Complement, AP50 total alternative pathway & CH50/THC total classical pathway function
The complement cascade is activated as part of the innate immune response to pathogens. It is also involved in removing immune complexes and apoptotic debris from the circulation.
These assays measure the ability of serum complement components to form the terminal membrane attack complex (MAC) via the classical and the alternative pathway. The MAC forms cytotoxic pores in the membrane of microbes leading to direct killing. These tests are used as a screening test for defects of individual components of the classical, alternative and terminal pathways and in the investigation of immune deficiency. It should not be used for monitoring complement consumption, instead request C3 and C4 levels.
These tests measure formation of the C5b-9 terminal MAC by ELISA.
Suspected complement deficiency
Recurrent infections with encapsulated bacteria in the setting of normal immunoglobulins and normal polysaccharide antibody responses
Recurrent Neisseria infections
AP50 – 50-125% of normal
CH50/THC – 50-125% of normal
(ranges derived and validated in house)
Record last updated
September 2, 2025
Sample Container
5ml RST Vacutainers (Rust top)
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Test Results
Yes, we have a Pathology User Guide
Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net
Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page
Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net
Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.
Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.
Phlebotomy services are not managed by NWLP. For further information please see:
Imperial College Healthcare Trust Phlebotomy services
Chelsea and Westminster Hospital NHS Foundation Trust Phlebotomy services
NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.
UKAS accredited medical laboratory/medical diagnostic service:
- Clinical Biochemistry No. 8673
- Haematology and Blood Transfusion No. 8674
- Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) No. 8659
- Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) No. 9615
If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.
UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).
The BD Hospital Tube Guide, BD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.
Home testing
INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION
We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.
Our accreditations
Upholding excellence in diagnostic standards
Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.
Find out more about our accreditations on the UKAS website.
UKAS website