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Immunochemical Methods in the Clinical Laboratory Roger L. Bertholf, Ph.D., DABCC Chief of Clinical Chemistry & Toxicology, UFHSC/Jacksonville Associate Professor of Pathology, University of Florida College of Medicine

Immunochemical Methods and Funtions

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Page 1: Immunochemical Methods and Funtions

Immunochemical Methods in the Clinical Laboratory

Roger L. Bertholf, Ph.D., DABCCChief of Clinical Chemistry & Toxicology, UFHSC/Jacksonville

Associate Professor of Pathology, University of Florida College of Medicine

Page 2: Immunochemical Methods and Funtions

ASCP/Bertholf

Name The Antigen

Page 3: Immunochemical Methods and Funtions

Early theories of antibody formation

• Paul Ehrlich (1854-1915) proposed that antigen combined with pre-existing side-chains on cell surfaces.

• Ehrlich’s theory was the basis for the “genetic theory” of antibody specificity.

• Paul Ehrlich (1854-1915) proposed that antigen combined with pre-existing side-chains on cell surfaces.

• Ehrlich’s theory was the basis for the “genetic theory” of antibody specificity.

Page 4: Immunochemical Methods and Funtions

The “Template” theory of antibody formation

• Karl Landsteiner (1868-1943) was most famous for his discovery of the A/B/O blood groups and the Rh factor.

• Established that antigenic specificity was based on recognition of specific molecular structures; he called these “haptens”; formed the basis for the “template” theory of antibody formation.

• Karl Landsteiner (1868-1943) was most famous for his discovery of the A/B/O blood groups and the Rh factor.

• Established that antigenic specificity was based on recognition of specific molecular structures; he called these “haptens”; formed the basis for the “template” theory of antibody formation.

Page 5: Immunochemical Methods and Funtions

Aminobenzene Sulphonate, a Hapten

NH2 NH2 NH2

SO3

SO3

SO3

Ortho Meta Para

Page 6: Immunochemical Methods and Funtions

Classification of immunochemical methods

• Particle methods

– Precipitation

• Immunodiffusion

• Immunoelectrophoresis

– Light scattering• Nephelometry

• Turbidimetry

• Particle methods

– Precipitation

• Immunodiffusion

• Immunoelectrophoresis

– Light scattering• Nephelometry

• Turbidimetry

• Label methods

– Non-competitive

• One-site

• Two-site

– Competitive

• Heterogeneous

• Homogeneous

• Label methods

– Non-competitive

• One-site

• Two-site

– Competitive

• Heterogeneous

• Homogeneous

Page 7: Immunochemical Methods and Funtions

Properties of the antibody-antigen bond

• Non-covalent

• Reversible

• Intermolecular forces

– Coulombic interactions (hydrogen bonds)

– Hydrophobic interactions

– van der Waals (London) forces

• Clonal variation

• Non-covalent

• Reversible

• Intermolecular forces

– Coulombic interactions (hydrogen bonds)

– Hydrophobic interactions

– van der Waals (London) forces

• Clonal variation

Page 8: Immunochemical Methods and Funtions

Antibody affinity

AgAbAgAb

]][[

][

AgAb

AgAbKa

Page 9: Immunochemical Methods and Funtions

Precipitation of antibody/antigen complexes

• Detection of the antibody/antigen complex depends on precipitation

• No label is involved

• Many precipitation methods are qualitative, but there are quantitative applications, too

• Detection of the antibody/antigen complex depends on precipitation

• No label is involved

• Many precipitation methods are qualitative, but there are quantitative applications, too

Page 10: Immunochemical Methods and Funtions

Factors affecting solubility

• Size

• Charge

• Temperature

• Solvent ionic strength

• Size

• Charge

• Temperature

• Solvent ionic strength

Page 11: Immunochemical Methods and Funtions

Zone of equivalence

The precipitin reaction

Pre

cipi

tate

Antibody/Antigen

etc.

Page 12: Immunochemical Methods and Funtions

Single radial immunodiffusion

Ag

Page 13: Immunochemical Methods and Funtions

Single radial immunodiffusion

][Agr r

Page 14: Immunochemical Methods and Funtions

Double immunodiffusion

Örjan Ouchterlony

Developed double immunodiffusion technique in 1948

Page 15: Immunochemical Methods and Funtions

Double immunodiffusion (Ouchterlony)

Page 16: Immunochemical Methods and Funtions

Quantitative double immunodiffusion

S1

S2

S3 S4

S5

P

Page 17: Immunochemical Methods and Funtions

Electroimmunodiffusion

• Why would we want to combine immunodiffusion with electrophoresis?

– SPEED

– Specificity

• Carl-Bertil Laurell (Lund University, Sweden)

– Laurell Technique (coagulation factors)

– “Rocket electrophoresis”

• Why would we want to combine immunodiffusion with electrophoresis?

– SPEED

– Specificity

• Carl-Bertil Laurell (Lund University, Sweden)

– Laurell Technique (coagulation factors)

– “Rocket electrophoresis”

Page 18: Immunochemical Methods and Funtions

Electroimmunodiffusion

+

-

Page 19: Immunochemical Methods and Funtions

Immunoelectrophoresis

• Combines serum protein electrophoresis with immunometric detection

– Electrophoresis provides separation

– Immunoprecipitation provides detection

• Two related applications:

– Immunoelectrophoresis

– Immunofixation electrophoresis

• Combines serum protein electrophoresis with immunometric detection

– Electrophoresis provides separation

– Immunoprecipitation provides detection

• Two related applications:

– Immunoelectrophoresis

– Immunofixation electrophoresis

Page 20: Immunochemical Methods and Funtions

Immunoelectrophoresis

Specimen

-human serum

+

-

Page 21: Immunochemical Methods and Funtions

Immunoelectrophoresis

P C P C P C

+

-

Page 22: Immunochemical Methods and Funtions

Immunofixation electrophoresis

SPE IgG IgA IgM

Page 23: Immunochemical Methods and Funtions

Particle methods involving soluble complexes

• The key physical property is still size

• Measurement is based on how the large antibody/antigen complexes interact with light

• The fundamental principle upon which the measurement is made is light scattering

• Two analytical methods are based on light scattering: Nephelometry and Turbidimetry

• The key physical property is still size

• Measurement is based on how the large antibody/antigen complexes interact with light

• The fundamental principle upon which the measurement is made is light scattering

• Two analytical methods are based on light scattering: Nephelometry and Turbidimetry

Page 24: Immunochemical Methods and Funtions

Light reflection

Page 25: Immunochemical Methods and Funtions

- -+

Molecular size and scattering

Page 26: Immunochemical Methods and Funtions

Distribution of scattered radiation

Page 27: Immunochemical Methods and Funtions

Nephelometry vs. Turbidimetry

0°-90°

Page 28: Immunochemical Methods and Funtions

Inte

nsit

y of

sca

tter

ing

Time

Rate nephelometry

Rate

C2

C1

Page 29: Immunochemical Methods and Funtions

Additional considerations for quantitative competitive binding immunoassays

• Response curve

• Hook effect

• Response curve

• Hook effect

Page 30: Immunochemical Methods and Funtions

Competitive immunoassay response curve%

Bou

nd la

bel

Antigen concentration

%Bound vs. log concentration

Page 31: Immunochemical Methods and Funtions

Logistic equation

%B

ound

labe

l

Log antigen concentration

a

d

c

Slope = b

d

cx

a

day b

Page 32: Immunochemical Methods and Funtions

Logit transformation

%B

ound

labe

l

Log antigen concentration

a

d

y

yyY

1lnlogit

da

dyy

where

Page 33: Immunochemical Methods and Funtions

Logit plotL

ogit

y

Log antigen concentration

Page 34: Immunochemical Methods and Funtions

High dose “hook” effect%

Bou

nd a

ntig

en

Antigen concentration

Page 35: Immunochemical Methods and Funtions

Analytical methods using labeled antigens/antibodies

• What is the function of the label?

– To provide a means by which the free antigens, or antigen/antibody complexes can be detected

– The label does not necessarily distinguish between free and bound antigens

• What is the function of the label?

– To provide a means by which the free antigens, or antigen/antibody complexes can be detected

– The label does not necessarily distinguish between free and bound antigens

Page 36: Immunochemical Methods and Funtions

Analytical methods using labeled antigens/antibodies

• What are desirable properties of labels?

– Easily attached to antigen/antibody

– Easily measured, with high S/N

– Does not interfere with antibody/antigen reaction

– Inexpensive/economical/non-toxic

• What are desirable properties of labels?

– Easily attached to antigen/antibody

– Easily measured, with high S/N

– Does not interfere with antibody/antigen reaction

– Inexpensive/economical/non-toxic

Page 37: Immunochemical Methods and Funtions

The birth of immunoassay

• Rosalyn Yalow (1921-) and Solomon Berson described the first radioimmunoassay in 1957.

• Rosalyn Yalow (1921-) and Solomon Berson described the first radioimmunoassay in 1957.

Page 38: Immunochemical Methods and Funtions

Radioisotope labels

• Advantages

– Flexibility

– Sensitivity

– Size

• Advantages

– Flexibility

– Sensitivity

– Size

• Disadvantages

– Toxicity

– Shelf life

– Disposal costs

• Disadvantages

– Toxicity

– Shelf life

– Disposal costs

Page 39: Immunochemical Methods and Funtions

Enzyme labels

• Advantages

– Diversity

– Amplification

– Versatility

• Advantages

– Diversity

– Amplification

– Versatility

• Disadvantages

– Lability

– Size

– Heterogeneity

• Disadvantages

– Lability

– Size

– Heterogeneity

Page 40: Immunochemical Methods and Funtions

Fluorescent labels

• Advantages

– Size

– Specificity

– Sensitivity

• Advantages

– Size

– Specificity

– Sensitivity

• Disadvantages

– Hardware

– Limited selection

– Background

• Disadvantages

– Hardware

– Limited selection

– Background

Page 41: Immunochemical Methods and Funtions

Chemiluminescent labels

• Advantages

– Size

– Sensitivity

– S/N

• Advantages

– Size

– Sensitivity

– S/N

• Disadvantages

– Hardware

– ?

• Disadvantages

– Hardware

– ?

Page 42: Immunochemical Methods and Funtions

Chemiluminescent labels

+ 2H2O2 + OH -

COO -

COO -

O -

O -

+ h ( max = 4 3 0 nm )

+ N2 + 3H2O

NH2

L um i n o l

P e r o x i d a s e

O

O

N

NH

NH2

H

O

O*NH2

Page 43: Immunochemical Methods and Funtions

Chemiluminescent labels

CH3

N+

CO2H

O O

B r -

Ac r i d i n i um e s t e r

O -

CO2H

+ H2O2 + OH -+ + CO2 + h

O

CH3

N

Page 44: Immunochemical Methods and Funtions

Introduction to Heterogeneous Immunoassay

• What is the distinguishing feature of heterogeneous immunoassays?– They require separation of bound and free ligands

• Do heterogeneous methods have any advantage(s) over homogeneous methods?– Yes

• What are they?– Sensitivity– Specificity

• What is the distinguishing feature of heterogeneous immunoassays?– They require separation of bound and free ligands

• Do heterogeneous methods have any advantage(s) over homogeneous methods?– Yes

• What are they?– Sensitivity– Specificity

Page 45: Immunochemical Methods and Funtions

Heterogeneous immunoassays

• Competitive

– Antigen excess

– Usually involves labeled competing antigen

– RIA is the prototype

• Competitive

– Antigen excess

– Usually involves labeled competing antigen

– RIA is the prototype

• Non-competitive

– Antibody excess

– Usually involves secondary labeled antibody

– ELISA is the prototype

• Non-competitive

– Antibody excess

– Usually involves secondary labeled antibody

– ELISA is the prototype

Page 46: Immunochemical Methods and Funtions

Enzyme-linked immunosorbent assay

Microtiter well

E E E E E

Specimen 2nd antibodyE

Substrate

S P

Page 47: Immunochemical Methods and Funtions

ELISA (variation 1)

Microtiter well

Specimen Labeled antigenE

EEE

S P

Page 48: Immunochemical Methods and Funtions

ELISA (variation 2)

Microtiter well

Specimen Labeled antibodyE

E E E E

EEE

Page 49: Immunochemical Methods and Funtions

Automated heterogeneous immunoassays

• The ELISA can be automated

• The separation step is key in the design of automated heterogeneous immunoassays

• Approaches to automated separation

– immobilized antibodies

– capture/filtration

– magnetic separation

• The ELISA can be automated

• The separation step is key in the design of automated heterogeneous immunoassays

• Approaches to automated separation

– immobilized antibodies

– capture/filtration

– magnetic separation

Page 50: Immunochemical Methods and Funtions

Immobilized antibody methods

• Coated tube

• Coated bead

• Solid phase antibody methods

• Coated tube

• Coated bead

• Solid phase antibody methods

Page 51: Immunochemical Methods and Funtions

Coated tube methods

Specimen Labeled antigen

Wash

Page 52: Immunochemical Methods and Funtions

Coated bead methods

Page 53: Immunochemical Methods and Funtions

Microparticle enzyme immunoassay (MEIA)

Labeled antibodyE

E E

S P

Glass fiber matrix

Page 54: Immunochemical Methods and Funtions

Magnetic separation methods

Fe

Fe

FeFe

Fe

Fe

FeFe

Fe

Page 55: Immunochemical Methods and Funtions

Magnetic separation methods

Fe Fe FeFe Fe

Aspirate/Wash

Page 56: Immunochemical Methods and Funtions

Electrochemiluminescence immunoassay (Elecsys™ system)

Flow cell

Fe

Oxidized

Reduced

Page 57: Immunochemical Methods and Funtions

ASCEND (Biosite Triage™)

Page 58: Immunochemical Methods and Funtions

ASCEND

Wash

Page 59: Immunochemical Methods and Funtions

ASCEND

Developer

Page 60: Immunochemical Methods and Funtions

Solid phase light scattering immunoassay

Page 61: Immunochemical Methods and Funtions

Introduction to Homogeneous Immunoassay

• What is the distinguishing feature of homogeneous immunoassays?

– They do not require separation of bound and free ligands

• Do homogeneous methods have any advantage(s) over heterogeneous methods?

– Yes

• What are they?

– Speed

– Adaptability

• What is the distinguishing feature of homogeneous immunoassays?

– They do not require separation of bound and free ligands

• Do homogeneous methods have any advantage(s) over heterogeneous methods?

– Yes

• What are they?

– Speed

– Adaptability

Page 62: Immunochemical Methods and Funtions

Homogeneous immunoassays

• Virtually all homogeneous immunoassays are one-site

• Virtually all homogeneous immunoassays are competitive

• Virtually all homogeneous immunoassays are designed for small antigens

– Therapeutic/abused drugs

– Steroid/peptide hormones

• Virtually all homogeneous immunoassays are one-site

• Virtually all homogeneous immunoassays are competitive

• Virtually all homogeneous immunoassays are designed for small antigens

– Therapeutic/abused drugs

– Steroid/peptide hormones

Page 63: Immunochemical Methods and Funtions

Typical design of a homogeneous immunoassay

No signal

Signal

Page 64: Immunochemical Methods and Funtions

Enzyme-multiplied immunoassay technique (EMIT™)

• Developed by Syva Corporation (Palo Alto, CA) in 1970s--now owned by Behring Diagnostics

• Offered an alternative to RIA or HPLC for measuring therapeutic drugs

• Sparked the widespread use of TDM

• Adaptable to virtually any chemistry analyzer

• Has both quantitative (TDM) and qualitative (DAU) applications; forensic drug testing is the most common use of the EMIT methods

• Developed by Syva Corporation (Palo Alto, CA) in 1970s--now owned by Behring Diagnostics

• Offered an alternative to RIA or HPLC for measuring therapeutic drugs

• Sparked the widespread use of TDM

• Adaptable to virtually any chemistry analyzer

• Has both quantitative (TDM) and qualitative (DAU) applications; forensic drug testing is the most common use of the EMIT methods

Page 65: Immunochemical Methods and Funtions

EMIT™ method

Enzyme

S

S P

No signal

SignalEnzyme

S

Page 66: Immunochemical Methods and Funtions

EMIT™ signal/concentration curveS

igna

l (en

zym

e ac

tivi

ty)

Antigen concentration

Functional concentration range

Page 67: Immunochemical Methods and Funtions

Fluorescence polarization immunoassay (FPIA)

• Developed by Abbott Diagnostics, about the same time as the EMIT was developed by Syva

– Roche marketed FPIA methods for the Cobas FARA analyzer, but not have a significant impact on the market

• Like the EMIT, the first applications were for therapeutic drugs

• Currently the most widely used method for TDM

• Requires an Abbott instrument

• Developed by Abbott Diagnostics, about the same time as the EMIT was developed by Syva

– Roche marketed FPIA methods for the Cobas FARA analyzer, but not have a significant impact on the market

• Like the EMIT, the first applications were for therapeutic drugs

• Currently the most widely used method for TDM

• Requires an Abbott instrument

Page 68: Immunochemical Methods and Funtions

Molecular electronic energy transitions

E0

E4E3

E2

E1

Singlet

Triplet

A

VR

F

IC

P

10-6-10-9 sec

10-4-10 sec

Page 69: Immunochemical Methods and Funtions

Polarized radiation

z

y

x

Polarizingfilter

Page 70: Immunochemical Methods and Funtions

Fluorescence polarization

OHO OH

C

O

O

Fluoresceinin

Orientation of polarized radiation is maintained!

out (10-6-10-9 sec)

Page 71: Immunochemical Methods and Funtions

Fluorescence polarization

OHO

OH

C

O

O

Rotational frequency 1010 sec-1

in

Orientation of polarized radiation is NOT maintained!

out (10-6-10-9 sec)

But. . .

Page 72: Immunochemical Methods and Funtions

Fluorescence polarization immunoassay

OHO OH

C

O

O

Polarization maintainedSlow rotation

OHO OH

C

O

O

Rapid rotation

Polarization lost

Page 73: Immunochemical Methods and Funtions

FPIA signal/concentration curveS

igna

l (I

/I)

Antigen concentration

Functional concentration range

Page 74: Immunochemical Methods and Funtions

Cloned enzyme donor immunoassay (CEDIA™)

• Developed by Microgenics in 1980s (purchased by BMC, then divested by Roche)

• Both TDM and DAU applications are available

• Adaptable to any chemistry analyzer

• Currently trails EMIT and FPIA applications in market penetration

• Developed by Microgenics in 1980s (purchased by BMC, then divested by Roche)

• Both TDM and DAU applications are available

• Adaptable to any chemistry analyzer

• Currently trails EMIT and FPIA applications in market penetration

Page 75: Immunochemical Methods and Funtions

Cloned enzyme donor

Donor

Acceptor

Monomer(inactive)

Active tetramer

Spontaneous

Page 76: Immunochemical Methods and Funtions

Cloned enzyme donor immunoassay

Donor

Acceptor

Donor

Acceptor

No activity

Active enzyme

Page 77: Immunochemical Methods and Funtions

CEDIA™ signal/concentration curveS

igna

l (en

zym

e ac

tivi

ty)

Antigen concentration

Functional concentration range

Page 78: Immunochemical Methods and Funtions

Other approaches to homogeneous immunoassay

• Fluorescence methods

• Electrochemical methods

• Enzyme methods

• Enzyme channeling immunoassay

• Fluorescence methods

• Electrochemical methods

• Enzyme methods

• Enzyme channeling immunoassay

Page 79: Immunochemical Methods and Funtions

Substrate-labeled fluorescence immunoassay

Enzyme

S

S Fluorescence

No signal

SignalEnzyme

S

Page 80: Immunochemical Methods and Funtions

Fluorescence excitation transfer immunoassay

Signal

No signal

Page 81: Immunochemical Methods and Funtions

Electrochemical differential polarographic immunoassay

Oxidized

Reduced

Page 82: Immunochemical Methods and Funtions

Prosthetic group immunoassay

Enzyme

Enzyme

P

P

S P

Signal

No signal

Page 83: Immunochemical Methods and Funtions

Enzyme channeling immunoassay

Ag

E1

E2

Substrate

Product 1

Product 2

Page 84: Immunochemical Methods and Funtions

Artificial antibodies

• Immunoglobulins have a limited shelf life

– Always require refrigeration

– Denaturation affects affinity, avidity

• Can we create more stable “artificial” antibodies?

– Molecular recognition molecules

– Molecular imprinting

• Immunoglobulins have a limited shelf life

– Always require refrigeration

– Denaturation affects affinity, avidity

• Can we create more stable “artificial” antibodies?

– Molecular recognition molecules

– Molecular imprinting

Page 85: Immunochemical Methods and Funtions

History of molecular imprinting

• Linus Pauling (1901-1994) first suggested the possibility of artificial antibodies in 1940

• Imparted antigen specificity on native globulin by denaturation and incubation with antigen.

• Linus Pauling (1901-1994) first suggested the possibility of artificial antibodies in 1940

• Imparted antigen specificity on native globulin by denaturation and incubation with antigen.

Page 86: Immunochemical Methods and Funtions

Fundamentals of antigen/antibody interaction

O

O-

O

O-

NH 3

+CH2-CH2-CH2-CH3

OH

N

NH2

Cl

Page 87: Immunochemical Methods and Funtions

Molecular imprinting (Step 1)

N

NO N

NH

O

H3C

CH3

N

NO N

NH

O

H3C

CH3

Methacrylic acid+ Porogen

Page 88: Immunochemical Methods and Funtions

Molecular imprinting (Step 2)

N

NO N

NH

O

H3C

CH3

N

NO N

NH

O

H3C

CH3

Page 89: Immunochemical Methods and Funtions

Molecular imprinting (Step 3)

N

NO N

NH

O

H3C

CH3

N

NO N

NH

O

H3C

CH3

Cross-linking monomerInitiating reagent

Page 90: Immunochemical Methods and Funtions

Molecular imprinting (Step 4)

Page 91: Immunochemical Methods and Funtions

Comparison of MIPs and antibodies

• In vivo preparation

• Limited stability

• Variable specificity

• General applicability

• In vivo preparation

• Limited stability

• Variable specificity

• General applicability

• In vitro preparation

• Unlimited stability

• Predictable specificity

• Limited applicability

• In vitro preparation

• Unlimited stability

• Predictable specificity

• Limited applicability

Antibodies MIPs

Page 92: Immunochemical Methods and Funtions

Immunoassays using MIPs

• Therapeutic Drugs: Theophylline, Diazepam, Morphine, Propranolol, Yohimbine (2-adrenoceptor antagonist)

• Hormones: Cortisol, Corticosterone

• Neuropeptides: Leu5-enkephalin

• Other: Atrazine, Methyl--glucoside

• Therapeutic Drugs: Theophylline, Diazepam, Morphine, Propranolol, Yohimbine (2-adrenoceptor antagonist)

• Hormones: Cortisol, Corticosterone

• Neuropeptides: Leu5-enkephalin

• Other: Atrazine, Methyl--glucoside

Page 93: Immunochemical Methods and Funtions

Aptamers

1014-1015 random sequences Target

Oligonucleotide-Target complex

Unbound oligonucleotides

Aptamer candidates

PCR

New oligonucleotide library

+ Target