Immunostaining in Neuropathology

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From:"Timothy R. Wheelock" <>
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        I manage and single-handedly work a neuropathology lab at a
Brain Bank, and I am considering adding an immuno-staining capability to
my classical staining routine. I have some general questions to ask
before making such a move.
    (1) Has immuno-staining become a  standard routine practice in
neuropathology these days?
          We concentrate on degenerative and psychiatric disorders, and
rarely see tumors, so we don't  have
            to worry about tumor identification. Or is it only used
occasionally, for example,  to distinguish Diffuse
            Lewy Body disease from Pick's disease using Alpha B
crystalline antibodies? I get different answers
            from different pathologists.
    (2) If it is used routinely, what sort of immuno-stains are used?
                From one pathologist I get a list of Tau, Ubiquitin,
Amyloid, and Alpha B crystalline. From another
                I'm told that he rarely uses immuno-staining at all
except occasionally and that my Bielschowsky
                stains and LHE's show more than 99% of what's needed to
make a complete and detailed
    (3) Whether routine, frequent or occasional, does the neuropathology
lab tech do the immuno themselves, or simply out-source the immuno work
            One pathologist says that his histo-tech sends the unstained
slides to another lab that specializes in
            immuno and gets the slides back in one day,  rather than his
tech having to re-invent the wheel, at
            considerable expense and time, in adding an immuno routine
to her schedule.
    (4) If the immuno function is out-sourced what sort of fees can we
be expected to encounter for such a
    (5) Is there a review paper or protocols book that I could consult
that reviews the immuno-stains used in neuropath (other than tumors)?

        Thank you very much for any information and advice that you
could give me,

         Tim Wheelock

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