L9: Immunoassay Configuration Flashcards

1
Q

Name IA Categories: Label

A
Radioactive Isotopes
– RIA, IRMA
Enzymes
– EIA, ELISA, CEDIA
Fluorescent Molecules
– FIA, FPIA
Particles
– PETIA/PENIA, PETINIA
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2
Q

For IA Categories: What is labelled?

A
Ligand
– Ligand-labeled (i.e.. EIA, RIA)
Antibody
– Immunometric (i.e.. IRMA, ELISA)
Nothing
– The Ab-Ag complex is detected (i.e. precipitin rxn,
immunoelectrophoresis, IFE, hemagglutination)
Analogue
– An analogue of the ligand is labeled
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3
Q

Name IA Categories: Assay Principle

A
Competitive
– Labeled and unlabeled ligand compete for limited
binding
Non-Competitive
– Excess Ab is present to bind to all Ag
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4
Q

Name IA Categories: Separation

A

Heterogeneous
– Bound and unbound elements are physically
separated prior to detection
Homogeneous
– Bound and unbound elements are not separated prior to detection

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5
Q

Name IA Categories: Incubation

A

One Step
– Ligand and detection molecule are incubated together
Two Step
– Ligand is applied first and unbound ligand is washed away prior to addition of the detection molecule

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6
Q

Describe the principles of competitive immunoassay

A
  • Competition of unlabelled Ag with labeled Ag* for a limited amount of binding sites (antibody)
  • A limited amount of Ab needed
  • Simultaneous or sequential addition of Ag and labeled Ag*
  • Sequential improves the detection limit 2-4X
  • LoD is limited by the Ka of the Ab

Inversely related to concentration of Ag (see more into on sequential in slides)

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7
Q

Describe the principles of a noncompetitive immunoassay.

A
  • An excess amount of Ab* is used to detect/extract Ag; excess unbound Ab* is removed (by various methods)
  • Provides highest level of assay sensitivity and specificity
  • LoD is dependent on the activity of the label
  • Maximum sensitivity achieved with:
  • High specific activity of Ab*
  • Low nonspecific binding of Ab*
  • High affinity constant of the Ab & Ag reaction
  • High concentration of Ab (capture max. amount of Ag)
  • Small experimental error in measuring bound Ab*
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8
Q

Described sandwich and one or two-step noncompetitive assay.

A

Most common is a sandwich assay,
• Ab attached to solid support (capture Ab) which binds Ag
• Ab* is second labeled Ab (detection Ab) detects bound Ag
• Requires Ag with at least two separate epitopes that can be bound simultaneously

As with competitive, can have 1-step or 2-step assays
• 1-step:
1) Ag + Ab* + Ab-solid ↔ Ab*-Ag-Ab-solid + Ab* + Ab-solid
2) Wash
3) Detect
• 2-step:
1) Ag + Ab-solid ↔ solid-Ab-Ag
2) Wash
3) Ab* ↔ Ab*-Ag-Ab-solid
4) Wash
5) Detect

Increases as analyte concentration increases

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9
Q

Describe a homogenous assay.

A
  • No physical separation of bound and free components
  • Activity of labeled Ag* is directly modulated by Ab binding:
  • Conformation change of enzyme
  • Inhibition of enzyme
  • Fluorescence energy transfer, protection or polarization
  • Technically simpler and faster vs. heterogeneous
  • Allows for full automation
  • Works with small antigen molecules: Drugs, T3/T4, etc.
  • Both competitive and non-competitive assays can be homogeneous
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10
Q

Describe a heterogeneous assay.

A
  • Physical separation of bound from free Ag and/or Ab
  • Implicitly assumes kon&raquo_space; koff
  • Both competitive and non-competitive assays can be heterogeneous
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11
Q

Describe types of separation.

A

Absorption
• Charcoal, Florisil, talc
• Free antigen absorbed, bound Ag left in solution

Precipitation
• Double-antibody: a second antibody from a different species of animal used to precipitate primary Ag-Ab complex; Protein A can also be used.
• Polyethylene glycol, ethanol, dioxane, ammonium
sulfate precipitate Ab

Solid Phase
• Ab attached to solid phase
• e.g. reaction tube, microtiter plate, plastic or magnetic beads, cellulose, Sephadex, etc

Column Separation
• Ion exchange, Gel filtration

Miscellaneous
• Electrophoresis, radial partition

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12
Q

Describe types of solid phase support.

A

Small Particles (<20 μm)
• Latex, microcrystalline cellulose, magnetic particles
• Pros: Can be dispensed as liquids, high surface area
• Cons: Centrifugation or filtration required for separation long magnetic precipitation

Medium Particles (<1 mm)
• Sepharose, sephadex, magnetic particle
• Pros: No centrifugation required, short magnetic
precipitation, moderate surface area
• Cons: Agitation required, slower reaction time

Large Particle (>1 mm)
• Polystyrene, nylon
• Pros: No Centrifugation or agitation required
• Cons: Low surface area, difficult to dispense, poor
reaction kinetics

Solid Surfaces
• Coated tubes, dipsticks, microtitre plates, membranes
• Pros: No centrifugation or agitation required, no dispensing of reagent, simplest to use
• Cons: Lowest surface area and slowest reaction kinetics

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13
Q

Describe and provide examples of unlabelled immunoassay.

A

a.k.a. Precipitin Reaction
• Light is scattered by particles in suspension
• Optimal light scatter is dependent on the size of particles and wavelength of light

  • Antibody is ~15nm in length
  • Chylomicrons ~250nm
  • RBCs ~1000nm
  • Ab-Ag aggregates 250-1500nm
  • Can quantitatively detect Ab-Ag complexes based on light scatter (turbidimitry or nephelometry)
  • Optimal precipitation occurs at zone of equivalence
  • Can couple Ab (or hapten) to a particle to enhance complex formation and light scatter

(See graph on slide 28)

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14
Q

Provide examples of competitive heterogenous assays.

A

Includes EIA, RIA, LIA (see slide 29)

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15
Q

Provide examples of competitive homogenous assays.

A

EMIT = Enzyme-Multiplied Immunoassay Technique

• Competitive; direct correlation between signal and [analyte]
• Not applicable for large antigens
(see slide 30)

CEDIA = Cloned Enzyme Donor Immunoassay
• Competitive; direct correlation between signal and [analyte]
• Not applicable for large antigens
• Example: b-galactosidase
(see slide 31)

FPIA = Fluorescence Polarization Immunoassay
(see slide 32)

PETINIA = Particle-Enhanced Turbidimetric Inhibition IA (slide 38)

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16
Q

Provide examples of noncompetitive heterogenous assays.

A

Includes IRMA, ELISA, ICMA (slide 34)

MEIA = Microparticle Enzyme Immunoassay (slide 35)

17
Q

Provide examples of Non/competitive Homogeneous assays.

A

PETIA/PENIA = Particle-Enhanced Immunoassay
• Ab coupled to particles
• “Middle-range” analytical method in terms of sensitivity
• Simple and cost effective for measuring analytes that do not require great sensitivity e.g. albumin in CSF or urine; yet, an improvement of 1000-fold over conventional methods can easily be achieved.
• Increasingly popular as no specialized equipment is
required; often on routine clinical auto-analyzers as
turbidimetric measurements.

18
Q

Describe 1-step analog immunoassay for free hormones.

A

1-step labeled hormone (Never really worked)
• Use a labeled hormone analog that does not bind to endogenous hormone binding proteins
• Ab affinity for the analog and free hormone are equal
• Incubate small amounts of Ab and analog together
with serum for a short period of time (do not shift the
free hormone equilibrium)

Hormone competes with the analog for Ab binding,
analog does not compete for binding proteins

1-step labeled antibody
• Use a hormone analog, bound to a solid phase, that
does not bind to endogenous hormone binding proteins
• Ab affinity for the analog and free hormone are equal
• Incubate small amounts of Ab and analog together with serum for a short period of time (do not shift the free hormone equilibrium)

19
Q

Described direct free hormone assays and 2-step back titration.

A
  1. Separate the free hormone from the bound hormone
  2. Measure the free hormone
    • Equilibrium dialysis
    • Ultrafiltration
    • RIA/EIA

2-step labeled hormone
• Incubate a limited amount of anti-hormone antibodies
with serum for a short period of time (avoid shifting the
free hormone equilibrium)
•Wash and then add labeled hormone to measure
unoccupied paratopes
• As long as the equilibrium is not dramatically disturbed, these assays can accurately estimate the level of free hormone

20
Q

Immunoassay interference: describe factors limiting LoD.

A
  • Background noise of detector
  • Blank signal of detection reagent
  • Non-specific binding of labeled reagent
  • Assay factors:
  • Measurement errors (i.e. pipetting)
  • Analytical sensitivity (slope of cal curve)
  • Assay design and optimization
21
Q

Immunoassay interference: list clues to their presence.

A

• Result incompatible with other clinical and/or biochemical
findings
• Outlier in method evaluation/comparison studies –
suspicious but not proof!
• Non-linearity upon dilution
• Poor recovery in spiking experiments with standard or reference material
• Atypical blank reading from some automated
immunoassay analyzers
• Icteric, lipemic, and or hemolyzed samples

22
Q

List immunoassay limitations.

A
  • Ab/Ag deformation (steric hindrance at solid phase)
  • > Reduces sensitivity
  • Non-specific binding of labeled Ag or Ab to solid surface
  • > Increases noise, reduces sensitivity

• Reduced label activity due to conjugation
• >Incubate longer (allow for more signal) or increase
labeling (can have other negative consequences)

23
Q

Describe matrix effects.

A
  • The matrix includes everything present within a sample excluding the analyte
  • A matrix effect is an interference caused by a difference in reactivity of an analyte due to the differences in the environment of the sample
  • Ab-Ag binding reactions can be sensitive to
  • [Protein], [Lipid], pH, Ionic strength
  • Differences between artificial matrices of standards, QC and PT samples and that of patient samples often cause marked biases between different assays
24
Q

Describe high hook dose effect.

A

Antigen Excess
• Affects 1-step sandwich assays and Precipitin reactions
• Does not affects 2-step sandwich assays

25
Q

List interferences for homogenous IA

A

• More susceptible to sample interferences (no washing)
• Fluorescence
• Enzyme activity
• Label-like substances
• Hemolysis/Icterus/Lipemia
• Can be partially compensated for by dilution or kinetic
measurements
• Are more precise than heterogeneous assays (no wash)

26
Q

List possible interferences.

A
1. Exogenous substances
• Anticoagulants can inhibit enzyme activities
• e.g. EDTA and ALP
• Biotin (in high doses)
• Hemolysis, Icterus, Lipemia
• Biologics / Therapeutic antibodies
• Foodstuffs, drugs, herbals/supplements
• Carryover contamination

Endogenous substances
• Cross reacting proteins, hormones or drug metabolites
• Hormone binding proteins
• Interfering antibodies can be present within individuals,
producing variable responses (i.e. pos or neg interference)
• Heterophilic antibodies
• HAMA/HAAA
• RF
• Analyte auto-antibodies
• Paraproteins

Heterophilic antibodies
• Poorly defined group of antibodies that react with a wide spectrum of antigens
• Originally defined as a group of IgM antibodies
associated with mononucleosis
• Seen in patients with chronic or acute diseases
• Bind to immunoglobulins from other species leading to false results

Human anti-mouse antibodies (HAMA)
• May develop as a result of both iatrogenic or
noniatrogenic causes
• Are distinguished from heterophilic Ab in that they are more specific and have a high affinity
• Can be found against any animal (HAAA)

Rheumatoid Factor (RF)
• Are autoantibodies that bind to multiple antigenic
determinants on the Fc portion of IgG
• Like HAAA, are specific antibodies produced against a defined immunogen

Paraproteins
• Due to multiple myeloma at very high concentrations
• Various effects on photometric and immunoassays

Analyte auto-antibodies
• Antibodies that bind to the analyte of interest, often
termed ”macro-complexes”
• Usually remain in circulation but not biologically active
• Location of binding of auto-antibody to the analyte affects the immunoassay Ab to cause positive or negative interference

Biotin
• Ingestion of high doses found in supplements
• Nature of interference
• Sandwich assay: falsely lowered results
• Competitive assay: falsely elevated results
• Theoretical interference not always observed
• Some biotin-based assays are designed with biotin prebound to streptavidin before the sample is present
• For patient recall, wash-out period may take 1-3 days

27
Q

Describe mechanisms of interference.

A
  1. Immunoglobulin Aggregation
    • Two-site immunometric assays
    • Can crosslink the capture and detection antibody in
    the absence of the analyte
    • Light scatter assays
    • Can add to the size of the precipitating immune
    complex
  2. Blocking of binding site
    • Two-site immunometric assays
    • Can inhibit binding of analyte to capture (or
    detection) Ab, leading to falsely low results
    • Competitive Assays
    • Can block the binding of labeled analyte to Ab,
    leading to falsely elevated results
3. Polyspecific binding to an antigen
• Can affect assays designed to measure
endogenous antibodies, leading to false positive
results
• e.g. serological assays
28
Q

Minimizing interferences through assay design.

A

• Including non-immune immunoglobulins from the species
used to raise the reagent antibodies may block the
interferences due to HAAA
• Does not always work, may need Ig from multiple species
• Idiotypic antibodies will not be eliminated
• Using Fab fragments as the capture antibodies (eliminate Fc portion of Ab)
• Use Capture and Detection Ab from different species
• Use Chicken antibodies (do not react with RF)

29
Q

Investigating interferences.

A

• ‘Non-linearity’ is often a clue to the presence of some type of interference
• Test the sample using a different immunoassay method
“Blocking” resins/reagents are commercially available and used to treat samples suspected to have
interferences
• Incubate sample with Protein A sepharose to remove immunoglobulins. Also streptavidin (magnetic) beads to remove biotin.
• Compare urine results to serum results (e.g. hCG)