Practical Immunology
4th Class
Lab 6: 19. 11. 2014
University of Sulaimani
School of Science
Department of Biology
Agglutination:
Latex Agglutination
Hemin M. Hussein
MSc Infection & Immunity
hemin.hmh@gmail.com
Objectives
• Explain latex agglutination (direct and indirect).
• Numerate some applications of latex agglutination
technique.
• Perform latex agglutination technique efficiently.
Agglutination Reaction
Particulate
Antigen
Antibody
Agglutination
Types of particles:
• Erythrocytes
• Inert carriers such as (Latex bead)
• Bacterial cells
Latex Agglutination Tests
• The specificity of antigen-antibody interactions has led to the
development of a variety of immunologic assays.
• These assays can be used to detect the presence of either
antibody or antigen. In all immunoassays, one of them (Ab or
Ag) is unknown.
• They have played vital roles in diagnosing diseases, monitoring
the level of the humoral immune response, and identifying
molecules of biological or medical interest.
• The agglutination reaction has principally been exploited using
erythrocytes as the particles and has been exploited in blood
group serological techniques.
Latex Agglutination Tests
• Sheep red blood cells (SRBS) have been used in many
immunological diagnostics.
• Till now its in use, for example for the diagnosis of infectious
mononucleosis (Epstein-Barr virus).
• Over the past several years, there has been a shift away from
red blood cells to synthetic particles, such as latex beads, as
matrices for agglutination reactions.
• The use of synthetic beads offers the advantage of stability.
• Furthermore, agglutination reactions employing synthetic beads
can be read rapidly, often within 3 to 5 minutes of mixing the
beads with the test sample.
• Agglutination reactions are simple to perform, do not require
expensive equipment, and can detect small amounts of antibody
HCG Latex Agglutination Test
Latex Agglutination Test for Pregnancy
Latex Agglutination Test for Pregnancy
• Latex agglutination test for pregnancy comprises the use
of suspensions of polystyrene latex particles sensitized
with anti-serum to human chorionic gonadotropin (hCG).
When mixed with urine or serum containing HCG,
agglutination indicating a positive test for pregnancy.
• First introduced in 1976
• Measure Urinary or serum human Chorionic gonadotropin
(hCG) levels.
• This glycoprotein hormone is released by placenta.
• The HCG becomes detectable 6-12 days post conception.
• Reason for use
• Detects pregnancy at very early stage
• Earlier prenatal care
HCG
HCG Latex Agglutination Test:
Procedure
• Allow kit reagents and patient sample to come to room
temperature.
• Place one drop of urine sample (50µL) on to the reaction
area of the slide using a disposable pipette.
• Shake the latex reagent, then add one drop and mix
using a stirrer.
• Gently and evenly rock and rotate the test slide for 2
minutes and under direct strong light source examine the
slide for agglutination.
• A positive result is indicated by the obvious agglutination
of the latex in clear solution.
C-Reactive Protein (CRP)
• Belong to a group of proteins known as acute phase
reactants (APRs)
• Whose plasma concentration changes in response to a
variety of inflammation states including:
•
•
•
•
•
•
Infection
Surgery
Trauma
Some cardiac diseases
Malignancy
Tissue necrosis.
• CRP was first identified in 1930 in the serum of a
patient with pneumonia and was the first recognized APR.
• After that, it was found that CRP is elevated in a
variety of other acute inflammatory diseases.
• It rises rapidly (24-48 hours) after inflammation and its
early return to normal levels after successful therapy
make CRP the best APR, suited for diagnostic purposes.
C-Reactive Protein (CRP)
CRP functions include:
• Initiation of opsonization and phagocytosis, activation of
complement by classical pathway, neutrophil and
monocyte-macrophage.
• So that, has an important role in recognition of microbial
organisms and immunomodulation.
An elevated CRP level is a sensitive although
nonspecific, indicator of inflammation
Latex Agglutination Test for C-Reactive Protein
Principle
CRP
CRP
Latex beads are
coated with antibodies
to human CRP.
When the latex
suspension mixed with
serum containing
elevated CRP level on a
slide, clear
agglutination is seen
within 2 minutes.
Latex Agglutination Test for C-Reactive Protein
Qualitative slide test: Procedure
1. Allow kit reagents and patient serum to come to room
temperature.
2. Transfer one drop (50µL) of patient's serum to the test
circle on the slide.
3. Shake the latex reagent, then using the dropper
provided, add one drop of the suspension to the circle
4. Mix the drops a disposable stirrer ensuring coverage of
the test circle with the mixture.
5. Gently and evenly rock and rotate the test slide for 2
minutes and under direct strong light source examine the
slide for agglutination.
6. A positive result is indicated by the obvious agglutination
of the latex in clear solution.
Latex Agglutination Test for C-Reactive Protein
Semiquantitative slide test: Procedure
1. If a positive reaction is obtained from qualitative slide test, the
specimen may be serially diluted with a glycine-saline buffer in
order to obtain a semiquantitative estimate of the CRP level.
2. Begin with a 1:2 dilution of patient serum obtained by mixing equal
parts specimen and glycine-saline buffer. Blend the tube contents
thoroughly.
3. Add 0.1 mL of buffer to the desired number of test tubes. Add 0.1
mL of 1:2 dilution to the first tube; mix and transfer 0.1 mL to the
next additional tube, and continue according to the used kit.
4. Perform a slide agglutination test on each dilution, and look for
agglutination.
The titer is represented by the last dilution
that shows a positive reaction.
A negative reaction is characterized by a
lack of visible agglutination in the
undiluted specimen.
Recommended Cleaning Procedure of Used Cards
• Used cards must be immediately immersed in
disinfectant solutions.
• The reaction circles must be physically rubbed with
non-abrasive material to ensure removal of possible
adhering particles.
• Thoroughly rinse in purified water
• Allow reaction card to dry
• Spray cards with a 70% alcohol solution
• Allow the alcohol to evaporate prior to re-use
References
• Hay FC & Westwood OM. (2002). Practical Immunology. 4th ed. Blackwell
Science Ltd. Oxford.
• Kindt TJ, Osborne BA & Goldsby RA. (2006). Kuby Immunology. 6th ed. W. H.
Freeman & Company.
• Kartz A, Lee-Lewandrowski E & Lewandrowski KB. (2002). The Plasma
Proteins. In: McClatchey KD. Clinical Laboratory Medicine. 2nd ed. Lippincott
Williams & Willkins, A Wolters Kluwer Company, Philadelphia.
• Wu AH. (2002). Diagnostic Enzymology & other Biochemical Markers of
Organ Damage. In: McClatchey KD. Clinical Laboratory Medicine. 2nd ed.
Lippincott Williams & Willkins, A Wolters Kluwer Company, Philadelphia.
• http://www.americanpregnancy.org/duringpregnancy/hcglevels.html
• http://www.lab21.com/biotec/Products/LatexSerology/tabid/1428/language/enUS/Default.aspx
• http://labtestsonline.org/understanding/analytes/hcg/tab/faq
• http://www.americanpregnancy.org/duringpregnancy/hcglevels.html
• http://faculty.ccbcmd.edu/courses/bio141/labmanua/lab17/lab17.html#pregan