Immunoradiometric Assay Kit Research Articles

ASSESSMENT OF INSULIN RESISTANCE IN NONALCOHOLIC FATTY LIVER DISEASE IN NON-DIABETIC PATIENTS

Background: Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of liver damage ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). The ectopic accumulation of fat in the liver has been strongly associated with insulin resistance. To Aim of the study: explore the proportion of insulin resistance in non-diabetic NAFLD patients compared to normal healthy populations using HOMA-IR model. Materials and Methods: This was a hospital based case control study carried out on 100 patients diagnosed with NAFLD by ultrasound. Fasting Insulin estimation was done by Insulin IRMA (IMMUNORADIOMETRIC ASSAY) Kit. P Results: atients with NAFLD had a higher prevalence (33%) of metabolic syndrome than the controls (15%) with an Odds Ratio of 2.791. Insulin resistance in non-diabetic NAFLD patients was higher (36%) than the control populations (11%) (p value was <0.001). This study has shown that insuli Conclusion: n resistance has a positive association with NAFLD

Identification of a novel mutation in thyroxine-binding globulin (TBG) gene associated with TBG-deficiency and its effect on the thyroid function.

This study presents a case of familial transmission of thyroxine-binding globulin (TBG) deficiency. The SERPINA7-gene which codes for TBG is located on the X-chromosome (Xq21-22). More than 45 mutations have been reported to cause TBG- deficiency from various countries, but none from India so far. Genetic analysis of SERPINA7 gene was carried out to determine the cause of low TBG levels in one family. DNA samples of the propositus and the family members were subjected to Polymerase Chain Reaction (PCR) followed by direct sequencing. Allele-specific PCR and Next-gen sequencing (NGS) were employed to confirm the site of the mutation. Thyroid function tests were estimated by Radioimmunoassay (RIA) and Immunoradiometric assay (IRMA) kits. X-chromosomal inactivation status was analyzed in the female members harboring the mutation. A mutational screening in this family revealed a novel frame-shift mutation S353Q, 354fs3X in the exon 4 ofthe SERPINA7gene which will be referred to as TBG-complete deficiency-India (TBG-CD-Ind). One out of four female family members harboring the mutation showed selective X-chromosomal inactivation. The affected family members were clinically euthyroid initially, showed changes in the thyroid function when tested after a long time span. However, the changes in the thyroid function in the affected family members had an autoimmune etiology. This study presents the first report of TBG-CD from India wherein a novel frameshift mutation referred to as TBG-CD-Ind (S353Q, 354fs3X)in the SERPINA7 gene was detected. No apparent association was identified between thyroid function and the TBG-mutation in the affected subjects. A detailed biochemical and genomic testing to determine the exact cause of discordant TFT in the patients would certainly aid in the unequivocal diagnosis of the thyroid function and for the precise individualized treatment.

Vitamin D status in pubertal children.

Optimal vitamin D status has a great importance in puberty, which is a period of peak bone mineral acquisition. In this study, we aimed to assess the effect of pubertal period on vitamin D status. The study included totally 200 healthy children, aged between 4 and 14 years. Group 1 included 100 prepubertal, children, aged between 4 and 8 years. Group 2 included 100 pubertal children, aged between 9 and 14 years. They had no chronic illnesses. Ages, heights, weights, genders, Body Mass Indexes (BMIs), socioeconomic and educational status of families were established. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured by high performance liquid chromatography (HPLC). Serum parathyroid hormone (PTH) was evaluated using an immunoradiometric assay kit. Serum calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) levels were measured. We determined that 25(OH)D levels were lower with higher PTH levels in the group aged 9 to 14 years (pubertal children), compared to the group aged 4 to 8 (prepubertal children). Gender, weight, height or BMI, family socioeconomic and education status did not affect serum 25(OH)D levels of children in each group. We demonstrated that vitamin D deficiency was more commonly seen in the pubertal children, compared to pre pubertal period. Children should be supported with vitamin D supplements during the puberty, which has a great importance for rapid increase in bone mass.

The relationship between serum 25-hydroxyvitamin D and parathyroid hormone concentration in assessing vitamin D deficiency in pet rabbits

BackgroundVitamin D deficiency and related metabolic bone diseases in pet rabbits have been intermittently debated. In human research, the parathyroid hormone concentration in relation to the 25-hydroxyvitamin D concentration is used to determine vitamin D deficiency. Thus, this study aimed to identify the breakpoint in the 25-hydroxyvitamin D concentration indicating a significant change in the parathyroid hormone concentration in 139 pet rabbits. An enzyme immunoassay kit was used for 25-hydroxyvitamin D analysis and the intact parathyroid hormone (PTH 1–84) immunoradiometric assay kit for parathyroid hormone analysis. The mid-tibial cortical bone density was measured using peripheral quantitative computed tomography. A segmented linear regression analysis was performed, with the 25-hydroxyvitamin D concentration as the independent variable, and parathyroid hormone, ionised calcium, total calcium, inorganic phosphorus concentrations and the mid-tibial cortical density as the dependent variables.ResultsThe breakpoint for the parathyroid hormone concentration occurred at a 25(OH)D concentration of 17 ng/mL, whereas the cortical bone density breakpoint occurred at a 25-hydroxyvitamin D concentration of 19 ng/mL. No breakpoints were found for ionised calcium, total calcium or phosphorus.ConclusionsThese results suggest that a serum 25-hydroxyvitamin D concentration of 17 ng/mL serves as the threshold for vitamin D deficiency in rabbits. Nearly one-third of the rabbits had a serum 25-hydroxyvitamin D concentration below this threshold. Concerns persist regarding the high prevalence of vitamin D deficiency in pet rabbits and the possible health consequences caused by a chronic vitamin D deficiency, including the risk for metabolic bone diseases.

Human mesenchymal stem cells-derived conditioned medium inhibits hypoxia-induced death of neonatal porcine islets by inducing autophagy.

The dysfunction of islet grafts is generally attributed to hypoxia-induced damage. Mesenchymal stem cells (MSCs) are currently thought to effectively protect cells from various risk factors via regulating autophagy. In our study, we investigated if human umbilical cord-derived MSCs could ameliorate hypoxia-induced apoptosis in porcine islets by modulating autophagy, and we explored the underlying mechanisms. Neonatal porcine islet cell clusters (NICCs) were cultured with human umbilical cord-derived MSC conditioned medium (huc-MSC-CM) and RPMI-1640 medium (control) under hypoxic conditions (1% O2 ) in vitro. NICCs were treated with 3-methyladenine (3-MA) and chloroquine (CQ) to examine the role of huc-MSC-CM in regulating autophagy. Finally, the levels of several cytokines secreted by huc-MSCs were detected by ELISAs, and the corresponding inhibitors were applied to investigate which cytokine mediates the protective effects of huc-MSC-CM. The effects of huc-MSC-CM on NICCs viability and autophagy were examined using AO/PI staining, flow cytometry analysis, transmission electron microscopy (TEM) and confocal fluorescence microscopy analysis. The insulin secretion of NICCs was tested with an insulin immunoradiometric assay kit. Compared to the control, the huc-MSC-CM treatment improved the viability of NICCs, inhibited apoptosis, increased autophagic activity and the levels of PI3K class III and phosphorylated Akt, while the ratio of phosphorylated mTOR/mTOR was reduced. These changes were reversed by CQ and 3-MA treatments. High concentrations of IL-6 were detected in hu-MSC-CM. Furthermore, recombinant IL-6 pre-treatment exerted similar effects as huc-MSC-CM, and these effects were reversed by a specific inhibitor of IL-6 (Sarilumab). Our results demonstrated that huc-MSC-CM improved islet viability and function by increasing autophagy through the PI3K/Akt/mTOR pathway under hypoxic conditions. Additionally, IL-6 plays an important role in the function of huc-MSC-CM.

Comparison Study Between Local TSH IRMA Kit (CRRT) and Imported TSH IRMA Kit (Riakey, Korea)

<p><em>Thyroid Stimulating Hormone</em> (TSH) is one of hormones that our body need for growth of brains, bones and other tissues and regulate the metabolism in the body. Normal range of TSH for adult is from 0.3 to 5.5 µIU/ml, whereas for baby ranged from 3 to 18 µIU/ml. An Immunoradiometricassay (IRMA) is one of immunoassay technique using radionuclide as the tracer to detect low quantity of analyte. This technique is suitable for determine TSH levels in human blood serum which has complex matrix and various concentration. The Center for Radioisotope and Radiopharmaceutical Technology (CRRT)-BATAN has developed a reagent of TSH IRMA kit. The aim of this research is to compare between local TSH IRMA kit (CRRT-BATAN) and imported TSH IRMA kit (Riakey, Korea) toward 110 adult samples obtained from PTKMR - BATAN. The results showed 97 samples as true negative, 5 samples as true positive, 1 sample as false negative and 7 samples false positive. The comparison study gave diagnostic sensitivity as much as 83.33 %, diagnostic spesificity as much as 93.27 % and accuracy as much as 92.72 %.</p>

Validation of the TSH IRMA Kit for Determination of the TSH Levels in Human Blood Serum

<p>TSH IRMA kit is a kit used for the determination of TSH (Thyroid Stimulating Hormone) levels in human blood serum. Thyroid hormone is a hormone that our bodies need for growth of the brain, bone and other tissues and regulate the metabolism in the body.<strong> </strong>TSH normal range for adult is in the range of 0.4-4.5 mIU/L, whereas for baby is about 3.0-18.0 mIU/L. Thyroid would affect the quality of optimal growth of children if disturbed. Therefore, TSH assay in the blood needs to be determined to know whether the function of the thyroid gland works normally or not. Detection of TSH in blood can be performed by Immunoradiometricassay (IRMA) method. IRMA method is one of the immunoassay techniques based on immunological reactions (antigen-antibody binding) using radionuclide <sup>125</sup>I as a tracer, that sample in small quantity can be detected.<em> </em> IRMA method was developed locally by replacing TSH IRMA kit which is costly since imported from commercial companies. Center for Radioisotope and Radiopharmaceutical Technology (PTRR) BATAN has successfully developed the TSH IRMA kit that can be used to determine the levels of TSH in human blood. TSH IRMA kit must be validated to know the limit of detection, sensitivity, accuracy, precision and the assay parameters, such as Non-Specific Binding (NSB) and Maximum Binding (MB). Validation of TSH IRMA kit had been carried out resulting in the limit of detection of 0.115 ng/mL, accuracy with a recovery of 93.6-108.0 %, intra-assay precision (% CV) QC L = 1.9848, QC M = 3.6360 % and QC H = 2.2085 % while the inter-assay precision (% CV) QC L = 11.0055, QC M = 5.6768 % and QC H = 5.4181 %. It was concluded that this TSH IRMA kit showed good performance based on the % NSB and % B/T of 0.68 and 34.64 %, respectively.</p>

Optimization of Thyroglobulin Coated Tube for Thyroglobulin IRMA Kit

<p>Immunoradiometric assay (IRMA) is a method of analysis based on immunological reactions of antigens-antibodies binding. This highly specific and sensitive method was used for in vitro diagnosis in small quantity of sample. Center for Radioisotope and Radiopharmaceutical Technology, BATAN has developed Thyroglobulin IRMA Kit using coated tube method that can determine thyroglobulin levels in microgram quantities. Coated tube was made with immobilisation of anti thyroglobulin into polistyrene tube. Development of IRMA kit performed through several steps including: optimization component of kit, optimization assay and kit validation. Optimization of coated tube involved selection and volume of solvent, using blocking and non-blocking agent, and volume of blocking agent. The optimum condition for coated tubes was found to be using 0.1M phosphate buffer pH 7.4 with coating volume of 500 μL, 3% BSA in 500 μL blocking agent 0.1M phosphate buffer pH 7.4, with maximum binding and non-specific binding (NSB) of 60.58 and 1.40%, respectively. The optimized coated tube was found to be stable up to 4 weeks.</p>

Role of Pro-Brain Natriuretic Peptide Serum Concentration in the Detection of Pulmonary Hypertension in Patients With End-Stage Lung Diseases Referred for Lung Transplantation

BackgroundSerum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration is elevated in patients with pulmonary hypertension (PH); however, its role in the detection of PH associated with lung disease is not well established. AimThe aim of this study was to assess the value of NT-proBNP in the detection of PH in patients with end-stage lung disease (esLD) referred for lung transplantation. Materials and methodsThe study population consisted of 65 patients: 37 with idiopathic pulmonary fibrosis (IPF), 20 with chronic obstructive pulmonary disease, and 8 patients with other interstitial lung diseases (75% men, mean age 53.3 ± 9.5 years). Serum concentration of NT-proBNP was assessed with an immunoradiometric assay kit. The mean pulmonary artery pressure (mPAP) was measured using a Swan-Ganz catheter. PH was defined as mPAP ≥ 25 mm Hg. ResultsMedian NT-proBNP concentrations were significantly higher in patients with PH than in patients without PH: 139 (49–1236) pg/mL vs 67 (38–116) pg/mL, respectively; P = .016. Receiver operating characteristic (ROC) analysis revealed that NT-proBNP concentration higher than 131.5 pg/mL was a predictor of PH with good specificity (81%) and positive predictive value (78.9%) but low sensitivity (55.6%) and negative predictive value (58.6%). The area under the ROC curve of serum NT-proBNP concentration for PH was 0.71 (95% confidence interval 0.57–0.85, P = .039). ConclusionSerum concentration of NT-proBNP may be useful in the diagnosis of PH in patients with esLD referred for lung transplantation.

White light reflectance spectroscopy biosensing system for fast quantitative prostate specific antigen determination in forensic samples

A label-free biosensor based on white light reflectance spectroscopy for the determination of PSA as semen indicator in forensic samples is presented. The sensor is based on a two-step immunoassay which employs the same polyclonal anti-PSA antibody as capture and detection antibody followed by reaction with streptavidin as a signal enhancement step. The whole assay time was set to 10min; 5min reaction of immobilized antibody with the PSA calibrators or the samples, 3min reaction with the biotinylated anti-PSA antibody and 2min reaction with streptavidin. Following this protocol, a detection limit of 0.5ng/mL was achieved and the assay's linear response range extended up to 500ng/mL. Thus, taking into account the quantification limit of 1.0ng/mL and the average PSA concentration in semen (0.2–5.5mg/mL), semen quantities of a few nanoliters could be detected. The accuracy of the sensor developed was demonstrated through recovery (% recovery ranged from 89.6 to 106) and semen dilution experiments. A linear correlation was found for semen dilutions ranging from 5000 to 360,000. The lack of interference by other bodily fluids was confirmed by analysing stains of blood, urine and saliva prior to and after the addition of semen. Finally, the sensor was evaluated by analysing 51 forensic casework samples which were also analysed with a semi-quantitative membrane strip test (Seratec® PSA), through microscopic detection of spermatozoa, and male DNA identification through detection of Y chromosome. The results obtained with the sensor were in excellent agreement with those provided by an immunoradiometric assay kit (PSA-RIACT) and in complete agreement with the findings using the membrane strip assay, spermatozoa and Y chromosome detection. The excellent analytical performance and small size of the instrument make the sensor developed an attractive tool for use in forensic evidence screening for semen detection.

Random Assay in Radioimmunoassay: Feasibility and Application Compared with Batch Assay.

The batch assay has been conventionally used for radioimmunoassay (RIA) because of its technical robustness and practical convenience. However, it has limitations in terms of the relative lag of report time due to the necessity of multiple assays in a small number of samples compared with the random assay technique. In this study, we aimed to verify whether the random assay technique can be applied in RIA and is feasible in daily practice. The coefficients of variation (CVs) of eight standard curves within a single kit were calculated in a CA-125 immunoradiometric assay (IRMA) for the reference of the practically ideal CV of the CA-125 kit. Ten standard curves of 10 kits from 2 prospectively collected lots (pLot) and 85 standard curves of 85 kits from 3 retrospectively collected lots (Lot) were obtained. Additionally, the raw measurement data of both 170 control references and 1123 patients' sera were collected retrospectively between December 2015 and January 2016. A standard curve of the first kit of each lot was used as a master standard curve for a random assay. The CVs of inter-kits were analyzed in each lot, respectively. All raw measurements were normalized by decay and radioactivity. The CA-125 values from control samples and patients' sera were compared using the original batch assay and random assay. In standard curve analysis, the CVs of inter-kits in pLots and Lots were comparable to those within a single kit. The CVs from the random assay with normalization were similar to those from the batch assay in the control samples (CVs % of low/high concentration; Lot1 2.71/1.91, Lot2 2.35/1.83, Lot3 2.83/2.08 vs. Lot1 2.05/1.21, Lot2 1.66/1.48, Lot3 2.41/2.14). The ICCs between the batch assay and random assay using patients' sera were satisfactory (Lot1 1.00, Lot2 0.999, Lot3 1.00). The random assay technique could be successfully applied to the conventional CA-125 IRMA kits. The random assay showed strong agreement with the batch assay. The random assay procedure could increase the flexibility and decrease the turnaround time of the radioimmunoassay technique.

Solid-phase Immuno Radio Metric Assay (IRMA) of 25-hydroxy Vitamin D and Displacement from Serum Binding Proteins for Resource-limited Settings

The development of a solid-phase immunoradiometric assay to satisfy the pressing need for a simple yet effective method for measuring 25-hydroxyvitamin D[25(OH)D] in a serum and thus more suited to routine use in clinical biochemical laboratories[1]. The aim of this study was not to compare our home made with commercially available method but tested for general assay performance, including homemade polyclonal antibody specificity. Methods: We used our home made radioiodine (125I)-based IRMA kit for the detection of 25(OH)D. It is based upon, non-competitive displacement agents which enable effective separation of vitamin D metabolites from binding proteins to enable the amount of vitamin D metabolites to be measured, without competing with the proteins or requiring its solvent extraction from the serum [2,3]. Results: Our package called: “cgea 25(OH)D-irma” is analytically, all qualities we expect from a good medical test kit, with a precision of coefficients below 13% as well as intra-series that in inter-series and inter-batch accuracy with a linearity estimated at 0.8ng/ml and good stability of the radio labeled trace (60 days) [4,5]. Conclusion: Simplification of the methods for extraction and separation has been a key feature in the improvement of assays for vitamin D in Democratic Republic of Congo. However, continuing efforts to improve laboratory performance vigilance with quality assurance programs are required and continuous efforts for improving the reliability of our homemade-test, such as regular internal QC are needed.

Amino acid differences in cat adrenocorticotropin account for the inability of a human-based immunoradiometric assay to detect the molecule in cat plasma

A commercial immunoradiometric assay kit designed for the measurement of endogenous adrenocorticotropin (ACTH) concentrations in human plasma does not detect the molecule in plasma samples from cats. It was hypothesized that the inability of the assay to detect the molecule was related to variation(s) in the amino acid sequence of cat ACTH, compared with human ACTH. Cat ACTH complementary DNA was cloned from pituitary tissue and sequenced. The deduced structure showed amino acid differences from the human molecule with cat ACTH having a valine instead of alanine at amino acid 32 and a threonine instead of alanine at amino acid 34. Cat and human ACTH were synthesized along with 2 modified peptides containing alanine substitutions at cat ACTH 32 and 34. Only the human ACTH was detected using the commercial kit, indicating that an epitope recognized by one of the antibodies in the assay requires the presence of 2 alanines near the C-terminus of the molecule.

Evaluation of TSH, T4 and T3 in Human Serum: Standardization on Normal Individuals

A cross-sectional study of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) in human serum was performed aiming to define their normal values. In total, 201 assays were performed on 70 normal individuals, 26 men and 44 women, with ages ranging from 2 to 84 years. Serum TSH was measured with a highly sensitive immunoradiometric assay (IRMA) kit and T4 & T3 were determined with commercially available radioimmunoassay (RIA) kits. The normal values of TSH, T4 and T3 observed in the present study were 0.5 - 5.0 mIU/L, 55 - 169 nmol/L and 1.2 - 3.4 nmol/L, respectively, and their means (±SD) were 2.06±1.08 mIU/L, 113.21±27.62 nmol/L and 1.96±0.54 nmol/L, respectively. The results obtained were found to be in excellent agreement with the previously reported series. It is, therefore, expected that the present study will contribute some useful data in literature to set up normal values of serum TSH, T4 and T3.

Calciotropic hormones and the risk of hip and nonspine fractures in older adults: The health ABC study

The effects of vitamin D and parathyroid hormone (PTH) levels on incident fracture remain uncertain. To test the hypothesis that increasing serum 25-hydroxyvitamin D [25(OH)D] and decreasing PTH levels are associated with decreased risk of hip and any nonspine fracture, we conducted a prospective cohort study among 2614 community-dwelling white and black participants, aged ≥70 years, from the Health, Aging and Body Composition (Health ABC) Study. Serum and plasma samples were drawn at year 2, which formed the baseline for this analysis. Serum 25(OH)D and intact PTH (1-84) were measured using radioimmunoassay with DiaSorin reagents and EDTA plasma with a two-site immunoradiometric assay kit, respectively. Incident fractures (hip and any nonspine) were assessed after year 2, every 6 months, by self-report and validated by radiology reports. The median (interquartile range) follow-up times for hip and any nonspine fractures were 6.4 (6.1-6.5) and 6.4 (5.5-6.5) years, respectively. Cox proportional hazards regression was used to estimate the hazard ratios (HR) with 95% confidence intervals (CI) for fracture. There were 84 hip and 247 nonspine fractures that occurred over the follow-up period. The multivariable adjusted HRs (95% CIs) of hip fracture for participants in the lowest (≤17.78 ng/mL), second (17.79 to 24.36 ng/mL), and third quartiles (24.37 to 31.94 ng/mL) of 25(OH)D were 1.92 (0.97 to 3.83), 0.75 (0.32 to 1.72) and 1.86 (1.00 to 3.45), respectively, compared with participants in the highest 25(OH)D quartile (>31.94 ng/mL) (p trend = 0.217). Additional adjustment for IL-6 (p = 0.107), PTH (p = 0.124), and hip areal bone mineral density (p = 0.137) attenuated HRs of hip fracture in the lowest quartile by 16.3%, 17.4%, and 26.1%, respectively. There was no evidence of an association between 25(OH)D and any nonspine fractures, or between PTH and hip or any nonspine fractures. We found limited evidence to support an association between calciotropic hormones and hip and nonspine fractures in older men and women.

Differences in serum thyroglobulin measurements by 3 commercial immunoradiometric assay kits and laboratory standardization using Certified Reference Material 457 (CRM‐457)

Serum thyroglobulin (Tg) is essential in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, interchangeability and standardization between Tg assays have not yet been achieved, even with the development of an international Tg standard (Certified Reference Material 457 [CRM-457]). Serum Tg from 30 DTC patients and serially diluted CRM-457 were measured using 3 different immunoradiometric assays (IRMA-1, IRMA-2, IRMA-3). The intraclass correlation coefficient (ICC) method was used to describe the concordance of each IRMA to CRM-457. The serum Tg measured by 3 different IRMAs correlated well (r > .85, p < .0001), but clinically relevant discrepancies were found in 13.3% of patients. IRMA-3, which claims to be standardized to CRM-457, showed the best ICC (p(1) = .98) for the CRM-457. Hospitals caring for patients with DTC should either set their own cutoffs for IRMAs for Tg based on their patient pools, or adopt IRMAs standardized to CRM-457 and calibrate their laboratory using CRM-457.

Long-term intrathecal morphine influence on major compounds of the endocrine system in elderly population

Background The influence of long-term opioid administration on hormonal levels is not well characterized in the literature. We previously showed that intrathecal opioid therapy significantly influences the homeostasis of immune and endocrine systems. Other authors confirmed that exogenous and endogenous opioids induce this effect. They have a cytokine-like behavior and may function as neurotransmitters, neuromodulators or hormones, as concerning their synthesis, storage and release. Aims To assess the effects of morphine long-term intrathecal administration on serum levels of Gonadal, Thyroidal and Adrenal axis hormones in an elderly population affected by chronic pain; to assess the correlation between hormone levels and morphine dosage. Methods Patients suffering from chronic non-cancer pain with or without intrathecal drug delivery system were studied and hormonal levels were monitored, using an immunoradiometric assay kit. Results The long-term administration of intrathecal morphine influenced part of the endocrine system, in particular, there was a reduction of FSH and LH and an increment of GH serum levels; this effect was morphine dose dependent. Conclusion Long-term intrathecal opioid administration influenced FSH, LH and GH serum levels. Data on this issue are inadequately described in the literature. The finding of endocrine effects of opioid therapy, nonetheless, cannot be ignored, as it may have clinical relevance in both elderly and young population. We believe that during long intrathecal pain treatments with morphine, clinicians should be aware of both immediate and later opioids side effects, and in particular, they should monitor immune and endocrine changes.

Inflammatory Mediators in Chinese Patients With Congestive Heart Failure

In this study, circulating levels of proinflammatory and anti-inflammatory mediators are studied in patients with chronic heart failure (CHF) in China. Sixty-five patients with CHF and 32 control subjects are studied. The proinflammatory and anti-inflammatory cytokines interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-alpha, atrial natriuretic peptide (ANP), and brain natriuretic peptide (BNP) in plasma are determined by immunoradiometric assay kits. Catecholamine (CA) in plasma is evaluated by high-performance liquid chromatography. Plasma levels of IL-6, IL-10, TNF-alpha, ANP, BNP, and CA in CHF patients are significantly higher than those in control subjects. Patients in a higher New York Heart Association (NYHA) class show higher concentrations of inflammatory mediators than those in a lower NYHA class, although the ratio of plasma IL-10 to TNF-alpha in patients with CHF is significantly lower than in the control group. It is concluded that proinflammatory and anti-inflammatory cytokine levels are increased and IL-10/TNF-alpha is decreased in Chinese patients with CHF.

Do Commercially Available Assay Kits for B-Type Natriuretic Peptide Measure Pro-BNP1-108, as Well as BNP1-32?

To the Editor: We read with great interest the recent article by Heublein et al1 on plasma pro-BNP1-108 measurement with commercially available assay kits and the effect of pro-BNP1-108 on cGMP levels. They demonstrated that Shionogi’s or Biosite’s triage assay kit did not cross-react with pro-BNP1-108 and that pro-BNP1-108 did not increase intracellular cGMP levels in cardiac myocytes or fibroblasts. Shionogi’s immunoradiometric assay kit uses 2 monoclonal antibodies: one recognizes the ring portion and the other recognizes the C-terminal tail. Therefore, this assay kit measures B-type natriuretic peptide independent of the length of the N-terminal extension from the ring structure. Indeed, Heublein et al1 reported that this assay …

Development of an immunoradiometric assay (IRMA) kit for determination of thyroid stimulating hormone in dry blood spot of newborns

Development of an immunoradiometric assay (IRMA) kit for determination of thyroid stimulating hormone in dry blood spot of newborns