Immunology & Serology - Laboratory - CRP & ASO

C-reactive protein

This protein was believed to be an antibody to the C-polysaccharide of Pneumonococcus.

Pneumonococcus

C-reactive protein was believed to be an antibody to the C-polysaccharide of ____.

Opsonin

C-reactive protein as an ___, it will bind to your microorganisms or cells and this will have the foreign antigens to be tagged and enabling the phagocytes for phagocytosis.

Dendrites, macrophages, neutrophils, monocytes

Cells that are able to phagocytosis are:

acute phase reactant

C-reactive protein is also an ____ meaning it increases during inflammation.

Transferrin, Albumin

Majority of the acute phase reactants increases during inflammation EXCEPT:

Negative acute phase reactants

What type of acute phase reactants are transferrin and albumin?

decreases

During inflammation, instead of the usual, your transferrin and albumin (increases/decreases).

acute phase reactant

____________s or normal serum constituents that rapidly increase during infection, injury or damage to the tissues. This gives us the idea that our body is under attack or is inflamed.

4-6 hours

CRP increases how many hours following injury to the tissues

48 hours

When does CRP peak? This will continue to decline as soon as the causative agent is gone.

Bacterial or viral infections, malignant diseases, tuberculosis, rheumatic fever, rheumatoid arthritis

CRP are elevated in conditions such as:

Rheumatoid

This term refers to clinical manifestations of symptoms associated with rheumatism.

C-reactive protein, Serum Amyloid A

These are the only acute phase reactants that can increase up to 100 to 1000 times fold during inflammation.

not specific

CRP is a very sensitive acute phase reactant but it's (specific/not specific) because it can increase all kinds of damages in the tissue.

No

Yes/No

Can you use CRP to diagnose a disease?

C-reactive protein

Because the levels rise and declines rapidly, ___ is the most widely used indicator of acute inflammation

sensitive but not specific

CRP elevation can be expected in all diseases in going tissue damage so the finding is _____.

Rheumatic fever, rheumatic arthritis

CRP is sensitive for these diseases

C Polysaccharide of Pneumococcus

How was CRP believed to be a opsonin in microbes?

Serum Amyloid A, Alpha1-antitrypsin, Fibrinogen Haptoglobin, Ceruloplasmin

Acute phase reactants that increase during inflammation

Rubor, Dolor, Calor, Tumor, Functio laesa

Signs of inflammation

Redness

meaning of Rubor

Pain

Dolor meaning

Heat

Calor meaning

Swelling

Tumor meaning

Loss of function

Functio laesa meaning

Reverse passive agglutination

CRP latex agglutination slide test principle

Reverse passive agglutination

The principle means that an antibody instead of an antigen is artificially coated with the latex particle.

C-reactive protein latex agglutination slide test

This test detects the presence of CRP antigen (antibody is coated)

Nonspecific anti-human C-reactive protein antibody

What are the CRP-carrier particles in the C-reactive protein latex agglutination slide test coated with?

Blue

What is the color of the polystyrene suspension coated with anti-human CRP antibody in the C-reactive protein latex agglutination slide test?

Reagent, positive and negative control

What are the contents of the C-reactive protein latex agglutination slide test?

Latex particles coated with Anti-human C-reactive protein, Sodium azide, Borate buffer

Reagents of the C-reactive protein latex agglutination slide test

pH 8.2

What is the pH of the Borate buffet in the C-reactive protein latex agglutination slide test?

Human serum containing CRP more than 6 mg/L

Positive control for C-reactive protein latex agglutination slide test

Human serum containing CRP less than 6 mg/L

Negative control for C-reactive protein latex agglutination slide test

Serum

What is the specimen used in the C-reactive protein latex agglutination slide test?

7 days at 2-8°C

What is the stability of the C-reactive protein latex agglutination slide test?

50 microliters

Sample volume in C-reactive protein latex agglutination slide test

1 drop

Positive control volume in C-reactive protein latex agglutination slide test

1 drop

Negative control volume in C-reactive protein latex agglutination slide test

1 drop

LR volume in C-reactive protein latex agglutination slide test

100 revolutions per minute for 2 minutes

After mixing the cards, how fast should you rotate the cards in the C-reactive protein latex agglutination slide test?

1 minute

When is the card in the C-reactive protein latex agglutination slide test visualized?

Visible agglutination

C-reactive protein latex agglutination slide test positive result

Absence of visible agglutination

C-reactive protein latex agglutination slide test negative result

False increase in CRP titer

Increased concentration of Rheumatoid factor leads to?

Anti-streptolysin O

is an extracellular enzyme that is secreted by your Lancefield Group A beta- hemolytic streptococcus (Streptococcus pyogenes)

Group A Beta-hemolytic Streptococci Streptococcus pyogenes

What specific bacteria secretes Anti-streptolysin O?

1 week to 1 month

When can antibodies against ASO be detected after onset of Streptococcal infection?

Acute pharyngitis, Tonsillitis

S. pyogenes or your beta-hemolytic strep causes a variety of wide upper respiratory infections mainly:

Glomerulonephritis, Rheumatic fever, Bacterial endocarditis, Scarlet fever

Other manifestations of the S. pyogenes infection

Glomerulonephritis, Rheumatic fever

S. pyogenes infections that are both detrimental to the patient

Glomerulonephritis

A simple skin infection cause by your S. pyogenes will lead to ____

Rheumatic fever

Pharyngitis or Tonsillitis: The patient is adverse for _________.

S. pyogenes pathogenesis that can lead to glomerulonephritis

Deposition of your immune complexes in glomeruli

M protein, T protein

2 major proteins of S. pyogenes

Cardiac myosin, 3, cross-reactivity

Our body will produce antibodies against M protein. Our heart, specifically the ________, has __ similar epitopes with the M protein of S. pyogenes. This cause ____. Frequent tonsilitis can cause our antibodies to attack cardiac myosin causing acute rheumatic fever.

not recommended

Screening methods for ASO are (recommended or not recommended)

Serological diagnosis

Gold standard of Rheumatic fever and Glomerulonephritis

Anti-streptolysin O

It is the antibody against Streptolysin O

Streptolysin O

Oxygen-labile S. pyogenes hemolysin

Streptolysin S

Oxygen-stable S. pyogenes hemolysin

Streptolysin O

Antigenic S. pyogenes hemolysin

Streptolysin S

Non-antigenic S. pyogenes hemolysin

Streptolysin O

Beta-hemolytic S. pyogenes hemolysin

Streptolysin S

Alpha-hemolytic S. pyogenes hemolysin

Enzyme, exoantigen, antigenic, oxygen-labile, heat-labile, hemolytic factor

Properties of Streptolysin O

10,000 daltons

Streptolysin O molecular weight

True

True/False

All enzymes are proteins. Not all proteins are enzymes.

Streptolysin O

Which S. pyogenes hemolysin is antigenic and immunogenic?

Passive agglutination

Latex agglutination slide test principle

Latex agglutination slide test

What test has an antigen is artificially coated to a carrier particle?

Latex agglutination slide test

What test for ASO has the detection of antibody reacting to a carrier particle coated with antigen?

Polystyrene, bentonite, charcoal, RBC

Latex agglutination slide test carrier particles (latex)

Reagent, positive and negative control

Latex agglutination slide test contents

White latex particles coated with Streptolysin O, Sodium azide, Ammonium chloride buffer

Latex agglutination slide test reagents

pH 8.2

Latex agglutination slide test ammonium chloride buffer pH

Serum

Latex agglutination slide test specimen

7 days at 2-8°C

Latex agglutination slide test stability

50 microliters

Latex agglutination slide test sample volume

1 drop

Latex agglutination slide test positive control volume

1 drop

Latex agglutination slide test negative control volume

1 drop

Latex agglutination slide test LR volume

100 revolutions per minute for 2 minutes

How long and how fast should you rotate the cards in the Latex agglutination slide test?

1 minute

When is the Latex agglutination slide test visualized after rotating?

1-2 weeks

When does ASO increase following symptoms like sore throat, skin infection, and impetigo?

3-6 weeks

When does ASO peak following symptoms like sore throat, skin infection, and impetigo?

>200 IU/mL

At what ASO value does Latex agglutination slide test show a positive result?

<200 IU/mL

At what ASO value does Latex agglutination slide test show a negative result?

Visible agglutination

Latex agglutination slide test positive result

Absence of visible agglutination

Latex agglutination slide test negative result

Rheumatoid fever, Glomerulonephritis, Acute Streptococcal infection

In what conditions are increased ASO titers of diagnostic value or significance?

Serial two-fold dilution

Latex agglutination slide test positive result can be followed by what procedure?

96 mg/L

What is the approximate concentration of the CRP in the patient with .... Serial dilution of 1 to 16 (1:16) or where 16 is the highest dilution?