Validation of a New Panel of Automated Chemiluminescence Assays for Anticardiolipin Antibodies in the Screening for Antiphospholipid Syndrome

BACKGROUND

Antibodies anticardiolipin (aCL) and anti-β2-glycoprotein I (aβ2GPI) are two of three laboratory criteria of antiphospholipid syndrome (APS). All of assays of antiphospholipid antibodies (aPL), coagulation assays as well as ELISAs, show methodological shortcomings, that affect their sensitivity and specificity. Therefore, we decided to validate these parameters for a new chemiluminescent examination (CLIA).

METHODS

aCL and aβ2GPI antibodies were measured by ELISAs (AIDA, Bad Kreuznach, Germany) and aβ2GPI with CLIA kits (Werfen, Barcelona, Spain).

RESULTS

When we evaluated both assays, the coefficient of variation for CLIA was slightly lower (9.04 - 12.74%) than for ELISA (11.05 - 15.3%) and the LOD was 0.2 U/L. The dilution series showed significant linearity for all CLIA methods, aCL IgG, aCL IgM, aβ2GPI IgG, and aβ2GPI IgM (0 - 3000 U/L), and method comparison studies revealed good agreement with the currently used ELISA (Kappa values ranging 0.534 - 0.936) without determination of aβ2GPI IgG. The determination aβ2GPI IgG by CLIA method shows higher positivity in 31 samples. These new aCL IgG, aCL IgM, aβ2GPI IgG, and aβ2GPI IgM tests have excellent analytical characteristics and allow fully automated and simultaneous analysis on an analyzer.

CONCLUSIONS

Chemiluminescent determination of an automated analyzer can improve the fundamental parameters of tests such as reproducibility between laboratories.

Health effects of soy-biodiesel emissions: mutagenicity-emission factors

CONTEXT

Soy biodiesel is the predominant biodiesel fuel used in the USA, but only a few, frequently conflicting studies have examined the potential health effects of its emissions.

OBJECTIVE

We combusted petroleum diesel (B0) and fuels with increasing percentages of soy methyl esters (B20, B50 and B100) and determined the mutagenicity-emission factors expressed as revertants/megajoule of thermal energy consumed (rev/MJ(th)).

MATERIALS AND METHODS

We combusted each fuel in replicate in a small (4.3-kW) diesel engine without emission controls at a constant load, extracted organics from the particles with dichloromethane, determined the percentage of extractable organic material (EOM), and evaluated these extracts for mutagenicity in 16 strains/S9 combinations of Salmonella.

RESULTS

Mutagenic potencies of the EOM did not differ significantly between replicate experiments for B0 and B100 but did for B20 and B50. B0 had the highest rev/MJ(th), and those of B20 and B100 were 50% and ∼85% lower, respectively, in strains that detect mutagenicity due to polycyclic aromatic hydrocarbons (PAHs), nitroarenes, aromatic amines or oxidative mutagens. For all strains, the rev/MJ(th) decreased with increasing biodiesel in the fuel. The emission factor for the 16 EPA Priority PAHs correlated strongly (r(2 )= 0.69) with the mutagenicity-emission factor in strain TA100 + S9, which detects PAHs.

CONCLUSIONS

Under a constant load, soy-biodiesel emissions were 50-85% less mutagenic than those of petroleum diesel. Without additional emission controls, petroleum and biodiesel fuels had mutagenicity-emission factors between those of large utility-scale combustors (e.g. natural gas, coal, or oil) and inefficient open-burning (e.g. residential wood fireplaces).

Identification of somatic hypermutations in the TP53 gene in B-cell chronic lymphocytic leukemia

Abnormalities of the TP53 gene are associated with a particularly severe prognosis in patients with B-cell chronic lymphocytic leukemia (B-CLL). This tumor-suppressor is mostly inactivated by the deletion of one and point mutation of the other allele and has not been previously shown to be hypermutated in B-CLL. We identified two patients whose lymphocytes showed repeatedly an extensive proportion of TP53 mutated cells by FASAY analysis (the yeast functional assay) and harbored various TP53 mutations, mostly single-base substitutions, in individual cells. The mutation targeting exhibited characteristic traits of the somatic hypermutation process. In the first patient (harboring the unmutated IgVH locus) a significant bias to point mutations at CG pairs (21/25; P=0.009), their remarkable preference for the RGYW/WRCY motives (28%) and the highest expression of the activation-induced cytidine deaminase (AID) mRNA among the 34 tested B-CLL samples. In the second patient no CG bias was observed but the targeting of point mutations into the RGYW/WRCY motives was even more prominent here (7/16; 44%). Moreover, six out of eight point mutations affecting AT pairs were localized in the WA/TW motives, which are also characteristic for the somatic hypermutations. This patient, who was IgVH-mutated, already did not express any significant amount of the AID transcript. Our findings add a new aspect to the mosaic of the p53 mutability in B-CLL.

[Inpatient post-transplant services and intermittent rehabilitation in patients after kidney transplantation]

Late graft outcome depends on an intensive post-transplant care program. Direct post-transplant inpatient rehabilitation in a specialized hospital as well as outpatient services, along with an inpatient check-up every 2-3 years are important for maintaining an excellent long-term graft function. In our experience recognizing and treating risk factors after organ transplantation such as arterial hypertension, vasculopathy, hyperlipidemia, metabolic syndrome including PTDM, osteoporosis, recurrent diseases and also the recipient's education (compliance) are most important landmarks in a post-transplant care program. This inpatient as well as outpatient post-transplant care program with the aim of long-term graft function for organ recipients, performed in a network, represents a modern health service including effective and economical aspects, which health insurance in Germany is obliged to pay for.