Agglutination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Agglutination is the clumping of particles. The word agglutination comes from the Latin agglutinare, "to glue to."

This occurs in biology in three main examples:

1. The clumping of cells such as bacteria or red blood cells in the presence of an antibody. The antibody or other molecule binds multiple particles and joins them, creating a large complex.

2. The coalescing of small particles that are suspended in solution; these larger masses are then (usually) precipitated.

3. An allergic reaction type occurrence where cells become more compacted together to prevent foreign materials entering them. This is usually the result of an antigen in the vicinity of the cells.

Agglutination in hematology

Hemagglutination

Hemagglutination is a more specific form of agglutination that involves red blood cells (RBCs) and can be used to identify RBC surface antigens (with known antibodies) or to screen for antibodies (with RBCs with known surface antigens).

Using anti-A and anti-B antibodies that bind specifically to either the A or to the B blood group surface antigens on RBCs it is possible to test a small sample of blood and determine the ABO blood group (or blood type) of an individual.

The bedside card method of blood grouping relies on visual agglutination to determine an individual's blood group. The card has dried blood group antibody reagents fixed onto its surface and a drop of the individuals blood is placed on each area on the card. The presence or absence of visual agglutination enables a quick convenient method of determining the ABO and Rhesus status of the individual.

The 'bedside card' method of blood typing, in this case using a Serafol card. The result is blood group A positive.

Coombs test

Main article: Coombs test

Agglutination of red blood cells is used in the Coombs test.

Cross-matching

Main article: cross-matching

In cross-matching, agglutination occurring when donor and recipient's blood are incubated together indicates that the donor blood is incompatible for that particular recipient.

Leukoagglutination

Leukoagglutination is when the particles involved are white blood cells.

Agglutination in microbiology

Agglutination is commonly used as a method of identifying specific bacterial antigens, and in turn, the identity of such bacteria. Because the clumping reaction occurs quickly and is easy to produce, agglutination is an important technique in diagnosis.

History of discoveries

Two bacteriologists, Herbert Edward Durham (-1945) and Max von Gruber (1853-1927), discovered specific agglutination in 1896. The clumping became known as Gruber-Durham reaction. Gruber introduced the term agglutinin (from the Latin) for any substance that caused agglutination of cells.

French physician Fernand Widal (1862-1929) put Gruber and Durham's discovery to practical use later in 1896, using the reaction as the basis for a test for typhoid fever. Widal found that blood serum from a typhoid carrier caused a culture of typhoid bacteria to clump, whereas serum from a typhoid-free person did not. This Widal test was the first example of serum diagnosis.

Austrian physician Karl Landsteiner found another important practical application of the agglutination reaction in 1900. Landsteiner's agglutination tests and his discovery of ABO blood groups was the start of the science of blood transfusion and serology which had made transfusion possible and safe.

Related chapters

• Macrophage
• Immune System

Acknowledgements

The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.

Initial content for this page in some instances may have came from Wikipedia and AskDrWiki

Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources:

1.The Disease Database

2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3

3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7

References

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