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Isfahan University of Medical Science, School of Pharmacy

Immunochemistry ELISA
Department of Clinical Biochemistry

Created by:
June 21, 2024 A.N. Emami
Total Razavi
slides : 115 1
Enzyme Linked Immunosurbent
Assay

ELISA
ELISA
Immunochemistry ELISA

Outlines

 What is ELISA
 History
 Application
 Mechanism & Reagents
 Types of ELISA
 Methods
 Quality control
 HIV test

June 21, 2024 Total slides : 115 3


What is ELISA?

ELISA
ELISA
Immunochemistry ELISA

 Enzyme-Linked ImmunoSorbent Assay, or ELISA, is


a biochemical technique used mainly in immunology
to detect the presence of an antibody or an antigen in
a sample. The ELISA has been used as a diagnostic
tool in medicine and plant pathology, as well as a
quality control check in various industries. In simple
terms, in ELISA an unknown amount of antigen is
affixed to a surface, and then a specific antibody is
washed over the surface so that it can bind the
antigen. This antibody is linked to an enzyme, and in
the final step a substance is added that the enzyme
can convert to some detectable signal.

June 21, 2024 Total slides : 115 5


Immunochemistry ELISA

 Between each step the plate is typically washed with


a mild detergent solution to remove any proteins or
antibodies that are not specifically bound. Older
ELISAs utilize chromogenic substrates, though newer
assays employ fluorogenic substrates with much
higher sensitivity.

June 21, 2024 Total slides : 115 6


Immunochemistry ELISA

Enzyme-linked immunosorbent assay


Name suggests three components
 Antibody
 Allows for specific detection of analyte of interest
 Solid phase (sorbent)
 Allows one to wash away all the material that is not
specifically captured
 Enzymatic amplification
 Allows you to turn a little capture into a visible color
change that can be quantified using an absorbance plate
reader

June 21, 2024 Total slides : 115 7


History

ELISA
ELISA
Immunochemistry ELISA

 Prior to the development of the EIA/ELISA, the only


option for conducting an immunoassay was
radioimmunoassay, a technique using radioactively-
labeled antigens or antibodies. In radioimmunoassay,
the radioactivity provides the signal which indicates
whether a specific antigen or antibody is present in
the sample. Radioimmunoassay was first described in
a paper by Rosalyn Sussman Yalow and Solomon
Berson published in 1960.

June 21, 2024 Total slides : 115 9


Immunochemistry ELISA


 The American
The American physicist
physicist
Rosalyn S.Yalow
Rosalyn S.Yalow (born(born
1921) made
1921) made her her mostmost
outstanding contribution
outstanding contribution toto
modern
modern medicine
medicine inin
developing
developing
radioimmunoassay(RIA),
radioimmunoassay (RIA),for
for
which she
which she received
received aa Nobel
Nobel
Prizeininphysiology/medicine
Prize physiology/medicine
(1977).
(1977).

June 21, 2024 Total slides : 115 10


Immunochemistry ELISA

Dr.Solomon
Dr. SolomonA.A.Berson,
Berson,M.D.
M.D.
'45 (1919-1972)
'45 (1919-1972) and
and Dr.
Dr.
Rosalyn Sussman
Rosalyn Sussman Yalow
Yalow
(1921- )) co-developed
(1921- co-developed the
the
radioimmunoassay (RIA)
radioimmunoassay (RIA) inin
1959.
1959.

June 21, 2024 Total slides : 115 11


Immunochemistry ELISA

 Because radioactivity poses a health threat, a safer


alternative was sought. A suitable alternative to
radioimmunoassay would substitute a non-radioactive
signal in place of the radioactive signal. When certain
enzymes (such as peroxidase) react with appropriate
substrates (such as ABTS or 3,3’,5,5’-
Tetramethylbenzidine), they can result in changes in
color, which can be used as a signal. However, the
signal has to be associated with the presence of
antibody or antigen, which is why the enzyme has to
be linked to an appropriate antibody. This linking
process was independently developed by Stratis
Avrameas and G.B. Pierce.

June 21, 2024 Total slides : 115 12


Immunochemistry ELISA

 Since it is necessary to remove any unbound antibody


or antigen by washing, the antibody or antigen has to
be fixed to the surface of the container, i.e. the
immunosorbent has to be prepared. A technique to
accomplish this was published by Wide and Porath in
1966
 In 1971, Peter Perlmann and Eva Engvall at
Stockholm University in Sweden, as well as Anton
Schuurs and Bauke van Weemen in The Netherlands,
independently published papers which synthesized
this knowledge into methods to perform EIA/ELISA

June 21, 2024 Total slides : 115 13


Immunochemistry ELISA

EvaEngvall
 Eva Engvallisisone
oneof
ofthe
the
scientistswho
scientists whoinvented
inventedthethe
ELISAtest
ELISA testinin1971.
1971.She
Sheisis
shownatather
shown herhome
homenear
near
Buellton,Calif.
Buellton, Calif.Engvall
Engvallisis
currentlyaaprofessor
currently professoratatthe
the
BurnhamInstitute
Burnham InstituteininLa
La
Jolla,Calif.
Jolla, Calif.

June 21, 2024 Total slides : 115 14


Applications

ELISA
ELISA
Immunochemistry ELISA

 Because the ELISA can be performed to


evaluate either the presence of antigen or the
presence of antibody in a sample, it is a useful
tool both for determining serum antibody
concentrations (such as with the HIV test or
West Nile Virus) and also for detecting the
presence of antigen. It has also found
applications in the food industry in detecting
potential food allergens such as milk, peanuts,
walnuts, almonds, and eggs.

June 21, 2024 Total slides : 115 16


Immunochemistry ELISA

What is it used for?

 Measure antibody levels (allergies, vaccines)


 Detect viruses (hepatitis, HIV, venereal
diseases)
 Detect hormonal changes (pregnancy)
 Detect circulatory inflammatory markers
(cytokines)

June 21, 2024 Total slides : 115 17


Immunochemistry ELISA

Advantages of ELISA
 Sensitive: nanogram levels or lower
 Reproducible
 Minimal reagents
 Qualitative & Quantitative
 Qualitative  Eg. HIV testing
 quantitative assays  Eg. Drug Monitoring

 Wells can be coated with Antigens OR Antibodies


 Suitable for automation high speed
 NO radiation hazards

June 21, 2024 Total slides : 115 18


Immunochemistry ELISA

Sensitivity
Relative sensitivities of tests (approx)

Usual operating range


[Ab] or [Ag]

precipitation
immunoelectrophoresis 10 g/ml - 1 mg/ml
double/radial diffusion

immunofluorescence 0.1 - 10 g/ml

ELISA (colour) 0.1 - 10 ng/ml


(chemiluminescence) 0.01 - 10 ng/ml

radioimmunoassay 0.01 - 10 ng/ml

June 21, 2024 Total slides : 115 19


Immunochemistry ELISA

Enzymes with Chromogenic Substrates

 High molar extinction coefficient (i.e., strong


color change)
 Strong binding between enzyme and substrate
(low KM)
 Linear relationship between color intensity and
[enzyme]

June 21, 2024 Total slides : 115 20


Immunochemistry ELISA

Limitations

 Results may not be absolute


 False positive possible
 Falsenegative possible
 Antibody must be available

June 21, 2024 Total slides : 115 21


Immunochemistry ELISA

Materials needed
 Testing sample
 Antibody (1st, 2nd) / Antigen
 Polystyrene microtiter plate
 Blocking buffer
 Washing buffer
 Substrate
 Enzyme

June 21, 2024 Total slides : 115 22


Mechanism & Reagents

ELISA
ELISA
Immunochemistry ELISA

Mechanism
 The basic mechanism involved in these test
utilizes absorption of antigen to a solid surface
which is placed in contact with a dilution of
serum. The reaction which detects and
quantifies the binding of antibody uses an
antibody labeled with an enzyme followed by
the addition of an appropriate substrate on
which the enzyme can act to produce a colour
reaction. Two distinct test mechanisms are
“noncompetitive " and "competitive".

June 21, 2024 Total slides : 115 24


Immunochemistry ELISA

Reagents
 Antigens may be produced using any of the standard
techniques. They may be purified by precipitation and ultra-
centrifugation or by column chromatography before being
absorbed onto the surface. An alternative method which
allows the use of relatively impure antigens is to bind specific
antibody to the surface and allow it to absorb the antigen from
the preparation. Since the latter approach usually adds an extra
stage to the test this is not the preferred approach for
commercial test kits. In most cases the antigen is delivered
pre-absorbed onto plates, though they need to be carefully
dried and packed to maintain their stability at refrigerator
temperature for a reasonable period.

June 21, 2024 Total slides : 115 25


Immunochemistry ELISA

Reagents

 The labeled anti-globulin used in the standard test is


included in the test kits as is the appropriate
substrates and stop-solutions for use with it. All of
these reagents may be purchased separately from a
number of sources however their titration to a
standard level of activity for a specific purpose is
rarely worthwhile for a commercial laboratory
carrying out routine serology.

June 21, 2024 Total slides : 115 26


Immunochemistry ELISA

Reagents
 Finally, and most importantly, standard negative sera
and positive sera of known potency are required.
These are even more important than those used in
other serological tests since it is common practice to
express the results of the test sera by comparing them
with those of the control sera (serum-to-positive or
serum-to-negative ratios). The objective of this is to
remove some of the variation due to operator,
environment and plate effects.

June 21, 2024 Total slides : 115 27


Types of ELISA

ELISA
ELISA
Immunochemistry ELISA

 Noncompetitive binding assay or


Sandwich method
 Antigen measuring system [Titrewells coated
with antibodies ; Enzyme labelled antibodies]
 Antibody measuring system [Titrewells coated
with antigens ; Enzyme labelled antiantibodies]

 Competitive binding assay


 Titrewells coated with antibodies ; Enzyme labelled
antigens

June 21, 2024 Total slides : 115 29


Immunochemistry ELISA

Noncompetitive or Sandwich Assay


 Antigen measuring system
 Titre wells coated with suitable antibody
 Add patient sample containing the antigen
 Incubate: till antigen antibody reaction is complete
 Wash remove unbound antigen
 Add Antibody labelled with Enzyme
 Incubate till antigen binds labelled antibody
 Wash  remove unbound labelled antibody
 Add substrate ; incubate
 Enzyme + Substrate  Product  measure colour
 Colour proportional to antigen in patient sample

June 21, 2024 Total slides : 115 30


Immunochemistry ELISA

Noncompetitive or Sandwich Assay


 Antibody measuring system
 Titre wells coated with suitable antigen
 Add patient sample containing the antibody
 Incubate: till antigen antibody reaction is complete
 Wash remove unbound antibody
 Add Antiantibody labelled with Enzyme
 Incubate till labelled antiantibodies binds antigen-
antibody complex
 Wash  remove unbound labelled antiantibody
 Add substrate ; incubate
 Enzyme + Substrate  Product  measure colour
 Colour proportional to antibody in patient sample

June 21, 2024 Total slides : 115 31


Immunochemistry ELISA

Competitive binding assay


 Titrewells coated with antibodies
 Known quantities of patient sample containing
antigen + antigen labelled with enzyme
 Incubate: till antigen antibody reaction is complete
 Wash remove unbound antigens
 Add substrate ; incubate
 Enzyme + Substrate  Product  measure colour
 Colour inversely related to antigen in patient sample

June 21, 2024 Total slides : 115 32


Immunochemistry ELISA

Enzyme labels
 Enzyme labels should have high specific reactivity
 Should be easily coupled to ligands & the labelled
complex must be stable
 The reactivity should be retained after linking of the
enzyme to the antigen/antibody
 The chosen enzymes should not be normally present
in the patient samples
 Examples of enzyme labels
 Horse radish peroxidase, Alkaline phosphatase, Glucose
oxidase

June 21, 2024 Total slides : 115 33


Immunochemistry ELISA

Enzyme-Mediated Detection
Enzyme Horseradish Peroxidase

Substrate Abbrev. Color


Diaminobenzidine DAB Brown

Enzyme Alkaline Phosphatase (AP)


Substrate Abbrev. Color
BromochloroindolylphosphateNitr BCIP (AP substrate) Purple
o Blue Tetrazolium NBT (Enhance color)

June 21, 2024 Total slides : 115 34


Methods

ELISA
ELISA
Immunochemistry ELISA

BASIC FORMAT

Solid phase = 96 / 384-well microplate

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Immunochemistry ELISA

96 Well 350µL Polypropylene Plates

June 21, 2024 Total slides : 115 37


Immunochemistry ELISA

96 Well 500µL Polypropylene Plates

June 21, 2024 Total slides : 115 38


Immunochemistry ELISA

96 Well 600µL Polypropylene Plates

June 21, 2024 Total slides : 115 39


Immunochemistry ELISA

96 Well 1mL Polypropylene Plates

June 21, 2024 Total slides : 115 40


Immunochemistry ELISA

96 Well 2mL Polypropylene Plates

June 21, 2024 Total slides : 115 41


Immunochemistry ELISA

384 Well Polystyrene Assay Plates

June 21, 2024 Total slides : 115 42


Immunochemistry ELISA

384 Well Polypropylene Microtiter Plates

June 21, 2024 Total slides : 115 43


Immunochemistry ELISA

1. Coat solid phase with


antigen when analysing antibody
antibody when analysing antigen

Analyte = antibody Analyte = antigen

Incubate, wash

June 21, 2024 Total slides : 115 44


Immunochemistry ELISA

2. Block free binding sites. Incubate. Wash.

Analyte = antibody Analyte = antigen

June 21, 2024 Total slides : 115 45


Immunochemistry ELISA

3. Add sample. Incubate. Wash

Analyte = antibody Analyte = antigen

June 21, 2024 Total slides : 115 46


Immunochemistry ELISA

4. Add conjugate. Incubate. Wash.

E E E E

Analyte = antibody Analyte = antigen

June 21, 2024 Total slides : 115 47


Immunochemistry ELISA

5. Add substrate
6. Incubate, stop, measure colour change

ENZYME

Colourless

OD

CONCENTRATION
June 21, 2024 Total slides : 115 48
Immunochemistry ELISA

COATING THE PLATE


 Dilute the Ag in PBS containing 0.02% NaN3 (5-10
ug/ml) and despense 50 ul into each well of 96-well
microtiter plate using a multipipette/dispenser. (Micro
plates vary in their ability to bind Ag. So each
resercher should test for the plates of choice for their
specific Ag). Seal plates with adhesive plate sealer
and incubate overnight at 4° C or 2 to 3 h at 37° C
(coated plates can be prepared and stored in the
refrigerator for several weeks).

June 21, 2024 Total slides : 115 49


Immunochemistry ELISA

WASHING THE PLATE


Wash the plate three time with PBS using the Nunc-
Immuno wash device (this device simultaneously
delivers and aspirates fluid)

June 21, 2024 Total slides : 115 50


Immunochemistry ELISA

BLOCKING THE PLATE

block any residual binding capacity by adding 50 ul of a


blocking buffer (PBS containing 5% BSA, 0.02%
NaN3) to each well. Incubate the plate for 1 h at room
temperature.

June 21, 2024 Total slides : 115 51


Immunochemistry ELISA

SAMPLE
 Dilute in buffer-Tween 20
 Include known positive and negative samples
 Standards……. recombinant protein
International standard antibody
Double-dilute from 10 pg/ml - 10 ng/ml
 100 l/well, duplicates
 2 - 4 hours 20/37oC or overnight 4oC
 3 - 6 washes with buffer-Tween 20

June 21, 2024 Total slides : 115 52


Immunochemistry ELISA

CONJUGATE

 For assays of (human) antibodies use anti-


(human) Ig-enzyme

 For assays of antigens use enzyme-conjugated


antibody

June 21, 2024 Total slides : 115 53


Immunochemistry ELISA

Conjugating antibodies to Alkaline


Phosphatase
 Centrifuge 5 mg of alkaline phosphatase suspension (supplied
as a suspension in 65% (NH4)SO4) in a microfuge for 5 to 10
min. resuspend the enzyme pellet in a total volume of 1 mg of
the antibody to be labeled.
 Dialyzed overnight against 0.1 M sodium phosphate buffer,
pH 6.8 to remove any contaminating free amino groups.
 In a fume hood, slowly add 50 ug 1% glutaraldehyde solution
while stirring for 5 min. Incubate at room temperatyre for 2 to
3 h, add 100 ul of 1 M ethanolamine, pH 7, and then incubate
for additional 2 h at room temperature.
 Dialyze overnight against PBS and remove any insoluble
materials by centrifugation at 40,000 x g for 30 min.
 Store the conjugate (supernatant) in the presence of 50%
glycerole,1mM MgCl2 1mM ZnCl2, and 0.02% NaN3 at 4ºC
June 21, 2024 Total slides : 115 54
Immunochemistry ELISA

AMPLIFICATION

Directly conjugated developing


antibody may give weak signal

June 21, 2024 Total slides : 115 55


Immunochemistry ELISA

amplify with

E
E

unlabelled (rabbit) anti-(human) Ig


followed by
anti-(rabbit) Ig-enzyme

June 21, 2024 Total slides : 115 56


Immunochemistry ELISA

or
E
S
E-S B S-E

Biotin-labelled anti-Ig
followed by
streptavidin-enzyme

June 21, 2024 Total slides : 115 57


Immunochemistry ELISA

SUBSTRATES
See Sigma catalogue for list of conjugates and substrates

Orthophenylene diamine Tetramethyl


hydrochloride (OPD) benzidine (TMP)

Horse radish peroxidase (HRP)

Orange, 490 nm Yellow, 450 nm

Spectrophotometer

June 21, 2024 Total slides : 115 58


Immunochemistry ELISA

Paranitrophenyl phosphate (PNP) Methyl umbelliferol phosphate

Alkaline phosphatase

Yellow, 405 nm Methyl umbelliferone


Spectrophotometer

365 nm 445 nm
Fluorimeter

June 21, 2024 Total slides : 115 59


Immunochemistry ELISA

June 21, 2024 Total slides : 115 60


Immunochemistry ELISA

June 21, 2024 Total slides : 115 61


Immunochemistry ELISA

June 21, 2024 Total slides : 115 62


Immunochemistry ELISA

 Micro-titre plate with a standard Elisa test seen from below. The first 2
wells at top right are the negative controls. The following 2 are positive
controls. The remaining sera are field test sera. Usually at least 2 wells
with a known laboratory positive control are included on each plate.

June 21, 2024 Total slides : 115 63


Immunochemistry ELISA

INDIRECT ELISA TO DETECT SPECIFIC ANTIBODIES

• screening hybridoma supernatants


• detecting clinically important antibodies
- autoantibodies
- anti-pathogens
- anti-allergens

1. Antigen

June 21, 2024 Total slides : 115 64


Immunochemistry ELISA

INDIRECT ELISA TO DETECT SPECIFIC ANTIBODIES

2. Sample (human) antibody

1. Antigen

June 21, 2024 Total slides : 115 65


Immunochemistry ELISA

INDIRECT ELISA TO DETECT SPECIFIC ANTIBODIES

E E E
3. Anti-(human) Ig-enzyme

2. Sample (human) antibody

1. Antigen

June 21, 2024 Total slides : 115 66


Immunochemistry ELISA

INDIRECT ELISA TO DETECT SPECIFIC ANTIBODIES

4. Substrate
E E E
3. Anti-(human) Ig-enzyme

2. Sample (human) antibody

1. Antigen

June 21, 2024 Total slides : 115 67


Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

Useful when pure antigen not available


or antigen coats poorly

1. Specific antibody

June 21, 2024 Total slides : 115 68


Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

2. Impure antigen
eg tissue homogenate

1. Specific antibody

June 21, 2024 Total slides : 115 69


Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

3. Wash  pure antigen

2. Impure antigen

1. Specific antibody

June 21, 2024 Total slides : 115 70


Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

4. Sample (human
antibody)

3. Wash  pure antigen

2. Impure antigen

1. Specific antibody
June 21, 2024 Total slides : 115 71
Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

5. Anti-human Ig-enzyme
E E
4. Sample (human antibody)

3. Wash  pure antigen

2. Impure antigen

1. Specific antibody

June 21, 2024 Total slides : 115 72


Immunochemistry ELISA

ANTIGEN-CAPTURE ELISA TO DETECT SPECIFIC ANTIBODIES

6. Substrate

5. Anti-human Ig-enzyme

4. Sample (human
antibody)

3. Wash  pure antigen

2. Impure antigen

1. Specific antibody
June 21, 2024 Total slides : 115 73
Immunochemistry ELISA

ANTIBODY SANDWICH ELISA TO DETECT ANTIGENS

eg. hormones
drugs
tumour antigens
cytokines

1. Anti-analyte

June 21, 2024 Total slides : 115 74


Immunochemistry ELISA

ANTIBODY SANDWICH ELISA TO DETECT ANTIGENS

2. Sample

1. Anti-analyte

June 21, 2024 Total slides : 115 75


Immunochemistry ELISA

ANTIBODY SANDWICH ELISA TO DETECT ANTIGENS

E E
3. Anti-analyte-enzyme
2. Sample

1. Anti-analyte

June 21, 2024 Total slides : 115 76


Immunochemistry ELISA

ANTIBODY SANDWICH ELISA TO DETECT ANTIGENS

3. Or: E E
anti-analyte-biotin S S
followed by E-S B S-E E-S B S-E
streptavidin-enzyme
2. Sample

1. Anti-analyte

June 21, 2024 Total slides : 115 77


Immunochemistry ELISA

ANTIBODY SANDWICH ELISA TO DETECT ANTIGENS

4. Substrate

3. Or:
anti-analyte-biotin
followed by
streptavidin-
enzyme
2. Sample

1. Anti-analyte

June 21, 2024 Total slides : 115 78


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS


(antigen-coated plate)

1. Analyte

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Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

E E E
E

E
E
E E E 2. Anti-analyte-E
E
+ sample

1. Analyte

June 21, 2024 Total slides : 115 80


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

3. Wash

E E E 2. Anti-analyte-E E
+ sample

1. Analyte

June 21, 2024 Total slides : 115 81


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

4. Substrate

3. Wash

2. Anti-analyte-E
+ sample

1. Analyte

June 21, 2024 Total slides : 115 82


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS


(antibody-coated plate)

1. Anti-analyte

June 21, 2024 Total slides : 115 83


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

2. Analyte-E
+ sample

1. Anti-analyte

June 21, 2024 Total slides : 115 84


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

3. Wash

2. Analyte-E
E E E E E + sample E E

1. Anti-analyte

June 21, 2024 Total slides : 115 85


Immunochemistry ELISA

COMPETITION ELISA TO DETECT ANTIGENS

Low [analyte] High [analyte]

4. Substrate

3. Wash

2. Analyte-E
+ sample

1. Analyte

June 21, 2024 Total slides : 115 86


Immunochemistry ELISA

CYTOKINES
Type 1 Type 2
IL2 HEALTH IL4
IL12 IL5
IFN IL6
TNF IL10

RHEUMATOID ARTHRITIS CANCER


MULTIPLE SCLEROSIS VIRUSES
DIABETES MYCOBACTERIA
2 1
ASTHMA, ALLERGY
LUPUS
1 2
June 21, 2024 Total slides : 115 87
Immunochemistry ELISA

Detection of cytokines by ELISA

 Plasma or supernatant of cultured mononuclear cells

 Coat plate with anti-CK (Pharmingen) 0.5 g/ml in


bicarbonate buffer, 4o overnight

 Wash x 2 with PBS-T

 Block with PBS + 10% FCS, 2 hours RT

 Wash x2 with PBS-T

June 21, 2024 Total slides : 115 88


Immunochemistry ELISA

 Add standards (recombinant CK 10 pg-10 ng /ml), controls


and samples

 4o overnight

 Wash x3 with PBS-T

 Add biotinylated anti-CK (Pharmingen) 0.5 g/ml

 RT 60 minutes

 Wash x6 with PBS-T

 Add streptavidin-peroxidase

 RT 30 min

June 21, 2024 Total slides : 115 89


Immunochemistry ELISA

 Wash x8 with PBS-T 2

 Add OPD substrate

 15 min RT, dark 1

 Stop with N H2SO4

 Read A490 0
[rCK]

June 21, 2024 Total slides : 115 90


HIV Test

ELISA
ELISA
Immunochemistry ELISA

HIV

 The ELISA test, or the enzyme immunoassay


(EIA), was the first screening test commonly
employed for HIV. It has a high sensitivity.

June 21, 2024 Total slides : 115 92


Immunochemistry ELISA

HIV
 An HIV ELISA, sometimes called an HIV
enzyme immunoassay (EIA) is the first and
most basic test to determine if an individual is
positive for a selected pathogen, such as HIV.
The test is performed in a 8 cm x 12 cm plastic
plate which contains an 8 x 12 matrix of 96
wells, each of which are about 1 cm high and
0.7 cm in diameter.

June 21, 2024 Total slides : 115 93


Immunochemistry ELISA

An ELISA plate

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Immunochemistry ELISA

The ELISA Method


 Partially purified, inactivated HIV antigens pre-
coated onto an ELISA plate
 Patient serum which contains antibodies. If the
patient is HIV+, then this serum will contain
antibodies to HIV, and those antibodies will bind to
the HIV antigens on the plate.
 Anti-human immunoglobulin coupled to an enzyme.
This is the second antibody, and it binds to human
antibodies.
 Chromogen or substrate which changes color when
cleaved by the enzyme attached to the second
antibody.

June 21, 2024 Total slides : 115 95


Immunochemistry ELISA

 Negative ELISA  PositiveELISA


Test Test

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Immunochemistry ELISA

ELISA data from three patients

Positive Control Negative Control Patient A Patient B Patient C Assay Control

1.689 0.153 O.055 0.412 1.999 0.123

 Above is ELISA data from three patients. Numbers are expressed as optical density
at 450 nm. The cutoff value indicating a positive result is 0.500. Optical densities
of 0.300 to 0.499 are indeterminate and need to be retested. Values below 0.300 are
considered to be negative. In most cases, a patient will be retested if the serum
gives a positive result. If the ELISA retests are positive, the patient will then be
retested by western blotting analysis.

June 21, 2024 Total slides : 115 97


Immunochemistry ELISA

Sources of Error for HIV EIA Tests

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Immunochemistry ELISA

Sources of False Negative Results

 Early Seroconverters
 the window between infection and an antibody response to the virus

 Operator Error
 Fail to add serum or reagent to the correct well
 Reagent diluted in wrong diluvent or in wrong dilution

 Equipment Error

June 21, 2024 Total slides : 115 99


Immunochemistry ELISA

Source of False Positive Results


 MULTIPLE PREGNANCY

 MULTIPLE TRANSFUSION

 AUTO IMMUNE DISORDER

 CHRONIC HEPATITIS,

 CHRONIC ALCOHOLIC

 HBV VACCINATION

 ANTIBODY TO POLYSTERENE

June 21, 2024 Total slides : 115 100


Immunochemistry ELISA

Trouble shooting EIA


 Kit integrity

 Controls (kit and in-house)

 Equipment

 Cross contamination

 Sample quality

 Personnel training

 Correct validation and interpretation of results

June 21, 2024 Total slides : 115 101


Immunochemistry ELISA

Kit integrity

 Was cold chain maintained


during kit transport?

 Has the kit expired?

 Has the kit been stored


properly in your lab?

June 21, 2024 Total slides : 115 102


Immunochemistry ELISA

Controls

 Kit Controls should be run on each EIA plate.


 Indicates whether the kit components are functioning.
 Used to validate EIA run, calculate cut off

 In-house controls
 Kit controls are designed to be quite robust and do not reflect subtle
changes in testing.
 In-house controls should be calibrated to test as a low positive (above
cut-off, below maximum)

June 21, 2024 Total slides : 115 103


Immunochemistry ELISA

Equipment : Pipettes

 Single and Multi channel Pipettes should be


calibrated on a monthly basis.

June 21, 2024 Total slides : 115 104


Immunochemistry ELISA

Equipment : Microplate Washers


 Daily
 Prime the washer with wash solution before running sample plates

 Set the washer to wash the recommended number of times (with correct
volume)

 Check for accurate dispensing and complete aspiration in each plate well,
if not clean the washer head

 Listen for changes in the sound the washer makes, this can indicate a
vacuum leak

 At the end of the day prime the washer with DI water

June 21, 2024 Total slides : 115 105


Immunochemistry ELISA

Equipment : Microplate Washers


 Weekly
 If a washer is not used during the week rinse it out with DI water
to reduce microbial growth.

 Monthly
 Run a 10% solution of ethanol through the washer to disinfect.
This can also be done if the washer exhibits signs of contamination
(high background).
 Thoroughly rinse the washer after alcohol is used.

June 21, 2024 Total slides : 115 106


Immunochemistry ELISA

Equipment : Micro-plate Reader


 Daily
 Each time a reader is turned on it runs a self test, it will then report any
errors.

 Weekly
 Run a control plate weekly. Variations in positive or negative specimens
could be a sign of a bad diode or a spill on a diode .

June 21, 2024 Total slides : 115 107


Immunochemistry ELISA

Cross contamination

 Can be caused by:

 Reusing pipette tips (contaminated with + plasma)

 Splashes from one well to another during removal of plate covers

June 21, 2024 Total slides : 115 108


Immunochemistry ELISA

Sample Quality

 Properly collected (no haemolysis)

 Transport conditions

 Storage conditions

 Number of freeze/thaw cycles

 Age of sample

June 21, 2024 Total slides : 115 109


Immunochemistry ELISA

Validation and Interpretation of Results

 Positive and Negative controls must fall within a certain range.

 Controls are used to calculate a cut-off.

 Samples below cut-off are negative, those above are positive

June 21, 2024 Total slides : 115 110


Immunochemistry ELISA

Test your self

1. What does ELISA measure?


2. What if serum were left out?
3. Omission of the wash step
4. Which patient is HIV positive?

Use these problems to test your understanding of


this topic.

June 21, 2024 Total slides : 115 111


Immunochemistry ELISA

Problem 1
What is the ELISA test intended to measure?
 Antibody
A
to HIV only

 Antigen
B
to HIV only

 Presence
C
of free, circulating virus in the patient

 Antibodies
D
directed against HLA molecules

June 21, 2024 Total slides : 115 112


Immunochemistry ELISA

Problem 2
 What would happen if serum were omitted from the
ELISA, but all other steps remained the same and
were performed properly?


A
Anti-human Ig-conjugate would not bind and be washed
away.
B
Anti-human Ig-conjugate would bind non-specifically to
the ELISA plate.
C The O.D. values would be nearly the same as the assay

control.
D
Both A and C.

June 21, 2024 Total slides : 115 113


Immunochemistry ELISA

Problem 3
 What would happen if the anti-human Ig-conjugate
were not washed free of the well before the substrate
was added?

A The ELISA would not develop when the substrate was
added.
B The ELISA would develop normally.


C All wells would show uniform over development due to
unbound and excess anti-human Ig enzyme conjugate.
D
Both A and B.

June 21, 2024 Total slides : 115 114


Immunochemistry ELISA

Problem 4
 From the ELISA data, which patient is
seropositive for HIV?
Positive Control Negative Control Patient A Patient B Patient C Assay Control

1.689 0.153 O.055 0.412 1.999 0.123

A
Patient A C
Patients A and B

B
Patient B D
Patient C

June 21, 2024 Total slides : 115 115


Thank you
Thank you

Questions
Questions
Immunochemistry ELISA

A
Antibody to HIV only

Correct!

Antibody from patient serum made in response


to various HIV proteins binds to antigen.

June 21, 2024 Total slides : 115 117


Immunochemistry ELISA

B Antigen to HIV only

Incorrect!

HIV antigens are already coated onto the plate.


Antibody from the patient binds to the HIV
antigens.

June 21, 2024 Total slides : 115 118


Immunochemistry ELISA

C
Presence of free, circulating virus in the
patient

Incorrect!

Serum antibody is detected, not circulating


virus in the serum.

June 21, 2024 Total slides : 115 119


Immunochemistry ELISA

D
Antibodies directed against HLA
molecules

Incorrect!

Although there may be anti-HLA


antibodies present in the serum, the test is
not designed to measure them.

June 21, 2024 Total slides : 115 120


Immunochemistry ELISA

A
Anti-human Ig-conjugate would not bind and
be washed away.

Correct!

 but there is another correct answer

June 21, 2024 Total slides : 115 121


Immunochemistry ELISA

B
Anti-human Ig-conjugate would bind non-
specifically to the ELISA plate.

Incorrect!

The anti-human Ig conjugate is specific


for human Ig and has very little nonspecific
binding activity.

June 21, 2024 Total slides : 115 122


Immunochemistry ELISA

C
The O.D. values would be nearly the same as
the assay control.

Correct!

but there is another correct answer.

June 21, 2024 Total slides : 115 123


Immunochemistry ELISA

D
Both A and C.

Correct!

Since no serum was added, the anti-human


Ig conjugate would not be able to bind to
human Ig and the O.D. values would be the
same as the assay control.

June 21, 2024 Total slides : 115 124


Immunochemistry ELISA

A
The ELISA would not develop when the
substrate was added.

Incorrect!

The substrate would overdevelop because


an excess of enzyme coupled to the anti-
human Ig was present.

June 21, 2024 Total slides : 115 125


Immunochemistry ELISA

B
The ELISA would develop normally.

Incorrect!

The substrate would overdevelop because


an excess of enzyme coupled to the anti-
human Ig was present.

June 21, 2024 Total slides : 115 126


Immunochemistry ELISA

C
All wells would show uniform over
development due to unbound and excess anti-
human Ig enzyme conjugate.

Correct!
Since the enzyme which acts on the
substrate is in excess, it would turn all the
wells a uniform color whether they were truly
positive or not.

June 21, 2024 Total slides : 115 127


Immunochemistry ELISA

D
Both A and B.

Incorrect!

The substrate would overdevelop because


an excess of enzyme coupled to the anti-
human Ig was present.

June 21, 2024 Total slides : 115 128


Immunochemistry ELISA

A
Patient A

Incorrect!

Patient A has an O.D. of 0.055 and


would be considered negative.

June 21, 2024 Total slides : 115 129


Immunochemistry ELISA

B
Patient B

Incorrect!

Patient B would be considered


indeterminate and would need to be retested.

June 21, 2024 Total slides : 115 130


Immunochemistry ELISA

C
Patients B and C

Incorrect!

Patient A has an O.D. of 0.055 and would


be considered negative and patient B would be
considered indeterminate and would need to be
retested.

June 21, 2024 Total slides : 115 131


Immunochemistry ELISA

D
Patient C

Correct!

Serum from patient C showed an O.D. of


1.999 which is even higher than the positive
control O.D. for the assay.

June 21, 2024 Total slides : 115 132


Immunochemistry ELISA

June 21, 2024 Total slides : 115 133


Immunochemistry ELISA

June 21, 2024 Total slides : 115 134


Immunochemistry ELISA

Extinction coefficient

 The extinction coefficient for a particular substance is a measure


of how well it scatters and absorbs electromagnetic radiation
(EM waves). If the EM wave can pass through very easily, the
material has a low extinction coefficient. Conversely, if the
radiation hardly penetrates the material, but rather quickly
becomes "extinct" within it, the extinction coefficient is high.
 A material can behave differently for different wavelengths of
electromagnetic radiation. Glass is transparent to visible light,
but many types of glass are opaque to ultra-violet wavelengths.
In general, the extinction coefficient for any material is a
function of the incident wavelength. The extinction coefficient is
used widely in ultraviolet-visible spectroscopy.

June 21, 2024 Total slides : 115 135

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