Commonly,
serological immunoassays and diagnostic kits include
reference standard reagents (calibrators) that contain specific antibodies
to be measured, which are used for the quantification of unknown antibodies
present in the sample. However, in some cases, such as the diagnosis
of allergies or autoimmune diseases, it is often difficult to have
sufficient quantities of these reference standards, and there are
limitations to their lot-to-lot reproducibility and standardization
over time. To overcome this difficulty, this study introduces the
use of surrogate recombinant calibrators formulated on the basis of
two single-domain antibodies (nanobodies) combined through a short
peptide linker to produce a recombinant bispecific construct. One
of the nanobodies binds to the cognate analyte of the target antibody
and the second is specific for the paratope of the secondary detecting
antibody. The bispecific nanobody inherits the outstanding properties
of stability and low-cost production by bacterial fermentation of
the parent nanobodies, and once calibrated against the biological
reference standard, it can be reproduced indefinitely from its sequence
in a highly standardized manner. As a proof of concept, we present
the generation and characterization of two bispecific calibrators
with potential application for the diagnosis of allergy against the
antibiotics aztreonam and amoxicillin in humans.