Development of a radioreceptor assay to measure glucocorticoids

We have developed a radioreceptor assay to measure glucocorticoids. The assay employs the partially purified 95-kDa receptor isolated from human liver and purified by size fractionation on high-performance liquid chromatography (HPLC). In the assay [3H]prednisolone competes with steroids (endogenous and exogenous) for binding to the receptor. Bound and free are separated by treatment with charcoal. The between-day precision [% coefficient of variation (CV)] at concentrations of 9.4, 18.7, and 69.9 micrograms/L prednisolone is 16.6, 9.3 and 4.5%, respectively. Specificity studies revealed that hydrocortisone, deoxycorticosterone, 4-pregnene-17 alpha,21-diol-3,20-dione, 17 alpha-hydroxyprogesterone, corticosterone and beta-hydroxyprogesterone all compete with [3H]prednisolone for binding to the receptor. Prednisone and 6 alpha-methyl prednisolone displace [3H]prednisolone to only a minor degree. The assay has been used to assess "glucocorticoid activity" in children with rheumatic diseases treated with prednisolone.

Lipoprotein(a) at birth, in blacks and whites

It has been shown that blacks have considerably higher concentrations than whites of lipoprotein(a) (Lp(a)), which has been identified as an independent risk factor for coronary heart disease, vein graft restenosis, and cerebrovascular disease. Smaller differences in Lp(a) concentrations have been noted between males and females. To examine whether gender and race differences are already detectable at birth, we examined Lp(a) concentrations in cord blood samples of 109 black (49 male and 60 female) and 123 white (67 male and 56 female) newborns. Maternal age, gestational age, fetal maturity indicators, weight, height and head circumference were analyzed as covariates. For race and sex combined, the mean Lp(a) concentration was 4.0 mg/dl (S.D. of 3.94 mg/dl), approximately 5-fold lower than that observed in adults. No statistically significant differences were found between race or gender groups. The cross-sectional examination of serum Lp(a) concentrations of 221 infants, children and adults showed a gradual increase in Lp(a) concentrations from birth to adult values by the second year of life. We conclude that the system responsible for the production and control of Lp(a) concentration is not yet mature--or has not yet been challenged--at birth.

Measurement of low-density-lipoprotein cholesterol in serum: a status report

Current recommendations of the Adult Treatment Panel and the Children and Adolescents Treatment Panel of the National Cholesterol Education Program make the concentration of low-density lipoproteins cholesterol (LDL-C) in serum the basis for the classification and treatment of hypercholesterolemia. Numerous methodologies for the determination of serum LDL-C concentrations, in research and clinical laboratories, have been described. Here, we review the principles, performance, and limitations of major current methodologies for determining LDL-C concentrations. These methods include sequential and density-gradient ultracentrifugation, chromatographic and electrophoretic techniques, and precipitation methods. In addition, the advantages and disadvantages of estimating LDL-C concentration by the Friedewald equation, the most commonly used approach in clinical laboratories, are addressed.

Organic acids interfere in the measurement of carbon dioxide concentration by the Kodak Ektachem 700

A significant discrepancy was noted in our laboratory between the total plasma carbon dioxide concentration measured by the Kodak Ektachem 700 and the bicarbonate concentration derived from the Corning 170 pH/Blood Gas analyser in an 8-day-old patient. The concentration of total carbon dioxide was 18 mmol/L while the derived bicarbonate was 13 mmol/L. The patient was eventually diagnosed as maple syrup urine disease. This finding led us to examine the effect of various organic acids on the measurement of carbon dioxide by the Ektachem 700. Several interfered significantly. Clinicians should be aware that when organic acid concentrations are increased, the Ektachem 700 total carbon dioxide result may be falsely raised.

Effects of exercise training on cardiovascular function and plasma lipid, lipoprotein, and apolipoprotein concentrations in premenopausal and postmenopausal women

This study examined the effects of aerobic exercise on lipid levels in premenopausal and postmenopausal women. Fifty healthy middle-aged women (mean age, 50 years) were randomly assigned to 12 weeks of either aerobic exercise (walking and jogging) or nonaerobic strength exercise (circuit Nautilus training). Concentrations of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and very low density lipoprotein cholesterol were assessed, along with apolipoprotein (apo) A-I, apo A-II, apo B, and triglycerides. To document changes in aerobic capacity, maximum treadmill testing was performed with expired-gas analysis before and after the exercise program. Aerobic exercise was associated with an 18% improvement in peak VO2. Women in the aerobic group had an increased VO2, from 26.7 to 31.4 ml/kg/min (p less than 0.0001), while the VO2 of the women in the strength training group did not change (25.8 ml/kg/min before and after). There were no differential changes in lipid levels because all subjects experienced slight reductions in high density lipoprotein cholesterol and total cholesterol and increases in apo A-I and the apo A-I to apo B ratio. There was a tendency for the aerobic group to exhibit lower levels of apo A-II and a greater apo A-I to apo A-II ratio, however. We conclude that premenopausal and postmenopausal women experience similar changes in aerobic capacity and lipid levels with exercise and that the short-term effects of aerobic and nonaerobic exercise on lipid profiles are generally comparable.

Stress reactivity and exercise training in premenopausal and postmenopausal women

Examined the influence of ovarian function on psychophysiological stress responses and determined if aerobic exercise reduced stress reactivity. Fifty premenopausal and postmenopausal women initially were subjected to a public speaking task and an ice-on-the-forehead procedure, during which time their blood pressure and heart rate were monitored and continuous blood samples were obtained. Subjects also underwent aerobic fitness evaluations with a maximum-exercise treadmill test. Subjects were then randomly assigned to a 12-week exercise program of either aerobic exercise (e.g., walking and jogging at a prescribed exercise intensity) or non-aerobic strength and flexibility training and were then reevaluated. Results indicated that postmenopausal women exhibited lower resting epinephrine levels but greater epinephrine reactivity to the speaking task compared to the premenopausal women. There were no differences between premenopausal and postmenopausal women with respect to cardiovascular or catecholamine responses during the cold challenge. Premenopausal and postmenopausal women also achieved comparable improvements in aerobic fitness. However, results of the mental stress testing were complex and provided only partial support for the role of aerobic exercise in reducing stress responses.

Beta 2-microglobulin and neopterin: predictive markers for human immunodeficiency virus type 1 infection in children?

The value of beta 2-microglobulin and neopterin concentrations in serum for early diagnosis of infants born to human immunodeficiency virus type 1 (HIV-1)-infected mothers was assessed. Concentrations of both markers were measured in serum samples from pediatric patients (Centers for Disease Control classifications P0, P1, and P2), as well as in age-matched normal subjects. Both beta 2-microglobulin and neopterin were significantly increased in HIV-1-infected symptomatic subjects (P2) compared to controls. Seventy-five percent of asymptomatic patients (P1) also had increased values. On the other hand, a significant overlap in concentrations of both markers in serum was found between controls and P0 patients. Thirty-eight percent of the P0 patients had values comparable to those of the P2 group. Persistently high concentrations of both markers in P0 patients may be indicative of HIV-1 infection.

Postprandial effect of a high fat meal on plasma lipid, lipoprotein cholesterol and apolipoprotein measurements

We investigated the effect of a fatty meal on plasma concentrations of lipids, apolipoproteins, and the cholesterol component of lipoproteins. Sixteen nonobese, healthy, asymptomatic males, 22-34 years of age, served as subjects for this study. None smoked, consumed more than two alcoholic drinks per day, or took any medication known to alter plasma lipids. After a 12 h fast, baseline plasma samples were obtained just before subjects consumed a high fat meal. The meal, standardized to a 70 kg individual, contained approximately 70 g fat, 580 mg cholesterol, and 1,100 cal, with 56% of the calories coming from fat. During the 8 h following consumption of the meal, subjects rested quietly and consumed no food or beverages except water. Blood specimens were obtained hourly. There was a significant increase in plasma triglyceride (150% from baseline at 3 h, P less than 0.0005). Very low density lipoprotein cholesterol (VLDL-C) concentrations increased 150% at 3 h (P less than 0.0005) while low density lipoprotein cholesterol (LDL-C) concentration decreased 37% at 3 h (P less than 0.005) when estimated by Friedewald's formula. No statistically significant differences were observed between fasting total cholesterol, high density lipoprotein cholesterol (HDL-C). HDL2-C, and HDL3-C, apolipoprotein AI (apo AI, AII), and B-100 concentrations and non-fasting samples. We conclude that plasma triglyceride concentration is significantly affected in the post-prandial state. As a result, VLDL-C and LDL-C when assessed by the Friedewald formula are also altered. A minimum of 8 h fasting is required to assess these concentrations accurately in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical effects of 17 beta-estradiol on UMR106 cells

The effect of 17 beta-estradiol (E) on an osteoblast-like cell line, UMR106, was studied in vitro. The concentrations of transferrin and seven enzymes (gamma glutamyl transferase, alkaline phosphatase, acid phosphatase, lactate dehydrogenase, creatine kinase, alanine aminotransferase and aspartate aminotransferase) were measured in these cells after incubation in culture medium containing either E or the vehicle. E treatment increased five of the seven enzymes and increased the transferrin concentration in the UMR106 cells while simultaneously reducing the proliferation rates. 4-Hydroxytamoxifen, an estrogen antagonist, produced a mild estrogen agonist action on growth rates and enzyme concentrations in the UMR106 cells. When E was present simultaneously, the agonist properties of 4-hydroxytamoxifen were enhanced. These studies show that E enhanced activity of five enzymes and the transferrin content of UMR106 cells after a 2-day incubation. 4-Hydroxytamoxifen enhanced the E effect, illustrating that estrogen antagonists may manifest agonist or antagonist properties depending on the model. These results extend our previous observations showing a direct effect of E in vitro on osteoblast-like cells.

Protracted anemia associated with chronic, relapsing systemic inflammation induced by arthropathic peptidoglycan-polysaccharide polymers in rats

Mild hypoproliferative anemia with abnormal iron metabolism frequently accompanies chronic inflammation and infection in humans. To determine whether anemia is associated with chronic relapsing arthritis induced by bacterial cell wall polymers, serial determinations of the hematocrit were measured in rats injected intraperitoneally with sonicated peptidoglycan-polysaccharide fragments from group A streptococci. Acute anemia peaked 5 to 10 days after injection, and chronic, spontaneously relapsing anemia persisted for 309 days. 51Cr labeling demonstrated decreased erythrocyte survival, i.e., a half-life of 8.4 days in cell wall-injected rats versus 11.8 days in controls. Erythrocytes were mildly microcytic, and leukocyte counts were elevated during early spontaneous reactivation of arthritis, 15 days after injection of peptidoglycan-polysaccharide. Bone marrow myeloid/erythroid precursor ratios were elevated in arthritic rats (P less than 0.0001). Purified peptidoglycan produced an acute anemia lasting 10 days, while injection of group A streptococcal polysaccharide and mutanolysin-digested cell wall did not affect the hematocrit. The minimal effective dose of peptidoglycan-polysaccharide was 5 micrograms of rhamnose per g (body weight). Serum iron and transferrin levels were decreased in cell wall-injected rats (P less than 0.005) and were closely correlated with hematocrit values and joint inflammatory scores. Stainable iron was increased in the liver, spleen, and mesenteric lymph nodes and unchanged in the bone marrow of cell wall-injected rats. Anemia accompanying chronic, relapsing systemic inflammation induced by peptidoglycan-polysaccharide polymers appears to be an excellent animal model of the anemia of chronic disease.

Hyperlipemic response of young trained and untrained men after a high fat meal

To test the hypothesis that endurance training is associated with a decreased lipemia after a high fat meal, 16 young men [22 to 34 years old, nine of whom were trained (T) and seven of whom were untrained (UT)] were recruited. T ran greater than 30 or biked greater than 100 miles a week, while UT had been sedentary for at least the preceding 3 months. Daily caloric intake and daily caloric expenditure during exercise were 35% and 704% greater, respectively, in T than in UT. VO2max was 31% greater, while percent body fat was 36% lower in T than in UT. Dietary composition and body height and weight were similar. After a fasting blood sample was taken, the men ate a high fat meal (approximately 56% of total calories as fat in 1100 kcal adjusted to body weight), and additional blood samples were taken hourly for 8 hours. Fasting lipids were similar. Postprandial peak triglyceride (TGmax), percent TG increase (%TGI), and total lipemic response (TLR, the area under the lipemia curve in excess of fasting TG) were 42%, 54%, and 75% greater, respectively, in UT vs. T. Stepwise regression analysis showed that the same three-variable model (training status, fasting TG, and VO2max) described the variation in TGmax (R2 = 0.97), %TGI (R2 = 0.75), and TLR (R2 = 0.92). Furthermore, this same analysis showed that after adjustment for fasting TG and VO2max, the UT group had a significantly greater postprandial lipemia whether expressed as TGmax (p less than 0.0001), %TGI (p = 0.0002), or TLR (p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of methsuximide and N-desmethylmethsuximide using solid-phase extraction and wide-bore capillary gas chromatography

A method for the determination of the anti-epileptic drug methsuximide (MSM) and its active metabolite N-desmethylmethsuximide (NDM) is presented. 5-Methyl-5-phenylhydantoin is used as the internal standard. A simple solid-phase extraction procedure utilizing disposable reversed-phase C18 columns is described. Samples are analyzed by gas chromatography with flame ionization detection using a wide-bore capillary column with a permanently bonded, non-polar stationary phase. The MSM assay possesses linearity to 6.0 micrograms/mL, sensitivity to 0.5 microgram/mL, recovery ranging from 93 to 110%, and precision reflected by a SD of +/- 0.37 microgram/mL. The NDM assay displays linearity up to 80.0 micrograms/mL, sensitivity to 5.0 micrograms/mL, recovery of 90 to 100%, and precision reflected by a SD +/- 0.90 microgram/dL. Lack interference is documented for 6 commonly prescribed anti-epileptic drugs and 4 drugs with similar retention times on this stationary phase; only guaifenesin was found to potentially interfere with the determination of methsuximide. We conclude that the method reported here is ideally suited for monitoring therapeutic and toxic levels of this anti-epileptic drug.

Review of serum lipids and apolipoproteins in risk-assessment of coronary heart disease

Coronary heart disease (CHD), the leading cause of death in the western world, is multifactorial in nature. Abnormal lipoprotein levels are among the risk factors that cause atherosclerosis and, therefore, have been used as biochemical markers in assessing risk of developing CHD. The measurement of serum cholesterol, lipoprotein cholesterol, and apolipoproteins accurately and reliably has been hampered with technical difficulties. In addition, the interpretation of these tests and the determination of their clinical values have been challenging for both physicians and laboratory scientists. This article addresses and reviews the major current analytical and clinical concerns in the testing of lipids as well as the prevention and treatment of CHD.

Measurement of antidepressants using solid-phase extraction and wide-bore capillary gas chromatography with nitrogen-selective detection

A comprehensive method is presented for the determination of nine antidepressant drugs and metabolites in serum: (1) amitriptyline, (2) nortriptyline, (3) imipramine, (4) desipramine, (5) maprotiline, (6) doxepin, (7) desmethyldoxepin, (8) protriptyline, and (9) trimipramine. Chlorimipramine is used as the internal standard. A simple solid-phase extraction procedure utilizing disposable reversed-phase C18 columns is described. Samples are analyzed by gas chromatography with nitrogen-selective detection using a wide-bore capillary column with a permanently bonded, non-polar stationary phase. The assay possesses linearity to 800 ng/mL for maprotiline and 500 ng/mL for the other antidepressants, sensitivity to at least 25 ng/mL, recovery ranging from 96 to 107%, and between-run precision reflected by CVs of 4.4 to 8.1%. Lack of interference is documented for over 27 commonly prescribed drugs. We conclude that the method reported here is ideally suited for monitoring therapeutic and toxic levels of antidepressant drugs.

Measurement of trazodone using solid-phase extraction and wide-bore capillary gas chromatography with nitrogen-selective detection

A method for the determination of the antidepressant drug trazodone is presented. 8-Hydroxyloxapine is used as the internal standard. A simple solid-phase extraction procedure utilizing disposable reversed-phase C18 columns is described. Samples are analyzed by gas chromatography with nitrogen-selective detection using a wide-bore capillary column with a permanently bonded, nonpolar stationary phase. The assay possesses linearity to 3.0 micrograms/mL, sensitivity to at least 0.25 microgram/mL, recovery averaging 96%, and between-run precision reflected by a CV of 5.6%. We conclude that the method reported here is ideally suited for monitoring therapeutic and toxic levels of trazodone.

Immunoturbidimetric measurement of serum retinol-binding protein in renal and hepatic disease

Serum retinol-binding protein (RBP), with a biological half-life of less than 12 h, is a useful indicator of liver or kidney dysfunction. An automated immunoturbidimetric assay for the measurement of RBP has been developed using the Cobas-BIO centrifugal analyser and commercially available materials. Serum samples with RBP concentrations as low as 3 mg/L were measured. Within-run and day-to-day imprecision were 3.7 and 5.7%, respectively. The reference range (mean +/- 2SD) for 51 adults was 17 to 61 mg/L. Slight haemolysis of serum (haemoglobin 10 g/L) resulted in an apparent 8% reduction of RBP with greater interference at higher haemoglobin concentrations. However, bilirubin in concentrations up to 0.15 g/L did not interfere with RBP measurements. There was good correlation between immunoturbidimetry and a commercial radial immunodiffusion method. Serum RBP concentrations were decreased in liver disease and increased in renal failure.

Effects of long-term haemodialysis on lipid, lipoprotein and apolipoprotein levels of black patients with chronic renal failure

Premature coronary artery disease is believed to be a major cause of death in patients undergoing long-term haemodialysis. We investigated the effects of chronic maintenance haemodialysis on lipid, lipoprotein and apolipoprotein levels of 42 black patients with chronic renal failure and compared them with those of 40 age- and sex-matched black controls to determine the changes in the lipoprotein profile and their possible contributions to increased risk of coronary heart disease in these patients. There were increases in triglyceride levels and in total/high density lipoprotein cholesterol ratios and decreases in high density lipoprotein cholesterol, in LDL cholesterol, in apolipoprotein AI and in apolipoprotein AII in haemodialysis patients in comparison to controls. No significant differences were observed in any of the lipid, lipoprotein and apolipoprotein levels between male and female patients and between patients receiving anti-hypertensive therapy and those who were not. Our findings suggest that haemodialysis and/or events associated with maintenance dialysis may contribute to unfavourable variations in lipoprotein metabolism and, in turn, the increased mortality from coronary artery disease in this patient population.

Cerebrospinal fluid and plasma apolipoproteins in patients with multiple sclerosis

Apolipoprotein (apo) E is synthesized by cells of the central and peripheral nervous systems, and its synthesis and secretion in the peripheral nervous systems, and its synthesis and secretion in the peripheral nervous system of animals are greatly stimulated following Wallerian degeneration. It has been suggested that apo E functions in the metabolism of myelin lipids, but its physiologic role in nervous tissue has not been elucidated. To determine if apo E might play a role in demyelinating neuropathy, the concentrations were examined of apos E and A-1 in the cerebrospinal fluid (CSF) and plasma of patients with multiple sclerosis during clinical remission, and in patients with no neurologic disease. Serum and CSF albumin concentrations were measured to account for the possible influences of serum apo E concentration and/or altered blood-brain barrier permeability on the CSF apo E pool. A CSF index for apo E and apo A-1 was calculated in the same manner presently used for calculation of immunoglobulin G (IgG) production in the nervous system of patients with multiple sclerosis (MS). The results showed that the concentrations of apo E, apo Al, and albumin in the CSF of the MS patients were not significantly altered. The concentration of apo E in the serum, however, was significantly (p less than 0.001) decreased by 44 percent in the MS patients. The difference was relatively specific for serum apo E because the serum apo Al and albumin concentrations were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Apolipoprotein E is released by rat sciatic nerve during segmental demyelination and remyelination

Apolipoprotein E (apo E) is synthesized and released in greatly increased amounts by peripheral nerve following Wallerian degeneration; it has been suggested that this protein may function in the transport of degenerated myelin lipid. The purpose of this study was to determine if the amount of apo E released by rat peripheral nerve is increased following selective demyelination, in the absence of significant axonopathy. Using an immunoturbidimetric assay, release of apo E from excised sciatic nerve segments was measured during the phases of acute demyelination and remyelination caused by tellurium (Te) toxicity, during segmental demyelination in chronic lead (Pb) poisoning, and during Wallerian degeneration following nerve crush. Morphologic changes were examined in contralateral sciatic nerves by nerve-fiber teasing or by light and electron microscopy of transverse sections. As in previous studies, the amount of apo E released from the nerves was greatly increased following Wallerian degeneration due to nerve crush. In Te neuropathy, increased release of apo E was first detected on the fourth day of Te exposure, corresponding temporally to the acute onset of paralysis and segmental demyelination. Apolipoprotein E release rose steeply to a maximum of ten times the control values by day 9 and then gradually waned during the next five weeks, corresponding to a period of active remyelination and resolution of the neuropathy. In the demyelinating neuropathy of chronic lead poisoning, apo E release was increased four times over control animals after seven weeks of exposure, with less than 10% of teased fibers showing early paranodal demyelination and no evidence of remyelination.(ABSTRACT TRUNCATED AT 250 WORDS)

Further evidence for the heterogeneity of high density lipoprotein isolates: HDL2:HDL3 cholesterol ratios and the presence of apolipoprotein B

The ratios were compared of HDL2 to HDL3 cholesterol and the quantitation of apo B in high density lipoprotein (HDL) isolated by the heparin manganese, dextran sulfate, and phosphotungstate precipitation procedures. Thirty-two sera with varied HDL cholesterol concentration were analyzed. Heparin manganese isolates had the highest HDL cholesterol concentrations and the lowest HLD2:HDL3 cholesterol ratios, which differed further from the other isolates at higher HDL concentrations. The corresponding values for dextran sulfate isolates did not differ significantly from phosphotungstate isolates. Heparin manganese and phosphotungstate isolates did not contain apo B, but dextran sulfate isolates contained an average of nine percent of the corresponding serum concentrations of apo B, with no dependence on HDL cholesterol concentration. These differences in HDL2:HDL3 cholesterol and apolipoprotein concentrations are further evidence for the marked heterogeneity of the lipid fraction isolated by various precipitation procedures.

Changes in cerebrospinal fluid IgG and apolipoprotein E indices in patients with multiple sclerosis during demyelination and remyelination

Approximately 85% of patients with multiple sclerosis (MS) can be diagnosed by using magnetic resonance imaging and laboratory tests such as determination of the cerebrospinal fluid (CSF) IgG Index and electrophoresis to detect oligoclonal banding. However, these tests results are abnormal in MS patients whether they are in clinical remission or acute exacerbation. Because apolipoprotein E (apo E) is synthesized in the central and peripheral nervous system, particularly during remyelination, we propose that apo E might be a reliable marker of the remyelination that accompanies clinical remission in MS patients. We studied 33 patients with MS, 22 in remission and 11 in exacerbation, and 26 controls of comparable ages. The apo E Index, calculated from the concentrations of apo E and albumin in CSF and serum, allowed us to discriminate between MS patients in remission and MS patients in exacerbation (P less than 0.001); the IgG Index failed to show similar differences. However, combining the apo E and IgG indices gave maximum discrimination between controls, MS patients in remission, and those in exacerbation. This study suggests that apo E measurements should be included in the laboratory evaluation of MS patients.

Changes in cerebrospinal fluid IgG and apolipoprotein E indices in patients with multiple sclerosis during demyelination and remyelination

Approximately 85% of patients with multiple sclerosis (MS) can be diagnosed by using magnetic resonance imaging and laboratory tests such as determination of the cerebrospinal fluid (CSF) IgG Index and electrophoresis to detect oligoclonal banding. However, these tests results are abnormal in MS patients whether they are in clinical remission or acute exacerbation. Because apolipoprotein E (apo E) is synthesized in the central and peripheral nervous system, particularly during remyelination, we propose that apo E might be a reliable marker of the remyelination that accompanies clinical remission in MS patients. We studied 33 patients with MS, 22 in remission and 11 in exacerbation, and 26 controls of comparable ages. The apo E Index, calculated from the concentrations of apo E and albumin in CSF and serum, allowed us to discriminate between MS patients in remission and MS patients in exacerbation (P less than 0.001); the IgG Index failed to show similar differences. However, combining the apo E and IgG indices gave maximum discrimination between controls, MS patients in remission, and those in exacerbation. This study suggests that apo E measurements should be included in the laboratory evaluation of MS patients.

Immunoturbidimetry: an attractive technique for the determination of urinary albumin and transferrin

Immunoturbidimetry is a suitable technique for the determination of urinary proteins in clinical laboratories. We have developed immunoturbidimetric assays for the measurement of urinary albumin and transferrin which are adapted for the Cobas-BIO centrifugal analyzer. Linear range for the albumin assay was 6.25-167 mg/L and for the transferrin assay 1.66-6.66 mg/L. The analytical recoveries of albumin and transferrin averaged 96%. The addition of up to 50 g/L hemoglobin to urine did not interfere with the determination of either protein. Within-run and between-run imprecision for albumin assay was 2.2% and 3.2% at an albumin level of 140 mg/L, and 4.8% and 8.7% at an albumin level of 16 mg/L; for transferrin assay the respective imprecisions were 3.6% and 6.7% at transferrin concentration of 6 mg/L, and 5.2% and 11.1% at a transferrin concentration of 1.5 mg/L. Reference ranges for both assays were established using urines from 17 healthy individuals; albumin had a range of 0-22 mg/L and transferrin 0-1.9 mg/L.

A simple immunotechnique for the determination of serum concentration of apolipoprotein E

Immunoturbidimetric assay for the determination of serum apolipoprotein E was developed on the Cobas-BIO centrifugal analyzer using commercially available antisera and reference sera. Within-run imprecision was 2.9% while day-to-day imprecision was 7.9%. Addition of up to 50 g/l hemoglobin or 0.15 g/l bilirubin to sera did not interfere with the determination of this apolipoprotein. Apolipoprotein E concentration was measured in sera from 40 normolipidemic and hyperlipidemic subjects by this immunoturbidimetric method (dependent variable) and radial immunodiffusion assay (independent variable). A slope of 0.90, an intercept of -7.9, and a correlation coefficient of 0.94 were obtained. Reference range for apolipoprotein E was established using sera from 100 normolipidemic subjects. The mean + 1 SD for apolipoprotein E levels of males and females were 36 + 13 mg/l and 29 + 8.4 mg/l, respectively. The distribution of apolipoprotein E among the various lipoprotein fractions of normals was significantly different than that of hypertriglyceridemic subjects.

A preliminary study of urinary transferrin as a marker for prostatic cancer

Traditional serum markers used in the diagnosis of prostate cancer lack sensitivity and specificity. Prostatic fluid is in direct contact with the prostate epithelium and, thus, has been investigated as a better source for potentially useful markers. Since prostatic fluid contents can enter the urine directly through the urethra, without prerequisite entry into blood, proteins present in significant quantities in prostatic fluid represent candidate markers for entry into the urine, particularly in diseases affecting the prostate epithelium, such as adenocarcinoma. High concentrations of transferrin in prostatic fluid led us to examine urine transferrin levels, using an immunoturbidimetric technique. Urine transferrin was significantly increased in 18 out of 22 patients with prostate cancer in comparison to age-matched controls. Since there was no evidence of increased transferrin excretion, we suggest that prostatic fluid is the source of transferrinuria.

Immunoturbidimetric techniques for quantifying apolipoproteins CII and CIII

Immunoturbidimetric assays for determination of serum apolipoproteins CII and CIII (apo CII and CIII) were developed for use on the Cobas-Bio centrifugal analyzer with commercially available antisera and reference sera. Within-run and between-run imprecision (CVs) for apo CII was respectively 3.3 and 6.2%, and for apo CIII 2.75 and 5.2%. Addition to sera of as much as 50 g of hemoglobin or 0.15 g of bilirubin per liter did not interfere with determinations of apolipoproteins. Concentrations of apo CII and CIII were measured in sera from 40 normolipidemic and hyperlipidemic subjects by these immunoturbidimetric methods (x) and by radial immunodiffusion assays (y). Apo CII and CIII gave slopes of 0.93 and 0.86, y-intercepts of 7.4 and 9.5 mg/L, and correlation coefficients of 0.96 and 0.94, respectively. Reference intervals for the two apolipoproteins were established with sera from 100 normolipidemic subjects. The distribution of apo CII and CIII among the various lipoprotein fractions for normal subjects differed significantly (p less than 0.005) from that for hypertriglyceridemic subjects.

Immunoturbidimetric techniques for quantifying apolipoproteins CII and CIII

Immunoturbidimetric assays for determination of serum apolipoproteins CII and CIII (apo CII and CIII) were developed for use on the Cobas-Bio centrifugal analyzer with commercially available antisera and reference sera. Within-run and between-run imprecision (CVs) for apo CII was respectively 3.3 and 6.2%, and for apo CIII 2.75 and 5.2%. Addition to sera of as much as 50 g of hemoglobin or 0.15 g of bilirubin per liter did not interfere with determinations of apolipoproteins. Concentrations of apo CII and CIII were measured in sera from 40 normolipidemic and hyperlipidemic subjects by these immunoturbidimetric methods (x) and by radial immunodiffusion assays (y). Apo CII and CIII gave slopes of 0.93 and 0.86, y-intercepts of 7.4 and 9.5 mg/L, and correlation coefficients of 0.96 and 0.94, respectively. Reference intervals for the two apolipoproteins were established with sera from 100 normolipidemic subjects. The distribution of apo CII and CIII among the various lipoprotein fractions for normal subjects differed significantly (p less than 0.005) from that for hypertriglyceridemic subjects.

Lipoproteins and apolipoproteins. Composition, metabolism, and association with coronary heart disease

Apolipoproteins play major roles in regulating lipoprotein synthesis and catabolism. Apolipoprotein AI activates the lecithin cholesterol acyltransferase, apolipoprotein CII and CIII regulate the lipoprotein lipase, and apolipoprotein B-100, B-48, and E control the cholesterol uptake into hepatic and extrahepatic cells. Therefore, investigating the alterations of lipoprotein metabolism in disease states at the apolipoprotein level may give increased insight into the underlying mechanisms of lipoprotein changes and provide better understanding about the premature development of the atherogenic process.

The effect of low-dose hydrochlorothiazide on blood pressure, serum potassium, and lipoproteins

Recent clinical trials in hypertension suggest that thiazide diuretics may increase coronary heart deaths in selected patients, possibly through adverse effects on serum potassium, lipids, lipoproteins, and/or apolipoproteins. Administration of smaller doses of diuretics has been recommended to decrease this risk. We evaluated 12.5-mg and 112.5-mg daily doses of hydrochlorothiazide (HCTZ) administered for 1 month to nine postmenopausal black female hypertensives using a double-blind, randomized, crossover design. Both regimens produced significant reductions in sitting diastolic blood pressure, a mean of 11 mm Hg with the high dose and 8 mm Hg with the low dose. The high dose produced a mean 0.7 mEq/L reduction in serum potassium while the low dose caused no change. Both doses produced similar changes in serum lipoproteins. Statistically significant elevations were seen in total cholesterol (approximately 12%), LDL cholesterol (approximately 20%), cholesterol: HDL ratio (approximately 15%), and apolipoprotein B (approximately 20%). Apolipoprotein A1 was significantly reduced (approximately 6%). These results support the use of low doses of HCTZ in mild hypertension to avoid hypokalemia, but suggest that adverse changes in serum lipids will occur.

Immunoturbidimetric assays of apolipoproteins A, AI, AII, and B in serum

In these immunoturbidimetric assays developed for apolipoproteins A, AI, AII, and B we used the Cobas-Bio centrifugal analyzer and commercially available antisera and calibrators. Within-day and within-run precision ranged from 1.0 to 5.8% for the four assays. The addition of bilirubin, up to 150 mg/L, or hemoglobin, 50 g/L, to sera did not interfere with the measurement of these apolipoproteins. Comparison of results of the immunoturbidimetric assays with those of radial immunodiffusion assays yielded slopes of 1.002, 0.822, and 0.957 and intercepts of -0.02, 0.47, and 0.03 g/L for apolipoproteins B, A, and AI, respectively. Reference intervals for the four apolipoproteins were determined by using sera from 193 apparently healthy individuals.

Immunoturbidimetric assays of apolipoproteins A, AI, AII, and B in serum

In these immunoturbidimetric assays developed for apolipoproteins A, AI, AII, and B we used the Cobas-Bio centrifugal analyzer and commercially available antisera and calibrators. Within-day and within-run precision ranged from 1.0 to 5.8% for the four assays. The addition of bilirubin, up to 150 mg/L, or hemoglobin, 50 g/L, to sera did not interfere with the measurement of these apolipoproteins. Comparison of results of the immunoturbidimetric assays with those of radial immunodiffusion assays yielded slopes of 1.002, 0.822, and 0.957 and intercepts of -0.02, 0.47, and 0.03 g/L for apolipoproteins B, A, and AI, respectively. Reference intervals for the four apolipoproteins were determined by using sera from 193 apparently healthy individuals.

Immunoturbidimetric assay of transferrin: effect of iron and need for serum blanks

The introduction of specific antisera has led to the replacement of total iron binding capacity assays with direct immunochemical measures of transferrin. However, some controversy exists over the effect of the degree of iron saturation on antigen-antibody interactions in these immunochemical assays. This study describes a simple automated immunoturbidimetric assay of transferrin, and includes a reference range and an evaluation of the effects of common potential interferents, including iron, bilirubin, lipemia, and hemoglobin. The measured and the calculated TIBC are also compared for 78 healthy individuals and 51 patients with anemia.