Serology section

Serology lab involved in the investigation and detection of antigen and antibodies using the
serum which collected in yellow and red top tube, because it’s free from anticoagulant. So, we
will get the serum. Many techniques used there and we will highlight some of it.

❖ Enzyme linked immunosorbent assay (ELISA)

ELISA is a labeled immunoassay that is considered the gold standard of immunoassays. This
immunological test is very sensitive and is used to detect and quantify substances, including
antibodies, antigens, proteins, glycoproteins, and hormones. They use ELISA test, in particular
sandwich type to detect antibodies present in the patient sample.
They use it as a screen test for HBV, HCV, HIV.
The confirmation test is done by other test for each virus, including;

• Neutralisation test for HBV.

• Recombinant ImmunoBlot Assay (RIBA) test for HCV.
• Western blot for HIV-1.
However, the polymerase chains reaction (PCR) is also specific and accurate test.

❖ TORCH screen
A series of blood tests make up the TORCH screen. These examinations look for a variety of
infections in a newborn. Toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and HIV are
collectively referred to as TORCH. It might, however, also have other newborn infections.
❖ Latex test
However, the latex test can also be used to find antibodies in patient samples. It uses reagents that
contain the necessary antigens for the antibodies. Additionally, is used to find salmonella, brucella,
rapid plasma regain (RPR), C-reactive protein (CRP), and anti-streptolysine O (ASO).

• Rapid plasma reagin (RPR)

test A blood test is used to check for syphilis antibodies. In the test, unheated plasma, heated
serum, and RPR antigen are combined on a plastic-coated card. The RPR test measures IgM and
IgG antibodies to material that is released from injured host cells that is lipoidal, lipoprotein-like,
and possibly cardiolipin from treponemes. Agglutinations will be visible in a positive test result.
While negative will not.
 Figure 5: RPR test. well 1 and 5 show agglutination which is a positive reaction. while well 3 is not.

• C-reactive protein (CRP)

Acute phase reactants, such as CRP, are proteins produced by the liver and released into the blood
shortly after tissue damage, the onset of an infection, or another inflammatory event. The latex
agglutination theory serves as the foundation for the CRP test .Human anti-CRP complexed with
latex particles reacts visibly in 2 minutes when combined with a patient's serum that contains CRP.

Figure 6 : CRP test.

• Antistreptolysin O titer (ASO) test

The ASO test method relies on an immunologic reaction between the test sample's streptococcal antibodies
and exotoxins bound to biologically inert latex particles. When the test specimen contains an elevated
antibody level, visible agglutination happens.
 • Salmonella latex test
The test makes use of latex particles that have been polyvalently immunosensitized against a
variety of Salmonella flagellar antigens and is capable of identifying the majority of common
Salmonella species. Its foundation is the agglutination of antigen and antibody.

• Brucella latex tests

The basis for serological tests is that serum antibodies created in response to exposure to bacterial
antigens will visibly agglutinate with bacteria carrying homologous antigens. Most, but not all,
Brucella abortus and B. suis strains have a high ratio of A antigens to M antigens, whereas the
opposite is true for most B. melitensis strains. Brucella surface antigens have two specificities
called A and M.