CLINICAL BIOCHEMISTRY

Multidisciplinary approach to redefining thyroid hormone reference intervals with big data analysis
Lewis CW, Raizman JE, Higgins V, Gifford JL, Symonds C, Kline G, Romney J, Doulla M, Huang C and Venner AA
This study aimed to employ big data analysis to harmonize reference intervals (RI) for thyroid function tests, with refinement to the TSH upper reference limit, and to optimize the TSH reflex algorithm to improve clinical management and test utilization.
Deteriorated thiol-disulphide and oxidized-reduced glutathione status in blood in Alzheimer's disease
Akunal C and Alisik M
Alzheimer's disease (AD) is a steadily advancing neurodegenerative condition, the occurrence and prevalence of which are on the rise in various populations. Suspected factors contributing to its development encompass the buildup of amyloid β (Aβ) plaques, the formation of neurofibrillary tangles induced by tau proteins, and heightened oxidative stress. In this study, we aimed to evaluate intra-cellular glutathione status and extracellular thiol-disulphide status in patients with AD.
Diagnostic value of serum GDF-15 in patients with pseudomyxoma peritonei
Wang B, Zhang J, Ma R, Bai M, Song Y and Liang G
Pseudomyxoma peritonei (PMP) is a rare malignancy that lacks a highly sensitive and specific biomarker for its diagnosis. Identifying reliable serum markers is crucial for improving the diagnostic accuracy and management of PMP. This study aims to explore the diagnostic value of serum growth differentiation factor 15 (GDF-15) in patients with PMP.
Relationship between analytical imprecision and coefficient of determination (R) of the calibration curve
Cheng WL, Low HQ, Chew S, Lim CY and Loh TP
Clinical, biochemical, molecular characteristics and clinical outcome of hyperhomocysteinemia in Malaysian children
Habib A, Idrus H, Malik NAA, Nor AM, Nasohah SM, Moey LH, Hian LS, Hock NL and Azize NAA
Hyperhomocysteinemia can be due to various abnormalities of the complex interaction of methionine, folate and vitamin B12. It has been known to be a cardiovascular risk factor. This study aims to review the clinical presentation, underlying causes and clinical outcome in paediatric patients diagnosed with significant hyperhomocysteinemia in Malaysia.
Minimal mathematical model for glycation of albumin
Stickle DF, DiNatale GJ and Molinaro R
Glycated albumin (GA) is often described as a reflection of glucose exposure over the past 2-4 weeks. We examined the scale of the operative interval for changes in %GA from the perspective of a theoretical model for GA formation, by simulating the time course of changes in %GA after changes in glucose.
Analytical evaluation of a direct ion-selective-based analyser: Still gaps to close
Oyaert M, Verougstraete N, Vandekerckhove B, Lapauw B, Hoste E and Stove V
Discrepancies between electrolyte concentrations determined by blood gas analysers (BGA) and core-lab chemistry analysers may create confusion in clinical practice. This problem is rooted in the different ion-selective electrode (ISE) methodologies that are used. Whilst most available chemistry analysers use indirect ISE, we evaluated the analytical performance of the new automated chemistry analyser Biossays™ E6 (Snibe), equipped with direct ISE, for the determination of sodium (Na), potassium (K), chloride (Cl), ionized calcium (iCa) and pH.
The changing landscape of autoantibody testing in myasthenia gravis in the setting of novel drug treatments
Mousavi A, Kumar P and Frykman H
Acquired myasthenia gravis (MG) is an autoimmune disease targeting the specific proteins in the postsynaptic muscle membrane. 50% of ocular and 80% of generalized MG have acetylcholine receptor antibodies (AChR Abs). 1-10% of MG patients have antibodies against muscle-specific kinase (MuSK), and 2-50 % of seronegative MG cases have antibodies against lipoprotein-receptor-related protein4 antibodies (LRP4 Abs). Serological testing is crucial for diagnosing and determining the appropriate therapeutic approach for MG patients. The radioimmunoprecipitation assay (RIPA) method is a historical standard test for detecting the AChR Abs and MuSK Abs. While it has nearly 100% specificity in the AChR Abs detection, its sensitivity is between 50--92%. The sensitivity and specificity of RIPA for detecting MuSK Abs is much lower. The fixed and live Cell-Based assays (f-CBA and L- CBA) have higher sensitivity than RIPA. With advancements in the serological diagnosis and management of MG, we now recommend a complete reflex testing algorithm on the first pretreatment sample of a suspected MG patient, starting with the binding and blocking assays for AChR Abs by RIPA and/ or f-CBA. If AChR Ab is negative, then reflex to MuSK Abs by RIPA and/ or CBAs. If AChR and MuSK Abs are negative, then use clustered L-CBA by request.
Impact of blood volume, air exposure duration, transport duration, and testing delay on plasma total carbon dioxide in simulated open collections using microtainers
Reid MS, Seiden Long I and de Koning L
Exposing blood specimens to air reduces plasma total carbon dioxide (TCO). We evaluated the degree of TCO reduction attributed to open collection of neonatal blood in BD microtainers® (microtainers), microtainer transport duration and delayed testing of open plasma aliquots.
Inflammation and lipoperoxidation in mucopolysaccharidoses type II patients at diagnosis and post-hematopoietic stem cell transplantation
Delgado CA, Lopes FF, Faverzani JL, Schmitt Ribas G, Padilha Marchetti D, de Souza CFM, Giugliani R, Baldo G and Vargas CR
Mucopolysaccharidosis type II (MPS II) is caused by deficiency of the enzyme iduronate-2-sulfatase; one possible therapy for MPS II is hematopoietic stem cell transplantation (HSCT). It is established that there is excessive production of reactive species in MPS II patients, which can trigger several processes, such as the inflammatory cascade.
Characterization of a novel 8.2 kb deletion causing beta-thalassemia
Wang G, Huang H, Chen L, Xiao Q, Zhang W and Zhang Q
Thalassemia is a prevalent monogenic blood disorder, clinically classified into alpha- and beta-thalassemia, characterized by the imbalance of the alpha- and beta-globin chains that constitute adult hemoglobin. Copy number variations (CNVs) and single nucleotide variants in globin genes are the primary genetic defects causing thalassemia.
Inter-laboratory variation for urine albumin among laboratories in a Swedish external quality assessment scheme 2005-2023
Lundgren M, Ridefelt P, Kristoffersson C, Samuelsson I and Larsson A
Increased albuminuria is associated with elevated mortality. Urine albumin (U-ALB) above 20 mg/L or albumin-to-creatinine ratio (U-ACR) of 3 g/mol are indicative of moderately increased albuminuria. Due to limited standardization among U-ALB methods, diagnosis of increased albuminuria might prove difficult.
Challenges and Perspectives on the Adoption of Cystatin C testing in China: A laboratory technician's perspective
Nizhamuding X, Liu Y, Zeng J, Zhao H, Zhang T and Zhang C
Cystatin C (CysC) belongs to the cysteine protease inhibitor superfamily and is produced by all nucleated cells in the body in very stable amounts independent of age, sex, diet, and muscle mass. CysC is considered an ideal biomarker for assessing glomerular filtration rate (GFR) compared to traditional biomarkers for assessing GFR, such as creatinine. However, CysC is not sufficiently utilized for GFR assessment by clinicians, probably for various reasons such as insufficient understanding among clinicians or a lack of standardized quantitative methods. This review discusses and analyzes the aforementioned issues from the perspective of laboratory technicians.
Quantitative evaluation of adalimumab and anti-adalimumab antibodies in sera using a surface plasmon resonance biosensor
Di Santo A, Accinno M, Errante F, Capone M, Vultaggio A, Simoncini E, Zipoli G, Cosmi L, Annunziato F, Rovero P and Real Fernandez F
Monitoring of therapeutic antibody adalimumab (ADL) and of anti-adalimumab antibodies (AAA) in autoimmune diseases patients' sera has achieved increased attention since several studies showed a correlation between AAA levels and treatment failure. We evaluated a new surface plasmon resonance (SPR)-based method that, with slight changes in the analysis condition and in the ligand immobilized on the chip surface, allows to monitor both AAA and ADL. This new label-free method does not require sample pretreatments, and it is fully automated, only requiring the preparation of the chip, which can be used for multiple analysis, and the preparation of the sample sets.
The potential of anti-glutamic acid decarboxylase antibodies to support a diagnosis of autoimmune diabetes mellitus
Liepert M, Alhaqqan S, Husain A, Lochnan H, Booth RA, Shaw J and Sun CJ
Anti-glutamic acid decarboxylase (anti-GAD) antibodies are a frequently used diagnostic marker for autoimmune forms of diabetes mellitus (DM), namely, type 1 diabetes mellitus (T1DM) and latent autoimmune diabetes in adults (LADA). We sought to provide insight into a unique diagnostic application of anti-GAD antibodies in patients potentially misdiagnosed with type 2 diabetes mellitus (T2DM).
Malignant pleural effusion risk based on a novel tool using homocysteine and carcinoembryonic antigen in pleural fluid: A multicenter study
Santotoribio JD, Corral-Pérez J, Nuñez-Jurado D, Fatela-Cantillo D, La Torre ÁG, Orantes-Maroto G, Valle-Vázquez LD, Castillo-Otero DD, Maira-Gonzalez N, Cobos-Díaz A, Guerrero JM and Lopez-Saez JB
This multicenter study aimed to evaluate the Malignant Pleural Effusion Risk (MPER) diagnostic accuracy in distinguishing between benign and malign pleural effusion.
Carrier frequency and molecular basis of hemoglobinopathies among blood donors in eastern Morocco: Implications for blood donation and genetic diagnosis
Belmokhtar I, Belmokhtar KY, Lhousni S, Charif M, Sidqi Z, Seddik R, Choukri M, Bellaoui M and Boulouiz R
Hemoglobinopathies represent the most commonly inherited autosomal recessive blood disorders in the world. The aim of this study was to determine the carrier frequency and molecular basis of hemoglobinopathies among blood donors in eastern Morocco. This is the first study of its kind for this country.
Reply to Letter to the Editor "The importance of SII and FIB-4 scores in predicting mortality in idiopathic pulmonary fibrosis patients"
Koyun GB, Berk S and Dogan OT
ROC of SII and FIB-4 index for predicting mortality in idiopathic pulmonary fibrosis patients
Zhang GM and Guo XX
Evaluation of the applicability of urine lateral flow immunochromatography tests for the detection of cocaine in plasma samples
Millan de Souza IA, Dos Santos BP, do Nascimento SN, Birk L, Sebben VC, Eller S and de Oliveira TF
Qualitative analysis of cocaine in urine is a common practice in emergency settings. However, positive results from urine screening tests do not necessarily indicate recent exposure. In this context, plasma is considered a more appropriate option due to its shorter detection window and better correlation with symptomatology. Therefore, the availability of rapid tests for this biological matrix is extremely relevant in the clinical and emergency context.
Decreased monocytic HLA-DR in patients with sepsis: Prediction of diagnosis, severity and prognosis
Cui J, Cai W, Zhang L, Wu Y, Huang Y and Zhao W
Sepsis is characterized by high incidence and mortality rates, making early recognition and risk stratification critical for preventing delayed treatment and overtreatment. This study investigated the potential of monocytic (m) HLA-DR as a diagnostic and prognostic biomarker of sepsis.