TUTOR IMUNOLOGI

TES AGLUTINASI DR. Drs. Suprapto Ma’at.,MS.,Apt Jeine Stela Akualing, dr

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IMUNOASAI

TIDAK BERLABEL

TES PRESIPITASI

TES FIKSASI KOMPLEMEN

BERLABEL

TES NETRALISASI TOKSIN

TES AGLUTINASI

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1896

Herbert Edward Durham

Max Von Gruber

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AGLUTINASI Reaksi antara antigen yang tidak larut dengan antibodi membentuk agregasi partikel (aglutinat ) Antigen dilekatkan pada partikel pembawa seperti eritrosit atau lateks Tahap aglutinasi : • Sensitisasi • Pembentukan lattice

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AGLUTINASI

• Antibodi berikatan dengan antigen pada permukaan partikel melalui single antigenic determinant •Berlangsung cepat dan reversibel •Belum terbentuk agregasi

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AGLUTINASI

•Adanya interaksi antara antibodi dengan multiple antigenic determinants •Terjadi cross-link sehingga terbentuk agregat yang dapat diamati

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AGLUTINASI Dipengaruhi oleh : 1. Jenis antibodi 2. Waktu inkubasi 3. Suhu, pH, konsentrasi elektrolit 4. Rasio antigen dan antibodi

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SLIDE AGGLUTINATION

TUBE AGGLUTINATION

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TES AGLUTINASI Aglutinasi langsung ( Direct agglutination )

Aglutinasi pasif ( Passive agglutination ) Aglutinasi pasif terbalik ( Reverse passive agglutination ) Hambatan aglutinasi ( Agglutination inhibition )

Ko-aglutinasi ( Coagglutination ) Antiglobulin mediated agglutination Direct Antiglobulin Test (DAT) ( Coomb’s Test Test ) Indirect Antiglobulin (IAT)

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AGLUTINASI LANGSUNG ( DIRECT AGGLUTINATION ) • Mendeteksi antibodi dalam serum • Menggunakan antigen yang telah diketahui (eritrosit atau suspensi bakteri ) • Contoh : Tes Penentuan golongan darah Tes Widal

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AGLUTINASI LANGSUNG TES WIDAL

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AGLUTINASI LANGSUNG TES PENENTUAN GOLONGAN DARAH

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AGLUTINASI PASIF ( PASSIVE AGGLUTINATION ) • Disebut juga aglutinasi tidak langsung (indirect agglutination) • Menggunakan antigen yang dilekatkan pada partikel ( lateks, eritrosit, gelatin, silikat) • Contoh : Pemeriksaan faktor rematoid

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AGLUTINASI PASIF Aglutinasi lateks ( Pemeriksaan Faktor Rematoid )

Partikel lateks

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AGLUTINASI PASIF TERBALIK (REVERSE PASSIVE AGGLUTINATION) Antibodi dilekatkan pada partikel pembawa Sampel yang mengandung antigen bereaksi dengan antibodi sehingga terbentuk aglutinasi Contoh : deteksi kuman Streptococcus grup B, Staphylococcus aureus dalam serum, urine atau LCS, pemeriksaan C-reactive protein.

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AGLUTINASI PASIF TERBALIK (REVERSE PASSIVE AGGLUTINATION)

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HAMBATAN AGLUTINASI (AGGLUTINATION INHIBITION) • Prinsip : Kompetisi antara particulate dengan antigen pada sampel untuk berikatan dengan antibodi • Sampel (antigen) + Reagen (antibodi) + antigen pada particulate lateks • Jika serum mengandung antigen, akan berikatan dengan antibodi. Penambahan particulate tidak akan menyebabkan aglutinasi hasil positif • Contoh : Deteksi antibodi terhadap virus ( Influenza, Measles, Mumps, Rubella )

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HAMBATAN AGLUTINASI (AGGLUTINATION INHIBITION)

1919 Page

HAMBATAN HEMAGLUTINASI

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KO – AGLUTINASI (COAGGLUTINATION) • Menggunakan antibodi yang dilekatkan pada partikel inert yaitu bakteri seperti Staphylococcus aureus • Apabila serum pasien mengandung antigen, akan berikatan dengan antibodi sehingga terjadi aglutinasi • Deteksi Neisseria meningitidis, Neisseria gonorrhoeae, Vibrio cholera

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ANTIGLOBULIN MEDIATED AGGLUTINATION ( Coomb’s TEST )

Direct Antiglobulin Test (DAT)

• Mendeteksi antibodi (IgG) pada permukaan eritrosit • Prinsip : Apabila eritrosit pasien telah dilapisi antibodi, dengan penambahan Anti Human Globulin akan terjadi aglutinasi

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ANTIGLOBULIN MEDIATED AGGLUTINATION ( Coomb’s TEST )

Indirect Antiglobulin Test (IAT)

• Deteksi antibodi terhadap eritrosit dalam serum pasien • Reaksi berlangsung dalam 2 tahap : • Serum pasien ( antibodi ) + Reagen (eritrosit), diinkubasi 370C kemudian dicuci • Ditambah Anti Human Globulin untuk memperbesar aglutinasi

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DIRECT ANTIGLOBULIN TEST

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INTERFERENSI Hasil positif palsu dapat disebabkan oleh : 1. Kontaminasi 2. Autoaglutinasi 3. Cross-reactivity 4. Adanya faktor rematoid 5. Antibodi heterofil 6. Slide terlalu lama dibaca

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INTERFERENSI

Hasil negatif palsu dapat disebabkan oleh : 1. Kerusakan reagen 2. Pencucian tidak adekuat 3. Keterlambatan melakukan prosedur tes 4. Temperatur dan lama inkubasi tidak tepat 5. Pro zone dan Post zone phenomenon

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TERIMA KASIH

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2. TUTOR IMUNOLOGI - TES AGLUTINASI.pdf

IMUNOASAI. TIDAK. BERLABEL. TES. PRESIPITASI. TES FIKSASI. KOMPLEMEN. TES. NETRALISASI. TOKSIN. BERLABEL. TES. AGLUTINASI. Page 2 of 29 ...

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