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Complement – Alternative Pathway (AH50) Functional, Serum

Test ID: AH50F S

Test

Aliases/Synonyms

aHUS

Method

ELISA

Method Description

The Wieslab enzyme-linked immunosorbent assay (ELISA) complement assay for the alternative pathway combines principles of the hemolytic assay for complement activation with the use of labeled antibodies specific for neoantigens produced as a result of complement activation. The micro titer plate strips are coated with lipopolysaccharide (LPS). Patient serum is diluted in diluent containing specific blocker to ensure that only the alternative pathway is activated. During the first incubation, the diluted patient serum in the wells is activated by the coating. The wells are then washed and C5b-9 (MAC) is detected with a specific alkaline phosphatase labeled antibody to the neoantigen expressed during MAC formation. After a final wash, an alkaline phosphatase substrate is added. The amount of alternative pathway complement activity correlates with the color intensity of the solution and is measured in terms of absorbance (optical density: OD).(Frazer-Abel A, Sepiashvili L, Mbughuni MM, Willrich MA: Overview of laboratory testing and clinical presentations of complement deficiencies and dysregulation. Adv Clin Chem. 2016;77:1-75. doi: 10.1016/bs.acc.2016.06.001)

Report Includes

Complement - Alternative Pathway (AH50) Functional

Specimens

Serum

Clinical Utility

Investigation of suspected alternative pathway complement deficiency, atypical hemolytic uremic syndrome, C3 glomerulonephritis, dense-deposit disease

Test Location

Mayo Clinical Labs, Minnesota USA

Test Version

15-Jan-2021

Specimen

Specimens

Serum

Collection Containers

Red top (no additive). Avoid gel separator tubes.

Sample Volume

1 mL

Minimum Volume

0.2 mL

Specimen Comment

Avoid gel separator tubes

Patient Preparation

Fasting

Collection & Handling

Collection Instructions

Collect a fasting sample.

Handling Information

Immediately after specimen collection, place the tube on wet ice. Centrifuge at 4°C and aliquot serum into plastic vial. Freeze specimen within 30 minutes.

Stability

Frozen 14 days

Rejection Criteria

Specimen Received not frozen

Test Version

15-Jan-2021

Performance / Interpretation

Method

ELISA

Method Description

The Wieslab enzyme-linked immunosorbent assay (ELISA) complement assay for the alternative pathway combines principles of the hemolytic assay for complement activation with the use of labeled antibodies specific for neoantigens produced as a result of complement activation. The micro titer plate strips are coated with lipopolysaccharide (LPS). Patient serum is diluted in diluent containing specific blocker to ensure that only the alternative pathway is activated. During the first incubation, the diluted patient serum in the wells is activated by the coating. The wells are then washed and C5b-9 (MAC) is detected with a specific alkaline phosphatase labeled antibody to the neoantigen expressed during MAC formation. After a final wash, an alkaline phosphatase substrate is added. The amount of alternative pathway complement activity correlates with the color intensity of the solution and is measured in terms of absorbance (optical density: OD).(Frazer-Abel A, Sepiashvili L, Mbughuni MM, Willrich MA: Overview of laboratory testing and clinical presentations of complement deficiencies and dysregulation. Adv Clin Chem. 2016;77:1-75. doi: 10.1016/bs.acc.2016.06.001)

Turnaround Time

12 Days

Results

Name Units Reference Range Conversion Factor
Complement - Alternative Pathway (AH50) Functional % of norm
  • ≥46

Absent complement alternative pathway (AH50) in the presence of a normal total hemolytic complement (CH50) suggests an alternative pathway component deficiency.
Normal AH50 with absent CH50 suggests an early (C1, C2, C4) classic pathway deficiency.
Absent AH50 and CH50 suggests a late (C3, C5, C6, C7, C8, C9) component deficiency or complement consumption.
Absent AH50 and CH50 in the presence of a normal C3 and C4 suggests a late (C5, C6, C7, C8, C9) component deficiency.
Normal CH50 and AH50 in the presence of recurrent infection and continued suspicion of complement deficiency, suggest testing for lectin pathway function.

Test Location

Mayo Clinical Labs, Minnesota USA

Test Version

15-Jan-2021

Interface / Setup

HL7 Interface Codes

Order Code Result Codes Units
AH50F S 63358Complement, Alternate Path, Func, S % of norm

Test Version

15-Jan-2021