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Scherer-Burić RA, Lesser-Wetzold K, Nagel D, Weigand M, Spannagl M, Teupser D, Bruegel M. Performance testing of four automated coagulation analyzers in a university hospital setting with focus on global coagulation assays. Int J Lab Hematol 2022; 44:643-653. [PMID: 35179298 DOI: 10.1111/ijlh.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/27/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Several automated coagulation analyzers are available for laboratory use. In a university hospital central laboratory, we compared four different instruments. The results for global coagulation assays are presented here. METHODS ACL TOP 750 CTS (Instrumentation Laboratory), Atellica COAG 360 (COAG 360), BCS XP (both Siemens Healthineers), and cobas t 711 (Roche Diagnostics) were compared. For inter-instrument comparison, five basic coagulation parameters were analyzed in 476 patient plasma samples. Additional assessments included precision testing using commercial control samples and plasma pools, analysis time for a defined set of samples, sample capacity testing, minimum required sample volumes, and detection quality for hemolytic, icteric, or lipemic (HIL) interferences. RESULTS Good concordance between different instruments was evident from Bland-Altman plots and comparison of data from each instrument with the overall median (τ≥0.8). Shortest analysis times were found for BCS XP and COAG 360, COAG 360 revealed highest sample capacity. Observed required sample volumes were broadly in line with manufacturer specifications and varied according to instrument configurations. HIL detection differed between instruments and was best with ACL TOP 750 CTS. CONCLUSION The four analyzers showed similarly high levels of concordance, although some variations were apparent. The most significant differences between the instruments were found in analysis times and sample capacity. Analyzer capabilities must be considered when selecting laboratory equipment and defining algorithms for clinical practice.
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Affiliation(s)
| | | | - Dorothea Nagel
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Weigand
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Spannagl
- Department of Transfusion Medicine, Cellular Therapeutics and Hemostaseology, Clinic for Anesthesiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mathias Bruegel
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Evaluation of release and pharmacokinetics of hexadecylphosphocholine (miltefosine) in phosphatidyldiglycerol-based thermosensitive liposomes. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2021; 1863:183698. [PMID: 34283999 DOI: 10.1016/j.bbamem.2021.183698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 12/18/2022]
Abstract
Hexadecylphosphocholine (HePC, Miltefosine) is a drug from the class of alkylphosphocholines with an antineoplastic and antiprotozoal activity. We previously reported that HePC uptake from thermosensitive liposomes (TSL) containing 1,2-dipalmitoyl-sn-glycero-3-phosphodiglycerol (DPPG2) into cancer cells is accelerated at mild hyperthermia (HT) resulting in increased cytotoxicity. In this study, we compared HePC release of different TSL formulations in serum. HePC showed rapid but incomplete release below the transition temperature (Tm) of investigated TSL formulations in serum. Short heating (5 min) to 42 °C increased HePC release from DPPG2-TSL (Tm = 41 °C) by a factor of two in comparison to body temperature (37 °C). Bovine serum albumin (BSA) induced HePC release from DPPG2-TSL comparable to serum. Furthermore, multilamellar vesicles (MLV) were capable to extract HePC from DPPG2-TSL in a concentration- and temperature-dependent manner. Repetitive exposure of DPPG2-TSL to MLV at 37 °C led to a fast initial release of HePC which slowed down after subsequent extraction cycles finally reaching approx. 50% HePC release. A pharmacokinetic study in rats revealed a biphasic pattern with an immediate clearance of approx. 50% HePC whereas the remaining 50% HePC showed a prolonged circulation time. We speculate that HePC located in the external leaflet of DPPG2-TSL is rapidly released upon contact with suitable biological acceptors. As demonstrated by MLV transfer experiments, asymmetric incorporation of HePC into the internal leaflet of DPPG2-TSL might improve HePC retention in presence of complex biological media and still give rise to HT-induced HePC release.
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Heckl C, Lang A, Rühm A, Sroka R, Duffield T, Vogeser M, Paal M. Spectrophotometric evaluation of hemolysis in plasma by quantification of free oxyhemoglobin, methemoglobin, and methemalbumin in presence of bilirubin. JOURNAL OF BIOPHOTONICS 2021; 14:e202000461. [PMID: 33527705 DOI: 10.1002/jbio.202000461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
Severe intravascular hemolysis leads to the simultaneous presence of free heme pigments (oxyhemoglobin, methemoglobin, and methemalbumin) and bilirubin in human plasma. Standard spectrophotometric methods used to assess in vivo hemolysis inadequately address this complex analytical situation. Thus, we propose a novel quantification algorithm to ensure the highest analytical specificity. A corresponding second-derivative fitting algorithm was validated according to the guideline of bioanalytical method validation from the European Medicines Agency using plasma specimens (n = 1759) spiked with different concentrations of oxyhemoglobin and methemoglobin. The results were compared to standard spectrophotometric quantification methods described by Harboe, Noe, and Fairbanks. Based on the second-derivative method, simultaneous quantification of oxyhemoglobin and methemoglobin/methemalbumin in samples with total bilirubin concentrations ≤4.9 mg/dL (83.8 μmol/L) provided robust results (inaccuracy ≤20%, imprecision ≤16%). Analyzing UV/VIS spectra of plasma from patients with confirmed severe intravascular hemolysis evidenced an underestimation of up to 33% for the combined free heme pigment content. The employed second-derivative algorithm allows for automated and highly specific quantification of the free heme pigment content in diluted human plasma, which cannot be realized with standard spectrophotometric evaluation methods. An Excel-based tool readily applicable to clinical datasets accompanies this manuscript.
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Affiliation(s)
- Christian Heckl
- Laser-Forschungslabor, LIFE-Center, University Hospital, LMU Munich, Germany
- Department of Urology, University Hospital, LMU Munich, Germany
| | - Alexander Lang
- Laser-Forschungslabor, LIFE-Center, University Hospital, LMU Munich, Germany
- Department of Urology, University Hospital, LMU Munich, Germany
| | - Adrian Rühm
- Laser-Forschungslabor, LIFE-Center, University Hospital, LMU Munich, Germany
- Department of Urology, University Hospital, LMU Munich, Germany
| | - Ronald Sroka
- Laser-Forschungslabor, LIFE-Center, University Hospital, LMU Munich, Germany
- Department of Urology, University Hospital, LMU Munich, Germany
| | - Thomas Duffield
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany
| | - Michael Vogeser
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany
| | - Michael Paal
- Institute of Laboratory Medicine, University Hospital, LMU Munich, Germany
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Heckl C, Eisel M, Lang A, Homann C, Paal M, Vogeser M, Rühm A, Sroka R. Spectroscopic methods to quantify molecules of the heme‐biosynthesis pathway: A review of laboratory work and point‐of‐care approaches. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202000026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Christian Heckl
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
| | - Maximilian Eisel
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
| | - Alexander Lang
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
| | - Christian Homann
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
| | - Michael Paal
- Institute of Laboratory Medicine University Hospital, LMU Munich Munich Germany
| | - Michael Vogeser
- Institute of Laboratory Medicine University Hospital, LMU Munich Munich Germany
| | - Adrian Rühm
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
| | - Ronald Sroka
- Laser‐Forschungslabor, LIFE Center, Department of Urology University Hospital, LMU Munich Munich Germany
- Department of Urology University Hospital, LMU Munich Munich Germany
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Lang A, Heckl C, Vogeser M, Stauch T, Homann C, Hennig G, Sroka R, Stepp H. Rapid spectrophotometric quantification of urinary porphyrins and porphobilinogen as screening tool for attacks of acute porphyria. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-12. [PMID: 29855177 DOI: 10.1117/1.jbo.23.5.055006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
Autosomal-dominant acute porphyria, a group of rare diseases, can lead to life-threatening neurovisceral attacks. No efficient screening test is available today. Elevated urinary porphobilinogen in addition to elevated porphyrins is highly specific for an attack of acute porphyria. This study proposes and evaluates a custom-made device, algorithm, and methods for a two-step quantification of urinary porphyrins and porphobilinogen. The first step is oxidation of the nonfluorescent porphyrinogens and subsequent fluorescence-spectroscopic determination of total urinary porphyrins (TUP) using second derivative spectral fitting. Photo-oxidation is compared with chemical oxidation methods. The second step is the quantification of porphobilinogen in case of elevated TUP. Heat-induced conversion products of porphobilinogen, namely uroporphyrin and porphobilin, are quantified by fluorescence and absorption spectroscopy. Results show that the preferred method combination is TUP quantification (lower limit of quantification: 0.2 μmol / L) after photo-oxidation with subsequent absorption-spectroscopic determination of porphobilin after heating for indirect quantification of porphobilinogen (quantification range: 0 to 20 mg / L). Urinary porphobilinogen and porphyrins of one acute porphyria patient were quantified with <10 % deviation from an external reference determination. The spectrophotometric approach requires only minimal sample processing and yields a result within 15 min, thus closing the screening gap for acute porphyria.
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Affiliation(s)
- Alexander Lang
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
| | - Christian Heckl
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
| | - Michael Vogeser
- University Hospital, Institute of Laboratory Medicine, LMU Munich, Munich, Germany
| | - Thomas Stauch
- German Competence Center for Porphyria Diagnosis and Consultation, MVZ Laboratory PD Dr. Volkmann un, Germany
| | - Christian Homann
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
| | - Georg Hennig
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
| | - Ronald Sroka
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
| | - Herbert Stepp
- University Hospital, Laser-Forschungslabor, LIFE-Center, LMU Munich, Munich, Germany
- University Hospital, Department of Urology, LMU Munich, Munich, Germany
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