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Nygaard-Odeh K, Soloy-Nilsen H, Kristiansen MG, Brekke OL, Mollnes TE, Berk M, Bramness JG, Oiesvold T. Cytokines in hepatitis C-infected patients with or without opioid maintenance therapy. Acta Neuropsychiatr 2024:1-7. [PMID: 38173235 DOI: 10.1017/neu.2023.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Both chronic hepatitis C virus (HCV) infection and opioids cause altered blood levels of cytokines. Previous studies have investigated levels of selected groups of cytokines in patients on opioid maintenance treatment. Little is known about the levels of multiple cytokines in patients with chronic HCV infection on opioid maintenance treatment. Our aim was to investigate the cytokine profile in patients with active HCV infection with and without opioid maintenance treatment. METHODS We conducted a cross-sectional study in an out-patients population included upon referral for antiviral hepatitis C infection treatment. The level of 27 cytokines was measured in serum using multiplex technology. Patients were interviewed using a modified version of the European addiction severity index. Data pertaining to weight, height, current medication, smoking habits, allergies, previous medical history and ongoing withdrawal symptoms were collected. Non-parametric testing was used to investigate differences in levels of cytokines between the two groups. A 3-model hierarchical regression analysis was used to analyse associations between cytokines and confounding variables. RESULTS Out of 120 included patients, 53 were on opioid maintenance treatment. Median duration of opioid treatment was 68.4 months. There were no demographical differences between the two groups other than age. IL-1β was lower and eotaxin-1 higher in the group on opioid maintenance treatment than in the non-opioid group. No other inter-group differences in the remaining cytokine levels were found. CONCLUSION In HCV infection patients, the impact of chronic opioid administration on peripheral circulating cytokine level is minimal.
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Affiliation(s)
- Kristin Nygaard-Odeh
- Nordland Hospital Trust, Bodoe, Norway
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
| | - Hedda Soloy-Nilsen
- Nordland Hospital Trust, Bodoe, Norway
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
| | - Magnhild Gangsoy Kristiansen
- Nordland Hospital Trust, Bodoe, Norway
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
| | - Ole Lars Brekke
- Nordland Hospital Trust, Bodoe, Norway
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
| | - Tom Eirik Mollnes
- Research Laboratory, Nordland Hospital Trust, Bodoe, Norway
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
- The National Centre of Excellence in Youth Mental Health, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jorgen G Bramness
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Terje Oiesvold
- Nordland Hospital Trust, Bodoe, Norway
- Institute of Clinical Medicine, UIT - The Arctic University of Norway, Tromsoe, Norway
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Zhang Y, Song H, Wang J, Xi X, Cefalo P, Wood LJ, Luo X, Wang QM. Multiplex array analysis of serum cytokines offers minimal predictive value for cognitive function in the subacute phase after stroke. Front Neurol 2022; 13:886018. [PMID: 36330425 PMCID: PMC9622930 DOI: 10.3389/fneur.2022.886018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/29/2022] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE The effects of inflammation on post-stroke cognitive function are still unclear. This study investigated the correlation between the Th17-related cytokines in peripheral blood and post-stroke cognitive function after ischemic stroke in the subacute phase. DESIGN A retrospective cohort study. SETTING Academic acute inpatient rehabilitation facility. PARTICIPANTS One hundred and fourteen patients with first ischemic stroke were categorized as the poor cognitive recovery group (n = 58) or good cognitive recovery group (n = 56) based on their cognitive MRFS efficiency. INTERVENTIONS All subjects received routine physical, occupational, and speech-language pathology therapy. MAIN OUTCOME MEASURES Serum cytokines/chemokine (IL-1 β, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-15, IL-17A, IL-17E, IL-17F, IL-21, IL-22, IL-23, IL-27, IL-28A, IL-31, IL-33, GM-CSF, IFN-γ, MIP-3 α, TNF-α, and TNF-β) levels were measured in duplicate using Human Th17 magnetic bead panel and multiplex array analysis (Luminex-200 system). The primary functional outcome was a gain in functional independence measure (FIM) cognitive subscore at discharge. The secondary outcome measures were FIM total score at discharge, length of stay in the hospital, and discharge destination. Cognitive Montebello Rehabilitation Factor Score (MRFS) and cognitive MRFS efficiency were calculated. Demographic and clinical characteristics were obtained from the medical record. RESULTS The good cognitive recovery group had an interesting trend of higher IL-13 than the poor cognitive recovery group (good cognitive recovery group 257.82 ± 268.76 vs. poor cognitive recovery group 191.67 ± 201.82, p = 0.049, unit: pg/ml). However, Pearson's correlation analysis showed no significant correlation between cytokine levels and gain of cognition, cognitive MRFS, or cognitive MRFS efficiency. Receiver operating characteristic (ROC) analysis of cytokines also suggested a low accuracy of prediction as a predictor for post-stroke cognitive recovery improvement. CONCLUSION Our preliminary findings suggested that the level of serum cytokines had minimal predictive value for the recovery of cognitive function during the subacute inpatient rehabilitation after stroke.
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Affiliation(s)
- Yuling Zhang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Haixin Song
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Rehabilitation Department, Sir Run Run Show Hospital, Hangzhou, China
| | - Jun Wang
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Xiao Xi
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Philip Cefalo
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
| | - Lisa J. Wood
- William F. Connell School of Nursing at Boston College, Boston, MA, United States
| | - Xun Luo
- School of Medicine, Shenzhen University, Shenzhen, China
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
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Denizli M, Capitano ML, Kua KL. Maternal obesity and the impact of associated early-life inflammation on long-term health of offspring. Front Cell Infect Microbiol 2022; 12:940937. [PMID: 36189369 PMCID: PMC9523142 DOI: 10.3389/fcimb.2022.940937] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
The prevalence of obesity is increasingly common in the United States, with ~25% of women of reproductive age being overweight or obese. Metaflammation, a chronic low grade inflammatory state caused by altered metabolism, is often present in pregnancies complicated by obesity. As a result, the fetuses of mothers who are obese are exposed to an in-utero environment that has altered nutrients and cytokines. Notably, both human and preclinical studies have shown that children born to mothers with obesity have higher risks of developing chronic illnesses affecting various organ systems. In this review, the authors sought to present the role of cytokines and inflammation during healthy pregnancy and determine how maternal obesity changes the inflammatory landscape of the mother, leading to fetal reprogramming. Next, the negative long-term impact on offspring’s health in numerous disease contexts, including offspring’s risk of developing neuropsychiatric disorders (autism, attention deficit and hyperactive disorder), metabolic diseases (obesity, type 2 diabetes), atopy, and malignancies will be discussed along with the potential of altered immune/inflammatory status in offspring as a contributor of these diseases. Finally, the authors will list critical knowledge gaps in the field of developmental programming of health and diseases in the context of offspring of mothers with obesity, particularly the understudied role of hematopoietic stem and progenitor cells.
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Affiliation(s)
- Merve Denizli
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis IN, United States
| | - Maegan L. Capitano
- Department of Microbiology & Immunology, Indiana University School of Medicine, Indianapolis IN, United States
| | - Kok Lim Kua
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis IN, United States
- *Correspondence: Kok Lim Kua,
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Knutti N, Neugebauer S, Scherr F, Mathay C, Marchese M, Henry E, Palm J, Betsou F, Kiehntopf M. Introduction of BD Vacutainer ® Barricor™ tubes in clinical biobanking and application of amino acid and cytokine quality indicators to Barricor plasma. Clin Chem Lab Med 2022; 60:689-700. [PMID: 35073617 DOI: 10.1515/cclm-2021-0899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/10/2022] [Indexed: 01/04/2024]
Abstract
OBJECTIVES The use of BD Vacutainer® Barricor™ tubes (BAR) can reduce turnaround time (TAT) and improve separation of plasma from cellular components using a specific mechanical separator. Concentrations of amino acids (AAs) and cytokines, known to be labile during pre-analytical time delays, were compared in heparin (BAR, BD Heparin standard tube [PST]), EDTA and serum gel tubes (SER) to validate previously identified quality indicators (QIs) in BAR. METHODS Samples of healthy individuals (n=10) were collected in heparin, EDTA and SER tubes and exposed to varying pre- and post-centrifugation delays at room temperature (RT). Cytokines (interleukin [IL]-8, IL-16 and sCD40L) were analyzed by enzyme-linked immunosorbent assay (ELISA) and AAs were characterized by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). RESULTS All QIs, AAs/AA ratio and cytokines increased during prolonged blood storage in heparin plasma (PST, BAR) and SER tubes. Comparison of 53 h/1 h pre-centrifugation delay resulted in an increase in taurine (Tau) and glutamic acid (Glu) concentrations by more than three times, soluble CD40L increased by 13.6, 9.2 and 4.3 fold in PST, BAR-CTRL and BAR-FAST, and IL-8 increased even more by 112.8 (PST), 266.1 (BAR-CTRL), 268.1 (BAR-FAST) and 70.0 (SER) fold, respectively. Overall, compared to prolonged blood storage, effects of post-centrifugation delays were less pronounced in all tested materials. CONCLUSIONS BAR tubes are compatible with the use of several established QIs and can therefore be used in clinical biobanking to reduce pre-analytical TAT without compromising QIs and thus pre-analytical sample quality analysis.
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Affiliation(s)
- Nadine Knutti
- Institute of Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, Jena, Germany
| | - Sophie Neugebauer
- Institute of Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, Jena, Germany
| | - Franziska Scherr
- Institute of Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, Jena, Germany
| | - Conny Mathay
- Integrated BioBank of Luxembourg (IBBL), Dudelange, Luxembourg
| | - Monica Marchese
- Integrated BioBank of Luxembourg (IBBL), Dudelange, Luxembourg
| | - Estelle Henry
- Integrated BioBank of Luxembourg (IBBL), Dudelange, Luxembourg
| | - Julia Palm
- Institute of Medical Statistics, Computer and Data Science, Jena University Hospital, Jena, Germany
| | - Fay Betsou
- Integrated BioBank of Luxembourg (IBBL), Dudelange, Luxembourg
- Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Diagnostics and Integrated Biobank Jena (IBBJ), Jena University Hospital, Jena, Germany
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Mouttham L, Castelhano MG, Akey JM, Benton B, Borenstein E, Castelhano MG, Coleman AE, Creevy KE, Crowder K, Dunbar MD, Ernst HR, Fajt VR, Fitzpatrick AL, Garrison SJ, Herndon RS, Jaramilla D, Jeffery U, Jonlin EC, Kaeberlein M, Karlsson EK, Kerr KF, Levine JM, Ma J, McClelland RL, Prescott JO, Promislow DEL, Ruple A, Schwartz SM, Shrager S, Snyder-Mackler N, Tinkle AK, Tolbert MK, Urfer SR, Wilfond BS. Purpose, Partnership, and Possibilities: The Implementation of the Dog Aging Project Biobank. Biomark Insights 2022; 17:11772719221137217. [PMID: 36468152 PMCID: PMC9716607 DOI: 10.1177/11772719221137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Biobanks have been supporting longitudinal prospective and retrospective studies by providing standardized services for the acquisition, transport, processing, storage, and distribution of high-quality biological material and associated data. Here, we describe how the Dog Aging Project (DAP), a large-scale longitudinal study of the domestic dog ( Canis familiaris) with translational applications for humans, developed a biobank of canine biospecimens and associated data. Design and methods: This was accomplished by working with the Cornell Veterinary Biobank, the first biobank in the world to receive accreditation to ISO 20387:2018—General Requirements for Biobanking. The biobank research team was involved in the early collection stages of the DAP, contributing to the development of appropriate workflows and processing fit-for-purpose biospecimens. In support of a dynamic strategy for real-time adjustment of processes, a pilot phase was implemented to develop, test, and optimize the biospecimen workflows, followed by an early phase of collection, processing, and banking of specimens from DAP participants. Results: During the pilot and early phases of collection, the DAP Biobank stored 164 aliquots of whole blood, 273 aliquots of peripheral blood mononuclear cells, 130 aliquots of plasma, and 70 aliquots of serum, and extracted high molecular weight genomic DNA suitable for whole-genome sequencing from 109 whole blood specimens. These specimens, along with their associated preanalytical data, have been made available for distribution to researchers. Conclusion: We discuss the challenges and opportunities encountered during the implementation of the DAP Biobank, along with novel strategies for promoting biobanking sustainability such as partnering with a DAP quality assurance manager and a DAP marketing and communication specialist and developing a pilot grant structure to fund small innovative research projects.
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Affiliation(s)
- Lara Mouttham
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Joshua M Akey
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Brooke Benton
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elhanan Borenstein
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
- Santa Fe Institute, Santa Fe, NM, USA
| | - Marta G Castelhano
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kate E Creevy
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Kyle Crowder
- Department of Sociology, University of Washington, Seattle, WA, USA
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Matthew D Dunbar
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, USA
| | - Holley R Ernst
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Virginia R Fajt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Susan J Garrison
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Reba S Herndon
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Debra Jaramilla
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Unity Jeffery
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Erica C Jonlin
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, USA
| | - Matt Kaeberlein
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Elinor K Karlsson
- Bioinformatics and Integrative Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Kathleen F Kerr
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Jing Ma
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Jena O Prescott
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Daniel EL Promislow
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
- Department of Biology, University of Washington, Seattle, WA, USA
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sandi Shrager
- Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Noah Snyder-Mackler
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School for Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Amanda K Tinkle
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - M Katherine Tolbert
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Silvan R Urfer
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Benjamin S Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, Division of Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, WA, USA
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Huang J, Khademi M, Lindhe Ö, Jönsson G, Piehl F, Olsson T, Kockum I. Assessing the Preanalytical Variability of Plasma and Cerebrospinal Fluid Processing and Its Effects on Inflammation-Related Protein Biomarkers. Mol Cell Proteomics 2021; 20:100157. [PMID: 34597789 PMCID: PMC8554621 DOI: 10.1016/j.mcpro.2021.100157] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 01/01/2023] Open
Abstract
Proteomics studies are important for the discovery of new biomarkers as clinical tools for diagnosis and disease monitoring. However, preanalytical variations caused by differences in sample handling protocol pose challenges for assessing biomarker reliability and comparability between studies. The purpose of this study was to examine the effects of delayed centrifuging on measured protein levels in plasma and cerebrospinal fluid (CSF). Blood from healthy individuals and patients with multiple sclerosis along with CSF from patients with suspected neurological disorders were left at room temperature for different periods (blood: 1, 24, 48, 72 h; CSF: 1 and 6 h) prior to centrifuging. Ninety-one inflammation-related proteins were analyzed using a proximity extension assay, a high-sensitivity multiplex immunoassay. Additional metabolic and neurology-related markers were also investigated in CSF. In summary, many proteins, particularly in plasma, had increased levels with longer delays in processing likely due in part to intracellular leakage. Levels of caspase 8, interleukin 8, interleukin 18, sirtuin 2, and sulfotransferase 1A1 increased 2-fold to 10-fold in plasma after 24 h at room temperature. Similarly, levels of cathepsin H, ectonucleoside triphosphate diphosphohydrolase 5, and WW domain containing E3 ubiquitin protein ligase 2 differentiated in CSF with <6 h delay in processing. However, the rate of change for many proteins was relatively consistent; therefore, we were able to characterize biomarkers for detecting sample handling variability. Our findings highlight the importance of timely and consistent sample collection and the need for increased awareness of protein susceptibility to sample handling bias. In addition, suggested biomarkers may be used in certain situations to detect and correct for preanalytical variation in future studies. Several blood and cerebrospinal fluid proteins are affected by sample handling. Plasma protein levels increased with longer centrifugation delay from hemolysis. Certain proteins may assess sample handling variability and predict delay time.
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Affiliation(s)
- Jesse Huang
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mohsen Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Örjan Lindhe
- Olink Proteomics AB, Uppsala Science Park, Uppsala, Sweden
| | - Gunn Jönsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center of Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
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Liu C, Chu D, Kalantar‐Zadeh K, George J, Young HA, Liu G. Cytokines: From Clinical Significance to Quantification. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2004433. [PMID: 34114369 PMCID: PMC8336501 DOI: 10.1002/advs.202004433] [Citation(s) in RCA: 242] [Impact Index Per Article: 80.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/26/2021] [Indexed: 05/24/2023]
Abstract
Cytokines are critical mediators that oversee and regulate immune and inflammatory responses via complex networks and serve as biomarkers for many diseases. Quantification of cytokines has significant value in both clinical medicine and biology as the levels provide insights into physiological and pathological processes and can be used to aid diagnosis and treatment. Cytokines and their clinical significance are introduced from the perspective of their pro- and anti-inflammatory effects. Factors affecting cytokines quantification in biological fluids, native levels in different body fluids, sample processing and storage conditions, sensitivity to freeze-thaw, and soluble cytokine receptors are discussed. In addition, recent advances in in vitro and in vivo assays, biosensors based on different signal outputs and intracellular to extracellular protein expression are summarized. Various quantification platforms for high-sensitivity and reliable measurement of cytokines in different scenarios are discussed, and commercially available cytokine assays are compared. A discussion of challenges in the development and advancement of technologies for cytokine quantification that aim to achieve real-time multiplex cytokine analysis for point-of-care situations applicable for both biomedical research and clinical practice are discussed.
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Affiliation(s)
- Chao Liu
- School of Materials Science and EngineeringUniversity of New South WalesSydneyNSW2052Australia
| | - Dewei Chu
- School of Materials Science and EngineeringUniversity of New South WalesSydneyNSW2052Australia
| | | | - Jacob George
- Storr Liver CentreWestmead Institute of Medical ResearchUniversity of Sydney and Department of Gastroenterology and HepatologyWestmead HospitalWestmeadNSW2145Australia
| | - Howard A. Young
- Laboratory of Cancer ImmunometabolismCenter for Cancer ResearchNational Cancer Institute at FrederickFrederickMD21702USA
| | - Guozhen Liu
- School of Life and Health SciencesThe Chinese University of Hong KongShenzhen518172P. R. China
- Graduate School of Biomedical EngineeringUniversity of New South WalesSydneyNSW2052Australia
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Verberk IM, Nossent EJ, Bontkes HJ, Teunissen CE. Pre-analytical sample handling effects on blood cytokine levels: quality control of a COVID-19 biobank. Biomark Med 2021; 15:987-997. [PMID: 34289718 PMCID: PMC8359910 DOI: 10.2217/bmm-2020-0770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Aim: We investigated the effect of pre-analytical sample handling variations on coronavirus disease 2019-relevant circulating cytokine levels IFN-γ, IL-10, IL-12p70, IL-17A, IL-6 and TNF-α. Materials & methods: We collected blood in different collection tubes (ethylenediaminetetraacetic acid, sodium citrate, lithium heparin, serum), and subjected ethylenediaminetetraacetic acid plasma to among others increasing delays in centrifugation or -80°C storage. Six subjects were included in each experimental condition. Cytokine levels were measured in these samples using the Simoa Cytokine 6-plex kit. Results: Different tube types resulted in different blood cytokine levels. IL-17A and IL-6 levels declined with 3 h centrifugation delay. IFN-γ levels declined with 24 h postcentrifugation storage delay. IL-17A levels declined with 2-week storage delay. Conclusion: It is recommended to centrifuge tubes quickly following collection, for accurate cytokine measurement.
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Affiliation(s)
- Inge Mw Verberk
- Department of Clinical Chemistry, Neurochemistry Laboratory, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Esther J Nossent
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hetty J Bontkes
- Department of Clinical Chemistry, Medical Immunology Laboratory, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Department of Clinical Chemistry, Neurochemistry Laboratory, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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9
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Blood Plasma Quality Control by Plasma Glutathione Status. Antioxidants (Basel) 2021; 10:antiox10060864. [PMID: 34072235 PMCID: PMC8226592 DOI: 10.3390/antiox10060864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022] Open
Abstract
Timely centrifugation of blood for plasma preparation is a key step to ensure high plasma quality for analytics. Delays during preparation can significantly influence readouts of key clinical parameters. However, in a routine clinical environment, a strictly controlled timeline is often not feasible. The next best approach is to control for sample preparation delays by a marker that provides a readout of the time-dependent degradation of the sample. In this study, we explored the usefulness of glutathione status as potential marker of plasma preparation delay. As the concentration of glutathione in erythrocytes is at least two orders of magnitude higher than in plasma, even the slightest leakage of glutathione from the cells can be readily observed. Over the 3 h observation period employed in this study, we observed a linear increase of plasma concentrations of both reduced (GSH) and oxidized glutathione (GSSG). Artificial oxidation of GSH is prevented by rapid alkylation with N-ethylmaleimide directly in the blood sampling vessel as recently published. The observed relative leakage of GSH was significantly higher than that of GSSG. A direct comparison with plasma lactate dehydrogenase activity, a widely employed hemolysis marker, clearly demonstrated the superiority of our approach for quality control. Moreover, we show that the addition of the thiol alkylating reagent NEM directly to the blood tubes does not influence downstream analysis of other clinical parameters. In conclusion, we report that GSH gives an excellent readout of the duration of plasma preparation and the associated pre-analytical errors.
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10
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Verrinder E, Wester N, Leppänen E, Lilius T, Kalso E, Mikladal B, Varjos I, Koskinen J, Laurila T. Electrochemical Detection of Morphine in Untreated Human Capillary Whole Blood. ACS OMEGA 2021; 6:11563-11569. [PMID: 34056312 PMCID: PMC8154029 DOI: 10.1021/acsomega.1c00773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/06/2021] [Indexed: 05/04/2023]
Abstract
Disposable single-use electrochemical sensor strips were used for quantitative detection of small concentrations of morphine in untreated capillary whole blood. Single-walled carbon nanotube (SWCNT) networks were fabricated on a polymer substrate to produce flexible, reproducible sensor strips with integrated reference and counter electrodes, compatible with industrial-scale processes. A thin Nafion coating was used on top of the sensors to enable direct electrochemical detection in whole blood. These sensors were shown to detect clinically relevant concentrations of morphine both in buffer and in whole blood samples. Small 38 μL finger-prick blood samples were spiked with 2 μL of morphine solution of several concentrations and measured without precipitation of proteins or any other further pretreatment. A linear range of 0.5-10 μM was achieved in both matrices and a detection limit of 0.48 μM in buffer. In addition, to demonstrate the applicability of the sensor in a point-of-care device, single-determination measurements were done with capillary samples from three subjects. An average recovery of 60% was found, suggesting that the sensor only measures the free, unbound fraction of the drug. An interference study with other opioids and possible interferents showed the selectivity of the sensor. This study clearly indicates that these Nafion/SWCNT sensor strips show great promise as a point-of-care rapid test for morphine in blood.
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Affiliation(s)
- Elsi Verrinder
- Department
of Electrical Engineering and Automation, Aalto University, Tietotie 3, Espoo 02150, Finland
| | - Niklas Wester
- Department
of Chemistry and Materials Science, Aalto
University, Kemistintie
1, Espoo 02150, Finland
| | - Elli Leppänen
- Department
of Electrical Engineering and Automation, Aalto University, Tietotie 3, Espoo 02150, Finland
| | - Tuomas Lilius
- Department
of Pharmacology, University of Helsinki, Haartmaninkatu 8, Helsinki 00290, Finland
- Department
of Clinical Pharmacology, University of
Helsinki and Helsinki University Hospital, Tukholmankatu 8C, Helsinki 00290, Finland
- Emergency
Medicine, University of Helsinki and Department of Emergency Medicine
and Services, Helsinki University Hospital, Helsinki 00014, Finland
| | - Eija Kalso
- Department
of Pharmacology, University of Helsinki, Haartmaninkatu 8, Helsinki 00290, Finland
- Department
of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2A, Helsinki 00290, Finland
| | | | - Ilkka Varjos
- Canatu
Oy, Tiilenlyöjänkuja 9, Vantaa 01720, Finland
| | - Jari Koskinen
- Department
of Chemistry and Materials Science, Aalto
University, Kemistintie
1, Espoo 02150, Finland
| | - Tomi Laurila
- Department
of Electrical Engineering and Automation, Aalto University, Tietotie 3, Espoo 02150, Finland
- Department
of Chemistry and Materials Science, Aalto
University, Kemistintie
1, Espoo 02150, Finland
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11
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The Potential of Soluble Human Leukocyte Antigen Molecules for Early Cancer Detection and Therapeutic Vaccine Design. Vaccines (Basel) 2020; 8:vaccines8040775. [PMID: 33353014 PMCID: PMC7766713 DOI: 10.3390/vaccines8040775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/11/2020] [Indexed: 01/08/2023] Open
Abstract
Human leukocyte antigen (HLA) molecules are essential for anti-tumor immunity, as they display tumor-derived peptides to drive tumor eradication by cytotoxic T lymphocytes. HLA molecules are primarily studied as peptide-loaded complexes on cell membranes (mHLA) and much less attention is given to their secretion as soluble HLA–peptide complexes (sHLA) into bodily fluids. Yet sHLA levels are altered in various pathologies including cancer, and are thus of high interest as biomarkers. Disconcordance in results across studies, however, hampers interpretation and generalization of the relationship between sHLA levels and cancer presence, thereby impairing its use as a biomarker. Furthermore, the question remains to what extent sHLA complexes exert immunomodulatory effects and whether shifts in sHLA levels contribute to disease or are only a consequence of disease. sHLA complexes can also bear tumor-derived peptides and recent advancements in mass spectrometry now permit closer sHLA peptide cargo analysis. sHLA peptide cargo may represent a “liquid biopsy” that could facilitate the use of sHLA for cancer diagnosis and target identification for therapeutic vaccination. This review aims to outline the contradictory and unexplored aspects of sHLA and to provide direction on how the full potential of sHLA as a quantitative and qualitative biomarker can be exploited.
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12
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Binnington B, Sakac D, Yi Q, Tong TN, Parmar N, Duong TT, Yeung RSM, Pendergrast J, Branch DR. Stability of 40 cytokines/chemokines in chronically ill patients under different storage conditions. Cytokine 2020; 130:155057. [PMID: 32182456 DOI: 10.1016/j.cyto.2020.155057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/05/2020] [Accepted: 03/08/2020] [Indexed: 01/06/2023]
Abstract
Numerous studies point to the utility of blood cytokine measurements in the diagnosis and treatment of human disease. Advances in detection allow robust multiplex analysis. However, cytokines are present at low levels and are produced and act in complex networks which can remain active in stored blood. A major barrier to the routine use of cytokines as clinical biomarkers is sample management prior to analysis. Studies on cytokine stability under storage frequently use 'spiked' normal control plasma or serum to generate detectable levels of the cytokines of interest. These conditions may oversimplify the reality of clinically complex samples and provide limited information regarding optimal management of whole blood samples prior to plasma separation. Cytokine stability has also been addressed previously using plasma from normal individuals under different conditions of anticoagulant use, storage time and temperature of storage. No studies have as yet been undertaken to address cytokine stability in critically ill patients which may differ from normal, healthy individuals due to underlying cofounders such as inflammation. To address these issues, we subjected samples from five patients exhibiting an inflammatory disease state to three storage extremes which might be encountered in a clinical setting, prior to analysis of 40 cytokines. Blood drawn into EDTA or ACD anticoagulant was immediately separated and plasma stored at -80 °C. Matched samples were stored as follows; whole blood overnight at room temperature, or whole blood or plasma stored 10 days at 4 °C. We used equivalence testing to determine the similarity of stored cytokine values to baseline values. In ACD plasma, Eotaxin, IL-6, IL-11, IL-15, IP10, MDC, MCP-1 met equivalence to baseline in all storage conditions while for EDTA plasma stored 10 days at 4 °C EGF, FGF2, Fractalkine, G-CSF, IL-1β, IL-5, IL-6, IL-7, IL-11, IP-10, TGFα and TNFα showed equivalence to baseline measurements. Intraclass Correlation Coefficients (ICC) were calculated and the following cytokines showed good to excellent agreement across all 4 storage conditions: Eotaxin, IL-5, IL-6, IL-11, IL-13, IP-10, MCP-1 and TNFα when collected in EDTA, and Eotaxin, IL-5, IL-6, IL-11, IL12-p40, IL-15, IP-10 and MCP-1 when collected in ACD. Five plasma cytokines were identified as being the least stable in both ACD and EDTA: IL-7, IL-9, IL12p70, RANTES, sCD40L, while IL-1β was identified as unstable stored in ACD plasma. This study identified several clinically important cytokines that are remarkably stable in blood and plasma, and some that stored poorly. To our knowledge, this is the first cytokine storage study to use medically unwell patient samples and equivalence testing to evaluate the stability of measured cytokine values after storage.
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Affiliation(s)
- Beth Binnington
- Canadian Blood Services, Centre for Innovation, Toronto, Ontario, Canada
| | - Darinka Sakac
- Canadian Blood Services, Centre for Innovation, Toronto, Ontario, Canada
| | - Qilong Yi
- Canadian Blood Services, Centre for Innovation, Ottawa, Ontario, Canada
| | - Tik Nga Tong
- Canadian Blood Services, Centre for Innovation, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Nagina Parmar
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Trang T Duong
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rae S M Yeung
- The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jacob Pendergrast
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Donald R Branch
- Canadian Blood Services, Centre for Innovation, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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13
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Stability of 12 T-helper cell-associated cytokines in human serum under different pre-analytical conditions. Cytokine 2020; 129:155044. [PMID: 32109722 DOI: 10.1016/j.cyto.2020.155044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/16/2020] [Accepted: 02/15/2020] [Indexed: 11/23/2022]
Abstract
Cytokines are soluble and readily analyzed signaling molecules which reveal vital cues about the state of the immune system. As such, they serve in diagnosis and monitoring of immune-related disorders, where strictly controlled handling of the samples including storage and freeze/thawing procedures are required. In basic research and clinical trials, human serum samples can be left for long-term storage before processing. Storage space is commonly limited in scientific laboratories, which require storage of fewer but larger aliquots of patient serum samples. There are also practical limitations to the number of analytes to be processed at the same time. Further, new findings and technological progress might prompt analysis of hitherto unconsidered or undetectable molecules. Repeated freeze/thawing of serum samples is therefore a likely scenario, raising the question of the stability of the measured analytes under such conditions. To address this question, we subjected serum samples with spiked-in T-helper cell associated cytokines to several cycles of freeze/thawing under different conditions, including storage at -20 °C or -80 °C and thawing at 4 °C, 22 °C, and 37 °C, respectively. The concentration of TNF-α, IL-4, IL-17F, and IL-22 decreased after storage at room temperature for 4 h before freezing. Generally, storage at -20 °C resulted in reduced cytokine concentrations. This contrasts storage at -80 °C, which gave stable analyte concentrations; unaffected by repeated freeze/thaw cycles. The study presented here highlights the need for sentinel samples with known cytokine concentrations as internal control for the freeze/thaw process.
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14
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Kupcova Skalnikova H, Vodickova Kepkova K, Vodicka P. Luminex xMAP Assay to Quantify Cytokines in Cancer Patient Serum. Methods Mol Biol 2020; 2108:65-88. [PMID: 31939171 DOI: 10.1007/978-1-0716-0247-8_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cytokines, chemokines, and growth factors are key mediators of cell proliferation, migration, and immune response, and in tumor microenvironment, such factors contribute to regulation of tumor growth, immune cell recruitment, angiogenesis, and metastasis. In body fluids, levels of inflammatory mediators reflect the patient immune response to the disease and may predict the effects of targeted therapies. Significant improvements in cytokine detection techniques have been made during last 10 years leading to sensitive quantification of such potent molecules present in low pg/mL levels. Among the techniques, Luminex xMAP® multiplex assays allow for simultaneous quantification of up to 100 analytes with high sensitivity, broad dynamic range of quantification, high throughput, and minimal sample requirements. In this chapter we describe a detailed protocol for the application of xMAP assays using Luminex® 200™ analyzer with xPonent® acquisition software to quantify cytokines, chemokines, and growth factors secreted to blood serum and plasma of cancer patients. We also discuss how sample preparation, instrument settings, and standard curve fitting algorithms can influence validity of obtained results. Special attention is paid to data analysis using open source R statistical environment and we provide an example dataset of cytokine levels measured in serum and corresponding R script for standard curve fitting and concentration estimates.
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Affiliation(s)
- Helena Kupcova Skalnikova
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Libechov, Czech Republic
| | - Katerina Vodickova Kepkova
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Libechov, Czech Republic
| | - Petr Vodicka
- Laboratory of Applied Proteome Analyses, Institute of Animal Physiology and Genetics of The Czech Academy of Sciences, Libechov, Czech Republic.
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15
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Valaperti A, Bezel P, Vonow-Eisenring M, Franzen D, Steiner UC. Variability of cytokine concentration in whole blood serum and bronchoalveolar lavage over time. Cytokine 2019; 123:154768. [PMID: 31276936 DOI: 10.1016/j.cyto.2019.154768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/28/2019] [Accepted: 06/25/2019] [Indexed: 01/01/2023]
Abstract
Measurement of cytokines in peripheral blood and bronchoalveolar lavage fluid (BALF) is a useful method to assess human immune responses in a large range of pulmonary diseases. One of the major pre-analytical challenges of cytokine analysis is the quality and stability of cytokines in the timeframe between sample collection and the separation of supernatant from cells. To evaluate if the method of storage may affect cytokine quantification, whole blood and BALF were collected, aliquoted, and left at room temperature (RT) to be processed at different time points. In addition, sera and BALF were left either at RT or at 4 °C for 24 h after cell separation to test cytokine variations in the absence of cells. Samples were analysed by a multiple array containing ten cytokines. Most of the cytokines analysed (interleukin (IL)-4, IL-5, IL-6, IL-12p70, IL-13, IL-17A, IL-23, interferon (IFN)-γ, and tumour necrosis factor (TNF)-α) did not show significant variations in whole blood and BALF. Levels of IL-8 however, increased after storage of whole blood and BALF for 24 h at RT. Ex vivo IL-8 production seems to correlate with higher numbers of macrophages in collected BALF. These data demonstrate that many cytokines are stable for a brief time after sample collection. For IL-8, freshly collected whole blood and BALF should be quickly processed and frozen to avoid false positive results.
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Affiliation(s)
- Alan Valaperti
- Department of Clinical Immunology, University Hospital Zurich, Gloriastrasse 23, 8091 Zurich, Switzerland
| | - Pascal Bezel
- Division of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Maya Vonow-Eisenring
- Department of Clinical Immunology, University Hospital Zurich, Gloriastrasse 23, 8091 Zurich, Switzerland
| | - Daniel Franzen
- Division of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Urs C Steiner
- Department of Clinical Immunology, University Hospital Zurich, Gloriastrasse 23, 8091 Zurich, Switzerland.
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16
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Gong Y, Liang S, Zeng L, Ni Y, Zhou S, Yuan X. Effects of blood sample handling procedures on measurable interleukin 6 in plasma and serum. J Clin Lab Anal 2019; 33:e22924. [PMID: 31131487 PMCID: PMC6757116 DOI: 10.1002/jcla.22924] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/04/2019] [Accepted: 05/09/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction Interleukin‐6(IL‐6) measurement is used as a biomarker in medical diagnosis, therapy, and prognosis in various diseases. However, several pre‐analytical factors may yield a false IL‐6 result. In this study, we set out to investigate the effects of corrected blood sample handling procedures on measurable IL‐6. Method EDTA plasma and serum samples were collected from 45 healthy individuals. The participants were divided into three groups to perform different handling procedures. Different centrifugal timing, storage temperature, and time were executed on the samples. The changed trends of IL‐6 levels were analyzed. Results At baseline, while the paired plasma and serum IL‐6 values had a good correlation, the plasma levels were higher than serum. In general, the unseparated EDTA plasma kept steady with time. With the increase in storage temperature and time, a more pronounced rise in unseparated serum IL‐6 was observed. Nevertheless, the samples in Group 3 which centrifuged and separated immediately kept stable after a different temperature and longtime storage. Conclusion Sample types, centrifugal timing, storage temperature, and time may affect the IL‐6 levels. A standard blood sample handling procedure should be performed to ensure the accuracy and stability of IL‐6 values.
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Affiliation(s)
- Yan Gong
- Department of Coloproctology, Zhujiang Hospital, Southern Medical University, GuangZhou, China.,Department of Geriatrics, Zhujiang Hospital, Southern Medical University, GuangZhou, China
| | - Shaocong Liang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, GuangZhou, China
| | - Lei Zeng
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, GuangZhou, China
| | - Yanli Ni
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, GuangZhou, China
| | - Shaosong Zhou
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, GuangZhou, China
| | - Xiaopeng Yuan
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, GuangZhou, China
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17
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Koelman L, Pivovarova-Ramich O, Pfeiffer AFH, Grune T, Aleksandrova K. Cytokines for evaluation of chronic inflammatory status in ageing research: reliability and phenotypic characterisation. IMMUNITY & AGEING 2019; 16:11. [PMID: 31139232 PMCID: PMC6530020 DOI: 10.1186/s12979-019-0151-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/08/2019] [Indexed: 12/31/2022]
Abstract
Background There is a growing interest in the role of inflammageing for chronic disease development. Cytokines are potent soluble immune mediators that can be used as target biomarkers of inflammageing; however, their measurement in human samples has been challenging. This study aimed to assess the reliability of a pro- and anti-inflammatory cytokine panel in a sample of healthy people measured with a novel electrochemiluminescent multiplex immunoassay platform (Meso Scale Discovery, MSD), and to characterize their associations with metabolic and inflammatory phenotypes. Results Overall, the majority of cytokines were above the limit of detection (in at least 85.3% of the samples). Cytokines IL-6, IL-8, TNF-α, IL-10, IL-13, and IFN-γ showed overall good to fair reliability (ICC > 0.40), whereas IL-1β, IL-2, IL-4, and IL-12p70 showed poor reliability (ICC < 0.40). The reliability estimates were not substantially influenced by participants' age, sex, obesity and C-reactive protein (CRP) levels. As expected, cytokine concentrations were elevated with advanced age most pronouncedly for IL-6, IL-8, Il-2, IFN- γ, and TNF-α. No major associations with metabolic phenotypes were observed for most cytokines, with the exception of a positive association between IL-6 and TNF-α with body mass index and CRP (ρ: 0.36; ρ: 0.20; ρ: 0.53; ρ: 0.22, respectively), and IFN-γ and IL-10 with CRP (ρ: 0.23 and ρ: 0.19, respectively). Conclusions Single measurements of selected cytokines using MSD platform, including IL-6, IL-8, IL-10, IL-13, TNF-α, and IFN-γ have shown to be representative of an individual's average level over time and could be suitable for use in prospective epidemiological and clinical studies. Such studies are highly warranted to characterize associations of cytokines with phenotypes and diseases associated with ageing.
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Affiliation(s)
- Liselot Koelman
- 1Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Olga Pivovarova-Ramich
- 3Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,4German Center for Diabetes Research (DZD), Neuherberg, Germany.,5Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany.,7Senior Scientist Group Molecular Nutritional Medicine, Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Andreas F H Pfeiffer
- 3Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.,4German Center for Diabetes Research (DZD), Neuherberg, Germany.,5Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Berlin, Germany
| | - Tilman Grune
- 6Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Krasimira Aleksandrova
- 1Senior Scientist Group Nutrition, Immunity and Metabolism, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.,University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
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18
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Kofanova O, Henry E, Aguilar Quesada R, Bulla A, Navarro Linares H, Lescuyer P, Shea K, Stone M, Tybring G, Bellora C, Betsou F. IL8 and IL16 levels indicate serum and plasma quality. Clin Chem Lab Med 2019; 56:1054-1062. [PMID: 29425105 DOI: 10.1515/cclm-2017-1047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/30/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Longer pre-centrifugation times alter the quality of serum and plasma samples. Markers for such delays in sample processing and hence for the sample quality, have been identified. METHODS Twenty cytokines in serum, EDTA plasma and citrate plasma samples were screened for changes in concentration induced by extended blood pre-centrifugation delays at room temperature. The two cytokines that showed the largest changes were further validated for their "diagnostic performance" in identifying serum or plasma samples with extended pre-centrifugation times. RESULTS In this study, using R&D Systems ELISA kits, EDTA plasma samples and serum samples with a pre-centrifugation delay longer than 24 h had an IL16 concentration higher than 313 pg/mL, and an IL8 concentration higher than 125 pg/mL, respectively. EDTA plasma samples with a pre-centrifugation delay longer than 48 h had an IL16 concentration higher than 897 pg/mL, citrate plasma samples had an IL8 concentration higher than 21.5 pg/mL and serum samples had an IL8 concentration higher than 528 pg/mL. CONCLUSIONS These robust and accurate tools, based on simple and commercially available ELISA assays can greatly facilitate qualification of serum and plasma legacy collections with undocumented pre-analytics.
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Affiliation(s)
- Olga Kofanova
- Integrated Biobank of Luxembourg, Strassen, Luxembourg
| | - Estelle Henry
- Integrated Biobank of Luxembourg, Strassen, Luxembourg
| | | | - Alexandre Bulla
- Sérothèque Centrale, Département de Médecine Génétique et de Laboratoire, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | | | - Pierre Lescuyer
- Sérothèque Centrale, Département de Médecine Génétique et de Laboratoire, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - Kathi Shea
- Precision for Medicine, Frederick, MD, USA
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, CA, USA
| | | | | | - Fay Betsou
- Integrated Biobank of Luxembourg, Strassen, Luxembourg
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19
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Karlsen TA, Brinchmann JE. Expression of inflammatory cytokines in mesenchymal stromal cells is sensitive to culture conditions and simple cell manipulations. Exp Cell Res 2018; 374:122-127. [PMID: 30496759 DOI: 10.1016/j.yexcr.2018.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/09/2018] [Accepted: 11/18/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Mesenchymal stromal cells (MSCs) can be used in several clinical applications. While MSCs are frequently cultured in fetal bovine serum for in vitro experimentation, human serum supplements are required for cells to be used in patients. Here we show how different human serum supplements and in vitro manipulations used during the cell culture impact on MSC proliferation rate and expression of inflammatory molecules. METHODS MSCs were cultured in medium supplemented with human plasma or serum combined with human platelet lysate (PL) and/or basic fibroblast growth factor (FGF2). Real time RT-PCR and western blot were used to assess expression of inflammatory cytokines. RESULTS Serum with addition of FGF2 gave the fastest proliferation rate. However, serum with FGF2 also increased expression of genes encoding inflammatory cytokines. The most favorable expansion condition for chondrogenic differentiation and inhibition of cartilage matrix degrading enzymes was plasma supplemented with PL and FGF2. Detachment of cells using trypsin gave considerable upregulation of inflammatory cytokine mRNAs which lasted for up to 24 h, with concomitant increase in protein levels. Even the gentle act of changing medium led to upregulation of cytokine mRNA, caused by addition of fresh serum. DISCUSSION Different culture conditions and simple cell manipulation influence proliferation rate and expression of inflammatory genes. Supplementing culture medium with allogeneic AB serum and FGF2 during monolayer expansion supported cell expansion better than other supplements, but also induced the highest levels of inflammatory cytokines and gave inferior results for chondrogenic differentiation. The importance of the composition of the culture medium and even gentle in vitro manipulation of the cells should be taken into account in the planning of procedures using in vitro expanded MSCs.
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Affiliation(s)
- Tommy A Karlsen
- Norwegian Center for Stem Cell Research, Department of Immunology, Oslo University Hospital Rikshospitalet, PO Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Jan E Brinchmann
- Norwegian Center for Stem Cell Research, Department of Immunology, Oslo University Hospital Rikshospitalet, PO Box 4950 Nydalen, 0424 Oslo, Norway; Department of Molecular Medicine, Faculty of Medicine, University of Oslo, PO Box 1078 Blindern, 0316 Oslo, Norway
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20
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Shen Q, Björkesten J, Galli J, Ekman D, Broberg J, Nordberg N, Tillander A, Kamali-Moghaddam M, Tybring G, Landegren U. Strong impact on plasma protein profiles by precentrifugation delay but not by repeated freeze-thaw cycles, as analyzed using multiplex proximity extension assays. Clin Chem Lab Med 2018; 56:582-594. [PMID: 29040064 DOI: 10.1515/cclm-2017-0648] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/11/2017] [Indexed: 01/06/2023]
Abstract
Background A number of factors regarding blood collection, handling and storage may affect sample quality. The purpose of this study was to assess the impact on plasma protein profiles by delayed centrifugation and plasma separation and multiple freeze-thaw cycles. Methods Blood samples drawn from 16 healthy individuals were collected into ethylenediaminetetraacetic acid tubes and kept either at 4 °C or 22 °C for 1-36 h prior to centrifugation. Plasma samples prepared 1 h after venipuncture were also subjected to two to eight cycles of freezing at -80 °C and thawing at 22 °C. Multiplex proximity extension assay, an antibody-based protein assay, was used to investigate the influence on plasma proteins. Results Up to 36 h delay before blood centrifugation resulted in significant increases of 16 and 40 out of 139 detectable proteins in samples kept at 4 °C or 22 °C, respectively. Some increases became noticeable after 8 h delay at 4 °C but already after 1 h at 22 °C. For samples stored at 4 °C, epidermal growth factor (EGF), NF-kappa-B essential modulator, SRC, interleukin 16 and CD6 increased the most, whereas the five most significantly increased proteins after storage at 22 °C were CD40 antigen ligand (CD40-L), EGF, platelet-derived growth factor subunit B, C-X-C motif chemokine ligand 5 and matrix metallopeptidase 1 (MMP1). Only matrix metallopeptidase 7 (MMP7) decreased significantly over time and only after storage at 22 °C. No protein levels were found to be significantly affected by up to eight freeze-thaw cycles. Conclusions Plasma should be prepared from blood after a limited precentrifugation delay at a refrigerated temperature. By contrast, the influence by several freeze-thaw cycles on detectable protein levels in plasma was negligible.
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Affiliation(s)
- Qiujin Shen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University,Uppsala, Sweden
| | - Johan Björkesten
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University,Uppsala, Sweden
| | - Joakim Galli
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University,Uppsala, Sweden
| | | | | | | | - Annika Tillander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Masood Kamali-Moghaddam
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University,Uppsala, Sweden
| | - Gunnel Tybring
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Landegren
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University,Uppsala, Sweden
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21
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Lee JE. How Should Biobanks Collect Biosamples for Clinical Application? A 20-year Biomarker-related Publication and Patent Trend Analysis. Osong Public Health Res Perspect 2018; 9:105-111. [PMID: 30023154 PMCID: PMC6037391 DOI: 10.24171/j.phrp.2018.9.3.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objectives This study was designed to analyze biomarker-related publications and patent trends which biobanks could consider in planning biosample collections for biomarker research. Methods Publications and patents containing the term “biomarker” in the title published between 1998 to 2017 were retrieved using Scopus database and Google Patents search engine. Results Over the last 20 years there has been a steady increase in biomarker-related publications and patents; however this has slowed for patents over the last few years. Publications in 2017 that contained blood, serum, and plasma search terms in the abstract accounted for 50%, and serum as a search term in the title and abstract was more numerous than those containing blood, plasma, tissue, or urine. Blood-related patents were the most common patent in the last 10 years, and accounted for 110 patents in 2017. Biomarker-related publications since 2010 containing RNA and protein search terms in the title and abstract, were more numerous than those containing DNA and metabolite search terms. More than 27% of biomarker-related publications in 2017 and 21% of biomarker-related patents were associated with cancer. Conclusion The results of this study will help biobanks establish a biosample collection strategy for clinical application.
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Affiliation(s)
- Jae-Eun Lee
- Division of Biobank for Health Sciences, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
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22
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van Waateringe RP, Muller Kobold AC, van Vliet-Ostaptchouk JV, van der Klauw MM, Koerts J, Anton G, Peters A, Trischler G, Kvaløy K, Naess M, Videm V, Hveem K, Waldenberger M, Koenig W, Wolffenbuttel BH. Influence of Storage and Inter- and Intra-Assay Variability on the Measurement of Inflammatory Biomarkers in Population-Based Biobanking. Biopreserv Biobank 2017; 15:512-518. [DOI: 10.1089/bio.2017.0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Anneke C. Muller Kobold
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Jan Koerts
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gabriele Anton
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Annette Peters
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Gerlinde Trischler
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Centre, Ulm, Germany
| | - Kirsti Kvaløy
- Department of Public Health and General Practice, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Naess
- Department of Public Health and General Practice, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Vibeke Videm
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Immunology and Transfusion Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Kristian Hveem
- Department of Public Health and General Practice, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
| | - Wolfgang Koenig
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Centre, Ulm, Germany
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23
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Lee JE, Kim YY. Impact of Preanalytical Variations in Blood-Derived Biospecimens on Omics Studies: Toward Precision Biobanking? OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2017; 21:499-508. [PMID: 28873014 DOI: 10.1089/omi.2017.0109] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Research data and outcomes do vary across populations and persons, but this is not always due to experimental or true biological variation. Preanalytical components of experiments, be they biospecimen acquisition, preparation, storage, or transportation to the laboratory, may all contribute to apparent variability in research data, outcomes, and interpretation. The present review article and biobanking innovation analysis offer new insights with a summary of such preanalytical variables, for example, the type of blood collection tube, centrifugation conditions, long-term sample storage temperature, and duration, on output of omics analyses of blood-derived biospecimens: whole blood, serum, plasma, buffy coat, and peripheral blood mononuclear cells. Furthermore, we draw parallels from the field of precision medicine in this study, with a view to the future of "precision biobanking" wherein such preanalytical variations are carefully taken into consideration so as to minimize their influence on outcomes of omics data, analyses, and sensemaking, particularly in clinical omics applications. We underscore the need for using broadly framed, critical, independent, social and political science, and humanities research so as to understand the multiple possible future trajectories of, and the motivations and values embedded in, precision biobanking that is increasingly relevant in the current age of Big Data.
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Affiliation(s)
- Jae-Eun Lee
- Division of Biobank for Health Sciences, Center for Genome Science, Korea National Institute of Health , Korea Centers for Disease Control and Prevention, Cheongju-si, Korea
| | - Young-Youl Kim
- Division of Biobank for Health Sciences, Center for Genome Science, Korea National Institute of Health , Korea Centers for Disease Control and Prevention, Cheongju-si, Korea
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24
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Lee JE, Lee JH, Hong M, Park SK, Yu JI, Shin SY, Kim SY. Instability of Plasma and Serum Progastrin-Releasing Peptide During Repeated Freezing and Thawing. Osong Public Health Res Perspect 2016; 7:351-355. [PMID: 28053839 PMCID: PMC5194227 DOI: 10.1016/j.phrp.2016.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/10/2016] [Indexed: 12/04/2022] Open
Abstract
Objectives Progastrin-releasing peptide (proGRP) is a promising biomarker for small cell lung cancer. However, not much is known about how sample processing and storage conditions affect the stability of proGRP. Here, we examined the effects of repeated freeze–thaw cycles on the stability of proGRP in plasma and serum. Methods Concentrations of proGRP were measured in plasma and serum samples exposed to two, three, or four freeze–thaw cycles and these were compared with values of corresponding samples exposed to one cycle (baseline). We also performed the area under the receiver-operating-characteristic curve (AUC) analysis to determine whether the differences of proGRP concentrations between each paired plasma and serum sample (ΔproGRP) can be used for identifying the samples that have been exposed to multiple freeze–thaw cycles. Results Concentrations of proGRP gradually decreased in both plasma and serum samples with increasing numbers of freeze–thaw cycles. Reduction rates of proGRP concentrations were greater in serum than in plasma samples and serum proGRP levels declined with statistical significance (p < 0.001) up to 10.1% after four freeze–thaw cycles. The ΔproGRP measurement showed fair accuracy (AUC = 0.741) for identifying samples that had been through four freeze–thaw cycles. The sensitivity was 82.8% and specificity was 62.1% at an optimal cut-off point of > 4.9. Conclusion Our study shows that the stability of circulating proGRP is affected in both plasma and serum samples by repeated freezing and thawing. We also show that ΔproGRP could be used for identifying paired plasma and serum samples subjected to multiple freeze–thaw cycles.
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Affiliation(s)
- Jae-Eun Lee
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Jin-Hyun Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Maria Hong
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Seul-Ki Park
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Ji-In Yu
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - So-Youn Shin
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Shine Young Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
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