Alternative Complement Pathway Activity (AH50)
Test Code
AM50
Description
The complement system is part of our innate immune response. It is vital to our defense against invasive microorganisms. Complement activation can occur through the classical, lectin and alternative pathway, which then converge to a common terminal pathway. Activation of the complement pathway(s) results in the generation of biologically active peptides, also known as complement split products, and referred to as anaphylatoxins (C4a, C3a, C5a) which protect us from invasive microorganisms by enhancing inflammation, facilitating the clearance of immune complexes and apoptotic cells, enhancing cellular, and antibody immune responses, and altering vascular permeability, as well as smooth muscle contractility.
Complement deficiency can lead to life-threatening infections well as long-term autoimmune conditions such as systemic lupus erythematosus (SLE) and hereditary angioedema (HAE). The AH50 hemolytic assay is a sensitive method for detection of total alternative complement activity or lack thereof. Severe or recurrent infections that produce strong activation of the alternative complement pathway may lower AH50 levels below normal. Genetic or acquired complement deficiency involving the alternative complement pathway components (Factor B, Factor D, Properdin, and C3) as well as terminal complement components (C5, C6, C7, C8, and C9) may lower AH50 levels. Severe or recurrent infections that produce strong activation of the alternative complement pathway may lower AH50 levels below normal. The AH50 assay can also be utilized to monitor response to anti-complement therapies
Collect
Serum from a Red top tube is the only acceptable sample type. Draw blood into a serum collection tube. The collection tube should be completely filled with blood. Invert tube several times to initiate the clotting process. Keep the collection tube filled with blood at room temperature for 30-60 minutes to allow the blood to clot.
Ensure that the blood is centrifuged within 60 (± 5) minutes of collection.
Patient Prep
Centrifuge the collection tube at 1600 (± 200) x g (rcf) at 4°C (± 2°C) for 15 (±1) minutes. Affix tube label to a polypropylene cryogenic storage tube. Immediately transfer the cell-free serum to the cryogenic tube on ice and immediately store the cryogenic tube at -60°C or below in an ultra-low freezer.
Preferred volume: 1.0 mL
Minimum volume: 0.25 mL
Pediatric Collection
Minimum volume: 0.25 mL serum
Unacceptable Conditions
Thawed samples or samples stored at room temperature prior to shipment.
Storage Transport Temp
Ship samples overnight in a well-insulated container on dry ice. We receive samples Monday - Friday. Avoid sending samples on the weekend and holidays to ensure that samples arrive frozen.
Stability
-60°C or below in an ultra-low freezer - up to 2 years
Notes
Additional tests may be needed for confirmatory testing or reflex testing.
To prevent unnecessary delays in testing, please send one aliquot per test request.
Performed
Monday - Friday
Methodology
Hemolytic Assay
Turnaround Time
Up to 4 weeks
Department
Complement Lab
Synonyms
Complement (Alternative Complement Pathway Activity), Hemolytic Assay (Alternative Complement Pathway Activity), AM50
Study Offerings
CAP/CLIA
Reference Interval
77 - 159 Units/mL
Interpretation
Low AH50 level is indicative of a reduction, absence, and/or inactivity of any components of the alternative complement pathway and/or terminal complement pathway. Anti-complement therapy with C5 inhibitors including Eculizumab or Ravulizumab is associated with complete loss or reduced AH50 level.
CPT Code
86162
New York Approved
No: Run with Waiver
FDA
LDT