Medical Microbiology

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&Thedirect’primary’antibody,orthedetected’secondary’antibody,isla-
beledwithperoxidase.Followingtheantigen-antibodyreaction,largepre-
formedperoxidase-antiperoxidasecomplexesareaddedtothetissuesection;
thesecomplexescanattachtotheperoxidase-labeledantibodies,whichare
alreadyspecificallybound,thusamplifyingthesignalconsiderably(Fig.2.26c).
&Similarly,biotinylatedantibodiescanbeused.Thevitaminbiotinisbound
withstrongaffinitybyavidin,abasicglycoprotein.Variouscolorantsoren-
zymescoupledtoavidinthusfacilitatethecolorreactions.Suchreactionscan
beamplifiedonthetissuesectionbyaddingpreformedbiotin-avidin-perox-
idasecomplexesthatbindtothosebiotin-coupledantibodieswhichhaveal-
readybeenbound.

RadioimmunologicalandEnzymeImmunologicalTests

Radioimmunoassay(RIA)andenzymeimmunoassay(EIA),alsoknownas
ELISA(enzyme-linkedimmunosorbentassay)(Fig.2. 28 ),arenowused
veryfrequentlytotestforantigensandantibodies.Allabsorbencytestsin-
volvethefixationofantigensorantibodiestoaplasticsurface.Thelowerde-
tectionlimitisafewnanograms.Thismethodformsthebasisofmodernhe-
patitisserology,HIVtests,andtestsforautoantibodies,lymphokines,cyto-
kines,etc.Alloftheseassayscanbeperformedinadirectform(different
sandwichcombinationsofantigen,antibodyandanti-antibody,Fig.2. 27 )

128 2 BasicPrinciplesofImmunology

Fig.2. 27 Forsolidphasetestsboththeantigenandantibodyareboundtoasolid
phase(e.g.,plasticsurface).Variousmethodsarethenusedtodetectanyinter-
actionbetweentheantigenandantibody.Inthedirecttest(a)animmobilized,
unknown,antigencanbedetectedusingafluorescent-labeledantibody.Iftheim-
mobilizedantigenisknown,thistestmethodcanalsobeusedtodetectananti-
bodyboundtotheantigen.Inthesandwichmethod(b)aknownantibodyisim-
mobilized.Detectionofantibody-antigenbindingisthenperformedusinga
second,labeledantibodywhichinteractswiththeantigenatadifferentsite.
Thecapturemethod(c)canbeusedtodetectanyantigen,forinstanceIgManti-
bodies.First,anti-IgMantibodiesareimmobilized,thenserumcontainingIgMis
addedtothem.TheboundIgMcanthenbindaforeignantigen(e.g.,avirus).The
detectionprocedurenextmakesuseofeitherthelabeledforeignantigenoraspe-
cific,additionallylabeled,antibodywhichbindstotheboundantigenbutnotto
theplasticboundantibody.Inthecompetitionorcompetitiveinhibitiontest(d)
antibodiesareimmobilized,andlabeledantigensarethenboundtothem.Anun-
labeled(unknown)antigenisadded,whichcompeteswiththelabeledantigen.
Thelevelofinteractionbetweentheantibodyandtheunknownantigenis
thendeterminedbymeasuringattenuationofthesignal. "

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Kayser, Medical Microbiology © 2005 Thieme
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