodies Antibody-Antigen complex

Ag Ag

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b) Monoclonal Antibodies

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3- Standards or calibrators

• By running a set of calibrators, a calibration curve is set up in the instrument’s software and correlates certain values of signal to known analyte concentrations

• By comparing levels of signal produced by patient samples to this calibration curve, a patient analyte concentration value, or result, can be determined

• Calibrators are solutions with known values that establish the relationship between the amount of signal produced in the assay and analyte concentration

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4- Separation Methods• In most assays, once the reaction between antigen and

antibody has taken place, there must be a way of separating reacted from unreacted analyte

• This can be accomplished by several different means• Unreacted analyte can be removed by:

• Adsorption on particles such as dextran-coated charcoal• These adsorb out the smaller unbound molecules, which are then

separated from bound molecules by centrifugation or filtration

• The amount of label remaining in the supernatant provides an indirect measure of analyte present in the patient's sample

• Another means of separation involves precipitation of antigen-antibody complexes• Complexes can be precipitated by adding concentrated solutions of

ammonium sulfate, or ethanol

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4- Separation Methods

• Currently, most immunoassays use a solid-phase stage for separation

• Numerous substances, such as polystyrene test tubes, microtiter plates are used for this purpose

• Antigen or antibody is attached by physical adsorption, and when specific binding takes place, complexes remain attached to the solid phase

• This provides a simple way to separate bound and free reactants

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5- Methods for detection of label

• The last step common for all immunoassays is detection of the labeled analyte

• The method depends on the label; • e.g. 125I is easily detected by a γ-counter • Enzymes are generally used to produce coloured

products from colourless substrates that can be determined easily using a spectrophotometer• Automated plate readers are commercially available which make

reading large numbers of samples relatively easy

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Quality Control in Immunoassays

• It is essential that quality control procedures be established

• This is done to limit random errors, such as• temperature fluctuations• minor changes in the concentration of reagents• and changes in detector efficiency

• A negative control and a positive control should be run

• This serves as a check on the quality of the reagents to make sure that the label is readily detectable under current testing conditions

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Methodological Principles

1. Competitive Immunoassays2. Noncompetitive Immunoassays3. Heterogeneous Immunoassays4. Homogeneous Immunoassays

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Specific Ab

Ag L antigen- enzyme conjugate

immobilisation surface

L

L

S

P

Enzym. reaction

Productmeasurement

L

Incubation

LL

Coating

1- Competitive Immunoassays

• Based on competition between the analyte in the sample and a labeled analyte for a limited mount of antibody

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1- Competitive Immunoassays

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2- Noncompetitive Immunoassays• Noncompetitive immunoassays (Sandwich) generally

provide the highest level of assay sensitivity and specificity• The reaction mixture typically includes an excess of labeled antibody,

so that all analyte is bound• The amount of antibody-antigen complex is then measured to

determine the amount of analyte present in the sample• The labeled antibody, is directly proportional to the amount of antigen

present in the sample

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Homogeneous versus Heterogeneous Immunoassays

3- Heterogeneous Immunoassay • Methods that require separation of bound Ab-Ag* complex

4- Homogeneous Immunoassay • Those that do not require separation • Homogeneous methods have been generally applied to the

measurement of small analytes such as abused and therapeutic drugs

• Since homogeneous methods do not require the separation of the bound Ab-Ag* from the free Ag*, they are generally much easier and faster to perform

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Homogeneous Immunoassays

Substrate Substrate reacting with enzyme

Drug blocking Drug attached to enzymeAntibody

Drug

Enzyme with Drug attached

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• Radioimmunoassays (RIAs) • utilize a radioactive label

(usually 125I, 3H or 14C), which emits radiation that can be measured with a beta or gamma counter

• Within the categories of competitive, noncompetitive, homogenous, and heterogeneous, there are specific types, which include:

Types of Immunoassays (Heterogeneous)

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Types of Immunoassays (Heterogeneous)

• Enzyme linked immunosorbant assay (ELISA): • Direct, sandwich and

competitive• Reaction components are

absorbed or bound to the surface of a solid phase, commonly a well of a microtiter plate

• Absorbance is measured using a micro-plate reader

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Types of Immunoassays (Homogeneous)

• Enzyme Multiplied Immunoassay (EMIT)• The drug in the sample and the

drug labeled with G6PD compete for antibody binding sites

• Binding inhibits enzyme activity, while free enzyme remains active to interact with the substrate

• Enzyme activity/absorbance is directly proportional to drug concentration.

Substrate Substrate reacting with enzyme

Drug blocking Drug attached to enzymeAntibody

Drug

Enzyme with Drug

attached

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Immunoassay Results• Qualitative

• Single point calibration at a specific cutoff

• Results are either ‘positive’ or ‘negative’ (i.e. above or below the cutoff)

• Quantitative• Provides numeric results that are an estimate the analyte

concentration based on the measurement standards

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Rubella IgM Test Kit

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Intended Use

• Rubella IgM ELISA test is an enzyme linked immunosorbent assay (ELISA) for the detection of IgM class antibodies to Measles (Rubella) in human serum or plasma

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Summary and explanation• Measles is an acute, highly contagious viral disease.• Although measles is usually considered a childhood disease, it

can be contracted at any age. • Measles is spread by direct contact with nasal or throat

secretions of infected people or, less frequently, by airborne transmission.

• Measles symptoms generally appear in two stages. • In the first stage, the individual may have a runny nose, cough and a

slight fever. • The second stage begins on the third to seventh day and consists of

high fever and red blotchy rash lasting four to seven days. • The rash usually begins on the face and then spreads over the entire

body. • Symptoms usually appear in 10-12 days, although they may occur

between 8-13 days after exposure.

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Summary and explanation

• The presence of IgG antibody to Rubella virus is indicative of previous exposure or vaccination.

• In individuals with acute measles, a significant increase in measles IgG antibody level is indicative of recent infection.

• IgM antibodies to Rubella virus are often detectable with onset of the rash and typically persist for 4 weeks.

• At least 80% of patients will be positive for Rubella IgM at 6 days and 100% at 16 days after onset of symptoms.

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Principle• Diluted patient serum is added to wells coated with

purified Rubella antigen. • Rubella IgM specific antibody, if present, binds to the

antigen. • All unbound materials are washed away and the

enzyme conjugate is added to bind to the antibody-antigen complex, if present.

• Excess enzyme conjugate is washed off and substrate is added.

• The plate is incubated to allow the hydrolysis of the substrate by the enzyme.

• The intensity of the color generated is proportional to the amount of IgM specific antibody in the sample.

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Procedure

1. Bring all specimens and kit reagents to room temperature (18-26 °C) and gently mix.

2. Place the desired number of coated strips into the holder.

3. Negative control, positive control, and calibrator are ready to use. Prepare 1:21 dilution of test samples, by adding 10 μl of the sample to 200 μl of sample diluent. Mix well.

4. Dispense 100 μl of diluted sera, calibrator and controls into the appropriate wells. For the reagent blank, dispense 100μl sample diluent in 1A well position. Tap the holder to remove air bubbles from the liquid and mix well. Incubate for 20 minutes at room temperature.

5. Remove liquid from all wells. Wash wells three times with 300 μl of 1X wash buffer. Blot on absorbance paper or paper towel.

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Procedure

6. Dispense 100 μl of enzyme conjugate to each well and incubate for 20 minutes at room temperature.

7. Remove enzyme conjugate from all wells. Wash wells three times with 300 μl of 1X wash buffer. Blot on absorbance paper or paper towel.

8. Dispense 100 μl of TMB substrate and incubate for 10 minutes at room temperature. Add 100 μl of stop solution.

9. Read O.D. at 450 nm using ELISA reader within 15 min.

10. A dual wavelength is recommended with reference filter of 600-650 nm.

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Calculation of results

1. Check Calibrator Factor (CF) value on the calibrator bottle. This value might vary from lot to lot. Make sure you check the value on every kit.

2. Calculate the cut-off value: • Calibrator OD x Calibrator Factor (CF).

3. Calculate the Ab (Antibody) Index of each determination by dividing the O.D. value of each sample by cut-off value.

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Example of typical results

• Calibrator mean OD = 0.8 • Calibrator Factor (CF) = 0.5 • Cut-off Value = 0.8 x 0.5= 0.400 • Positive control O.D. = 1.2

• Ab Index = 1.2 / 0.4 = 3

• Patient sample O.D. = 1.6 • Ab Index = 1.6 / 0.4 = 4.0

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Validation requirement and quality control

1. The O.D. of the Calibrator should be greater than 0.250.

2. The Ab index for Negative control should be less than 0.9.

3. The Ab Index for Positive control should be greater than 1.2.

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Interpretation of results

• The following is intended as a guide to interpretation of Measles IgM test results; each laboratory is encouraged to establish its own criteria for test interpretation based on sample populations encountered.

• Antibody Index Interpretation • < 0.9 No detectable Ab to Rubella IgM by ELISA.• 0.9 – 1.1Borderline positive, follow up testing is

recommended if clinically indicated.• > 1.1 Detectable antibody to measles IgM by ELISA.