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  • If a patient's blood agglutinates with anti-B serum, what is the patient’s blood type?
  • What is a cross-match assay, and why is it performed?

[link] summarizes the various kinds of agglutination assays discussed in this section.

Mechanisms of Select Antibody-Antigen Assays
Type of Assay Mechanism Example
Agglutination Direct: Antibody is used to clump bacterial cells or other large structures Serotyping bacteria
Indirect: Latex beads are coupled with antigen or antibody to look for antibody or antigen, respectively, in patient serum Confirming the presence of rheumatoid factor (IgM-binding Ig) in patient serum
Hemagglutination Direct: Some bacteria and viruses cross-link red blood cells and clump them together Diagnosing influenza, mumps, and measles
Direct Coombs’ test (DAT): Detects nonagglutinating antibodies or complement proteins on red blood cells in vivo Checking for maternal antibodies binding to neonatal red blood cells
Indirect Coombs’ test (IAT): Screens an individual for antibodies against red blood cell antigens (other than the A and B antigens) that are unbound in a patient’s serum in vitro Performing pretransfusion blood testing
Viral hemagglutination inhibition: Uses antibodies from a patient to inhibit viral agglutination Diagnosing various viral diseases by the presence of patient antibodies against the virus
Blood typing and cross-matching: Detects ABO, Rh, and minor antigens in the blood Matches donor blood to recipient immune requirements

Key concepts and summary

  • Antibodies can agglutinate cells or large particles into a visible matrix. Agglutination tests are often done on cards or in microtiter plates that allow multiple reactions to take place side by side using small volumes of reagents.
  • Using antisera against certain proteins allows identification of serovars within species of bacteria.
  • Detecting antibodies against a pathogen can be a powerful tool for diagnosing disease, but there is a period of time before patients go through seroconversion and the level of antibodies becomes detectable.
  • Agglutination of latex beads in indirect agglutination assays can be used to detect the presence of specific antigens or specific antibodies in patient serum.
  • The presence of some antibacterial and antiviral antibodies can be confirmed by the use of the direct Coombs’ test , which uses Coombs’ reagent to cross-link antibodies bound to red blood cells and facilitate hemagglutination .
  • Some viruses and bacteria will bind and agglutinate red blood cells; this interaction is the basis of the direct hemagglutination assay , most often used to determine the titer of virus in solution.
  • Neutralization assays quantify the level of virus-specific antibody by measuring the decrease in hemagglutination observed after mixing patient serum with a standardized amount of virus.
  • Hemagglutination assays are also used to screen and cross-match donor and recipient blood to ensure that the transfusion recipient does not have antibodies to antigens in the donated blood.

Fill in the blank

In the major cross-match, we mix ________ with the donor red blood cells and look for agglutination.

patient serum

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Coombs’ reagent is an antiserum with antibodies that bind to human ________.

immunoglobulins/antibodies and/or complement

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Short answer

Explain why the titer of a direct hemagglutination assay is the highest dilution that still causes hemagglutination, whereas in the viral hemagglutination inhibition assay, the titer is the highest dilution at which hemagglutination is not observed.

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Why would a doctor order a direct Coombs’ test when a baby is born with jaundice?

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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