Standardization of immunoassay for CRM-related proteins in Japan: from evaluating CRM 470 to setting reference intervals

Clinical significance of serum complement factor 3 in patients with type 2 diabetes mellitus

AIMS

Although serum complement factor 3 (C3) is an acute phase reactant mainly synthesized in the liver, several recent studies have shown high C3 gene expression in adipose tissue (AT). However, the relationship between C3 and AT levels has not been fully clarified in type 2 diabetes mellitus (T2DM) patients.

METHODS

A total of 164 T2DM patients (109men and 55 women) participated in this cross-sectional study. A computed tomography scan was performed to measure visceral, subcutaneous, and total AT. The correlation between these factors and C3 levels was examined using Pearson's correlation analysis. A multivariate regression model was used to assess an independent determinant associated with C3 levels after adjusting the explanatory variables (i.e., all ATs [visceral, subcutaneous, and total], and clinical features [sex, age, body mass index, waist circumference, glycated hemoglobin, duration of diabetes, systolic blood pressure, diastolic blood pressure, aspartate aminotransferase levels, alanine aminotransferase levels, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, log(triglyceride levels), estimated glomerular filtration rate, and log(high-sensitivity C-reactive protein levels)]).

RESULTS

Serum C3 levels were correlated with visceral, subcutaneous, and total AT among both men (r=0.505, p<0.001; r=0.545, p<0.001; r=0.617, p<0.001, respectively) and women (r=0.396, p=0.003; r=0.517, p<0.001; r=0.548, p<0.001, respectively). In the multivariate regression model, the association between total AT and C3 levels remained significantly positive (β=0.490, p<0.001).

CONCLUSIONS

Serum C3 levels are associated with visceral, subcutaneous, and total AT in T2DM patients. Furthermore, C3 levels seem to be a marker for overall adiposity rather than regional adiposity.

Multiarmed star-like platinum nanowires with multienzyme assembly for direct electronic determination of carcinoembryoninc antigen in serum

A new electrochemical immunoassay strategy for direct detection of carcinoembryoninc antigen (CEA) in serum was developed by using multiarmed star-like platinum nanowires (PtNWs) with biomolecular assembly as signal tags on an anti-CEA-functionalized graphene sensing platform. Initially, the PtNWs were synthesized via a wet chemical method, and then the synthesized PtNWs were used for the co-immobilization of CEA and horseradish peroxidase (HRP). Compared with platinum nanoparticles, the prepared PtNWs could provide a large room for the conjugation of HRP and CEA. With a competitive-type immunoassay format, the assay was performed in two types of supporting electrolytes including new born cattle serum (NBCS) and acetate buffer solution (ABS, pH 5.5), respectively. Similar detection limit (LOD) of 5.0 pg mL(-1) vs. 1.0 pg mL(-1) but narrower dynamic working linear range of 0.01-60 ng mL(-1) vs. 0.002-80 ng mL(-1) was obtained toward CEA standards in the NBCS compared to the ABS. The intra-assay coefficients of variation (CVs) were 4.3%, 8.6%, and 6.2% at 0.05, 10, and 40 ng mL(-1) CEA, respectively, while the inter-assay CVs were 7.6%, 10.5%, and 8.9% at the above-mentioned levels, respectively. In addition, the selectivity and stability of the electrochemical immunosensor were acceptable. Importantly, the developed method was used to assay clinical serum specimens, receiving a good relation with those obtained from the referenced method.

Present status of autoimmune hepatitis in Japan: a nationwide survey

BACKGROUND

A nationwide survey of autoimmune hepatitis (AIH) was conducted in Japan, and the clinical features of patients with AIH were analyzed.

METHODS

A total of 1,056 patients were enrolled through questionnaires sent to 153 hospitals and clinics with hepatology specialists.

RESULTS

The clinical features of Japanese AIH were as follows: (1) most patients were middle-aged women, with ages peaking in the 60s; (2) serum immunoglobulin G (IgG) levels were high, but more than 30% of the patients had serum IgG levels less than 2,000 mg/dl; the cutoff level of IgG to distinguish between patients with AIH and those with chronic hepatitis resulting from hepatitis virus was approximately 2,000 mg/dl; (3) autoantibodies, particularly the antinuclear antibody, were frequently present; (4) most patients showed histological features of chronic hepatitis or liver cirrhosis, but 10.9% of the patients showed histological features of acute hepatitis; (5) approximately 75% of the patients were treated with corticosteroids and showed a favorable response to treatment, whereas ursodeoxycholic acid was administered to 60% of the patients.

CONCLUSIONS

The clinical features of patients with AIH in Japan were clarified. The mean age at diagnosis was higher than that in previous studies. In addition, the number of patients with AIH having the histological features of acute hepatitis increased. Diagnosis of AIH does not preclude the presence of acute hepatitis and/or serum IgG levels less than 2,000 mg/dl.

Serum vitamin C concentration is influenced by haptoglobin polymorphism and iron status in Chinese

BACKGROUND

Vitamin C is a powerful antioxidant (free radical scavenger). Apart from the diet, other factors regulating its catabolism may affect its serum concentration. Haptoglobin (Hp) is a plasma protein participating in iron metabolism. It shows a genetic polymorphism which shows marked geographical differences. We investigated the relationship between vitamin C, iron status and haptoglobin polymorphism in Chinese men and women.

METHODS

Iron status markers were compared according to Hp phenotypes determined by chemiluminescence detection in 110 healthy Chinese subjects. The concentration of haptoglobin was determined using an immunoturbidimetric method. Serum vitamin C was tested by a 2,4-dinitrophenylhydrazine based method.

RESULTS

In Chinese, the haptoglobin phenotype distribution was 10.0% Hp 1-1, 33.6% Hp 2-1, and 56.4% Hp 2-2. In the study group, serum vitamin C concentration was associated with haptoglobin type, showing lowest values in serum from Hp 2-2 subjects in males (p=0.028, ANOVA). In contrast to Hp phenotype, Hp concentration did not affect vitamin C concentration. Hp 2-2 shows higher haptoglobin (p=0.002 (ANOVA)) than individuals with the other types. Furthermore, vitamin C was influenced by (log)ferritin levels. In Chinese, vitamin C is influenced by haptoglobin polymorphism and iron status.

CONCLUSION

The present findings support the role of non-nutritional factors in vitamin C status.

Impact of a common CV evaluation scheme on overall laboratory performance: 8-year experience of a large national proficiency testing program in Japan

In proficiency testing (PT), it is difficult to set rational criteria for determining target values and allowable limits. In Japan, the largest national PT program has for the past 8years used an evaluation scheme based on a “common coefficient of variation” (cCV) to overcome this difficulty. The cCV, the average within-method variation, is derived by one-way analysis of variance from data of peer groups after excluding those with large variations. A unit interval used for grading participants is obtained by multiplying the cCV by the peer-group mean which is computed using an iterative method featuring repeated removal of a large portion of the tails of the distribution and reinflation of the standard deviation (SD) to compensate for the trimming. The evaluation scheme gives a relatively better grade to those participants in peer groups with small CVs, compared to use of individual peer-group CVs. The scheme has expedited the transition to more reproducible methods, resulting in a notable overall improvement in laboratory performance. The cCV evaluation scheme is uniformly applicable to any analyte measured quantitatively. The iterative method, an integral part of the scheme, effectively precludes bias in the evaluation.

Novel amperometric immunosensor for rapid separation-free immunoassay of carcinoembryonic antigen

A novel immunosensor for rapid separation-free determination of carcinoembryonic antigen (CEA) in human serum is proposed. The immunosensor is prepared by co-immobilizing thionine and horseradish peroxidase (HRP)-labeled CEA antibody on a glassy carbon electrode (GCE) through covalently binding them to GCE with a glutaraldehyde (GA) linkage. The electrochemical behavior of the immobilized thionine displays a surface-controlled electrode process with an average electron transfer rate constant of 4.74+/-2.99 s(-1). It can be used as an electron transfer mediator for enzymatic activity detection of the HRP-labeled antibody to CEA. After the immunosensor is incubated with CEA solution at 23 degrees C for 40 min, the access of activity center of the HRP to thionine is partly inhibited, which leads to a linear decrease in the catalytic efficiency of the HRP to the oxidation of immobilized thionine by H(2)O(2) at -300 mV over two CEA concentration ranges from 0.5 to 3.0 and 3.0 to 167 ng/ml. Under optimal conditions, the detection limit for the CEA immunoassay is 0.1 ng/ml at three times background noise. The immunosensor shows good accuracy and acceptable storage stability, precision and reproducibility with intra-assay CVs of 6.1% and 5.8% at 2.5 and 50 ng/ml CEA, respectively, and an inter-assay CV of 6.3% at 50 ng/ml. This method is economical and shortens the analytical time, making it potentially attractive for clinical immunoassays.

Total iron binding capacity and transferrin concentration in the assessment of iron status

Transferrin concentration and total iron binding capacity (TIBC) are currently used to assess iron status. Although correlation between TIBC and transferrin is generally considered as good, conversion factors between the two analytes found in literature show large differences. Although the price per test is lower for TIBC, there are a number of analytical advantages of serum transferrin. Due to binding of iron to other plasma proteins (mainly albumin), TIBC methods generally overestimate the iron binding capacity of transferrin. Moreover, no generic reference values are available for TIBC. In contrast to TIBC, internationally accepted interim reference ranges are available for serum transferrin. The introduction of the international CRM 470 protein standard material has lead to a significant reduction in interlaboratory variation for transferring measurements. In view of these observations, determination of transferrin concentration, rather than TIBC, is recommended. However, in non-European populations characterized by a marked genetic variation in transferrin (TF BC and TF CD variants), in certain cases, immunochemical determination of transferrin may lead to errors. In these populations, TIBC measurements may be preferred.