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As a demonstration of the protocol, baseline sera were assayed from 16 individuals within a prospective cohort study of college students followed for influenza infection on the influenza antigen microarray. To demonstrate assay reproducibility, these specimens were probed twice, on different slides and different days.
For this study, purified influenza antigens containing His10 tags were obtained from commercial vendor (see Table of Materials) and collaborators. These antigens include 251 total HA antigens, with 63 globular head domains (HA1) and 186 full-length proteins (HA0), including 96 monomeric HA0 proteins and 90 trimerized HA0 proteins containing fused trimerization ("foldon") domain23. A full list of antigens and controls used in this study is included as a Supplementary File. For this study, secondary antibodies used were goat anti-human IgG conjugated to quantum dot emitting at 800 nm (GAH-IgG-Q800) and goat anti-human IgA conjugated to quantum dot emitting at 585 nm (GAH-IgA-Q585) for multiplex detection of IgG and IgA antibodies as shown in Figure 3. IgG and IgA antibody binding to different subtypes and molecular forms of influenza HA antigens were compared for sera obtained from the clinical cohort described above.
The resulting heat map is shown in Figure 4 with graphical representation in Figure 5. In these figures, only the clinically relevant subtypes with high representation on the array are labeled to save space, with "+" denoting all remaining subtypes of higher number, and minor or less well represented subtypes included as ordered (e.g., H2 in between H1 and H3). A full list of strains and subtypes on the array is included as Supplementary File. These data demonstrate that antibodies to the head group of HA are subtype-specific with expected high quantity of antibodies to clinically prevalent strains (H1N1, H3N2, and B) and low quantity of antibodies to other strains. However, antibodies to the whole HA, which includes the stalk domain, are more cross-reactive across subtypes, and this effect appears to be augmented when the whole HA is trimerized. This result is not unexpected, as the whole HA includes the stem region, which is highly conserved across subtypes. Therefore, antibodies to whole HA molecules from non-clinical subtypes (e.g., H5 and H7) likely represent anti-stem antibodies originally elicited against clinical subtypes (e.g., H1 and H3) that are cross-reacting with the stem regions of the other HA subtypes on the array. This point illustrates the importance of including both head HA and whole molecule HA on the array to distinguish between antibodies to the head and the stem regions which show different reactivity profiles.
The assay demonstrates good reproducibility across probing runs. The second run does show slightly lower IgG antibodies across all strains, although the pattern between the strains is consistent. This across-the-board slight decrease is likely due to batch-to-batch variability in the secondary antibody, which was changed between runs for IgG but not for IgA. Thus, as noted in the protocol, it is recommended to use the same batch of each secondary antibody for any experiments between which quantitative comparison is planned. If different batches of antibody are necessary due to a high number of samples to be tested, we recommended including shared samples between experimental runs with different antibody batches to allow for quantitative comparison with correction.

Figure 1: Schematic of protein microarray. Each slide contains multiple pads each with a single array, which consists of hundreds of antigens printed onto spots arranged in a grid, with each spot containing one antigen adsorbed onto the 3-dimensional topography of the nitrocellulose surface to which antibodies from serum are bound. Please click here to view a larger version of this figure.

Figure 2: Schematic of influenza antigen microarray printing and probing protocol. From left to right, microarray is printed using onto nitrocellulose-coated slides, which are used to probe sera for IgG and IgA antibodies using quantum-dot-conjugated secondary antibodies, with slides imaged using a portable imager, and results analyzed to generate a heat map. Please click here to view a larger version of this figure.

Figure 3: Procedure for attaching probing chamber to microarray slide. From A to F, the probing chamber is placed on top of slide in correct orientation, attached to the slide using horizontal clips on the sides, and placed in the probing tray. Please click here to view a larger version of this figure.

Figure 4: Representative results of influenza antigen microarray. Heat maps represent antigen-specific antibody responses, with each row representing a single antigen arranged by molecule, subtype, and strain, and each column representing a probing run of a single specimen, arranged by antibody isotype and run (A, white = 0, black = 20000, red = 40000 fluorescence intensity). The antigen subtypes including all hemagglutinin subtypes from 1 to 18 and all neuraminidase subtypes from 1 to 10 are arranged vertically and labeled on the left. A comparison of the fluorescence intensity between two runs demonstrates good assay reproducibility by linear regression for IgA (B) and IgG(C). Please click here to view a larger version of this figure.

Figure 5: Breadth of serum antibodies measured on influenza antigen microarray. Serum IgA (A) and IgG (B) are grouped by HA and NA molecular forms and subtypes to demonstrate high specificity of HA head group antibodies for clinical subtypes and high cross-reactivity of whole HA and trimerized whole HA antibodies with inclusion of stalk region. Please click here to view a larger version of this figure.
Supplementary File: List of antigens on influenza antigen microarray. Content is shown for all 324 spots on the array, including blanks, fiducials, controls (human IgG and IgA and anti-human IgG and IgA at 0.1 mg/mL and 0.3 mg/mL), and antigens with information on source, molecular form, subtype, and strain. Abbreviations are as follows: for source, Sino = Sino Biological Inc., FKL = Florian Krammer Laboratory; for molecular form, HA1 = head HA, HA0 = whole HA, HA2 = stalk HA, NP = nucleoprotein. For antigens sourced from Sino Biological Inc., catalog numbers are shown; for antigens sourced from Krammer Laboratory, antigen IDs are listed. Please click here to download this file.