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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/05/24 11:03:04」(JST)

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Immunodiagnostics is a diagnostic methodology that uses an antigen-antibody reaction as their primary means of detection. The concept of using immunology as a diagnostic tool was introduced in 1960 as a test for serum insulin. A second test was developed in 1970 as a test for thyroxine in the 1970s.

It is well-suited for the detection of even the smallest of amounts of (bio)chemical substances. Antibodies specific for a desired antigen can be conjugated with a radiolabel, fluorescent label, or color-forming enzyme and are used as a "probe" to detect it. Well known applications include pregnancy tests, immunoblotting, ELISA and immunohistochemical staining of microscope slides. The speed, accuracy and simplicity of such tests has led to the development of rapid techniques for the diagnosis of disease, microbes and even illegal drugs in vivo (of course tests conducted in a closed environment have a higher degree of accuracy). Such testing is also used to distinguish compatible blood types.

The Enzyme-Linked ImmunoSorbent Assay or ELISA and the Lateral-Flow test, also known as the dipstick or rapid test, currently are the two predominant formats in immunodiagnostics.

The ELISA [edit]

For more details on ELISA, see Immunoassay.

The ELISA (sometimes also called an EIA) is a sensitive, inexpensive assay technique involving the use of antibodies coupled with indicators (e.g. enzymes linked to dyes) to detect the presence of specific substances, such as enzymes, viruses, or bacteria. While there are several different types, basically ELISAs are created by coating a suitable plastic (the solid phase) with an antibody. To complete the reaction, a sample believed to contain the antigen of interest is added to the solid phase. Then a second antibody coupled with an enzyme is used followed by the addition of a color-forming substrate specific to the antibody.

References [edit]

RS Yalow and SA Berson, “Immunoassay of Endogenous Plasma Insulin in Man,” Journal of Clinical Investigation 39, no. 7 (1960): 1157–1175.
RJ Ekins, “Radioimmunoassay of Thyroid and Steroid Hormones,” British Journal of Radiology 43, no. 515 (1970): 828.

External links [edit]

Immunologic diagnosis at the US National Library of Medicine Medical Subject Headings (MeSH)

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English Journal

Utility of immunologic testing in suspected rheumatologic disease.

Bhagat M, Sehra ST, Shahane A, Kwan M.Author information Division of Pulmonary, Allergy, and Critical Care, Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.AbstractThe use of diagnostic testing in the clinical practice of medicine has been a shifting landscape from the time that the first blood test was utilized. This is no different in the field of immunology and in particular rheumatology. As the field of immunology is relatively young, the clinical tests are not well established and therefore guidelines for use are still under debate. In this review, we seek to look at some of the key autoantibodies, as well as other tests that are available to diagnose suspected rheumatologic disease, and examine how to best use these tests in the clinic. In particular, we will focus on the anti-nuclear antibodies, anti-neutrophil cytoplasmic antibodies, complement, cryoglobulins, rheumatoid factor, and anti-citrullinated protein antibodies.
Current allergy and asthma reports.Curr Allergy Asthma Rep.2014 Jan;14(1):405. doi: 10.1007/s11882-013-0405-5.
The use of diagnostic testing in the clinical practice of medicine has been a shifting landscape from the time that the first blood test was utilized. This is no different in the field of immunology and in particular rheumatology. As the field of immunology is relatively young, the clinical tests ar
PMID 24370946

Neurocysticercosis.

Del Brutto OH.Author information School of Medicine, Universidad de Especialidades Espiritu Santo and Department of Neurological Sciences, Hospital Clinica Kennedy, Guayaquil, Ecuador. Electronic address: oscardelbrutto@hotmail.com.AbstractKnown as a disease of swine in ancient civilizations, cysticercosis is currently considered the most common helminthic infection of the nervous system, and a leading cause of acquired epilepsy worldwide. The disease occurs when humans become intermediate hosts of the tapeworm Taenia solium by ingesting its eggs from contaminated food or, most often, directly from a Taenia carrier by the fecal-oral route. Once in the human intestine, Taenia eggs evolve to oncospheres that, in turn, cross the intestinal wall and lodge in human tissues - especially the nervous system - where cysticerci develop. The brain is a hostile environment in which parasites attempt to escape the immune surveillance while the host is trying to drive out the infection. In some cases, cysticerci are destroyed by this immunological attack, while in others, parasites may live unchanged for years. Cysticerci may be located in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing a myriad of pathologic changes that are the main changes responsible for the clinical pleomorphism of neurocysticercosis. Seizures are the most common clinical manifestation of the disease, but some patients present with focal deficits, intracranial hypertension, or cognitive decline. With the exception of cystic lesions showing the scolex as an eccentric nodule, neuroimaging findings of neurocysticercosis are nonspecific and may be seen in other diseases of the nervous system. Likewise, immune diagnostic tests have been faced with problems related to poor sensitivity or specificity. Accurate diagnosis is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunologic tests, in a proper epidemiologic scenario. The introduction of cysticidal drugs has changed the prognosis of neurocysticercosis. Praziquantel and albendazole have been shown to reduce the burden of infection in the brain (as seen on neuroimaging studies) and to improve the clinical course of the disease in most patients. Further efforts should be directed towards eradicating this disease through the implementation of control programs for all the interrelated steps in the life cycle of T. solium, including human carriers of the adult tapeworm, infected pigs, and eggs in the environment.
Handbook of clinical neurology.Handb Clin Neurol.2014;121:1445-59. doi: 10.1016/B978-0-7020-4088-7.00097-3.
Known as a disease of swine in ancient civilizations, cysticercosis is currently considered the most common helminthic infection of the nervous system, and a leading cause of acquired epilepsy worldwide. The disease occurs when humans become intermediate hosts of the tapeworm Taenia solium by ingest
PMID 24365429

Ovarian cancer: designing effective vaccines and specific diagnostic tools.

Spinosa JP, Kanduc D.Author information Department Biosciences, Biotechnologies & Biopharmaceutics, University of Bari, Bari, Italy.AbstractAim: Notwithstanding a renewed interest in the application of immunotherapy as an alternative to chemotherapy and radiotherapy for the treatment of ovarian cancer (OC), and in spite of the available knowledge about ovarian tumor-associated-antigens, the search for a vaccine against OC remains a scientific and clinical challenge. Likewise, immunodiagnostics can detect only a late stage of the disease. Thus, the development of new therapeutic and diagnostic options is highly desirable. Methods: Based on the low-similarity hypothesis, which supports the concept that immunogenicity is preferentially associated to sequences with no/low-similarity to the host proteome, and using Protein Information Resource peptide match program, we searched the ovarian tumor antigen CA125 for amino acid sequences unique to CA125 and absent in the remaining human proteins. Results & conclusion: We identified a set of 159 pentapeptides unique to CA125 that might be used to design specific and effective immunological tools for diagnosis and treatment of OC.
Immunotherapy.Immunotherapy.2014 Jan;6(1):35-41. doi: 10.2217/imt.13.144.
Aim: Notwithstanding a renewed interest in the application of immunotherapy as an alternative to chemotherapy and radiotherapy for the treatment of ovarian cancer (OC), and in spite of the available knowledge about ovarian tumor-associated-antigens, the search for a vaccine against OC remains a scie
PMID 24341882