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Indian Journal of Clinical Biochemistry logoLink to Indian Journal of Clinical Biochemistry
. 2001 Jan;16(1):15–21. doi: 10.1007/BF02867563

Impact of Ultra-Sensitive technology and contemporary therapy on laboratory results

Sheshadri Narayanan 1,✉
PMCID: PMC3453621  PMID: 23105287

Abstract

The introduction of ultra-sensitive labels for immunoassays has exposed some of the limitations inherent in them. Thus, for instance a major problem with acridinium esters used, as chemiluminescence label is the formation of the so called “pseudobases” at an alkaline pH, which if not suppressed can affect the rate of the chemiluminescence reaction. Chemiluminescence labels such as luminol can also be problematic when attached to antibodies and small molecules to the extent that the sensitivity of the assay can be reduced by the decrease in the intensity of chemiluminescence. The increased use of molecular methods such as polymerase chain reaction (PCR) and post PCR methods to study mutations have various pittalls, which if unrecognized and uncontrolled can lead to incorrect results and misinterpretation. Patients who are exposed to mouse immunoglobulins through imaging or therapeutic techniques can develop antibodies to mouse immunoglobulins (human anti-mouse antibodies or HAMA) which can be a major problem for non optimized immunoassays using murine monoclonal antibodies. The types of therapy such as anticoagulant used in anticoagulant therapy, blood substitute and drug therapy can impact on the measurements of some of the biochemical and other analytes. One must separate the transient, physiological effects introduced by therapy from long-term biochemical alterations due to disease.

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References

  • 1.Littig J. S., Nieman T. A. Quantitation of acridinium esters using electrogenerated chemiluminescence and flow injection. Anal. Chem. 1992;64:1140–1144. doi: 10.1021/ac00034a012. [DOI] [Google Scholar]
  • 2.Narayanan S. Quality control in tumor marker analysis: preanalytical, analytical and post-analytical issues. J. Clin. Ligand Assay. 1988;21:11–17. [Google Scholar]
  • 3.Narayanan S. Concepts, principles and applications of selected molecular biology techniques in clinical biochemistry. Adv. Clin. Chem. 1996;32:1–38. doi: 10.1016/s0065-2423(08)60424-2. [DOI] [PubMed] [Google Scholar]
  • 4.Pringle M. J. Acridinium ester labels: Esters, sulfonamides, and their applications. J. Clin. Ligand Assay. 1999;22:105–122. [Google Scholar]
  • 5.Gala J., Heusterspreute M., Loric S., Hanon F., Tombal B., Cangh P., Nayer P., Phillipe M. Expression of prostate-specific antigen and prostate-specific membrane antigen transcripts in blood cells: implications for the detection of hematogenous prostate cells and standardization. Clin. Chem. 1998;44:472–481. [PubMed] [Google Scholar]
  • 6.Inazuka M., Tahira T., Hayashi K. One-tube post-PCR fluorescent labeling of DNA fragments. Genome Res. 1996;6:551–557. doi: 10.1101/gr.6.6.551. [DOI] [PubMed] [Google Scholar]
  • 7.Narayanan S. Preanalytical and analytical pitfalls in molecular biology techniques. J. Clin. Ligand Assay. 1997;20:200–205. [Google Scholar]
  • 8.Kwiatkowska J., Widgowska-Sowinska J., Napierala D., Slomski R., Kwiatkowski D. J. Mosaicism in tuberous sclerosis as a potential cause of the failure of molecular diagnosis. New Engl. J. Med. 1999;340:703–707. doi: 10.1056/NEJM199903043400905. [DOI] [PubMed] [Google Scholar]
  • 9.Bagg A., Kallakury BVS. Molecular pathology of leukemia and lymphoma. Amer. J. Clin. Pathol. 1999;112(suppl. 1):576–592. [PubMed] [Google Scholar]
  • 10.Hansen H. J., Fontaine G., Newman E. S., Schwartz M. K., Malkin A., Mojzisik K., Martin E. W., Goldenberg D. M. Solving the problem of antibody interference in commercial “sandwich-type” immunoassays of carcinoembryonic antigen. Clin. Chem. 1989;35:146–151. [PubMed] [Google Scholar]
  • 11.Kuroki M., Matsumoto Y., Arakawa F., Haruno M., Murakami M., Kuwahara M., Ozaki H., Senba T., Matsuoka Y. Reducing interference from heterophilic antibodies in a two-site immunoassay for carcinoembryonic antigen (CEA) by using a human/mouse chimeric antibody to CEA as a tracer. J. Immunol. Methods. 1995;180:81–91. doi: 10.1016/0022-1759(94)00301-C. [DOI] [PubMed] [Google Scholar]
  • 12.Stevenson H. P., Archbold G. P. R., Johnson P., Young I. S., Sheridan B. Misleading serum free thyroxine results during low molecular weight heparin treatment. Clin. Chem. 1998;44:1002–1007. [PubMed] [Google Scholar]
  • 13.Ma Z., Monk T. G., Goodnough L. T., McCiellan A., Gawryl M., Clark T., Moreira P., Keipert P. E., Scott M. G. Effect of hemoglobin and perfluobron-based oxygen carriers on common clinical laboratory tests. Clin. Chem. 1997;43:1732–1737. [PubMed] [Google Scholar]
  • 14.Shepherd A. P., Steinke J. M. Co-oximetry interference by perfluobron emulsion: comparison of hemolyzing and non-hemolyzing instruments. Clin. Chem. 1998;44:2183–2190. [PubMed] [Google Scholar]
  • 15.Narayanan S. Current concepts of thyroid function and laboratory evaluation. Indian J. Clin. Biochem. 1997;12:25–34. doi: 10.1007/BF02867951. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Oesterling J. E., Roy J., Agha A., Shown T., Krarup T., Johansen T., Lagerkvist M., Gormley G., Bach M., Waldstreicher J., Finasteride PSA Study Group. Biologic variability of prostate-specific antigen and its usefulness as a marker for prostate cancer: effects of finasteride. Finasteride study group. Urology. 1998;51(suppl 4-A):58–63. doi: 10.1016/s0090-4295(98)00059-4. [DOI] [PubMed] [Google Scholar]
  • 17.Narayanan S. The preanalytic phase. An important component of laboratory medicine. Amer. J. Clin. Pathol. 2000;113:429–452. doi: 10.1309/C0NM-Q7R0-LL2E-B3UY. [DOI] [PubMed] [Google Scholar]
  • 18.Engstad C. S., Guttenberg T. J., Osterud B. Modulation of blood cell activation by four commonly used anticoagulants. Thromb. Haemost. 1997;77:690–696. [PubMed] [Google Scholar]
  • 19.Narayanan S., Hamasaki N. Current concepts of coagulation and fibrinolysis. Adv. Clin. Chem. 1999;33:133–168. doi: 10.1016/S0065-2423(08)60207-3. [DOI] [PubMed] [Google Scholar]
  • 20.Saag M. S., Holodniy M., Kuritzkes D. R., O'Brien W. A., Coombs R., Poscher M. E., Jacobsen D. M., Shaw G. M., Richmann D. D., Volberding P. A. HIV viral load markers in clinical practice. Nature. Med. 1996;2:625–629. doi: 10.1038/nm0696-625. [DOI] [PubMed] [Google Scholar]
  • 21.Klebanoff S. J., Coombs R. W. Viricidal effect of polymorphonuclear leukocytes on human immunodeficiency virus-1. Role of myeloperoxidase system. J. Clin. Invest. 1992;89:2014–2017. doi: 10.1172/JCI115810. [DOI] [PMC free article] [PubMed] [Google Scholar]

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