II. Definitions

  1. Agglutinin
    1. Substance that induces particles (e.g. Bacteria, viruses, cells) to stick together, forming a clump or mass
    2. Agglutinin examples include antibodies, lectins, and viral proteins
  2. Agglutinogen
    1. Antigens to which Agglutinins (e.g. antibodies) bind, resulting in Agglutination
  3. Agglutination
    1. Clumping together of material suspended in solution in response to exposure to specific agents
    2. Allows for Antigen-Antibody complexes to become visible in solution
  4. Flocculation
    1. Similar to Agglutination, but the aggregated complexes are smaller, finer and of a cloudy appearance
  5. Hemagglutination
    1. Red Blood Cell aggregation by Agglutinins
  6. Direct Agglutination (Active Agglutination)
    1. Antigen-Antibody complexes readily agglutinate without aid of other agents
    2. Original Agglutination technique used by Lancefield et. al. in the 1920s to identify Beta-hemolytic Streptococcus strains
  7. Indirect Agglutination (Passive Agglutination, Latex Agglutination)
    1. Agglutination of particles is made evident by attaching Antigen to inert substances (typically latex beads)
  8. Latex Agglutination (Latex Fixation)
    1. Passive Agglutination test in which specific Antigen is attached to latex particles
    2. Particles clump (or aggregate) when exposed to Antibody specific for the embedded Antigen

III. Types: Hemagglutination Examples

  1. ABO Typing
    1. Combine patient's Red Blood Cells with known anti-A serum and observe for Agglutination
    2. Combine patient's Red Blood Cells with known anti-B serum and observe for Agglutination
  2. Direct Coombs Test
    1. Detects presence of antibodies that have already bound to Red Blood Cells (e.g. Hemolytic Anemia)
    2. Antiglobulin (Antibody to Antibody) is added to a patient's blood sample
    3. Agglutination occurs if the patient's Red Blood Cells are coated with Antibody against the Red Blood Cells
  3. Indirect Coombs Test
    1. Detects presence of antibodies that may bind to specific Red Blood Cells when exposed (e.g. pre-transfusion, Rh factor)
    2. Donor Red Blood Cells are added to patient's serum
    3. Antiglobulin (Antibody to Antibody) is added to the combined sample
    4. Agglutination occurs if the patient has Antibody to the donor's Red Blood Cells
  4. Cold Agglutinins
    1. Autoantibodies to Red Blood Cells that are activated by cold
    2. Cold Agglutinins are present in low levels in normal patients
      1. Cold Agglutinins may increase with Mycoplasma pneumoniae, Lymphoma and other conditions
      2. Cold Agglutinins may also be increased in a rare Autoimmune Hemolytic Anemia
  5. Heterophil Antibody (Mononucleosis)
    1. Antibodies react to multiple Antigens
    2. Heterophil Antibody agglutinates sheep RBCs, and in the case of Monospot Test, horse RBCs

IV. Types: Direct Agglutination Examples

  1. VDRL (Syphilis Screening, requires confirmation)
    1. Based on finding that Treponema organisms release cardiolipin Antigen
    2. Colorless Alcohol based solution of beef cardiolipin, Cholesterol, and lecithin is added to patient's serum
    3. Fluid is examined on glass slide for microflocculation
    4. Microflocculation suggests possible Syphilis, but has high False Positive Rate and requires confirmation
  2. RPR (Syphilis Screening, requires confirmation)
    1. Modified VDRL test using charcoal bound cardiolipin, easier to detect without microscope
    2. RPR test is performed on a detection card and can be read with the naked eye
  3. Widal Test (Typhoid Fever, requires confirmation)
    1. Salmonella typhiAntigen is exposed to patient's serum
    2. Agglutination suggests possible Typhoid Fever, but has a high False Positive Rate and requires confirmation

V. Types: Latex Agglutination Examples

  1. Rheumatoid Factor
    1. Rheumatoid Factor is an Antibody to the Fc portion of IgG found in Rheumatoid Arthritis
    2. Latex Agglutination test in which IgG-coated latex beads are exposed to a patients serum
    3. Rheumatoid Factor IgM in a patient's serum will agglutinate the suspended beads
  2. Human chorionic gonadotropin (Urine bHCG or qualitative Pregnancy Test)
    1. Patient urine is mixed with anti-HCG antibodies
    2. HCG-coated latex particles added to the patient's urine
      1. Agglutination occurs if the patient is NOT pregnant (xHCG binds HCG-coated latex)
      2. Agglutination does NOT occur if patient is pregnant (xHCG binds HCG in urine)

VI. Resources

VII. References

  1. Goldberg (2014) Clinical Physiology, Medmaster, Miami, p. 83-5

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Ontology: agglutination (C0001801)

Definition (MSH) The clumping together of suspended material resulting from the action of AGGLUTININS.
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SnomedCT 82383000
English Agglutination, Agglutination, function, agglutinations, Agglutination, function (observable entity), Agglutination (function), agglutination
Swedish Agglutination
Czech aglutinace
Finnish Agglutinaatio
Russian AGGLIUTINATSIIA, АГГЛЮТИНАЦИЯ
Croatian AGLUTINACIJA
Polish Aglutynacja
Norwegian Agglutinasjon, Sammenklumping
Spanish aglutinación (entidad observable), aglutinación (función), aglutinación, Aglutinación
French Agglutination
German Agglutination, Verklumpung
Italian Agglutinazione
Dutch Agglutinatie
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Ontology: Agglutination Tests (C0001802)

Definition (MSH) Tests that are dependent on the clumping of cells, microorganisms, or particles when mixed with specific antiserum. (From Stedman, 26th ed)
Definition (CSP) mixing of antibodies with their corresponding antigens on the surface of large, easily sedimented particles such as animal cells, erythrocytes, or bacteria; the antibodies cross-link the particles, forming visible clumps.
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English Agglutination Test, Test, Agglutination, Tests, Agglutination, agglutination reaction, agglutination reactions, agglutination tests, agglutination testing, agglutination assay, agglutination test, Agglutination Tests, Agglutination tests, Agglutination procedure, Agglutination assay (procedure), Agglutination assay, Agglutination procedure (procedure), Agglutination assay, NOS, Agglutination procedure, NOS, Agglutination assay (procedure) [Ambiguous]
Swedish Agglutinationstester
Czech aglutinace - testy
Finnish Agglutinaatiokokeet
French Tests d'agglutination, Réactions d'agglutination
Russian AGGLIUTINATSII TESTY, АГГЛЮТИНАЦИИ ТЕСТЫ
Croatian AGLUTINACIJSKI TESTOVI
Polish Odczyny aglutynacyjne, Testy aglutynacyjne
Norwegian Agglutinasjonstester, Sammenklumpingstester
Spanish Tests de Aglutinación, procedimiento de aglutinación (procedimiento), procedimiento de aglutinación, prueba de aglutinación (concepto no activo), prueba de aglutinación (procedimiento), prueba de aglutinación, Pruebas de Aglutinación
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Ontology: Agglutinins (C0001804)

Definition (NCI_NCI-GLOSS) A substance that makes particles (such as bacteria or cells) stick together to form a clump or a mass.
Definition (CSP) antibody or other substance that reacts with surface antigens of particles, such as red cells and bacteria, to agglutinate them.
Definition (MSH) Substances, usually of biological origin, that cause cells or other organic particles to aggregate and stick to each other. They include those ANTIBODIES which cause aggregation or agglutination of particulate or insoluble ANTIGENS.
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Swedish Agglutininer
Czech aglutininy
Finnish Agglutiniinit
Russian AGGLIUTININY, АГГЛЮТИНИНЫ
Croatian AGLUTININI
Polish Aglutyniny
Spanish aglutinina (concepto no activo), aglutinina (sustancia), aglutinina, Aglutininas
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Ontology: flocculation (C0016243)

Definition (MSH) The aggregation of suspended solids into larger clumps.
Definition (GO) The reversible, non-sexual aggregation of single-celled organisms in suspension to form aggregates of many cells known as flocs. [GOC:jl, GOC:vw, PMID:21114594, PMID:8740415]
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SnomedCT 13402008
English Flocculation, Flocculations, Flocculation, function, Flocculation, function (observable entity), Flocculation (function), flocculation
Swedish Flockulering
Czech flokulace, vločkování
Finnish Flokkulaatio
Russian FLOKKULIATSIIA, ФЛОККУЛЯЦИЯ
Croatian FLOKULACIJA, PAHULJANJE
Polish Kłaczkowanie, Flokulacja
Norwegian Not Translated[Flocculation]
Spanish floculación (entidad observable), floculación (función), floculación, Floculación
French Floculation
German Ausflockung
Italian Flocculazione
Dutch Flocculatie
Portuguese Floculação

Ontology: Flocculation Tests (C0016244)

Definition (MSH) Precipitin tests which occur over a narrow range of antigen-antibody ratio, due chiefly to peculiarities of the antibody (precipitin). (From Stedman, 26th ed)
Concepts Laboratory Procedure (T059)
MSH D005428
SnomedCT 5818005
English Flocculation Tests, Test, Flocculation, Tests, Flocculation, Flocculation Test, flocculation test, Flocculation test, Flocculation test (procedure)
Swedish Flockuleringstest
Czech flokulační testy
Finnish Flokkulaatiokokeet
French Tests de floculation, Réactions de floculation
Russian FLOKULIATSII TESTY, ФЛОКУЛЯЦИИ ТЕСТЫ
Croatian FLOKULACIJSKI TESTOVI
Polish Próby kłaczkowania, Testy kłaczkowania
Norwegian Flokkuleringstester, Flokkulasjonstester
Spanish Tests de Floculación, prueba de floculación (procedimiento), prueba de floculación, Pruebas de Floculación
German Flockungstests
Italian Prove di flocculazione
Dutch Flocculatietest, Test, flocculatie-
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Ontology: Hemagglutination (C0018903)

Definition (MSH) The aggregation of ERYTHROCYTES by AGGLUTININS, including antibodies, lectins, and viral proteins (HEMAGGLUTINATION, VIRAL).
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Russian GEMAGGLIUTINATSIIA, ГЕМАГГЛЮТИНАЦИЯ
Croatian HEMAGLUTINACIJA
Polish Hemaglutynacja
Norwegian Hemagglutinasjon, Sammenklumping av erytrocytter
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Italian Emoagglutinazione
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Ontology: Latex Fixation Tests (C0023117)

Definition (HL7V3.0) <p>Agglutination, Latex</p>
Definition (MSH) Passive agglutination tests in which antigen is adsorbed onto latex particles which then clump in the presence of antibody specific for the adsorbed antigen. (From Stedman, 26th ed)
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Swedish Latexagglutinationstester
Czech latex fixační testy, latex aglutinační testy
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German Latex-Fixationstests, Latex-Agglutinationstests
Russian LATEKS-TEST, LATEKS-AGGLIUTINATSII TESTY, ЛАТЕКС-АГГЛЮТИНАЦИИ ТЕСТЫ, ЛАТЕКС-ТЕСТ
French Tests de fixation au latex, Tests d'agglutination au latex, Tests au latex
Italian Test di agglutinazione al lattice, Test di fissaggio mediante lattice
Croatian LATEKS, FIKSACIJSKI TESTOVI, LATEKS, TEST AGLUTINACIJE
Polish Testy aglutynacyjne lateskowe, Testy lateksowe, Odczyny lateksowe
Japanese ラテックス吸着テスト, ラテックス吸着試験, ラテックス凝集反応, ラテックス凝集法
Norwegian Lateks fiksasjonsprøver, Lateks agglutinasjonstester
Spanish Tests de Fijación de Látex, prueba de aglutinación del látex (procedimiento), prueba de aglutinación del látex, Pruebas de Fijación de Látex, Tests de Aglutinación de Látex
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