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Zhang Y, Abdollahi A, Andolino C, Tomoo K, Foster BM, Aryal UK, Henderson GC. Performance evaluation of different albumin assays for the detection of analbuminemia. PLoS One 2024; 19:e0300130. [PMID: 38446837 PMCID: PMC10917273 DOI: 10.1371/journal.pone.0300130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Abstract
Analbuminemia is characterized by the near absence of albumin in the plasma. Different methods are available for measuring albumin levels, but they do not necessarily agree with one another. It is a concern that analbuminemic samples could be falsely characterized due to the incorrect estimation of albumin. The objective of the work was to evaluate the performance of different assays in detecting analbuminemia. Albumin knockout (Alb-/-) mouse plasma was used to test the suitability of different albumin assays for their ability to properly characterize extreme albumin deficiency. Bromocresol green (BCG), bromocresol purple (BCP), enzyme-linked immunosorbent assay (ELISA), liquid chromatography-tandem mass spectrometry (LC-MS/MS), and gel electrophoresis were tested. The LC-MS/MS assay exhibited broad coverage of the amino acid sequence of albumin and indicated 8,400-fold lower (P<0.0001) albumin expression in Alb-/- than wildtype (WT), demonstrating its suitability for identifying extreme albumin deficiency. ELISA estimated albumin at 1.5±0.1 g/dL in WT and was below the detection limit in all Alb-/- samples. Gel electrophoresis yielded consistent results with LC-MS/MS and ELISA. The BCG assay overestimated albumin with apparently appreciable albumin concentrations in Alb-/- mice, yet the assay still indicated a significant difference between genotypes (Alb-/-, 1.2±0.05 g/dL, WT, 3.7±0.1 g/dL, P<0.0001). BCP drastically overestimated albumin and could not successfully identify the known analbuminemic phenotype of Alb-/- mice. By using Alb-/- plasma as a reference material and LC-MS/MS as a reference method, ELISA and gel electrophoresis appear appropriate for identifying analbuminemia, while BCG and BCP are not suitable. It is concluded that dye-binding assays should be avoided when extreme hypoalbuminemia or analbuminemia is suspected.
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Affiliation(s)
- Yi Zhang
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
| | - Chaylen Andolino
- Purdue Proteomics Facility, Purdue University, West Lafayette, IN, United States of America
| | - Keigo Tomoo
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
| | - Bailey M. Foster
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
| | - Uma K. Aryal
- Purdue Proteomics Facility, Purdue University, West Lafayette, IN, United States of America
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States of America
| | - Gregory C. Henderson
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States of America
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Alterations in the Plasma Protein Expression Pattern in Congenital Analbuminemia—A Systematic Review. Biomolecules 2023; 13:biom13030407. [PMID: 36979342 PMCID: PMC10046341 DOI: 10.3390/biom13030407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 02/25/2023] Open
Abstract
Albumin is a highly abundant plasma protein with multiple functions, including the balance of fluid between body compartments and fatty acid trafficking. Humans with congenital analbuminemia (CAA) do not express albumin due to homozygosity for albumin gene mutation. Lessons about physiological control could be learned from CAA. Remarkably, these patients exhibit an apparently normal lifespan, without substantial impairments in physical functionality. There was speculation that tolerance to albumin deficiency would be characterized by significant upregulation of other plasma proteins to compensate for analbuminemia. It is unknown but possible that changes in plasma protein expression observed in CAA are required for the well-documented survival and general wellness. A systematic review of published case reports was performed to assess plasma protein pattern remodeling in CAA patients who were free of other illnesses that would confound interpretation. From a literature search in Pubmed, Scopus, and Purdue Libraries (updated October 2022), concentration of individual plasma proteins and protein classes were assessed. Total plasma protein concentration was below the reference range in the vast majority of CAA patients in the analysis, as upregulation of other proteins was not sufficient to prevent the decline of total plasma protein when albumin was absent. Nonetheless, an impressive level of evidence in the literature indicated upregulated plasma levels of multiple globulin classes and various specific proteins which may have metabolic functions in common with albumin. The potential role of this altered plasma protein expression pattern in CAA is discussed, and the findings may have implications for other populations with hypoalbuminemia.
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Al-lawama M, Albaramki J, Kiswani A, Kussad S, Odeh R, Altamimi E. Congenital Analbuminemia Associated with Hypothyroidism in a Preterm Neonate: The First Case from a Highly Consanguineous Community. JOURNAL OF CHILD SCIENCE 2022. [DOI: 10.1055/s-0042-1757149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AbstractAnalbuminemia is a rare autosomal recessive disease characterized by extremely low or zero levels of circulating serum albumin. The diagnosis is made by ruling out other causes of hypoalbuminemia and should be confirmed by gene mutation analysis. In this article, we describe the clinical findings of a preterm neonate born to a consanguineous family who presented with progressive lower limb edema at the age of 7 days and who was confirmed as having congenital analbuminemia by genetic testing (homozygous mutation ALB NP_000468.1: p. Val78CysfsTer2) and hypothyroidism. This is the first case of congenital analbuminemia to be reported from Jordan.
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Affiliation(s)
- Manar Al-lawama
- The Pediatric Department, The University of Jordan, Amman, Jordan
| | - Jumana Albaramki
- The Pediatric Department, The University of Jordan, Amman, Jordan
| | - Arwa Kiswani
- The Pediatric Department, The University of Jordan, Amman, Jordan
| | - Sara Kussad
- The Pediatric Department, The University of Jordan, Amman, Jordan
| | - Rasha Odeh
- The Pediatric Department, The University of Jordan, Amman, Jordan
| | - Eyad Altamimi
- The Pediatric and Neonatal Department, Jordan University for Science and Technology, Irbid, Jordan
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Overview of Albumin Physiology and its Role in Pediatric Diseases. Curr Gastroenterol Rep 2021; 23:11. [PMID: 34213692 DOI: 10.1007/s11894-021-00813-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Albumin plays a critical role in a wide range of disease processes; however, the role of albumin in pediatric patients has not been well described. This article aims to review albumin physiology and kinetics in children, albumin's impact on pediatric diseases, and the utility of albumin as a predictor of clinical outcome. RECENT FINDINGS Hypoalbuminemia is seen in a wide range of conditions, including protein-losing enteropathy, hepatic synthetic failure, malnutrition, inflammatory states, and renal disease. While the impact of hypoalbuminemia has been more extensively studied in adult patients, there is a relative paucity of literature in the pediatric population. Hypoalbuminemia is a marker of poor outcome in critically ill children and those undergoing a wide range of medical interventions. Albumin infusions may be an effective therapy for fluid resuscitation and for patients with severe hypoalbuminemia.
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Aboulkacem S, Arem K, Ayoub M, Ba A, Raddaoui H, Hajlaoui N, Fehri W, Ouni Z, Mazigh CH. [Congenital analbuminemia complicated by relapsing acute coronary syndrome : A case report and literature review]. Ann Cardiol Angeiol (Paris) 2021; 70:256-258. [PMID: 34217481 DOI: 10.1016/j.ancard.2021.06.004] [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: 02/20/2021] [Accepted: 06/08/2021] [Indexed: 11/26/2022]
Abstract
Congenital analbuminemia (CAA) is a very rare disorder with an estimated prevalence of less than one in one million. This anomaly can be lethal at birth and in early infancy but it's not very symptomatic in adulthood. The clinical signs are edema, lipodystrophy, fatigue… Hypercholesterolemia is the main biological disorder and it predisposes to cardiovascular complications. The mild symptoms of CAA leads to delay diagnosis. That's why clinical and biological signs of this disorder should be known by both of biologist and clinician to establish an early diagnosis in order to prevent cardiovascular complications. We report a new case of congenital analbuminemia complicated by recurrent acute coronary artery disease in 34-year-old man. This complication has been reported only once according to the register of analbuminemia cases.
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Affiliation(s)
- S Aboulkacem
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie.
| | - K Arem
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie
| | - M Ayoub
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie
| | - A Ba
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie
| | - H Raddaoui
- Service de cardiologie de l'hôpital militaire de Tunis, Tunisie
| | - N Hajlaoui
- Service de cardiologie de l'hôpital militaire de Tunis, Tunisie
| | - W Fehri
- Service de cardiologie de l'hôpital militaire de Tunis, Tunisie
| | - Z Ouni
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie
| | - C H Mazigh
- Service de biochimie clinique de l'hôpital militaire de Tunis, Tunisie
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Caridi G, Farokhnia A, Lugani F, de Luca AM, Campagnoli M, Galliano M, Schröpfer D, Minchiotti L. A novel nonsense variation in the albumin gene (c.1309 A>T) causing analbuminaemia. Br J Biomed Sci 2020; 78:154-157. [PMID: 32881634 DOI: 10.1080/09674845.2020.1819632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- G Caridi
- Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
| | - A Farokhnia
- The Health Department of the City of Zurich, Ambulatorium Kanonengasse, Zurich, Switzerland
| | - F Lugani
- Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
| | - A M de Luca
- The Health Department of the City of Zurich, Ambulatorium Kanonengasse, Zurich, Switzerland
| | - M Campagnoli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - M Galliano
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - D Schröpfer
- The Health Department of the City of Zurich, Ambulatorium Kanonengasse, Zurich, Switzerland
| | - L Minchiotti
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Minchiotti L, Caridi G, Campagnoli M, Lugani F, Galliano M, Kragh-Hansen U. Diagnosis, Phenotype, and Molecular Genetics of Congenital Analbuminemia. Front Genet 2019; 10:336. [PMID: 31057599 PMCID: PMC6478806 DOI: 10.3389/fgene.2019.00336] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/29/2019] [Indexed: 12/25/2022] Open
Abstract
Congenital analbuminemia (CAA) is an inherited, autosomal recessive disorder with an incidence of 1:1,000,000 live birth. Affected individuals have a strongly decreased concentration, or complete absence, of serum albumin. The trait is usually detected by serum protein electrophoresis and immunochemistry techniques. However, due to the existence of other conditions in which the albumin concentrations are very low or null, analysis of the albumin (ALB) gene is necessary for the molecular diagnosis. CAA can lead to serious consequences in the prenatal period, because it can cause miscarriages and preterm birth, which often is due to oligohydramnios and placental abnormalities. Neonatally and in early childhood the trait is a risk factor that can lead to death, mainly from fluid retention and infections in the lower respiratory tract. By contrast, CAA is better tolerated in adulthood. Clinically, in addition to the low level of albumin, the patients almost always have hyperlipidemia, but they usually also have mild oedema, reduced blood pressure and fatigue. The fairly mild symptoms in adulthood are due to compensatory increment of other plasma proteins. The condition is rare; clinically, only about 90 cases have been detected worldwide. Among these, 53 have been studied by sequence analysis of the ALB gene, allowing the identification of 27 different loss of function (LoF) pathogenic variants. These include a variant in the start codon, frame-shift/insertions, frame-shift/deletions, nonsense variants, and variants affecting splicing. Most are unique, peculiar for each affected family, but one, a frame-shift deletion called Kayseri, has been found to cause about one third of the known cases allowing to presume a founder effect. This review provides an overview of the literature about CAA, about supportive and additional physiological and pharmacological information obtained from albumin-deficient mouse and rat models and a complete and up-to-date dataset of the pathogenic variants identified in the ALB gene.
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Affiliation(s)
| | - Gianluca Caridi
- Laboratory of Molecular Nephrology, Istituto Giannina Gaslini (IRCCS), Genoa, Italy
| | | | - Francesca Lugani
- Laboratory of Molecular Nephrology, Istituto Giannina Gaslini (IRCCS), Genoa, Italy
| | - Monica Galliano
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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