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Ramos-Vara JA, Miller MA. When tissue antigens and antibodies get along: revisiting the technical aspects of immunohistochemistry--the red, brown, and blue technique. Vet Pathol 2013; 51:42-87. [PMID: 24129895 DOI: 10.1177/0300985813505879] [Citation(s) in RCA: 246] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Once focused mainly on the characterization of neoplasms, immunohistochemistry (IHC) today is used in the investigation of a broad range of disease processes with applications in diagnosis, prognostication, therapeutic decisions to tailor treatment to an individual patient, and investigations into the pathogenesis of disease. This review addresses the technical aspects of immunohistochemistry (and, to a lesser extent, immunocytochemistry) with attention to the antigen-antibody reaction, optimal fixation techniques, tissue processing considerations, antigen retrieval methods, detection systems, selection and use of an autostainer, standardization and validation of IHC tests, preparation of proper tissue and reagent controls, tissue microarrays and other high-throughput systems, quality assurance/quality control measures, interpretation of the IHC reaction, and reporting of results. It is now more important than ever, with these sophisticated applications, to standardize the entire IHC process from tissue collection through interpretation and reporting to minimize variability among laboratories and to facilitate quantification and interlaboratory comparison of IHC results.
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Affiliation(s)
- J A Ramos-Vara
- Animal Disease Diagnostic Laboratory and Department of Comparative Pathobiology, Purdue University, 406 South University, West Lafayette, IN 47907, USA.
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Eltoum I, Fredenburgh J, Grizzle WE. Advanced Concepts in Fixation: 1. Effects of Fixation on Immunohistochemistry, Reversibility of Fixation and Recovery of Proteins, Nucleic Acids, and other Molecules from Fixed and Processed Tissues. 2. Developmental Methods of Fixation. J Histotechnol 2013. [DOI: 10.1179/his.2001.24.3.201] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Grizzle WE, Stockard CR, Billings PE. The Effects of Tissue Processing Variables Other Than Fixation on Histochemical Staining and Immunohistochemical Detection of Antigens. J Histotechnol 2013. [DOI: 10.1179/his.2001.24.3.213] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ramos-Vara JA, Kiupel M, Baszler T, Bliven L, Brodersen B, Chelack B, West K, Czub S, Del Piero F, Dial S, Ehrhart EJ, Graham T, Manning L, Paulsen D, Valli VE. Suggested Guidelines for Immunohistochemical Techniques in Veterinary Diagnostic Laboratories. J Vet Diagn Invest 2008; 20:393-413. [DOI: 10.1177/104063870802000401] [Citation(s) in RCA: 185] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This document is the consensus of the American Association of Veterinary Laboratory Diagnosticians (AAVLD) Subcommittee on Standardization of Immunohistochemistry on a set of guidelines for immunohistochemistry (IHC) testing in veterinary laboratories. Immunohistochemistry is a powerful ancillary methodology frequently used in many veterinary laboratories for both diagnostic and research purposes. However, neither standardization nor validation of IHC tests has been completely achieved in veterinary medicine. This document addresses both issues. Topics covered include antibody selection, fixation, antigen retrieval, antibody incubation, antibody dilutions, tissue and reagent controls, buffers, and detection systems. The validation of an IHC test is addressed for both infectious diseases and neoplastic processes. In addition, storage and handling of IHC reagents, interpretation, quality control and assurance, and troubleshooting are also discussed. Proper standardization and validation of IHC will improve the quality of diagnostics in veterinary laboratories.
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Affiliation(s)
- José A. Ramos-Vara
- Animal Disease Diagnostic Laboratory, Purdue University, West Lafayette, IN
| | - Matti Kiupel
- Diagnostic Center for Population and Animal Health, Michigan State University, East Lansing, MI
| | - Timothy Baszler
- Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA
| | - Laura Bliven
- Marshfield Clinic Laboratories Veterinary Services, Marshfield, WI
| | - Bruce Brodersen
- Veterinary Diagnostic Laboratory, University of Nebraska, Lincoln, NE
| | - Brian Chelack
- Prairie Diagnostic Services Inc., Saskatoon, Saskatchewan, Canada
| | - Keith West
- Prairie Diagnostic Services Inc., Saskatoon, Saskatchewan, Canada
| | - Stefanie Czub
- National Centre for Foreign Animal Diseases, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Fabio Del Piero
- Department of Pathobiology and Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA
| | - Sharon Dial
- Department of Veterinary Science and Microbiology, University of Arizona, Tucson, AZ
| | - E. J. Ehrhart
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO
| | - Tanya Graham
- Animal Disease Research and Diagnostic Laboratory, South Dakota State University, Brookings, SD
| | - Lisa Manning
- National Centre for Foreign Animal Diseases, Canadian Food Inspection Agency
| | - Daniel Paulsen
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, LA
| | - Victor E. Valli
- Department of Pathobiology, University of Illinois, Champaign, IL
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Namimatsu S, Ghazizadeh M, Sugisaki Y. Reversing the effects of formalin fixation with citraconic anhydride and heat: a universal antigen retrieval method. J Histochem Cytochem 2005; 53:3-11. [PMID: 15637333 DOI: 10.1177/002215540505300102] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Formalin is a commonly used fixative for tissue preservation in pathology laboratories. A major adverse effect of this fixative is the concealing of tissue antigens by protein cross-linking. To achieve a universal antigen retrieval method for immunohistochemistry under a constant condition, we developed a new method in which the effects of formalin fixation were reversed with citraconic anhydride (a reversible protein cross-linking agent) plus heating. Formalin-fixed, paraffin-embedded tissues from various organs were examined for immunohistochemical localization of a wide variety of antigens. Deparaffinized tissue sections were placed in an electric kitchen pot containing 0.05% citraconic anhydride solution, pH 7.4, and the pot was set at "keep warm" temperature mode of 98C for 45 min. This mode allowed heating the sections at a constant temperature. The sections were then washed in buffer solution and immunostained using a labeled streptavidin-biotin method using an automated stainer. In general, formalin-fixed tissues demonstrated specific immunostainings comparable to that in fresh frozen tissues and significantly more enhanced than after conventional antigen retrieval methods. In particular, even difficult-to-detect antigens such as CD4, cyclin D1, granzyme beta, bcl-6, CD25, and lambda chain revealed distinct immunostainings. Different classes of antigens such as cellular markers and receptors, as well as cytoplasmic and nuclear proteins, consistently produced enhanced reactions. This method provides efficient antigen retrieval for successful immunostaining of a wide variety of antigens under an optimized condition. It also allows standardization of immunohistochemistry for formalin-fixed tissues in pathology laboratories, eliminating inter-laboratory discrepancies in results for accurate clinical and research studies.
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Affiliation(s)
- Shigeki Namimatsu
- Department of Surgical Pathology, Nippon Medical School Hospital, Tokyo, Japan
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