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Kioi Y, Itotagawa E, Kawachi Y, Ichikawa R, Obata Y, Tsujimoto K, Kawasaki T, Akira T, Kosaka K, Park J, Narazaki M, Shimomura I, Kumanogoh A. Case report: Avacopan-induced severe liver injury with prolonged jaundice and lipoprotein X-induced dyslipidemia. Int J Rheum Dis 2024; 27:e15400. [PMID: 39467032 DOI: 10.1111/1756-185x.15400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 09/17/2024] [Accepted: 10/16/2024] [Indexed: 10/30/2024]
Affiliation(s)
- Yoshiyuki Kioi
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eri Itotagawa
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yusuke Kawachi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Rumiko Ichikawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshinari Obata
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kohei Tsujimoto
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takahiro Kawasaki
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Taro Akira
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuma Kosaka
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Jeonghoon Park
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masashi Narazaki
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
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Garcia E, Shalaurova I, Matyus SP, Freeman LA, Neufeld EB, Sampson ML, Zubirán R, Wolska A, Remaley AT, Otvos JD, Connelly MA. A High-Throughput NMR Method for Lipoprotein-X Quantification. Molecules 2024; 29:564. [PMID: 38338310 PMCID: PMC10856374 DOI: 10.3390/molecules29030564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Lipoprotein X (LP-X) is an abnormal cholesterol-rich lipoprotein particle that accumulates in patients with cholestatic liver disease and familial lecithin-cholesterol acyltransferase deficiency (FLD). Because there are no high-throughput diagnostic tests for its detection, a proton nuclear magnetic resonance (NMR) spectroscopy-based method was developed for use on a clinical NMR analyzer commonly used for the quantification of lipoproteins and other cardiovascular biomarkers. The LP-X assay was linear from 89 to 1615 mg/dL (cholesterol units) and had a functional sensitivity of 44 mg/dL. The intra-assay coefficient of variation (CV) varied between 1.8 and 11.8%, depending on the value of LP-X, whereas the inter-assay CV varied between 1.5 and 15.4%. The assay showed no interference with bilirubin levels up to 317 mg/dL and was also unaffected by hemolysis for hemoglobin values up to 216 mg/dL. Samples were stable when stored for up to 6 days at 4 °C but were not stable when frozen. In a large general population cohort (n = 277,000), LP-X was detected in only 50 subjects. The majority of LP-X positive cases had liver disease (64%), and in seven cases, had genetic FLD (14%). In summary, we describe a new NMR-based assay for LP-X, which can be readily implemented for routine clinical laboratory testing.
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Affiliation(s)
- Erwin Garcia
- Labcorp, Morrisville, NC 27560, USA; (E.G.); (I.S.); (S.P.M.)
| | | | | | - Lita A. Freeman
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
| | - Edward B. Neufeld
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
| | - Maureen L. Sampson
- Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Rafael Zubirán
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
| | - Anna Wolska
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
| | - Alan T. Remaley
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
- Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA;
| | - James D. Otvos
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (L.A.F.); (E.B.N.); (R.Z.); (A.W.); (A.T.R.); (J.D.O.)
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Zheng C, Zhou W, Zhou R, Zhang H, Liang S, Zhang W, Li G, Zhang C, Gan W. The necessity for improving lipid testing reagents: A real world study. Clin Chim Acta 2023; 548:117529. [PMID: 37640131 DOI: 10.1016/j.cca.2023.117529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/10/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND We investigated the interference of vitamin C (VitC), glycerol fructose, lipoprotein X (LpX) and lipemia on the analysis of serum lipids. METHODS Serum were collected from 44 patients with VitC infusion, serum lipid concentrations before and after VitC auto-oxidation were compared. Serum of 31 patients with glycerol fructose infusion were collected, triglycerides (TG) measured by glycerol blanking and non-blanking reagents were compared. Forty-four serum samples suspected to contain LpX were collected, LDL-C measured by reagents from five manufacturers were compared. Lipemia samples were collected, LDL-C measured using five different reagents were compared. The interference rate was considered unacceptable if it was greater than 1/2 total allowable error (TEa). RESULTS In patients with VitC infusion, the interference rates of TG and total cholesterol (TC) were -59% (-123%, -28%) and -15% (-21%, -11%), respectively. In patients with glycerol fructose infusion, the interference rate of TG was 13% (4%, 113%). LpX interference led to increased LDL-C results for most reagents. Lipemia caused great interference with LDL-C analysis. CONCLUSION VitC, glycerol fructose, LpX and lipemia significantly interfered with lipid assays. The reagent formulation should be improved to get reliable results.
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Affiliation(s)
- Chuan Zheng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China; Department of Clinical Laboratory, The First People's Hospital of Shuangliu District, Chengdu/West China (Airport) Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Ruyi Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - He Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shanshan Liang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Zhang
- Department of Clinical Laboratory, The First People's Hospital of Shuangliu District, Chengdu/West China (Airport) Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guixing Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
| | - Wei Gan
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
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