Chapter 40 : Introduction

Abstract:

Immunohistochemistry techniques are integral to the practice of anatomic pathology. In contrast to the 7th edition of this Manual, in which a separate chapter discusses the principles and advances of immunohistochemistry, these techniques have been directly incorporated in two chapters along with figures illustrating the detection of antibodies involved in renal and cardiac diseases. In the first chapter, Collins et al. provide a brief history of immunofluorescence. Methods for the handling, freezing, and storage of tissue specimens, typically obtained by biopsy, are discussed. While most immunofluorescence studies are performed with unfixed frozen tissue, tissue fixation and tissue sectioning are detailed. Direct immunofluorescence is illustrated for the detection of immunoglobulin G (IgG), IgA, IgM, C3, C1q, fibrinogen, and kappa and lambda light chain deposition in renal tissue. A brief discussion of dual fluorescence and microscope instrumentation is followed by an overview of interpretation. In the second chapter, Collins and Smith discuss Western blot analysis for the detection of antibodies specific for glomerular basement membrane and phospholipase A2 receptors. Special requirements are highlighted for antigen presentation, enzymatic digestion of glomeruli, and transfer onto nitrocellulose paper. Section G provides an overview of immunohistology and immunopathology measurements in present-day clinical practice.