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Intelligent immunostaining: the latest system assessed at the Christie Hospital

Significant advances in immunohistochemical technique made over the past four decades have revolutionised surgical pathology practice. Now, the latest automated immunostainer from Menarini is set to enhance the service provided to clinicians and patients alike.

The Christie Hospital in Manchester is one of Europe’s leading cancer centres, treating over 40,000 patients a year. The histopathology service provides diagnostic tumour pathology not only for the hospital’s own patients but also for those from other hospitals across the region and sometimes even further afield. The immunohistochemistry (IHC) service provided by the histopathology laboratory is extensive, with over 50,000 slides processed each year. This service is incredibly important and it is essential that the laboratory keeps up to date with developments in the field to provide a fast, efficient and reliable service. The laboratory therefore opted for the latest development in automated IHC systems – but more later.

The rest is history
Immunohistochemistry was first described in the 1940s using immunofluorescence for the detection of antigens in frozen sections. However, it wasn’t until the 1970s that the methods were applied successfully to routine formalin-fixed, paraffin wax-embedded (FFPE) tissue.

Two significant developments in the 1970s helped to shape the field of IHC. The first was the introduction of hybridomas to make monoclonal antibodies. These cell lines are capable of producing large quantities of primary antibodies that are made available commercially. The second development was the application of enzyme digestion to unmask antigens previously thought to be lost in FFPE tissue.
 These two developments meant that there was a large increase in the number of antibodies produced for diagnostic purposes. Then, in the early 1990s, the use of heat-induced epitope retrieval (HIER) was first described. This led to an explosion in the number of commercially available antibodies as more antigens could be detected than previously thought. Much effort has also been applied to improving the sensitivity of the detection methods available, with advances from the direct method through to avidin-biotin systems and more recently to the sensitive micropolymer detection kits.

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