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Tanaka Y, Takahashi K, Hattori N, Yokoyama H, Yamaguchi K, Shibui Y, Kawaguchi S, Shimazaki T, Nakai K, Kusuhara H, Saito Y. The influence of serial 50 μL microsampling on rats administered azathioprine, the immunosuppressive drug. Toxicol Rep 2023; 10:334-340. [PMID: 36923445 PMCID: PMC10008918 DOI: 10.1016/j.toxrep.2023.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
According to the ICH S3A Q&A, microsampling is applicable to pharmaceutical drugs and toxicological analysis. Few studies have reported the effect of microsampling on the toxicity of immunotoxicological drugs. The aim of this multicenter study was to evaluate the toxicological effects of serial microsampling on rats treated with azathioprine as a model drug with immunotoxic effects. Fifty microliters of blood were collected from the jugular vein of Sprague-Dawley rats at six time points from day 1 to 2 and 7 time points from day 27 to 28. The study was performed at three organizations independently. The microsampling effect on clinical signs, body weights, food consumption, hematological parameters, biochemical parameters, urinary parameters, organ weights, and tissue pathology was evaluated. Azathioprine-induced changes were observed in certain hematological and biochemical parameters and thymus weight and pathology. Microsampling produced minimal or no effects on almost all parameters; however, at 2 organizations, azathioprine-induced changes were apparently masked for two leukocytic, one coagulation, and two biochemical parameters. In conclusion, azathioprine toxicity could be assessed appropriately as overall profiles even with blood microsampling. However, microsampling may influence azathioprine-induced changes in certain parameters, especially leukocytic parameters, and its usage should be carefully considered.
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Key Words
- A/G, albumin/globulin
- ALP, alkaline phosphatase
- ALT, alanine transaminase
- APTT, activated partial thromboplastin time
- AST, aspartate transaminase
- Azathioprine
- BUN, blood urea nitrogen
- CPK, creatine phosphokinase
- Ca, calcium
- Cl, chloride
- Cre, creatinine
- GLDH, glutamate dehydrogenase
- Hematological parameter
- ICH, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
- Jugular vein
- K, potassium
- LDH, lactate dehydrogenase
- MCH, mean corpuscular hemoglobin
- MCHC, mean corpuscular hemoglobin concentration
- MCV, mean corpuscular volume
- Microsampling
- Na, sodium
- P, inorganic phosphorus
- PT, prothrombin time
- RBC, red blood cell
- Rat
- TK, toxicokinetics
- Toxicokinetics
- WBC, leukocyte/white blood cell
- γGT, γ-glutamyltranspeptidase
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Affiliation(s)
- Yoichi Tanaka
- Division of Medicinal Safety Science, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-ku, Kasasaki-shi, Kanagawa, Japan
| | - Kazuaki Takahashi
- LSIM Safety Institute Corporation., 14-1 Sunayama, Kamisu-shi, Ibaraki, Japan
| | - Norimichi Hattori
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Hideaki Yokoyama
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Koki Yamaguchi
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Yusuke Shibui
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Sayaka Kawaguchi
- Ajinomoto Fine-Techno Co., Inc., 1-1, Suzuki-cho, Kawasaki-ku, Kwasaki-shi, Kanagawa, Japan
| | - Taishi Shimazaki
- Japan Tobacco Inc., 1-13-2, Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Keiko Nakai
- LSIM Safety Institute Corporation., 14-1 Sunayama, Kamisu-shi, Ibaraki, Japan
| | - Hiroyuki Kusuhara
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-ku, Kasasaki-shi, Kanagawa, Japan
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Bawua SA, Ichihara K, Keatley R, Arko-Mensah J, Ayeh-Kumi PF, Erasmus R, Fobil J. Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults. Clin Chem Lab Med 2022; 60:1426-1439. [PMID: 35786502 DOI: 10.1515/cclm-2022-0293] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTVIES This study is aimed at establishing reference intervals (RIs) of 40 chemistry and immunochemistry analytes for Ghanaian adults based on internationally harmonized protocol by IFCC Committee on Reference Intervals and Decision Limits (C-RIDL). METHODS A total of 501 healthy volunteers aged ≥18 years were recruited from the northern and southern regions of Ghana. Blood samples were analyzed with Beckman-Coulter AU480 and Centaur-XP/Siemen auto-analyzers. Sources of variations of reference values (RVs) were evaluated by multiple regression analysis (MRA). The need for partitioning RVs by sex and age was guided by the SD ratio (SDR). The RI for each analyte was derived using parametric method with application of the latent abnormal values exclusion (LAVE) method. RESULTS Using SDR≥0.4 as threshold, RVs were partitioned by sex for most enzymes, creatinine, uric acid (UA), bilirubin, immunoglobulin-M. MRA revealed age and body mass index (BMI) as major source of variations of many analytes. LAVE lowered the upper limits of RIs for alanine/aspartate aminotransferase, γ-glutamyl transaminase and lipids. Exclusion of individuals with BMI≥30 further lowered the RIs for lipids and CRP. After standardization based on value-assigned serum panel provided by C-RIDL, Ghanaian RIs were found higher for creatine kinase, amylase, and lower for albumin and urea compared to other collaborating countries. CONCLUSIONS The LAVE effect on many clinical chemistry RIs supports the need for the secondary exclusion for reliable derivation of RIs. The differences in Ghanaian RIs compared to other countries underscore the importance of country specific-RIs for improved clinical decision making.
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Key Words
- AG, anion gap
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AMY, amylase
- AST, aspartate aminotransferase
- Alb, albumin
- BD, Becton Dickinson
- BMI, body mass index
- BR, bias ratio
- C-RIDL, Committee on Reference Intervals and Decision Limits
- C3, complement component 3
- C4, complement component 4
- CDL, clinical decision limit
- CI, confidence interval
- CK, creatine kinase
- CRP, C-reactive protein
- CV(b), CV of the regression slope b
- Ca, calcium
- Cl, chloride
- Cre, creatinine
- DBil, direct bilirubin
- F, female
- GGT, gamma-glutamyl transferase
- Glb, globulin
- Glu, glucose
- HDL-CHDL-C, high-density lipoprotein cholesterol
- HbA1c, hemoglobin A1c
- IFCC, International Federation of Clinical Chemistry and Laboratory Medicine
- IP, inorganic phosphate
- IgA, immunoglobulin A
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- K, potassium
- LAVE, latent abnormal values exclusion
- LDH, lactate dehydrogenase
- LDL-C, low-density lipoprotein cholesterol
- LL, lower limit
- M, male
- MF, male + female
- MRA, multiple regression analysis
- Mg, magnesium
- NP, non-parametric
- Na, sodium
- P, parametric
- RI, reference interval
- RV, reference values
- SDR, standard deviation ratio
- SV, sources of variation
- TBil, total bilirubin
- TC, total cholesterol
- TCO2, total carbon dioxide
- TG, triglycerides
- TP, total protein
- UA, uric acid
- UL, upper limit
- between-country differences
- bias ratio
- eGFR, estimated glomerular filtration rate
- ethnicity
- latent abnormal values exclusion method
- multiple regression analysis
- nonparametric method
- parametric method
- rp, standardized partial correlation coefficient
- standard deviation ratio
- standardization
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Affiliation(s)
- Serwaa Akoto Bawua
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Department of Clinical Laboratory Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | - John Arko-Mensah
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
| | - Patrick F Ayeh-Kumi
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
| | - Rajiv Erasmus
- University of Stellenbosch, Division of Chemical Pathology, Tygerberg, Cape Town, South Africa
| | - Julius Fobil
- Department of Biological, Environmental & Occupational Health Sciences, University of Ghana School of Public Health, Accra, Ghana
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Wyness SP, Hunsaker JJ, Snow TM, Genzen JR. Evaluation and analytical validation of a handheld digital refractometer for urine specific gravity measurement. Pract Lab Med 2016; 5:65-74. [PMID: 28856206 PMCID: PMC5574504 DOI: 10.1016/j.plabm.2016.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/13/2016] [Accepted: 06/01/2016] [Indexed: 11/28/2022] Open
Abstract
Objectives Refractometers are commonly used to determine urine specific gravity (SG) in the assessment of hydration status and urine specimen validity testing. Few comprehensive performance evaluations are available demonstrating refractometer capability from a clinical laboratory perspective. The objective of this study was therefore to conduct an analytical validation of a handheld digital refractometer used for human urine SG testing. Design and methods A MISCO Palm Abbe™ refractometer was used for all experiments, including device familiarization, carryover, precision, accuracy, linearity, analytical sensitivity, evaluation of potential substances which contribute to SG (i.e. “interference”), and reference interval evaluation. A manual refractometer, urine osmometer, and a solute score (sum of urine chloride, creatinine, glucose, potassium, sodium, total protein, and urea nitrogen; all in mg/dL) were used as comparative methods for accuracy assessment. Results Significant carryover was not observed. A wash step was still included as good laboratory practice. Low imprecision (%CV, <0.01) was demonstrated using low and high QC material. Accuracy studies showed strong correlation to manual refractometry. Linear correlation was also demonstrated between SG, osmolality, and solute score. Linearity of Palm Abbe performance was verified with observed error of ≤0.1%. Increases in SG were observed with increasing concentrations of albumin, creatinine, glucose, hemoglobin, sodium chloride, and urea. Transference of a previously published urine SG reference interval of 1.0020–1.0300 was validated. Conclusions The Palm Abbe digital refractometer was a fast, simple, and accurate way to measure urine SG. Analytical validity was confirmed by the present experiments.
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Key Words
- ACSM, American College of Sports Medicine
- ALB, albumin
- AMR, analytical measurement range
- ARUP, Associated Regional & University Pathologists
- CLSI, Clinical & Laboratory Standards Institute
- CR, creatinine
- CV, coefficient of variation
- Cl, chloride
- Digital refractometry
- FDA, Food and Drug Administration
- GLU, glucose
- Hydration
- IRB, Institutional Review Board
- K+, potassium
- LIMS, laboratory information management system
- LLMI, lower limit of the measuring interval
- LOB, limit of blank
- LOD, limit of detection
- LOQ, limit of quantitation
- NATA, National Athletic Trainers Association
- NCAA, National Collegiate Athletic Association
- Na, sodium
- Osmolality
- POC, point of care
- QC, quality control
- RI, reference interval
- SAMHSA, Substance Abuse and Mental Health Services Administration
- SD, standard deviation
- SG, specific gravity
- Specific gravity
- Sports medicine
- TAE, total allowable error
- TE, total error
- TP, total protein
- UN, urea nitrogen
- Urine adulteration
- Urine drug testing
- ddH2O, demineralized distilled water
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Affiliation(s)
- Sara P. Wyness
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Joshua J.H. Hunsaker
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Taylor M. Snow
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
| | - Jonathan R. Genzen
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, United States
- Department of Pathology, University of Utah, 500 Chipeta Way, Mail Code 115, Salt Lake City, UT 84108, United States
- Corresponding author at: Department of Pathology, University of Utah, 500 Chipeta Way, Mail Code 115, Salt Lake City, UT 84108, United States.Department of Pathology, University of Utah500 Chipeta Way, Mail Code 115Salt Lake CityUT84108United States
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