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Dhont E, Van Der Heggen T, Snauwaert E, Willems J, Croubels S, Delanghe J, De Waele JJ, Colman R, Vande Walle J, De Paepe P, De Cock PA. Predictors of augmented renal clearance based on iohexol plasma clearance in critically ill children. Pediatr Nephrol 2024; 39:1607-1616. [PMID: 37994980 DOI: 10.1007/s00467-023-06221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Augmented renal clearance (ARC) holds a risk of subtherapeutic drug concentrations. Knowledge of patient-, disease-, and therapy-related factors associated with ARC would allow predicting which patients would benefit from intensified dosing regimens. This study aimed to identify ARC predictors and to describe ARC time-course in critically ill children, using iohexol plasma clearance (CLiohexol) to measure glomerular filtration rate (GFR). METHODS This is a retrospective analysis of data from the "IOHEXOL" study which validated GFR estimating formulas (eGFR) against CLiohexol. Critically ill children with normal serum creatinine were included, and CLiohexol was performed as soon as possible after pediatric intensive care unit (PICU) admission (CLiohexol1) and repeated (CLiohexol2) after 48-72 h whenever possible. ARC was defined as CLiohexol exceeding normal GFR for age plus two standard deviations. RESULTS Eighty-five patients were included; 57% were postoperative patients. Median CLiohexol1 was 122 mL/min/1.73 m2 (IQR 75-152). Forty patients (47%) expressed ARC on CLiohexol1. Major surgery other than cardiac surgery and eGFR were found as independent predictors of ARC. An eGFR cut-off value of 99 mL/min/1.73 m2 and 140 mL/min/1.73 m2 was suggested to identify ARC in children under and above 2 years, respectively. ARC showed a tendency to persist on CLiohexol2. CONCLUSIONS Our findings raise PICU clinician awareness about increased risk for ARC after major surgery and in patients with eGFR above age-specific thresholds. This knowledge enables identification of patients with an ARC risk profile who would potentially benefit from a dose increase at initiation of treatment to avoid underexposure. TRIAL REGISTRATION ClinicalTrials.gov NCT05179564, registered retrospectively on January 5, 2022.
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Affiliation(s)
- Evelyn Dhont
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Tatjana Van Der Heggen
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Evelien Snauwaert
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Pediatric Nephrology, ERKNet Center, Ghent University Hospital, Ghent, Belgium
| | - Jef Willems
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Siska Croubels
- Department of Pathobiology, Pharmacology and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan J De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Roos Colman
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Pediatric Nephrology, ERKNet Center, Ghent University Hospital, Ghent, Belgium
| | - Peter De Paepe
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Pieter A De Cock
- Pediatric Intensive Care Unit, Department of Intensive Care Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
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Wielders JPM, Porpiglia NM, Schellenberg F, Deenmamode J, Delanghe J, Anton RF, Bortolotti F, Siebelder C, Tagliaro F, Weykamp C, Helander A. Recommendations on the measurement and use of the alcohol consumption biomarker CDT. A position paper from the IFCC Working Group on CDT standardisation. Clin Chim Acta 2024; 555:117800. [PMID: 38309557 DOI: 10.1016/j.cca.2024.117800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Carbohydrate deficient transferrin (CDT) is a biomarker for excessive alcohol consumption utilized in clinical and forensic medicine and workplace testing. Previously, many different analytical methods for CDT were used and the measurand varied considerably, making direct comparison of test results difficult. To end this confusion, the IFCC established a working group on CDT standardisation (WG-CDT) which completed its tasks in 2017. METHODS This IFCC position paper by the WG-CDT summarizes state of the art information about the measurand and the analytical methods and gives concise recommendations for its utilization. RESULTS The results achieved by the CDT standardisation process led to accuracy improvements in national external quality assessment schemes over the years. A brief review of ROC based comparison studies with the traditional biomarkers (GGT, MCV, ALT and AST) discusses the bias resulting from inadequate study populations. In large groups of the general population the superior diagnostic performance of CDT is confirmed. CONCLUSION The relationship between alcohol intake versus resulting CDT is discussed as well as the cutoff and measurement uncertainty. Concerning the application in practice, potential pitfalls are considered and recommendations handling both analytical and preanalytical caveats are given. Finally, some examples of serious misunderstandings in publications about CDT are addressed.
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Affiliation(s)
- J P M Wielders
- Joseph Peter Marie Wielders, Amersfoort, the Netherlands.
| | - N M Porpiglia
- Nadia Maria Porpiglia, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy.
| | | | | | - J Delanghe
- Joris Delanghe, Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - R F Anton
- Raymond Francis Anton, Medical University of South Carolina, Charleston, SC, USA
| | - F Bortolotti
- Federica Bortolotti, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy
| | - C Siebelder
- Carla Siebelder, MCA Laboratory, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - F Tagliaro
- Franco Tagliaro, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy
| | - C Weykamp
- Cas Weykamp, MCA Laboratory, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - A Helander
- Anders Helander, Karolinska Institutet, Karolinska University Laboratory, Stockholm, Sweden
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Oyaert M, De Bruyne S, Van Camp C, Van de Caveye I, Delanghe J. Lipid droplets may interfere with urinary red blood cell and crystal counts by urinary flow cytometry. Clin Chem Lab Med 2024; 62:e65-e67. [PMID: 37650386 DOI: 10.1515/cclm-2023-0783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Sander De Bruyne
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | | | | | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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4
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Delanghe J. Human urea production, an ignored factor in the nitrogen debate. Acta Clin Belg 2024; 79:75-76. [PMID: 38044691 DOI: 10.1080/17843286.2023.2290412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
A public debate idealing with nitrogen (N) emissions is ongoing. Government reports use models in which the major N producers are agriculture and industry. Flemish NOx emission amounted to 26.4 kt N accompanied by an ammonia emission of 34.0 kt N. Major sources of Flemish N emission are agriculture (59% of total emission) and transport (21%); 95 percent of the ammonia emission is reported to come from agriculture. In this government's view, it looks like Flanders is unpopulated. In Flanders, 6,800,000 inhabitants show an average urea production of 20 g/day, or 3.65 kg N/year. This urea production eventually ends up in wastewaters as ammonia. Human urea production represents the grand total of 24.8 kl N/year. However, this contribution is made invisible in the statistics. Flemish reports mention a grand total of 33 kt/year, so Flemish numbers appear to be incomplete. Human production has not been taken into account. When calculating human N excretion in Flanders, 24.8 kt N/12.322 km2 is obtained, corresponding to an additional N load of ± 20 kg/ha. Implementing human N excretion into the calculation thoroughly changes the situation: adding human N production results in peak loads of 40 kg N/ha. The human nitrogen input is comparable with the heavily criticized contribution by agriculture. Policy should take into account the real size of the problem and not selectively focus on partial problems.
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Affiliation(s)
- Joris Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium
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Fortes-Lima CA, Burgarella C, Hammarén R, Eriksson A, Vicente M, Jolly C, Semo A, Gunnink H, Pacchiarotti S, Mundeke L, Matonda I, Muluwa JK, Coutros P, Nyambe TS, Cikomola JC, Coetzee V, de Castro M, Ebbesen P, Delanghe J, Stoneking M, Barham L, Lombard M, Meyer A, Steyn M, Malmström H, Rocha J, Soodyall H, Pakendorf B, Bostoen K, Schlebusch CM. The genetic legacy of the expansion of Bantu-speaking peoples in Africa. Nature 2024; 625:540-547. [PMID: 38030719 PMCID: PMC10794141 DOI: 10.1038/s41586-023-06770-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023]
Abstract
The expansion of people speaking Bantu languages is the most dramatic demographic event in Late Holocene Africa and fundamentally reshaped the linguistic, cultural and biological landscape of the continent1-7. With a comprehensive genomic dataset, including newly generated data of modern-day and ancient DNA from previously unsampled regions in Africa, we contribute insights into this expansion that started 6,000-4,000 years ago in western Africa. We genotyped 1,763 participants, including 1,526 Bantu speakers from 147 populations across 14 African countries, and generated whole-genome sequences from 12 Late Iron Age individuals8. We show that genetic diversity amongst Bantu-speaking populations declines with distance from western Africa, with current-day Zambia and the Democratic Republic of Congo as possible crossroads of interaction. Using spatially explicit methods9 and correlating genetic, linguistic and geographical data, we provide cross-disciplinary support for a serial-founder migration model. We further show that Bantu speakers received significant gene flow from local groups in regions they expanded into. Our genetic dataset provides an exhaustive modern-day African comparative dataset for ancient DNA studies10 and will be important to a wide range of disciplines from science and humanities, as well as to the medical sector studying human genetic variation and health in African and African-descendant populations.
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Affiliation(s)
- Cesar A Fortes-Lima
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Concetta Burgarella
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden
- AGAP Institut, University of Montpellier, CIRAD, INRAE, Institut Agro, Montpellier, France
| | - Rickard Hammarén
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Anders Eriksson
- cGEM, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Mário Vicente
- Centre for Palaeogenetics, University of Stockholm, Stockholm, Sweden
- Department of Archaeology and Classical Studies, Stockholm University, Stockholm, Sweden
| | - Cecile Jolly
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - Armando Semo
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Vairão, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, Portugal
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Hilde Gunnink
- UGent Centre for Bantu Studies (BantUGent), Department of Languages and Cultures, Ghent University, Ghent, Belgium
- Leiden University Centre for Linguistics, Leiden, the Netherlands
| | - Sara Pacchiarotti
- UGent Centre for Bantu Studies (BantUGent), Department of Languages and Cultures, Ghent University, Ghent, Belgium
| | - Leon Mundeke
- University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Igor Matonda
- University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Joseph Koni Muluwa
- Institut Supérieur Pédagogique de Kikwit, Kikwit, Democratic Republic of Congo
| | - Peter Coutros
- UGent Centre for Bantu Studies (BantUGent), Department of Languages and Cultures, Ghent University, Ghent, Belgium
| | | | | | - Vinet Coetzee
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
| | - Minique de Castro
- Biotechnology Platform, Agricultural Research Council, Onderstepoort, Pretoria, South Africa
| | - Peter Ebbesen
- Department of Health Science and Technology, University of Aalborg, Aalborg, Denmark
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Mark Stoneking
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, Université Lyon 1, CNRS, Villeurbanne, France
| | - Lawrence Barham
- Department of Archaeology, Classics & Egyptology, University of Liverpool, Liverpool, UK
| | - Marlize Lombard
- Palaeo-Research Institute, University of Johannesburg, Johannesburg, South Africa
| | - Anja Meyer
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maryna Steyn
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Helena Malmström
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden
- Palaeo-Research Institute, University of Johannesburg, Johannesburg, South Africa
| | - Jorge Rocha
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Vairão, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, Portugal
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Himla Soodyall
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Academy of Science of South Africa, Pretoria, South Africa
| | | | - Koen Bostoen
- UGent Centre for Bantu Studies (BantUGent), Department of Languages and Cultures, Ghent University, Ghent, Belgium
| | - Carina M Schlebusch
- Human Evolution Program, Department of Organismal Biology, Uppsala University, Uppsala, Sweden.
- Palaeo-Research Institute, University of Johannesburg, Johannesburg, South Africa.
- SciLifeLab, Uppsala, Sweden.
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Vermassen T, Geboes K, Lumen N, Van Praet C, Rottey S, Delanghe J. Comparison of different estimated glomerular filtration rates for monitoring of kidney function in oncology patients. Clin Kidney J 2024; 17:sfae006. [PMID: 38288036 PMCID: PMC10823486 DOI: 10.1093/ckj/sfae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Indexed: 01/31/2024] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) are associated with kidney function deterioration. A shift is ongoing towards glomerular filtration rate (GFR) equations based on other protein markers, such as cystatin C (CSTC) and β-trace protein (BTP). We evaluated various GFR equations for monitoring of kidney function in actively treated oncology patients. Methods We monitored 110 patients receiving a TKI. Blood and urine were collected during therapy. Serum analysis included creatinine (Cr), CSTC and BTP; for consequent GFR determination. Urine was analysed for protein, albumin, immunoglobulin G, and α-1-microglobulin. A similar analysis was done in a patient subgroup receiving immune checkpoint inhibitors (ICI) as prior or subsequent line of therapy. Results Cr remained constant during TKI treatment (P = 0.7753), whereas a significant decrease in CSTC (from week 2 onward, P < 0.0001) and BTP (at weeks 2 and 4, P = 0.0100) were noticed. Consequently, GFR estimations, using CSTC and/or BTP as a biochemical parameter, showed an apparent increase in GFR, whereas this was not observed for Cr-related GFR estimations. As a result, the GFR gap (ΔGFR) was significantly different from week 2 onward between Cr-based and CSTC-based GFR and between BTP-based and CSTC-based GFR. Glomerular damage was noticed with significant increase in urine protein-to-creatinine ratio, albumin-to-creatinine ratio and immunoglobulin G (all P < 0.0001). No change in α-1-microglobulin was seen. ICI treatment had no effect on Cr (P = 0.2262), CSTC (P = 0.7341), and BTP concentrations (P = 0.3592). Conclusion GFR equations, in which CSTC is incorporated, fail to correctly estimate the GFR in oncology patients treated with TKIs. As TKI-treated patients show clear signs of glomerular injury, further assessment is needed on how to correctly monitor the kidney function in actively treated oncology patients.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, University Hospital Ghent, Ghent, Belgium
- Biomarkers in Cancer, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Karen Geboes
- Cancer Research Institute Ghent, Ghent, Belgium
- Digestive Oncology, Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Nicolaas Lumen
- Cancer Research Institute Ghent, Ghent, Belgium
- Department of Urology, University Hospital Ghent, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Charles Van Praet
- Cancer Research Institute Ghent, Ghent, Belgium
- Department of Urology, University Hospital Ghent, Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Sylvie Rottey
- Department of Medical Oncology, University Hospital Ghent, Ghent, Belgium
- Biomarkers in Cancer, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
- Drug Research Unit Ghent, University Hospital Ghent, Ghent, Belgium
| | - Joris Delanghe
- Cancer Research Institute Ghent, Ghent, Belgium
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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Debunne N, Delanghe J, Raman L, Oyaert M. Urine transfer devices may impact urinary particle results: a pre-analytical study. Clin Chem Lab Med 2023; 61:2186-2194. [PMID: 37340894 DOI: 10.1515/cclm-2023-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES Well-standardized procedures in the pre-analytical phase of urine diagnostics is of utmost importance to obtain reliable results. We investigated the effect of different urine collection methods and the associated urine transfer tubes on urine test strip and particle results. METHODS In total, 146 selected urine samples were subdivided into three different collection containers and subsequently transferred into its accompanying transfer tube (BD, Greiner, Sarstedt vacuum and Sarstedt aspiration). As reference, the original urine sample was directly measured on the analyser. Both chemical test strip analysis (Sysmex UC-3500) and fluorescence flow cytometry particle analysis (Sysmex UF-5000) were performed on all samples. RESULTS No statistically significant differences in test strip results were found between the studied transfer methods. On the contrary, transfer of urine samples to the secondary tubes affected their particle counts. Clinically significant reductions in counts of renal tubular epithelial cells and hyaline casts were observed using the BD and Greiner transfer tubes and in counts of pathological casts using the BD, Greiner and Sarstedt vacuum tubes. CONCLUSIONS The results of this study indicate that the use of urine transfer tubes may impact counts of fragile urine particles. Clinical laboratories need to be aware about the variation that urine collection methods can induce on urine particle counts.
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Affiliation(s)
- Nathan Debunne
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
| | - Leen Raman
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
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Abstract
Detection of hemoglobin (Hb) and red blood cells in urine (hematuria) is characterized by a large number of pitfalls. Clinicians and laboratory specialists must be aware of these pitfalls since they often lead to medical overconsumption or incorrect diagnosis. Pre-analytical issues (use of vacuum tubes or urine tubes containing preservatives) can affect test results. In routine clinical laboratories, hematuria can be assayed using either chemical (test strips) or particle-counting techniques. In cases of doubtful results, Munchausen syndrome or adulteration of the urine specimen should be excluded. Pigmenturia (caused by the presence of dyes, urinary metabolites such as porphyrins and homogentisic acid, and certain drugs in the urine) can be easily confused with hematuria. The peroxidase activity (test strip) can be positively affected by the presence of non-Hb peroxidases (e.g. myoglobin, semen peroxidases, bacterial, and vegetable peroxidases). Urinary pH, haptoglobin concentration, and urine osmolality may affect specific peroxidase activity. The implementation of expert systems may be helpful in detecting preanalytical and analytical errors in the assessment of hematuria. Correcting for dilution using osmolality, density, or conductivity may be useful for heavily concentrated or diluted urine samples.
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Affiliation(s)
- Joris Delanghe
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
| | - Marijn Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | | | - Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
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Delanghe J, Oyaert M, De Buyzere M, Delanghe S, Speeckaert M. Glucosuria and interference of urinary albumin-to-creatinine ratio. Kidney Int 2023; 104:201. [PMID: 37349050 DOI: 10.1016/j.kint.2023.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 03/24/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Joris Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marc De Buyzere
- Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Sigurd Delanghe
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Marijn Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium; Research Foundation Flanders, Brussels, Belgium
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Wauthier L, Jacques S, Delanghe J, Favresse J. Optimizing the screening of alpha-1 antitrypsin deficiency using serum protein electrophoresis. Clin Chem Lab Med 2023; 61:427-434. [PMID: 36420543 DOI: 10.1515/cclm-2022-0967] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Alpha-1 antitrypsin (A1AT) deficiency was first identified in patients with emphysema by the absence of the α1 band on serum protein electrophoresis (SPE). Today, capillary zone electrophoresis is widely performed in laboratories. Here, we compared two SPE systems to detect decreased A1AT concentrations to optimize their use as a screening tool for A1AT deficiency. METHODS Serum protein electrophoresis was performed on 200 samples on the Capillarys 2 and the V8 Nexus. The latter presents two α1 bands (α1 band 1 and 2) while the Capillarys 2 has only one (Capillarys 2 total α1). The measures of A1AT and α1 acid glycoprotein (AAG) were performed as well as the phenotyping of M, S and Z alleles. RESULTS At a A1AT cutoff of 0.80 g/L, a cutoff of 1.21 g/L using the V8 Nexus α1 band 2 corresponded to a 100% sensitivity and a 92.4% specificity while a 1.69% cutoff corresponded to a 100% sensitivity and a 92.4% specificity. The performance of the α1 band 1 was suboptimal and rather corresponded to AAG. On the Capillarys 2, a cutoff of 2.0 g/L corresponded to a 75.0% sensitivity and a 86.6% specificity, while a 3.2% cutoff showed a 96.4% sensitivity and a 67.4% specificity. The V8 Nexus α1 band 2 was the method the most correlated with A1AT (r=0.90-0.94). CONCLUSIONS The V8 Nexus α1 band 2 was the best predictor of A1AT deficiency, probably owing to a better resolution. The use of SPE was however unable to predict each phenotype. Phenotype or genotype studies are therefore still advisable in case of A1AT deficiency.
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Affiliation(s)
- Loris Wauthier
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | - Stéphanie Jacques
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | - Joris Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Gent, Belgium
| | - Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium.,Department of Pharmacy, Namur Research Institute for LIfes Sciences, University of Namur, Namur, Belgium
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Verbakel I, Maenhout T, Petrovic M, Weiss J, Van Laecke E, Delanghe J, Everaert K. Laying the foundation for enhancing safety of desmopressin in older people: Validation of capillary blood sodium levels. Neurourol Urodyn 2023; 42:303-308. [PMID: 36321798 DOI: 10.1002/nau.25084] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/10/2022] [Revised: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE We aim to make desmopressin a safe treatment option for (older) patients at risk for hyponatremia, by introducing a new way of sodium monitoring. The goal is to reduce the risk of hyponatremia, enhance patient safety and ultimately introduce self-monitoring of sodium levels. The first step in the aforementioned is to validate capillary sodium. MATERIALS AND METHODS 100 randomly selected patients admitted to the urology department received a single finger prick to collect capillary blood (250 µl) in a lithium-heparin tube. Each patient acted as its own control for the capillary and venous blood sample. Venous and capillary plasma sodium were analyzed by indirect ion-selective electrode measurement. The primary outcome was the agreement between capillary and venous sodium measurements, measured by the intra-class correlation coefficient (ICC). RESULTS One hundred paired blood samples were obtained of which four were excluded. There was no significant statistical difference observed between venous and capillary sodium (-0.23 mmol/L, p = 0.374). The ICC for single measures between capillary and venous sodium was 0.82 (95% confidence interval 0.75-0.88). Inter-method differences analyzed by a Bland-Altman plot and a Passing-Bablock regression did not reveal a statistically significant difference between both groups. CONCLUSIONS We demonstrated that venous and capillary sodium levels are interchangeable, taken into account the inter- and intravariability between analyses. We provided the first step towards a simple and safe solution for frequent sodium monitoring through a minimal invasive capillary blood collection. The results are of direct clinical relevance to safely use desmopressin in (older) patients at risk.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Erik Van Laecke
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Clinical Laboratory, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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12
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Dhont E, Windels C, Snauwaert E, Van Der Heggen T, de Jaeger A, Dhondt L, Delanghe J, Croubels S, Walle JV, De Paepe P, De Cock PA. Reliability of glomerular filtration rate estimating formulas compared to iohexol plasma clearance in critically ill children. Eur J Pediatr 2022; 181:3851-3866. [PMID: 36053381 DOI: 10.1007/s00431-022-04570-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED Accurate renal function assessment is crucial to guide intensive care decision-making and drug dosing. Estimates of glomerular filtration rate (eGFR) are routinely used in critically ill children; however, these formulas were never evaluated against measured GFR (mGFR) in this population. We aimed to assess the reliability of common eGFR formulas compared to iohexol plasma clearance (CLiohexol) in a pediatric intensive care (PICU) population. Secondary outcomes were the prevalence of acute kidney injury (AKI) (by pRIFLE criteria) and augmented renal clearance (ARC) (defined as standard GFR for age + 2 standard deviations (SD)) within 48 h after admission based on mGFR and eGFR by the revised Schwartz formula and the difference between these two methods to diagnose AKI and ARC. In children, between 0 and 15 years of age, without chronic renal disease, GFR was measured by CLiohexol and estimated using 26 formulas based on creatinine (Scr), cystatine C (CysC), and betatrace protein (BTP), early after PICU admission. eGFR and mGFR results were compared for the entire study population and in subgroups according to age, using Bland-Altman analysis with calculation of bias, precision, and accuracy expressed as percentage of eGFR results within 30% (P30) and 10% (P10) of mGFR. CLiohexol was measured in 98 patients. Mean CLiohexol (± SD) was 115 ± 54 ml/min/1.73m2. Most eGFR formulas showed overestimation of mGFR with large bias and poor precision reflected by wide limits of agreement (LoA). Bias was larger with CysC- and BTP-based formulas compared to Scr-based formulas. In the entire study population, none of the eGFR formulas showed the minimal desired P30 > 75%. The widely used revised Schwartz formula overestimated mGFR with a high percentage bias of - 18 ± 51% (95% confidence interval (CI) - 29; - 9), poor precision with 95% LoA from - 120 to 84% and insufficient accuracy reflected by P30 of only 51% (95% CI 41; 61), and P10 of 21% (95% CI 13; 66) in the overall population. Although performance of Scr-based formulas was worst in children below 1 month of age, exclusion of neonates and younger children did not result in improved agreement and accuracy. Based on mGFR, prevalence of AKI and ARC within 48 h was 17% and 45% of patients, respectively. There was poor agreement between revised Schwartz formula and mGFR to diagnose AKI (kappa value of 0.342, p < 0.001; sensitivity of 30%, 95% CI 5; 20%) and ARC (kappa value of 0.342, p < 0.001; sensitivity of 70%, 95% CI 33; 58). CONCLUSION In this proof-of-concept study, eGFR formulas were found to be largely inaccurate in the PICU population. Clinicians should therefore use these formulas with caution to guide drug dosing and therapeutic interventions in critically ill children. More research in subgroup populations is warranted to conclude on generalizability of these study findings. CLINICALTRIALS gov NCT05179564, registered retrospectively on January 5, 2022. WHAT IS KNOWN • Both acute kidney injury and augmented renal clearance may be present in PICU patients and warrant adaptation of therapy, including drug dosing. • Biomarker-based eGFR formulas are widely used for GFR assessment in critically ill children, although endogenous filtration biomarkers have important limitations in PICU patients and eGFR formulas have never been validated against measured GFR in this population. WHAT IS NEW • eGFR formulas were found to be largely inaccurate in the PICU population when compared to measured GFR by iohexol clearance. Clinicians should therefore use these formulas with caution to guide drug dosing and therapeutic interventions in critically ill children. • Iohexol plasma clearance could be considered an alternative for accurate GFR assessment in PICU patients.
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Affiliation(s)
- Evelyn Dhont
- Department of Pediatric Intensive Care, Pediatric Intensive Care 1K12D, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium.
| | - Charlotte Windels
- Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium
| | - Evelien Snauwaert
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Tatjana Van Der Heggen
- Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Annick de Jaeger
- Department of Pediatric Intensive Care, Pediatric Intensive Care 1K12D, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Laura Dhondt
- Faculty of Veterinary Medicine, Department of Pathobiology, Pharmacology and Zoological Medicine, Ghent University, Ghent, Belgium
| | - Joris Delanghe
- Faculty of Medicine and Health Sciences, Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Siska Croubels
- Faculty of Veterinary Medicine, Department of Pathobiology, Pharmacology and Zoological Medicine, Ghent University, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Peter De Paepe
- Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
| | - Pieter A De Cock
- Department of Pediatric Intensive Care, Pediatric Intensive Care 1K12D, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
- Department of Pharmacy, Ghent University Hospital, Ghent, Belgium
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13
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Oyaert M, Maghari S, Speeckaert M, Delanghe J. Improving clinical performance of urine sediment analysis by implementation of intelligent verification criteria. Clin Chem Lab Med 2022; 60:1772-1779. [PMID: 36069776 DOI: 10.1515/cclm-2022-0617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Urinary test strip and sediment analysis integrated with intelligent verification criteria can help to select samples that need manual review. This study aimed to evaluate the improvement in the diagnostic performance of combined urinary test strip and urinary sediment analysis using intelligent verification criteria on the latest generation automated test strip and urinary fluoresce flow cytometry (UFFC) analysers. METHODS Urine test strip and sediment analysis were performed using the Sysmex UC-3500 and UF-5000 (Kobe, Japan) on 828 urinary samples at the clinical laboratory of the Ghent University Hospital. The results were compared to manual microscopy using phase-contrast microscopy as a reference. After the application of the intelligent verification criteria, we determined whether the diagnostic performance of urine sediment analysis could be improved. RESULTS Application of intelligent verification criteria resulted in an increase in specificity from 88.5 to 96.8% and from 88.2 to 94.9% for red blood cells and white blood cells, respectively. Implementing review rules for renal tubular epithelial cells and pathological casts increased the specificity from 66.7 to 74.2% and from 96.2 to 100.0%, respectively; and improved the diagnostic performance of urinary crystals and atypical cells. CONCLUSIONS The implementation of review rules improved the diagnostic performance of UFFC, thereby increasing the reliability and quality of urine sediment results.
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Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Sena Maghari
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marijn Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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14
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Bahati YL, Delanghe J, Balaluka GB, Vandepoele K, Cirhuza JC, Kishabongo AS, Philippé J. Ferroportin Q248H mutation was not found to be protective against malaria and anemia in children under 5 years living in South Kivu/Democratic Republic of Congo, an endemic area of Plasmodium infection. Heliyon 2022; 8:e10460. [PMID: 36060466 PMCID: PMC9437791 DOI: 10.1016/j.heliyon.2022.e10460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/21/2022] [Accepted: 08/22/2022] [Indexed: 10/31/2022] Open
Abstract
Background Materials and methods Results Conclusion Frequency of ferroportin Q248H is high in African population. Ferroportin has been described to protect red blood cells against oxidative stress and malaria infection. Ferroportin allele frequency was similar in anemic and non-anemic children. No difference according to ferroportin allele frequency was observed among children in endemic area of Plasmodium infection. Ferroportin Q248H mutation, G6PD deficiency and sickle cell anemia did not affect susceptibility to malaria in endemic area.
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15
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Pauwaert K, Bodé S, Alwis US, Mylle T, Boeckx P, Delanghe J, Everaert K, Roggeman S. Observing the water handling in humans to resolve the role of the interstitium: preliminary results of the usability of deuterium oxide and bio-impedance analysis - a pilot analysis. Isotopes Environ Health Stud 2022; 58:99-110. [PMID: 35072572 DOI: 10.1080/10256016.2022.2026349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
The aim of this research was to evaluate the relevance of using deuterium oxide (2H2O) and bio-impedance analysis (BIA) to assess size and function of the interstitium for urological research. Nineteen volunteers were recruited to this prospective trial combining ingestion of 2H2O and BIA. Blood samples were obtained every 10 min after ingestion of 2H2O. Urine was collected before and after the experiment. BIA was performed every 5 min. Body position was alternated to study the effect on fluid distribution. First order kinetics were assumed for the uptake of 2H2O from the gastrointestinal tract to the blood. Sex seemed to have an influence with a significantly slower exchange for women (p = 0.041, men: 0.052 min-1, women: 0.038 min-1). Impedance measured in legs (men: p = 0.012, women: p = 0.008) and trunk (both p < 0.001) decreased significantly with posture change. These changes probably reflect the orthostatic redistribution of fluid with an increase of fluid in both trunk and legs. Both methods were tested and found to be useful for further urological research. Significant gender differences in 2H2O uptake dynamics from the gastrointestinal pool were observed. An impact of posture changes on the electrical impedance measured was observed.
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Affiliation(s)
- Kim Pauwaert
- Department of Urology, University Hospital Ghent, Ghent, Belgium
| | - Samuel Bodé
- Isotope Bioscience Laboratory - ISOFYS, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | | | - Toon Mylle
- Department of Urology, University Hospital Ghent, Ghent, Belgium
| | - Pascal Boeckx
- Isotope Bioscience Laboratory - ISOFYS, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, University Hospital Ghent, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, University Hospital Ghent, Ghent, Belgium
| | - Saskia Roggeman
- Department of Urology, University Hospital Ghent, Ghent, Belgium
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16
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Alwis US, Verbakel I, Pauwaert K, Delanghe J, Dossche L, Van Camp J, Roggeman S, Everaert K. The Influence of Salt Sensitivity Phenotype on Sodium Excretion and Diuresis: A Chrononutrition Pilot Study. Int J Clin Pract 2022; 2022:9608962. [PMID: 35685516 PMCID: PMC9159230 DOI: 10.1155/2022/9608962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chrononutrition studies on interaction of diet/nutrients on endogenous circadian clocks and meal timing on metabolic homeostasis may be of importance in the management of nocturnal polyuria (NP), owing to loss of circadian rhythm in nighttime urination. Dietary salt restriction is an increasingly popular lifestyle recommendation for NP patients. AIM This study aims to evaluate the effect of an acute salt load on diuresis and to study the phenomenon of salt sensitivity. Methodology. Young, healthy men (n = 21, fasted and sober) ingested 500 ml of water on the control day and 8 g and 12 g of salt with water (500 ml) on two other days. Blood and urine samples were collected at 0 hrs, 2 hrs, and 4 hrs and voided volumes were recorded. Diuresis, serum and urine osmolality, sodium, potassium, urea, and creatinine were measured. Salt sensitivity was determined based on the rate of sodium excretion. RESULTS Compared to 8 g, ingestion of 12 g of salt significantly increased diuresis after 4 hrs. Pure water load induced fast diuresis, whereas salt and water load initially reduced diuresis and promoted late increase in diuresis. The total voided volume was significantly lower in the salt sensitive individuals. CONCLUSION Taken together, salt sensitivity profile and type and time of fluid intake are important considerations to build effective personalized lifestyle recommendations for NP patients, which needs further investigation.
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Affiliation(s)
| | - Irina Verbakel
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Kim Pauwaert
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, Belgium
| | - Lien Dossche
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium
- Department of Pediatric Nephrology, Ghent University, 9000 Ghent, Belgium
| | - John Van Camp
- Department of Food Technology, Safety and Health, Ghent University, 9000 Ghent, Belgium
| | - Saskia Roggeman
- Research and Policy Department, Psychiatric Center Sint-Jan-Baptist, 9060 Zelzate, Belgium
| | - Karel Everaert
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
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17
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Vermassen T, Himpe J, Coopman R, Van Praet C, Lumen N, Rottey S, Delanghe J. Prognostic Features of Near-Infrared Spectroscopy Following Primary Radical Prostatectomy. Cancers (Basel) 2021; 13:cancers13236034. [PMID: 34885144 PMCID: PMC8656494 DOI: 10.3390/cancers13236034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/30/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Only a few biomarkers have been evaluated for their prognostic value with regard to biochemical recurrence (BCR) following primary radical prostatectomy. We explored the possibilities of using near-infrared (NIR) spectroscopy as a prognostic biomarker for BCR-free survival (BCR-FS). METHODS Tissue specimens from 82 prostate cancer patients were obtained. Formalin-fixed paraffin-embedded slides (hematoxylin-eosin-stained) were analyzed using NIR spectroscopy. Prognostic features for BCR-FS were determined following normalization of the spectra. RESULTS Several differences were found throughout the NIR spectrum for the patients with or without BCR, for both the first derivative and second derivative of the NIR spectrum. Following categorization and Cox regression analysis, spectral regions at 5236 cm-1 (first derivative; median BCR-FS not reached versus 3.2 years; HRhigh = 0.18 [0.08-0.39]; and p < 0.0001) and at 5956 cm-1 (second derivative; median BCR-FS not reached versus 3.8 years; HRlow = 0.22 [0.10-0.48]; and p = 0.0002) showed prognostic properties for BCR-FS. The combination of both parameters further increased the prognostic value of NIR (p < 0.0001). CONCLUSIONS We demonstrated NIR spectral variations between patients with or without BCR, which have been shown to have prognostic value. This easy-to-use technique could possibly further improve post-primary radical prostatectomy monitoring and swift referral to adjuvant local therapies. Further elaboration is highly recommended to fully elucidate these variations and to gain a deeper insight into the changing chemical and physical compositions of the prostate tumor architecture.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium;
- Correspondence: ; Tel.: +32-9-332-5449
| | - Jonas Himpe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium; (J.H.); (J.D.)
| | - Renaat Coopman
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Ghent, 9000 Ghent, Belgium;
| | - Charles Van Praet
- Department of Urology, University Hospital Ghent, 9000 Ghent, Belgium; (C.V.P.); (N.L.)
| | - Nicolaas Lumen
- Department of Urology, University Hospital Ghent, 9000 Ghent, Belgium; (C.V.P.); (N.L.)
| | - Sylvie Rottey
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium;
| | - Joris Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium; (J.H.); (J.D.)
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18
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Favresse J, Delanghe J. High-resolution capillary electrophoresis for the determination of carbamylated albumin. Clin Chem Lab Med 2021; 60:229-234. [PMID: 34751528 DOI: 10.1515/cclm-2021-0926] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/19/2021] [Accepted: 10/28/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Carbamylation is a non-enzymatic post-translational reaction of a primary amino group of a protein with isocyanate. The albumin carbamylation is a negative prognostic factor in chronic kidney disease (CKD) patients and induce charge difference implying an observed shift in electrophoretic mobility that can be measured through a symmetry factor (SF). METHODS The Helena V8 and the Sebia Capillarys 2 systems were used for all experiments. The effect of in vitro carbamylation on the SF by spiking increasing concentrations of potassium isocyanate (KCNO) in serum of three healthy volunteers was investigated. Theoretical plate numbers (N) as a surrogate of separation efficiency were also calculated and correlations between SF and renal function biomarkers were performed on 284 patients. RESULTS A dose-dependent impact of KCNO on the SF was observed for both methods with the Helena V8 being more sensitive. The mean N was significantly higher on the Helena V8 as compared to the Sebia Capillarys 2 (2,972 vs. 444.1, p<0.0001). The SF correlated significantly with eGFR (r=0.50, p<0.0001), creatinine (r=-0.31, p<0.0001) and urea (r=-0.34, p<0.0001) on the Helena V8. On the Sebia Capillarys 2, a significant correlation was only observed with eGFR (r=0.17, p=0.004). A better discrimination between CKD stages was also observed using the Helena V8. CONCLUSIONS Thanks to a higher mean N, the Helena V8 might offer new possibilities, including detection of carbamylated albumin through SF calculation. Further studies are still needed to confirm the interest of using this type of assays in clinical routine.
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Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium.,Department of Pharmacy, Namur Research Institute for LIfes Sciences, University of Namur, Namur, Belgium
| | - Joris Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Gent, Belgium
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19
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De Bruyne S, Ommeslag D, Himpe J, Delanghe J, Van Den Abeele AM. On the nature of peculiar expectorated bronchial casts: Can infrared spectroscopy enlighten us? Clin Chim Acta 2021; 523:31-34. [PMID: 34481761 DOI: 10.1016/j.cca.2021.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/20/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bronchial casts can be defined as gelatinous structures originating from the airways. While several cases of bronchial cast formation have been reported in literature, unravelling its nature is often a difficult task. METHODS In this case report, we applied infrared (IR) spectroscopy on a bronchial cast fragment originating from a patient who suffered from a 2-y history of frequent coughing accompanied by the occasional expectoration of viscous and thick white-yellow bronchial-like structures. RESULTS Based on a markedly high lipid to protein ratio and presence of long-chain fatty acids, the resulting IR spectrum appeared to be very suggestive for chyloptysis. CONCLUSION Taking into account the patient's prior history of radiation therapy for a lymphoma complicated by congestive heart failure, we hypothesized that an impairment of adequate lymphatic flow into the venous system due to a combination of lymphatic obstruction and high venous pressures is the most plausible culprit.
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Affiliation(s)
- Sander De Bruyne
- Department of Laboratory Medicine, AZ Sint-Lucas, Ghent, Belgium.
| | - Dirk Ommeslag
- Department of Pulmonary and Infectious Diseases, AZ Sint-Lucas, Ghent, Belgium
| | - Jonas Himpe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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20
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Mulinganya GM, Claeys M, Balolebwami SZ, Bamuleke BA, Mongane JI, Boelens J, Delanghe J, De Vos D, Kambale RM, Maheshe GB, Mateso GM, Bisimwa GB, Malembaka EB, Vaneechoutte M, Cools P, Callens S. Etiology of Early-Onset Neonatal Sepsis and Antibiotic Resistance in Bukavu, Democratic Republic of the Congo. Clin Infect Dis 2021; 73:e976-e980. [PMID: 33575791 DOI: 10.1093/cid/ciab114] [Citation(s) in RCA: 3] [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: 08/03/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Democratic Republic of the Congo (DRC) has one of the highest neonatal death rates (between 14% and 28%) in the world. In the DRC, neonatal sepsis causes 15.6% of this mortality, but data on the bacterial etiology and associated drug susceptibility are lacking. METHODS Hemocultures of 150 neonates with possible early-onset neonatal sepsis (pEOS) were obtained at the Hôpital Provincial Général de Référence de Bukavu (Bukavu, DRC). The newborns with pEOS received an empirical first-line antimicrobial treatment (ampicillin, cefotaxime, and gentamicin) based on the synopsis of international guidelines for the management of EOS that are in line with World Health Organization (WHO) recommendations. Isolates were identified using matrix-assisted laser desorption/ ionization time-of-flight mass spectrophotometry. Antibiotic resistance was assessed using the disk diffusion method. RESULTS Fifty strains were obtained from 48 patients and identified. The 3 most prevalent species were Enterobacter cloacae complex (42%), Klebsiella pneumoniae (18%), and Serratia marcescens (12%). Enterobacter cloacae isolates were resistant to all first-line antibiotics. All K. pneumoniae and S. marcescens isolates were resistant to ampicillin, and the majority of the K. pneumoniae and half of the S. marcescens isolates were resistant to both cefotaxime and gentamicin. All E. cloacae complex strains, 89% of K. pneumoniae, and half of S. marcescens had an extended-spectrum ß-lactamase phenotype. CONCLUSIONS The most prevalent pathogens causing EOS in Bukavu were E. cloacae complex, K. pneumoniae, and S. marcescens. Most of these isolates were resistant to the WHO-recommended antibiotics.
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Affiliation(s)
- Guy M Mulinganya
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maud Claeys
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Serge Z Balolebwami
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Bertrand A Bamuleke
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Jules I Mongane
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Jerina Boelens
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Daniel De Vos
- Laboratory for Molecular and Cellular Technology, Burn Wound Center, Queen Astrid Military Hospital, Brussels, Belgium
| | - Richard M Kambale
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Ghislain B Maheshe
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Guy M Mateso
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Ghislain B Bisimwa
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Catholic University of Bukavu, School of Public Health, Democratic Republic of the Congo
| | - Espoir B Malembaka
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.,Catholic University of Bukavu, School of Public Health, Democratic Republic of the Congo
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Piet Cools
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Steven Callens
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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21
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Steenbeke M, Valkenburg S, Van Biesen W, Delanghe J, Speeckaert M, Glorieux G. MO460ASSOCIATION BETWEEN CARBAMYLATED ALBUMIN, GUT MICROBIOTA AND THEIR DERIVED METABOLITES IN CHRONIC KIDNEY DISEASE. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab090.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Chronic kidney disease (CKD) is characterized by gut dysbiosis. We recently demonstrated a decrease of short-chain fatty acid (SCFA) producing bacterial species with the progression of CKD. Besides, levels of protein-bound uremic toxins (PBUTs) and post-translational modifications of protein are increased in CKD, both are risk factors for accelerated cardiovascular morbidity and mortality. The link between the gut-kidney axis and protein carbamylation is unclear. The aim of the study was to explore the relation between carbamylated albumin, estimated by the albumin symmetry factor, and plasma levels of PBUTs, fecal levels of SCFAs (ongoing), and the abundance of related gut microbiota in different stages of CKD (1-5).
Method
The study cohort includes 103 non-dialyzed CKD patients (stages 1-5). Serum proteins were detected by capillary electrophoresis and UV absorbance at 214 nm with the symmetry factor as a marker of albumin carbamylation [the lower the symmetry factor, the more carbamylated albumin].
The quantification of PBUTs and SCFAs in plasma and fecal samples, respectively, using validated UPLC methods.
Results
The Pearson correlation coefficient (r) shows a positive correlation between the albumin symmetry factor and the estimated glomerular filtration rate (eGFR) (r=0.3025; p=0.0019).
The albumin symmetry factor correlates positively with the abundance of Butyricicoccus spp. (r= 0.3211; p=0.0009), Faecalibacterium prausnitzii (r=0.2765; p=0.0047) and Roseburia spp. (r=0.2527; p=0.0100) and negatively with the PBUTs, p-cresyl sulfate (pCS) (r=-0.2819; p=0.0039), p-cresyl glucuronide (pCG) (r=-0.2819; p=0.0039) and indoxyl sulfate (IxS) (r=-0.2650; p=0.0068).
Conclusion
The decreased abundance of SCFA producing gut bacteria with the progression of CKD can evoke unfavorable conditions in the gut. This can contribute to increased plasma levels of PBUTs potentially (indirectly) playing a role in albumin carbamylation. It will be further explored whether fecal levels of SCFAs are affected in parallel and could be potential targets to restore gut dysbiosis and uremia.
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Affiliation(s)
- Mieke Steenbeke
- Ghent University Hospital, Department of Internal Medicine and Pediatrics, Nephrology Unit, Gent, Belgium
| | - Sophie Valkenburg
- Ghent University Hospital, Department of Internal Medicine and Pediatrics, Nephrology Unit, Gent, Belgium
| | - Wim Van Biesen
- Ghent University Hospital, Department of Internal Medicine and Pediatrics, Nephrology Unit, Gent, Belgium
| | - Joris Delanghe
- Ghent University, Department of Diagnostic Sciences, Gent, Belgium
| | - Marijn Speeckaert
- Ghent University Hospital, Department of Internal Medicine and Pediatrics, Nephrology Unit, Gent, Belgium
- Research Foundation Flanders (FWO), Brussel, Belgium
| | - Griet Glorieux
- Ghent University Hospital, Department of Internal Medicine and Pediatrics, Nephrology Unit, Gent, Belgium
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22
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Varney M, Steyaert W, Coucke P, Delanghe J, Benovic J. G Protein‐Coupled Receptor Kinase 6 (GRK6) Regulation of Insulin Processing and Secretion. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.02961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Matthew Varney
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
| | - Wouter Steyaert
- Department of Human GeneticsRadboud Institute for Molecular Life SciencesNijmegen
- Center for Medical GeneticsRadboud Institute for Molecular Life SciencesNijmegen
| | - Paul Coucke
- Center for Medical GeneticsGhent University and Ghent University HospitalGhent
| | | | - Jeffrey Benovic
- Department of Biochemistry and Molecular BiologyThomas Jefferson UniversityPhiladelphiaPA
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23
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Vermassen T, Van Den Broeck A, Lumen N, Callewaert N, Rottey S, Delanghe J. Tissue N-linked glycosylation as potential prognostic biomarker for biochemical recurrence-free survival. Biomarkers 2021; 26:275-285. [PMID: 33657946 DOI: 10.1080/1354750x.2021.1891290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Only few biomarkers have been evaluated for their prognostic value following radical prostatectomy. We explored if tissue N-glycosylation shows prognostic properties for biochemical recurrence (BCR)-free survival. MATERIALS AND METHODS Tissue N-glycosylation profile was determined from 82 prostate cancer (PCa) patients and prognostic features were compared to clinical and biochemical parameters for BCR-free survival. RESULTS Majority presented with Gleason score 3 + 4 (41%), extensive local disease (62%) and without pelvic lymph nodes invasion (83%). Several parameters (low T stage, low Gleason score, low EAU risk groups for BCR, absence of positive surgical margins, high ratio of fucosylated triantennary structures on total of multiantennary structures [3AFc/MA], low ratio of fucosylated biantennary with core-branched N-acetylglucosamine on total of biantennary structures, and high ratio of triantennary structures on total of multiantennary structures) proved to have a univariate beneficial effect on BCR-free survival. Multivariate analysis proved positive surgical margins and 3AFc/MA to be independent prognosticators. CONCLUSIONS Tissue N-glycans are a powerful prognostic tool and can be an asset in PCa as the ratio of 3AFc/MA is independently associated with BCR-free survival. This could be of clinical use in guiding patients following radical prostatectomy, e.g. referral to adjuvant radiotherapy. Further elaboration of this biomarker is warranted.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | | | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Nico Callewaert
- Department for Molecular Biomedical Research, VIB-UGent Center for Medical Biotechnology, Ghent, Belgium
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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24
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Verougstraete N, Berth M, Vaneechoutte M, Delanghe J, Callewaert N. Interference of anti-streptavidin antibodies in immunoassays: a very rare phenomenon or a more common finding? Clin Chem Lab Med 2020; 58:1673-1680. [DOI: 10.1515/cclm-2019-1064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background
Anti-streptavidin antibodies (ASA) may cause analytical interference on certain immunoassay platforms. Streptavidin is purified from the non-pathogenic Streptomyces avidinii soil bacterium. In contrast to interference with biotin, ASA interference is supposed to be much rarer. In-depth studies on this topic are lacking. Therefore, we carried out an analysis toward the prevalence and the possible underlying cause of this interference.
Methods
Anti-streptavidin (AS)-immunoglobulin G (IgG) and AS-IgM concentrations were determined on multiple samples from two patients with ASA interference and on 500 random samples. On a subset of 100 samples, thyroid-stimulating hormone (TSH) was measured on a Cobas analyzer before and after performing a neutralization protocol which removes ASA. The relationship between the ratio of TSH after neutralization/TSH before neutralization and the ASA concentration was evaluated. Subsequently, an extract of S. avidinii colonies was analyzed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting.
Results
A positive correlation between AS-IgM concentrations and TSH ratio was obtained. Eight samples out of 500 exceeded the calculated AS-IgM cut-off value. In comparison to the AS-IgM concentrations in the population, titers from the two described cases clearly stood out. The isolated cases represent the end of a broader spectrum as there is a continuum of AS-IgM reactivity in the general population. We could not observe any differences in the immunoblot patterns between the cases and controls, which may indicate the general presence of ASA in the population.
Conclusions
Interference due to ASA is more prevalent than initially thought and is caused by IgM antibodies.
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Affiliation(s)
- Nick Verougstraete
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
- Clinical Laboratory , AZ Groeninge Hospital , Kortrijk , Belgium
| | - Mario Berth
- Immunology Department , Algemeen Medisch Laboratorium (AML) , Antwerp , Belgium
| | | | - Joris Delanghe
- Department of Diagnostic Sciences , Ghent University , Ghent , Belgium
| | - Nico Callewaert
- Clinical Laboratory , AZ Groeninge Hospital , Kortrijk , Belgium
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25
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Alwis US, Haddad R, Monaghan TF, Abrams P, Dmochowski R, Bower W, Wein AJ, Roggeman S, Weiss JP, Mourad S, Delanghe J, Everaert K. Impact of food and drinks on urine production: A systematic review. Int J Clin Pract 2020; 74:e13539. [PMID: 32441853 DOI: 10.1111/ijcp.13539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/14/2020] [Indexed: 12/09/2022] Open
Abstract
CONTEXT The impact of food and drinks on body fluid metabolism is of direct clinical relevance but current evidence remains fragmented. AIM Synthesise current evidence on the role of food and drinks in urine production. METHODS Systematic review as per PRISMA guidelines using MEDLINE and EMBASE databases (completed October 2019). Studies reporting on the effect of food, food constituents, and drinks on urine production were included. Two authors performed an independent extraction of relevant articles using predetermined data sets and completed quality-of-study indicators. RESULTS A total of 49 studies were included, of which 21 enroled human subjects, and 28 were clinically relevant animal studies (all of which utilised rodent models). The included studies were determined to be of variable quality. High dietary sodium, as well as wine, spirits, high-caffeine coffee, and caffeinated energy drinks, increased urine production in human studies. Decreased urine production was associated with low dietary sodium and consumption of milk, orange juice, and high-salt/high-sugar drinks. In animal models, a variety of fruits, vegetables, herbs, spices, and honey were associated with increased urine production. CONCLUSION Current evidence suggests that although several types of food and drinks may impact body fluid metabolism, the quality of the data is variable. Urine production appears to be influenced by multiple factors including composition (ie, moisture, macronutrients, and electrolytes), metabolite load, and the presence of specific diuresis-promoting substances (eg, caffeine, alcohol) and other bioactive phytochemicals. Future research is needed to support current evidence and the physiologic mechanisms underlying these findings.
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Affiliation(s)
- Upeksha S Alwis
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Rebecca Haddad
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
- Sorbonne Université, GRC 001, GREEN Groupe de recherche en Neuro-Urologie, AP-HP, Hôpital Rothschild, Paris, France
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Paul Abrams
- Department of Urology, Bristol Urological Institute, Bristol, UK
| | - Roger Dmochowski
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wendy Bower
- Department of Medicine and Community Care, University of Melbourne, Melbourne, Australia
| | - Alan J Wein
- Department of Urology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Saskia Roggeman
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sherif Mourad
- Department of Urology, Ain Shams University, Cairo, Egypt
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
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26
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Alwis US, Delanghe J, Dossche L, Walle JV, Van Camp J, Monaghan TF, Roggeman S, Everaert K. Could Evening Dietary Protein Intake Play a Role in Nocturnal Polyuria? J Clin Med 2020; 9:jcm9082532. [PMID: 32764521 PMCID: PMC7464190 DOI: 10.3390/jcm9082532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/20/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023] Open
Abstract
Urea is the most abundant and the largest contributing factor for urine osmolality. Urinary urea excretion is highly interrelated with dietary protein intake. Accordingly, an increase of urinary urea excretion due to high protein diet may lead to urea-induced osmotic diuresis. This study aims to explore the association between nocturnal polyuria (NP) and urea. This is a post hoc analysis of a prospective observational study of subjects who completed a renal function profile between October 2011 and February 2015 (n = 170). Each subject underwent a 24 h urine collection, which included 8 urine samples collected at 3 h intervals. Urine volume, osmolality, creatinine, urea and sodium were determined. Urinary urea excretion was used to estimate dietary protein intake. Compared to the control group, subjects with NP exhibited significantly higher nighttime urea and sodium excretion. Estimated evening dietary protein intake was correspondingly significantly higher amongst the NP subgroup. Nighttime diuresis rate was positively associated with age and nighttime free water clearance, creatinine clearance, sodium excretion, and urea excretion in NP subjects. Therefore, increased nocturnal urinary urea excretion may reflect an additional important mediator of nocturia owing to excess nocturnal urine production.
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Affiliation(s)
- Upeksha S. Alwis
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium;
- Correspondence:
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Lien Dossche
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (L.D.); (J.V.W.)
- Department of Pediatric Nephrology, Ghent University, 9000 Ghent, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (L.D.); (J.V.W.)
- Department of Pediatric Nephrology, Ghent University, 9000 Ghent, Belgium
| | - John Van Camp
- Department of Food Technology, Safety and Health, Ghent University, 9000 Ghent, Belgium;
| | - Thomas F. Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Saskia Roggeman
- Research and Policy Department, Psychiatric Center Sint-Jan-Baptist, 9060 Zelzate, Belgium;
| | - Karel Everaert
- Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium;
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27
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Lufungulo Bahati Y, Delanghe J, Bisimwa Balaluka G, Sadiki Kishabongo A, Philippé J. Asymptomatic Submicroscopic Plasmodium Infection Is Highly Prevalent and Is Associated with Anemia in Children Younger than 5 Years in South Kivu/Democratic Republic of Congo. Am J Trop Med Hyg 2020; 102:1048-1055. [PMID: 32124722 DOI: 10.4269/ajtmh.19-0878] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
One of the most important problems in controlling malaria is the limited access to effective and accurate diagnosis of malaria parasitemia. In the Democratic Republic of Congo (DRC), malaria is one of the leading causes of morbidity and mortality. The purpose of this study was to assess the prevalence of anemia and the relationship with asymptomatic submicroscopic Plasmodium infection. A cross-sectional study was carried out among 1,088 apparently healthy children aged between 6 and 59 months selected at random in the health zone of Miti Murhesa in South Kivu/DRC. Capillary blood was obtained for hemoglobin (Hb) concentration measurement by Hemocue® Hb 301. Malaria detection was performed by microscopy and the loop-mediated isothermal amplification (LAMP) assay. Anemia was defined as Hb < 11g/dL. We applied the chi-square test for comparisons, and multiple logistic regression was used to identify the risk factors for anemia and submicroscopic Plasmodium infection. The prevalence of anemia was 39.6%, and the prevalence of parasitemia was 15.9% and 34.0% using microscopy and LAMP test, respectively. Submicroscopic Plasmodium infection was found in 22.3% of the children. The independent risk factors for anemia are Plasmodium infection, children younger than 24 months, low middle-upper arm circumference, and history of illness two weeks before. Otherwise, children with submicroscopic malaria infection have a significantly increased risk for anemia, with a need of transfusion. The prevalence of malaria infection was underestimated, when microscopy was used to diagnose malaria. Children with low parasitemia detected by LAMP but not by microscopy showed a significantly increased prevalence of anemia.
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Affiliation(s)
- Yvette Lufungulo Bahati
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.,Department of Pediatrics, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | | | | | - Jan Philippé
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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28
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Mulinganya G, Balolebwami S, Zigabe S, Mongane J, Nianci I, Burume A, Hendwa E, Kampara F, Maheshe G, Sadiki Kishabongo A, Bisimwa G, Cools P, Speeckaert M, Callens S, Delanghe J. Evaluation of a turbidimetric C-reactive protein assay to monitor early-onset neonatal sepsis in South Kivu (Democratic Republic of the Congo). Clin Chem Lab Med 2020; 59:625-630. [PMID: 32374279 DOI: 10.1515/cclm-2020-0309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/12/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Neonatal sepsis, a condition defined as bacteremia within the first month of life accompanied by signs of systemic infection, is the most preventable cause of infant mortality in sub-Saharan Africa. Despite the development of new infection markers, C-reactive protein (CRP) is the most extensively studied acute phase reactant so far and the preferred index in many neonatal intensive care units (NICUs). The aim of the present study was to evaluate an affordable, non-commercial turbidimetric CRP assay for monitoring early-onset neonatal sepsis (EOS). METHODS A total of 148 neonates admitted at the NICU of the Hôpital Provincial Général de Référence de Bukavu to diagnose and to monitor EOS were enrolled in the study. CRP was assayed using a functional turbidimetric assay based on the interaction of CRP with phosphocholine containing particles (Intralipid®). RESULTS In total, 62/148 (41.9%) cases were identified as blood culture-proven EOS. Different serum CRP slopes were observed among the different birth weight categories. Moreover, the serum (CRP 48 h-CRP 12 h) difference and the birth weight predicted the outcome of these septic newborns. CONCLUSIONS Our turbidimetric CRP assay is a potential novel tool that can be used in the management of EOS in sub-Saharan Africa. The simplicity of the assay and the extremely low price make the CRP method very well suited for developing countries.
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Affiliation(s)
- Guy Mulinganya
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Serge Balolebwami
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Serge Zigabe
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Jules Mongane
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Isia Nianci
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Adrien Burume
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Erick Hendwa
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Freddy Kampara
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Ghislain Maheshe
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Antoine Sadiki Kishabongo
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Ghislain Bisimwa
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo
- Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Marijn Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Steven Callens
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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29
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Depypere H, Dierickx A, Vandevelde F, Stanczyk F, Ottoy L, Delanghe J, Lapauw B. A randomized trial on the effect of oral combined estradiol and drospirenone on glucose and insulin metabolism in healthy menopausal women with a normal oral glucose tolerance test. Maturitas 2020; 138:36-41. [PMID: 32631586 DOI: 10.1016/j.maturitas.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/18/2020] [Revised: 04/04/2020] [Accepted: 04/13/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Menopause is often associated with a central accumulation of body fat. This provokes insulin resistance. The resulting hyperinsulinemia may increase the risk of diabetes, cardiovascular disease and breast cancer. Long-term studies indicate that menopausal hormone therapy (MHT) reduces insulin resistance. To broaden knowledge of the mechanisms behind the influence of MHT on glucose homeostasis we focused on the direct short-term effects of MHT with oral combined estradiol and drospirenone on glucose and insulin metabolism in healthy postmenopausal women. METHODS This randomized, placebo-controlled study recruited 80 healthy postmenopausal women. Women were randomized to treatment with estradiol 1 mg continuously combined with drospirenone 2 mg or placebo for 6-8 weeks. All participants underwent an oral glucose tolerance test (OGTT) before and after the treatment period. Glucose, insulin, fructosamine and C-peptide levels were measured in serum before and 30, 60, 90, 120 and 150 min after a 75-gram oral glucose challenge. RESULTS After intervention, significantly higher glucose levels at 120 min (p < 0.024) and 150 min (p < 0.030) were observed in the MHT group compared with the placebo group. These glucose levels remained within the normal range. A significantly lower insulin peak serum level (p < 0.040) and a non-significantly smaller area under the curve (AUC) for insulin levels (p = 0.192) was observed in the MHT group at the end of the study period relative to baseline. No significant change in the insulin AUC in the placebo group was observed. There were no significant differences in fructosamine, HOMA-IR and C-peptide levels between the MHT group and the placebo group. CONCLUSION This double-blind randomized study (EC/2008/694) indicates that treating healthy, postmenopausal women with 1 mg estradiol continuously combined with 2 mg drospirenone significantly decreases peak insulin levels and increases peak glucose levels during an OGTT compared to placebo. These glucose levels remained within the normal range.
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Affiliation(s)
- H Depypere
- Breast and Menopause Clinic, Ghent University Hospital, Ghent, Belgium.
| | - A Dierickx
- Breast and Menopause Clinic, Ghent University Hospital, Ghent, Belgium
| | - F Vandevelde
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - F Stanczyk
- Departments of Obstetrics and Gynecology, and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - L Ottoy
- Breast and Menopause Clinic, Ghent University Hospital, Ghent, Belgium
| | - J Delanghe
- Department Clinical Chemistry, Ghent University Hospital, Ghent, Belgium
| | - B Lapauw
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
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Oyaert M, Heireman L, Delanghe J. Potentially Confounding Variables in the Validation of Hospital Pneumatic Tube Systems. J Appl Lab Med 2020; 5:422-423. [PMID: 32445375 DOI: 10.1093/jalm/jfz009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Laura Heireman
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
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Somer FD, Ceelen W, Delanghe J, Smet DD, Vanackere M, Pattyn P, Mortier E. Severe Hyponatremia, Hyperglycemia, and Hyperlactatemia Are Associated with Intraoperative Hyperthermic Intraperitoneal Chemoperfusion with Oxaliplatin. Perit Dial Int 2020. [DOI: 10.1177/089686080802800111] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Since the introduction of surgical debulking in combination with intraoperative hyperthermic intra-peritoneal chemoperfusion (HIPEC) with oxaliplatin in our institution, severe hyponatremia (sodium: 126.5 ± 3.8 mmol/L), hyperglycemia (glucose: 22.37 ± 4.89 mmol/L), and hyperlactatemia (lactate: 3.17 ± 1.8 mmol/L) have been observed post HIPEC. This metabolic disorder was not observed in patients in whom cisplatin or mitomycin C was used as a chemotherapeutic drug. Methods In order to understand the pathophysiology of this finding, an analysis of our data was made. In a first analysis, plasma sodium was corrected for hyperglycemia based on the formula of Hillier. In a second analysis, the influence of total exchangeable sodium, total exchangeable potassium, and total body water on plasma sodium concentration was modeled. Results Analysis of our data revealed a double mechanism for the observed metabolic disorder: hyperglycemia caused by dextrose 5%, which is used as a carrier for the oxaliplatin, and major loss of sodium into the dialysate (256.7 ± 68.7 mmol). Conclusion Better control of hyperglycemia and intravenous compensation of sodium loss into the dialysate can attenuate the reported biochemical disturbance.
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Affiliation(s)
- Filip De Somer
- Departments of Cardiac Surgery, University Hospital Ghent, Ghent, Belgium
| | - Wim Ceelen
- Abdominal Surgery, University Hospital Ghent, Ghent, Belgium
| | - Joris Delanghe
- Central Laboratory, University Hospital Ghent, Ghent, Belgium
| | - Dirk De Smet
- Departments of Cardiac Surgery, University Hospital Ghent, Ghent, Belgium
| | - Martin Vanackere
- Departments of Cardiac Surgery, University Hospital Ghent, Ghent, Belgium
| | - Piet Pattyn
- Abdominal Surgery, University Hospital Ghent, Ghent, Belgium
| | - Eric Mortier
- Anaesthesia, University Hospital Ghent, Ghent, Belgium
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Steenbeke M, De Bruyne S, Van Aken E, Glorieux G, Van Biesen W, Himpe J, De Meester G, Speeckaert M, Delanghe J. UV Fluorescence-Based Determination of Urinary Advanced Glycation End Products in Patients with Chronic Kidney Disease. Diagnostics (Basel) 2020; 10:diagnostics10010034. [PMID: 31936498 PMCID: PMC7168138 DOI: 10.3390/diagnostics10010034] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 11/26/2019] [Revised: 12/27/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
Advanced glycation end products (AGEs) are a class of proteins or lipids that are non-enzymatically glycated and oxidized after contact with aldose sugars. The accumulation of AGEs results in carbonyl stress, which is characteristic for diabetes mellitus, uremia, atherosclerosis and vascular dysfunction. In recent decades, several innovative methods have been developed to measure the concentration of AGEs in blood or urine. In the present study, we evaluated the use of UV fluorescence as an alternative tool to detect urinary AGEs in four groups of well characterized chronic kidney disease (CKD) patients over a wide range of kidney insufficiency and in a group of healthy subjects. Using an excitation wavelength of 365 nm, the fluorescence spectra of urinary AGEs were recorded in the 400–620 nm emission range. When considering the emission peaks at 440 nm and 490 nm, a significantly higher AGE-specific fluorescence intensity was detected in CKD patients compared to healthy subjects (p < 0.0001 and p = 0.0001, respectively). The urinary creatinine adjusted fluorescence emission spectra in the group of CKD patients with diabetes mellitus were comparable with those of CKD patients without diabetes mellitus. Creatinine-adjusted fluorescence emission spectra were highest in CKD patients with proteinuria, moderate in CKD patients without proteinuria and lowest in healthy controls (p < 0.0001 at both emission wavelengths). In a multiple regression analysis, age, CRP and insulin treatment were predictors of fluorescence intensity at the emission wavelength of 440 nm. Age and insulin treatment were predictors at 490 nm. The presented method is a simple, cheap, alternative method to monitor the AGE-load in the CKD population.
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Affiliation(s)
- Mieke Steenbeke
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium; (M.S.); (G.G.); (W.V.B.)
| | - Sander De Bruyne
- Department of Laboratory Medicine, Clinical Chemistry, Ghent University Hospital, 9000 Ghent, Belgium; (S.D.B.); (J.H.); (G.D.M.)
| | - Elisabeth Van Aken
- Department of Ophthalmology, Sint-Elisabeth Ziekenhuis, 9620 Zottegem, Belgium;
| | - Griet Glorieux
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium; (M.S.); (G.G.); (W.V.B.)
| | - Wim Van Biesen
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium; (M.S.); (G.G.); (W.V.B.)
| | - Jonas Himpe
- Department of Laboratory Medicine, Clinical Chemistry, Ghent University Hospital, 9000 Ghent, Belgium; (S.D.B.); (J.H.); (G.D.M.)
| | - Gilles De Meester
- Department of Laboratory Medicine, Clinical Chemistry, Ghent University Hospital, 9000 Ghent, Belgium; (S.D.B.); (J.H.); (G.D.M.)
| | - Marijn Speeckaert
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium; (M.S.); (G.G.); (W.V.B.)
- Research Foundation Flanders, 1000 Brussels, Belgium
- Correspondence: ; Tel.: +32-933-245-09; Fax: +32-933-238-47
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, Belgium;
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Oyaert M, Delanghe J, Van den Bossche J, Ghys T, Stove V. Non-linearity in commercially available lipase assays: still gaps to close. Clin Chem Lab Med 2019; 58:e21-e23. [DOI: 10.1515/cclm-2019-0587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/21/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine , Ghent University Hospital , C. Heymanslaan 10 , Ghent 9000 , Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
| | - Jan Van den Bossche
- Department of Laboratory Medicine , Antwerp University Hospital , Antwerp , Belgium
| | - Timothy Ghys
- Department of Laboratory Medicine , AZ Sint-Lucas , Ghent , Belgium
| | - Veronique Stove
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
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Vercauteren KOA, Lambrecht S, Delanghe J. Preanalytical classical and alternative complement pathway activity loss. Biochem Med (Zagreb) 2019; 29:030701. [PMID: 31379459 PMCID: PMC6610672 DOI: 10.11613/bm.2019.030701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/07/2019] [Accepted: 05/17/2019] [Indexed: 12/25/2022] Open
Abstract
Introduction Complement functional analyses provide insight into the integrity of the entire complement reaction cascade. These tests are suitable for investigating suspected complement deficiencies. Falsely reduced test outcomes may result from preanalytical instabilities of individual complement components. To generate rationale for this or potential alternative practices, this study aimed to extend the knowledge on the preanalytical stability of widely used tests to screen the complement system. We assessed the influence of time, temperature and EDTA on classical (CH50) and alternative pathway (AP50) functional assay test results. Materials and methods We used nephelometric (C3d) and immunofixation (C3c) techniques to support the investigation of the preanalytical phase of basic complement system activity tests. Quantitative determination of classical and alternative pathway function was performed with a haemolytic activity assay and a C5b-9 neo-epitope ELISA-based assay respectively. Blood of five healthy volunteers was sampled and complement components allowed to degrade under different conditions. Results CH50 and AP50 remain stable for approximately one week in serum samples incubated on ice. CH50 activity decreased almost twice as fast in EDTA plasma compared to serum at room temperature. AP50 activity contrastingly, decreased twice as slow in EDTA plasma compared to serum at room temperature. Conclusion Serum on ice remains the preferred specimen for functional complement analyses. In the absence of serum transported on ice, serum kept at room temperature (not exceeding 24h) is suitable for classical and alternative pathway analyses. For alternative pathway analyses specifically, the C3-stabilising effect of EDTA allows for the extended use of EDTA plasma (not over 4 days). In these conditions, at least 85% of baseline complement activity remains.
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Affiliation(s)
| | - Stijn Lambrecht
- Department of clinical chemistry, Ghent University Hospital, Belgium
| | - Joris Delanghe
- Department of clinical chemistry, Ghent University Hospital, Belgium
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Alwis US, Roggeman S, Monaghan TF, Denys MA, Everaert K, Delanghe J. Haptoglobin 1-1 phenotype: A risk factor for 24-hours polyuria. Int J Clin Pract 2019; 73:e13419. [PMID: 31508879 DOI: 10.1111/ijcp.13419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Haptoglobin (Hp) displays three major phenotypes (Hp 1-1, Hp 2-2 and Hp 2-1). Hp 1-1 has been implicated in high blood pressure and salt sensitivity, and thus may mediate excess urine production. AIM To explore the relationship between Hp polymorphisms and polyuria (>40 mL/kg/24 hours). METHODOLOGY Post hoc analysis of a prospective observational study of subjects who completed a renal function profile between October 2011 and February 2015 (n = 170). Hp phenotypes were determined by starch gel electrophoresis using haemoglobin-supplemented serum. The distribution of Hp phenotypes in subjects with and without polyuria was compared to a reference group of the same geography and ethnic composition. Diuresis rate, sodium clearance and free water clearance were compared within and between phenotypes. RESULTS The Hp1 allele frequency was significantly overexpressed in subjects with polyuria compared to the reference group (0.500 vs 0.400, P < .05). Consistently, the Hp 1-1 phenotype was more prevalent in subjects with polyuria compared to the reference group (28% vs 16%, P < .05). In contrast to Hp 2-1/2-2, Hp 1-1 demonstrated no circadian variation in diuresis rate, sodium clearance or free water clearance. A significant association between plasma Hp concentration and 24-hours sodium clearance was observed in Hp 1-1 subjects without polyuria (β = 0.222; 95% CI 0.003-0.441; P = .047). CONCLUSION The Hp1 allele was more frequent in subjects with polyuria, and participants with the Hp 1-1 phenotype were at greater risk for polyuria. Hp 1-1 subjects demonstrated an altered ability to concentrate urine with a slower continuous excretion of sodium throughout the day. Plasma Hp concentration of Hp 1-1 was positively correlated with 24-hours sodium clearance in subjects without polyuria.
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Affiliation(s)
- Upeksha S Alwis
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Saskia Roggeman
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Thomas F Monaghan
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Marie-Astrid Denys
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent, Belgium
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Vermassen T, Geboes K, De Man M, Laurent S, Decoene E, Lumen N, Delanghe J, Rottey S. Neither creatinine- nor cystatin C-estimated glomerular filtration rate is optimal in oncology patients treated with targeted agents. Nephrol Dial Transplant 2019; 33:402-408. [PMID: 28482048 DOI: 10.1093/ndt/gfx063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/10/2017] [Indexed: 02/06/2023] Open
Abstract
Background In the last decade, there has been an increase in the use of anti-angiogenic drugs as treatment for metastatic malignancies. However, use of these targeted therapies could induce both glomerular and tubular damage. Also during targeted therapy, the lysosomal protease cathepsin D is released from the tumour, which is inhibited by the protease inhibitor cystatin C. The aim of this study is to determine if use of cystatin C-estimated glomerular filtration rate (eGFR) is applicable to a patient cohort treated with targeted agents. Methods A cohort of 80 patients with various malignancies were continuously recruited and prospectively analysed. Serum and urinary biochemical analytes for renal toxicities were assessed at different time points during treatment. The association between serum cystatin C and cathepsin D was also determined. Results A decrease in serum cystatin C concentrations (1.03 versus 0.90 mg/L; P < 0.001), together with an increase in cystatin C-eGFR (71 versus 89 mL/min/1.73 m2; P = 0.002) was observed during therapy, compared with baseline. This decrease in cystatin C concentrations was correlated with cathepsin D (r = 0.307; P < 0.001), which was released from the tumour during targeted therapy. Further analysis demonstrated cathepsin D-mediated proteolysis of cystatin C in serum. Conclusions Cystatin C concentrations were decreased during targeted therapy due to cathepsin D-mediated proteolysis. Cystatin C-eGFR is therefore not considered a suitable marker for assessing kidney function in oncology patients, and other techniques to estimate the GFR have to be applied in this patient population.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Karen Geboes
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Marc De Man
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Stéphanie Laurent
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Elsie Decoene
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
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Verbeke F, Lambrecht S, Lecocq E, Parez JJ, Delanghe J. Increased C-reactive protein values in the absence of inflammation: monoclonal immunoglobulin interference in immunonephelometry. ACTA ACUST UNITED AC 2019; 57:e311-e313. [DOI: 10.1515/cclm-2019-0398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/11/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Frederick Verbeke
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
| | - Stijn Lambrecht
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
| | - Elke Lecocq
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium
| | - Jean-Jacques Parez
- Department of Laboratory Medicine , Centre Hospitalier de Wallonie , Tournai , Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine , Ghent University Hospital , Ghent , Belgium , Phone: +329 332 29 56, Fax: +329 332 49 85
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Verougstraete N, Callewaert N, Berth M, Vaneechoutte M, Lecocq E, Delanghe J. Exploring anti-streptavidin antibodies interference. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vermassen T, De Bruyne S, Himpe J, Lumen N, Callewaert N, Rottey S, Delanghe J. N-Linked Glycosylation and Near-Infrared Spectroscopy in the Diagnosis of Prostate Cancer. Int J Mol Sci 2019; 20:ijms20071592. [PMID: 30934974 PMCID: PMC6479798 DOI: 10.3390/ijms20071592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/21/2019] [Accepted: 03/23/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Performing a prostate biopsy is the most robust and reliable way to diagnose prostate cancer (PCa), and to determine the disease grading. As little to no biochemical markers for prostate tissue exist, we explored the possibilities of tissue N-glycosylation and near-infrared spectroscopy (NIR) in PCa diagnosis. Methods: Tissue specimens from 100 patients (benign prostate hyperplasia (BPH), n = 50; and PCa, n = 50) were obtained. The fresh-frozen tissue was dispersed and a tissue N-glycosylation profile was determined. Consequently, the formalin-fixed paraffin-embedded slides were analyzed using NIR spectroscopy. A comparison was made between the benign and malignant tissue, and between the various Gleason scores. Results: A difference was observed for the tissue of N-glycosylation between the benign and malignant tissue. These differences were located in the fycosylation ratios and the total amount of bi- and tetra-antennary structures (all p < 0.0001). These differences were also present between various Gleason scores. In addition, the NIR spectra revealed changes between the benign and malignant tissue in several regions. Moreover, spectral ranges of 1055–1065 nm and 1450–1460 nm were significantly different between the Gleason scores (p = 0.0042 and p = 0.0195). Conclusions: We have demonstrated biochemical changes in the N-glycan profile of prostate tissue, which allows for the distinction between malignant and benign tissue, as well as between various Gleason scores. These changes can be correlated to the changes observed in the NIR spectra. This could possibly further improve the histological assessment of PCa diagnosis, although further method validation is needed.
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Affiliation(s)
- Tijl Vermassen
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Sander De Bruyne
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
| | - Jonas Himpe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
| | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Nico Callewaert
- Unit for Medical Biotechnology, Inflammation Research Center, VIB⁻Ghent University, 9052 Zwijnaarde, Belgium.
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Joris Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, 9000 Ghent, Belgium.
- Department of Clinical Chemistry, Ghent University Hospital, 9000 Ghent, Belgium.
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De Bruyne S, Speeckaert R, Boelens J, Hayette M, Speeckaert M, Delanghe J. 红外光谱和甲真菌病. Br J Dermatol 2019. [DOI: 10.1111/bjd.17562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Bruyne S, Speeckaert R, Boelens J, Hayette M, Speeckaert M, Delanghe J. Infrared spectroscopy and onychomycosis. Br J Dermatol 2019. [DOI: 10.1111/bjd.17546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brochez L, Speeckaert R, De Bacquer D, Delanghe J, Hoorens I. Haptoglobin polymorphism and the risk of actinic keratoses and cutaneous squamous cell carcinoma: A case-control study. J Dermatol 2019; 46:274-275. [PMID: 30614562 DOI: 10.1111/1346-8138.14751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Lieve Brochez
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
| | | | - Dirk De Bacquer
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Joris Delanghe
- Department of Clinical Biology, University Hospital Ghent, Ghent, Belgium
| | - Isabelle Hoorens
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
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Fogazzi G, Delanghe J. Microscopic examination of urine sediment: Phase contrast versus bright field. Clin Chim Acta 2018; 487:168-173. [DOI: 10.1016/j.cca.2018.09.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
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Abstract
New technological advances have paved the way for significant progress in automated urinalysis. Quantitative reading of urinary test strips using reflectometry has become possible, while complementary metal oxide semiconductor (CMOS) technology has enhanced analytical sensitivity and shown promise in microalbuminuria testing. Microscopy-based urine particle analysis has greatly progressed over the past decades, enabling high throughput in clinical laboratories. Urinary flow cytometry is an alternative for automated microscopy, and more thorough analysis of flow cytometric data has enabled rapid differentiation of urinary microorganisms. Integration of dilution parameters (e.g., creatinine, specific gravity, and conductivity) in urine test strip readers and urine particle flow cytometers enables correction for urinary dilution, which improves result interpretation. Automated urinalysis can be used for urinary tract screening and for diagnosing and monitoring a broad variety of nephrological and urological conditions; newer applications show promising results for early detection of urothelial cancer. Concomitantly, the introduction of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) has enabled fast identification of urinary pathogens. Automation and workflow simplification have led to mechanical integration of test strip readers and particle analysis in urinalysis. As the information obtained by urinalysis is complex, the introduction of expert systems may further reduce analytical errors and improve the quality of sediment and test strip analysis. With the introduction of laboratory-on-a-chip approaches and the use of microfluidics, new affordable applications for quantitative urinalysis and readout on cell phones may become available. In this review, we present the main recent developments in automated urinalysis and future perspectives.
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Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Joris Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
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De Bruyne S, Speeckaert R, Boelens J, Hayette MP, Speeckaert M, Delanghe J. Infrared spectroscopy as a novel tool to diagnose onychomycosis. Br J Dermatol 2018; 180:637-646. [PMID: 30216405 DOI: 10.1111/bjd.17199] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The determination of causative organisms of onychomycosis is still not optimal. There remains a need for a cheap, fast and easy-to-perform diagnostic tool with a high capacity to distinguish between organisms. OBJECTIVES To determine whether attenuated total-reflectance Fourier transform infrared (ATR-FTIR) spectroscopy can detect and differentiate causative agents in culture-based, ex vivo nail and in vivo nail models. METHODS A methodological study was conducted. Both the ex vivo nail model and in vivo pilot study were carried out in an academic university hospital. RESULTS Analysis of cultured fungi revealed spectral differences for dermatophytes (1692-1606 and 1044-1004 cm-1 ) and nondermatophytes and yeasts (973-937 cm-1 ), confirmed by dendrograms showing an excellent separation between samples from different genera or species. Exploration of dermatophytes, nondermatophytes and yeasts growing on ex vivo nails exposed prominent differences from 1200 to 900 cm-1 . Prediction models resulted in a 96·9% accurate classification of uninfected nails and nails infected with dermatophytes, nondermatophytes and yeasts. Overall correct classification rates of 91·0%, 97·7% and 98·6% were obtained for discrimination between dermatophyte, nondermatophyte and yeast genera or species, respectively. Spectra of in vivo infected and uninfected nails also revealed distinct spectral differences (3000-2811 cm-1 , 1043-950 cm-1 and 1676-1553 cm-1 ), illustrated by two main clusters (uninfected vs. infected) on a dendrogram. CONCLUSIONS Our data suggest that ATR-FTIR spectroscopy may be a promising, fast and accurate method to determine onychomycosis, including identification of the causative organism, bypassing the need for lengthy fungal cultures.
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Affiliation(s)
- S De Bruyne
- Department of Laboratory Medicine, Ghent University, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium
| | - R Speeckaert
- Department of Dermatology, Ghent University, Ghent, Belgium
| | - J Boelens
- Department of Laboratory Medicine, Ghent University, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium
| | - M-P Hayette
- Department of Clinical Microbiology, CHU Sart-Tilman, Liège, Belgium
| | - M Speeckaert
- Department of Nephrology, Ghent University, Ghent, Belgium
| | - J Delanghe
- Department of Laboratory Medicine, Ghent University, Ghent, Belgium.,Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium
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Van Biervliet S, Hauser B, Verhulst S, Stepman H, Delanghe J, Warzee JP, Pot B, Vandewiele T, Wilschanski M. Probiotics in cystic fibrosis patients: A double blind crossover placebo controlled study: Pilot study from the ESPGHAN Working Group on Pancreas/CF. Clin Nutr ESPEN 2018; 27:59-65. [PMID: 30144894 DOI: 10.1016/j.clnesp.2018.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 01/11/2018] [Revised: 04/25/2018] [Accepted: 06/22/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND A potential positive effect of probiotics in cystic fibrosis (CF) on fecal calprotectin (FCP), pulmonary exacerbations and weight has been described in small controlled trials. METHODS A double-blind multicenter cross-over study (2 × 4 m) was performed looking at abdominal pain, nutritional status, pulmonary function, pulmonary exacerbation, FCP and lactulose/mannitol gut permeability test. Patients kept a diary with daily scoring of abdominal pain, stool frequency and consistency as well as treatment changes. RESULTS 31 CF patients entered the study of which 25 finished it. At start patients aged 9.3yrs (6.9-12.2), had a median BMI z-score of -0.5 (-1.5-0.08), height z-score of -0.4 (-1.1-0.05) and FEV1% of 100% (87.2-106.6). Median FCP at start was 61 μg/g (17-108) and gut permeability 0.079 (0.051-0.122). No significant changes were observed in the clinical parameters (BMI, FEV1%, abdominal pain, exacerbations). Despite being frequently abnormal (17/28 (61%) >50 mg/kg), FCP did not change significantly with probiotics. The proportion of patients with normal permeability was 8% during placebo and 32% during probiotic treatment (p = 0.031). FCP correlated to BMI z-score (p = 0.043) and gut permeability to abdominal pain (p = 0.015). The microbiome revealed a high predominance of Actinobacteria and Proteobacteriae. Probiotic supplementation did not result in a shift at the phylum nor at phylogenetic level. CONCLUSION Normalization of gut permeability was observed in 13% of patients during probiotic treatment. However, none of the previously described effects could be confirmed.
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Affiliation(s)
| | - Bruno Hauser
- Vrije Universiteit Brussel, Pediatric Gastroenterology, CF Centre, Brussels, Belgium
| | - Stijn Verhulst
- Antwerp University, Pediatric Pulmonology, CF Centre, Antwerp, Belgium
| | - Hedwig Stepman
- Ghent University Hospital, Laboratory of Clinical Chemistry, Microbiology and Immunology, Ghent, Belgium
| | - Joris Delanghe
- Ghent University Hospital, Laboratory of Clinical Chemistry, Microbiology and Immunology, Ghent, Belgium
| | | | - Bruno Pot
- Vrije Universiteit Brussel, Research Group of Industrial Microbiology and Food Biotechnology, Brussels, Belgium
| | | | - Michael Wilschanski
- Hadassah University Hospitals, Pediatric Gastroenterology, CF Centre, Jerusalem, Israel
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Lauwens S, Costas-Rodríguez M, Delanghe J, Van Vlierberghe H, Vanhaecke F. Quantification and isotopic analysis of bulk and of exchangeable and ultrafiltrable serum copper in healthy and alcoholic cirrhosis subjects. Talanta 2018; 189:332-338. [PMID: 30086927 DOI: 10.1016/j.talanta.2018.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/01/2018] [Accepted: 07/05/2018] [Indexed: 02/07/2023]
Abstract
Information on the Cu speciation in blood serum can be valuable for a better understanding of the metabolism of this essential transition metal, but Cu speciation analysis and, to an even larger extent, compound-specific high-precision Cu isotopic analysis are challenging. In this work, quantification and isotopic analysis of Cu were carried out in bulk serum and in both its exchangeable + ultrafiltrable (EXCH + UF) Cu fraction and its non-exchangeable + non-ultrafiltrable (NEXCH + NUF) fraction using quadrupole and multi-collector ICP-mass spectrometry, respectively. The EXCH + UF serum Cu represents the labile Cu pool, i.e. Cu loosely bound to proteins, such as albumin, alpha-2 macroglobulin and other low molecular weight compounds, while the NEXCH + NUF serum Cu contains the Cu firmly bound to ceruloplasmin (Cp). The method was evaluated using human, goat and fetal bovine serum and applied to serum samples from assumed healthy subjects and from patients with alcoholic liver cirrhosis (AC). The healthy subjects showed an isotopic composition of EXCH + UF serum Cu heavier (by on average + 0.4‰) than that of their total serum Cu. In general, patients with AC showed higher EXCH + UF serum Cu concentrations and significantly lower δ65CuEXCH+UF and δ65Cuserum values than did healthy subjects. Within the AC population, δ65CuEXCH+UF values were comparable to or lower than the corresponding δ65Cuserum values, potentially reflecting the extent of labile Cu deregulation. As to be expected, the NEXCH + NUF serum Cu isotopic composition was similar to that of the total serum Cu, as most of the serum Cu is firmly bound to Cp.
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Affiliation(s)
- Sara Lauwens
- Ghent University, Department of Chemistry, Atomic and Mass Spectrometry (A&MS) Research Unit, Campus Sterre, Krijgslaan 281-S12, 9000 Ghent, Belgium
| | - Marta Costas-Rodríguez
- Ghent University, Department of Chemistry, Atomic and Mass Spectrometry (A&MS) Research Unit, Campus Sterre, Krijgslaan 281-S12, 9000 Ghent, Belgium
| | - Joris Delanghe
- Ghent University, Department of Clinical Chemistry, Microbiology and Immunology, Campus UZ Gent, De Pintelaan 185-P8, 9000 Ghent, Belgium
| | - Hans Van Vlierberghe
- Ghent University Hospital, Department of Gastroenterology and Hepatology, Campus UZ Gent, De Pintelaan 185-1K12IE, 9000 Ghent, Belgium
| | - Frank Vanhaecke
- Ghent University, Department of Chemistry, Atomic and Mass Spectrometry (A&MS) Research Unit, Campus Sterre, Krijgslaan 281-S12, 9000 Ghent, Belgium.
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Heireman L, Stroobants J, Uyttenbroeck W, Goossens Y, Dreezen C, Luyts D, Broeck LVD, Delanghe J, Heylen E, Mahieu B. Smartphone Application Monitoring of Acceleration Forces During Pneumatic Tube System Transport of Emergency Department Patient Samples. Clin Lab 2018; 64:1297-1304. [PMID: 30146841 DOI: 10.7754/clin.lab.2018.180325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The use of pneumatic tube system (PTS) transport has gained considerable popularity in modern hospitals but is also associated with sample hemolysis. The potential contribution of PTS-associated acceleration forces to high hemolysis rates observed in the emergency department (ED) has not been investigated before and can be easily examined nowadays using smartphone applications. The first aim of our study was to investigate whether our PTS induces hemolysis of patient samples obtained from our ED. We also explored a potential correlation between hemolysis index (HI) on the one hand and acceleration forces during PTS transport or other potential causes of hemolysis related to patient characteristics on the other for two different blood sampling techniques. METHODS Blood samples from 100 ED patients were collected in one Sarstedt S-Monovette® serum tube (PTStransported to laboratory) and two BD Vacutainer® serum tubes (one PTS-transported and one hand-carried). For all serum samples HI was measured. A smartphone was sent along with the samples in order to register accelerations during transport. Patient's erythrocyte sedimentation rate (ESR), mean corpuscular volume (MCV), hematocrit, total cholesterol, low density lipoprotein (LDL), and high-density lipoprotein (HDL) concentration were determined as well. RESULTS Hemolysis rate was only 1 - 4% and 5% for PTS and hand-carried transport, respectively. Calculated acceleration vector sums for PTS transport from the ED to laboratory reached up to 131.49 m/second2 (13.40 g). No correlation could be demonstrated between HI on the one hand and acceleration forces acting on the samples during PTS transport or ESR, MCV, hematocrit, and HDL concentration on the other. However, an inverse correlation was noted between HI and cholesterol (total and LDL) concentration in serum tubes transported via PTS, though not in those carried by hand. CONCLUSIONS We demonstrated that our PTS does not induce or contribute to hemolysis of ED patient samples, even at high acceleration vector sums up to 13 g. Technological advancements such as the development of smartphone applications offer the ability to regularly monitor acceleration forces during PTS transport of patient samples. Low total cholesterol and LDL concentrations may affect the erythrocyte membrane fluidity, making erythrocytes more prone to hemolysis.
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Delanghe S, Speeckaert M, De Bruyne S, Delanghe J. On the nature of toenail opacities in renal insufficiency. Clin Exp Nephrol 2018; 23:146-147. [PMID: 29730728 DOI: 10.1007/s10157-018-1576-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Sigurd Delanghe
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | | | - Sander De Bruyne
- Department of Clinical Chemistry, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Joris Delanghe
- Department of Clinical Chemistry, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
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50
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Vanholder R, Van Landschoot N, Waterloos M, Delanghe J, Van Maele G, Ringoir S. Phagocyte Metabolic Activity during Hemodialysis with Different Dialyzers Not Affecting the Number of Circulating Phagocytes. Int J Artif Organs 2018. [DOI: 10.1177/039139889201500205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Overall leukocyte counts decrease during certain forms of hemodialysis, but little information is available on the intradialytic evolution of phagocytic metabolic function, especially during dialysis with dialyzers not affecting the number of circulating phagocytes. This study evaluated the phagocytic capacity of granulocytes and monocytes to generate CO2 out of glucose under basic unchallenged conditions and after stimulation with latex or zymosan, before and after 15, 60 and 240 minutes of dialysis with reused cuprophan, AN69S, polysulphone, polymethylmethacrylate and hemophan hemodialyzers. Phagocytic metabolic function was assessed in whole blood on the basis of 14CO2-production from labelled glucose during the phagocytic process. There were no changes in basic unchallenged CO2-production with any of the dialyzers. Reactivity to latex and zymosan, expressed per number of phagocytes, showed no decrease, irrespective of the membrane type. For polymethylmethacrylate and reused cuprophan, a slight but significant increase in metabolic reactivity was observed in response to latex and zymosan. The test employed may give a screening picture of the phagocytic reaction to contact with dialyzers and membranes and thus of their degree of biocompatibility towards the phagocyte system.
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Affiliation(s)
- R. Vanholder
- Clinical Biology, University Hospital, De Pintelaan, Ghent - Belgium
| | - N. Van Landschoot
- Clinical Biology, University Hospital, De Pintelaan, Ghent - Belgium
| | - M.A. Waterloos
- Clinical Biology, University Hospital, De Pintelaan, Ghent - Belgium
| | - J. Delanghe
- Department of Nephrology and De Pintelaan, Ghent - Belgium
| | - G. Van Maele
- Department of Nephrology and De Pintelaan, Ghent - Belgium
| | - S. Ringoir
- Clinical Biology, University Hospital, De Pintelaan, Ghent - Belgium
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