A multicenter nationwide reference intervals study for common biochemical analytes in Turkey using Abbott analyzers

BACKGROUND

A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality.

METHODS

Blood samples were collected nationwide in 28 laboratories from the seven regions (≥400 samples/region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the non-parametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA).

RESULTS

By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and γ-glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI >28 kg/m2. Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI.

CONCLUSIONS

With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.

A high-confidence human plasma proteome reference set with estimated concentrations in PeptideAtlas

Human blood plasma can be obtained relatively noninvasively and contains proteins from most, if not all, tissues of the body. Therefore, an extensive, quantitative catalog of plasma proteins is an important starting point for the discovery of disease biomarkers. In 2005, we showed that different proteomics measurements using different sample preparation and analysis techniques identify significantly different sets of proteins, and that a comprehensive plasma proteome can be compiled only by combining data from many different experiments. Applying advanced computational methods developed for the analysis and integration of very large and diverse data sets generated by tandem MS measurements of tryptic peptides, we have now compiled a high-confidence human plasma proteome reference set with well over twice the identified proteins of previous high-confidence sets. It includes a hierarchy of protein identifications at different levels of redundancy following a clearly defined scheme, which we propose as a standard that can be applied to any proteomics data set to facilitate cross-proteome analyses. Further, to aid in development of blood-based diagnostics using techniques such as selected reaction monitoring, we provide a rough estimate of protein concentrations using spectral counting. We identified 20,433 distinct peptides, from which we inferred a highly nonredundant set of 1929 protein sequences at a false discovery rate of 1%. We have made this resource available via PeptideAtlas, a large, multiorganism, publicly accessible compendium of peptides identified in tandem MS experiments conducted by laboratories around the world.

The effects of abundant plasma protein depletion on global glycan profiling using nanoLC FT-ICR mass spectrometry

We report the results of abundant plasma protein depletion on the analysis of underivatized N-linked glycans derived from plasma proteins by nanoLC Fourier-transform ion cyclotron resonance mass spectrometry. N-linked glycan profiles were compared between plasma samples where the six most abundant plasma proteins were depleted (n = 3) through a solid-phase immunoaffinity column and undepleted plasma samples (n = 3). Three exogenous glycan standards were spiked into all samples which allowed for normalization of the N-glycan abundances. The abundances of 20 glycans varying in type, structure, composition, and molecular weight (1,200-3,700 Da) were compared between the two sets of samples. Small fucosylated non-sialylated complex glycans were found to decrease in abundance in the depleted samples (greater than or equal to tenfold) relative to the undepleted samples. Protein depletion was found to marginally effect (less than threefold) the abundance of high mannose, hybrid, and large highly sialylated complex species. The significance of these findings in terms of future biomarker discovery experiments via global glycan profiling is discussed.

Systematic internal standard selection for capillary liquid chromatography-mass spectrometry time normalization to facilitate serum proteomics

Because blood interacts with almost all tissues of the body, it is likely that changes in the overall health of an organism will be reflected in the quantities of specific serum peptides and proteins, making them biomarkers. Due to the complexity of serum, pre-analytical sample simplification and separation are needed prior to mass spectrometric analysis. Use of a reverse-phase capillary column coupled to a mass spectrometer allows for separation and analysis of serum as part of efforts to discover biomarkers. Even after sample simplification by organic solvent precipitation, data files for a single sample typically exceed one gigabyte, making it difficult to analyze complete serum mass spectrometry profiles with currently available software. However, with adequate safeguards, it appears possible to consider portions of mass spectra to find differences in peak intensities between clinical comparison groups visually. To facilitate this, the elution profile was divided into 2-min intervals in which mass spectrometry data were averaged. This required that molecular species had defined reproducible elution times. Given liquid chromatography coupled to mass spectrometry variation, misalignment of elution times of individual peaks occurred often. Hence, internal time controls were identified within each window and used for elution time normalization. This significantly reduced variability in data. This approach allowed for peak alignment across samples, improving biomarker discovery.

Design of Adsorptive Columns for Specific Pathogen Removal: Application to Staphylococcal Enterotoxin B

The removal of pathogens such as toxins, viruses, bacteria, and prions in human blood, mammalian cell culture media, fermentation broths, food items, and water streams has gained increasing importance in ensuring product safety and in combatting acts of terrorism. Adsorption processes can play an important role in removing such pathogens from solution without affecting other desirable components. Adsorptive columns that can remove specific families of pathogens would need to achieve a reduction of several logs in pathogen concentration. This requirement is much more stringent than the normal yield requirements associated with adsorptive separations aimed at product recovery and purification in a process stream. This paper considers the design of an adsorptive column aimed at reducing the concentration of infectious agents from a known volume of solution by several logs in a fixed amount of time. The general rate (GR) model of chromatography is used in the analysis, including all major transport and kinetic steps in the adsorption process. The theory, with no adjustable parameters, is shown to predict with great accuracy the effect of residence time on the log removal of staphylococcal enterotoxin B (SEB) from solution using an affinity resin with a small peptide (YYWLHH) that has been found to bind specifically to this toxin.

Standards for Plasma and Serum Proteomics in Early Cancer Detection: A Needs Assessment Report from the National Institute of Standards and Technology-National Cancer Institute Standards, Methods, Assays, Reagents and Technologies Workshop, August 18–19, 2005

NIST and the National Cancer Institute cosponsored a workshop on August 18–19, 2005, to examine needs for reference materials for early cancer detection. This meeting focused on standards, methods, assays, reagents, and technologies. Needs for plasma and serum proteomics, DNA methylation, and specimen reference collections were discussed, and recommendations from participants were solicited. This report summarizes the discussion and recommendations for proteomics reference materials.

Ensuring the biologic safety of plasma-derived therapeutic proteins: detection, inactivation, and removal of pathogens

Human plasma-derived proteins, such as immunoglobulins, coagulation factors, α₁-antitrypsin, fibrin sealants, and albumin, are widely used as therapeutics for many serious and life-threatening medical conditions. The human origin of these proteins ensures excellent efficacy and compatibility but may also introduce the risk of unintentional disease transmission. Historically, only viruses, particularly hepatitis and HIV, have posed serious threats to the safety of these therapeutics. Fortunately, between 1970 and 1990, the molecular biology of each of the major viruses was elucidated. These advances led to the development and implementation of effective donor screening tests, mainly based on immunoassays and nucleic acid testing, which resulted in a significant reduction of disease transmission risk. In addition, viral inactivation and removal steps were implemented and validated by manufacturers, further reducing the risk associated with known, as well as unidentified, viruses. Since the late 1990s, a different class of transmissible agent, referred to as prions, has been identified as a new risk for disease transmission. However, prion diseases are very rare, and prion transmission through plasma-derived proteins has not been reported to date. The prion-related risk is minimized by deferring donors with certain key risk factors, and by the manufacturing processes that are capable of removing prions. Advances in science and pathogen safety-related technology, compliance with good manufacturing practices by manufacturers, and increasingly stringent regulatory oversight, has meant that plasma-derived proteins have been developed into today’s highly effective therapeutics with very low risk of disease transmission.

Protein Z in normal pregnancy

Changes in the coagulation and fibrinolytic systems during pregnancy lead to a higher risk of thromboembolism. These changes include the increase of many clotting factors, as well as a significant fall in activity of fibrinolytic proteins, such as protein C. Protein Z is a vitamin-K-dependent plasma glycoprotein and inhibits the activation of factor X by serving as a cofactor to a plasma proteinase inhibitor. Protein Z deficiency has recently been reported in women with unexplained early fetal losses, and antibodies to protein Z can contribute to adverse pregnancy outcomes. The aim of this study was to determine the range of protein Z in normal pregnancies at different gestational weeks in a cross-sectional and a longitudinal setting. In the longitudinal study we found a 20% increase (p=0.006) of protein Z from first trimester to delivery and a 30% decrease (p<0.0001) 6 to 12 weeks after delivery. In the cross-sectional study these findings were reproducible. In summary, our data show a progressive increase in protein Z levels with gestational age in normal pregnancies and a return to normal levels around 6 to 12 weeks postpartum. The normal increase of protein Z during pregnancy may balance the increase of clotting factors to protect pregnant women from thrombosis.

Diagnostic and epidemiological implications of regional differences in serum concentrations of proteins observed in six Asian cities

The IFCC Committee on Plasma Proteins has been investigating regional differences for commonly assayed plasma proteins to determine whether universal reference intervals can be applied. As a part of this study, we launched an Asian project analyzing the concentrations of 13 serum proteins whose values are standardized to CRM470, and five newer analytes: retinol-binding protein (RBP), cystatin C (CysC), light-chain-kappa (L-kappa), and light-chain-lambda (L-lambda). In Tokyo, Seoul, Kuala Lumpur, Hong Kong, Taipei and Shanghai, serum samples were collected from 146 to 415 apparently healthy individuals with nearly equal gender ratios. All assays were performed in Tokyo on a Behring Nephelometer II (BN II). Seven chemical analytes (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (gammaGT), creatinine, total cholesterol (TC), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C)) were also measured. These results were used for excluding individuals with possible latent clinical disorders. Positive acute phase reactants were consistently lower, and negative ones were higher, in Tokyo than those in other cities. The most conspicuous difference was observed in C-reactive protein (CRP). There were no regional differences in transferrin, albumin, or CysC. Creatinine was much lower in Tokyo despite comparable CysC levels. ALT and gammaGT were higher in Shanghai, Taipei and Seoul; gammaGT and TG were higher in Shanghai; and HDL-C was higher in Tokyo. Gender-related differences in reference intervals were observed for immunoglobulin (Ig)M, haptoglobin, RBP, transferrin, alpha2-macroglobulin (A2M), transthyretin, alpha1-acid glycoprotein, CysC, and C4 in all cities. Slight age-related differences were observed, irrespective of the region, in IgA and ceruloplasmin (increase) and A2M (decrease). Environmental factors and lifestyle seem to have a great influence on many commonly measured analytes.

Reference intervals for plasma proteins: similarities and differences between adult Caucasian and Asian Indian males in Yorkshire, UK

The aim of this study was to investigate similarities and differences in the distribution of serum concentrations of nine proteins in two racial groups (Caucasian and Asian Indian) of adult males living in the same geographical area (Leeds, Bradford, UK) for at least two generations. This is part of a larger study to determine the need for separating reference intervals for racial and ethnic groups worldwide. The distributions of concentrations for all proteins evaluated in the Indians fit ln-Gaussian distributions, indicating probable homogeneity. However, for the Caucasians, the distributions for α

Neonatal thromboembolism

In neonates and infants numerous clinical and environmental conditions such as the use of central lines, cardiac diseases and polycythemia, renal diseases such as congenital nephrotic syndrome and neonatal hemolytic uremic syndrome, peripartal asphyxia, infants of diabetic mothers, dehydration, septicemia, necrotizing enterocolitis, acute respiratory distress syndrome, and extracorporeal membrane oxygenation lead to elevated thrombin generation and subsequent thrombus formation. Genetic prothrombotic defects [protein C, protein S and antithrombin deficiency, mutations of coagulation factor V and factor II, elevated lipoprotein (a)] have been established as risk factors for thromboembolic events. The interpretation of laboratory results relies on age-dependent normal reference values. Because appropriate clinical trials are missing in these age groups, treatment recommendations are adapted from small-scale studies in neonates and infants and from guidelines relating to adult patient protocols. Secondary long-term anticoagulation should be administered on an individual basis.

[Reference ranges of 9 plasmatic proteins in Tunisian population based on the new IFCC reference material CRM 470]

The interpretation of biological exam results requires the knowledge of physiological variation factors and reference values for every parameter. Following the preparation and the diffusion by the International Federation of Clinical Chemistry (IFCC) of a new reference material for the dosage of plasmatic proteins (CRM470) and in order to take part in the international effort of standardization of these dosages, we established reference ranges in the tunisian population for 9 plasmatic proteins: the Immunoglobulines G, A and M, complement factors C3 and C4, albumin, transferrin, haptoglobin and the a 1-glycoprotéin acid. Our sample of 211 healthy blood donors aged between 18 and 63 years. Reference limits 0.95 that we obtained are located within variation of most reference values lately found in the literature.

The Fibrinolytic System in Children

The fibrinolytic system comprises a cascade of serine proteinase activation events that culminate in the generation of plasmin and, subsequently, degradation of fibrin. Although all components of the fibrinolytic system are present at birth, plasma concentrations of key components in infants and children differ physiologically from those in adults. Until the age of 6 months, plasma concentrations of plasminogen and alpha (2)-antiplasmin are decreased to 50% and 80% of adult values, respectively, while plasma concentrations of tissue-type plasminogen activator are decreased and plasminogen activator inhibitor-1 are increased throughout childhood. In addition, the rate of plasmin generation in newborns and the overall fibrinolytic activity during childhood are decreased compared with adults. Strong evidence suggests that age-dependent differences in the fibrinolytic system critically influence the effectiveness and safety of thrombolytic agents. In addition, recent studies suggest that impaired fibrinolysis may play an important role in the pathogenesis of several diseases such as venous and arterial diseases and vasculitis, which are associated with both endothelial cell damage and increased thrombotic risk. This article will discuss the ontogenic features of the fibrinolytic system in children and summarize the available information on the effect of developmental fibrinolysis on both the course of specific disease states and the response to thrombolytic therapy in children.

Effect of certified reference material 470 (CRM 470) on national quality assurance programs for serum proteins in Europe

The introduction of the international reference material for serum proteins, CRM 470, has resulted in significant reduction of the among-laboratory variance for most proteins assayed in European national quality assurance programs. In general, the CVs have decreased by 5 to 65%. However, both among- and within-manufacturer variances in many cases remain unacceptably high. In addition, concentration-dependent differences in variance and bias are present for some proteins. Although some variance will persist, reducing variance and bias to levels required for the institution of universal reference ranges will necessitate more accurate transfer of values to calibrants and controls and improved calibration curve fitting by manufacturers, as well as better quality control within laboratories.

Protein standardization II: Dry mass determination procedure for the determination of the dry mass of a pure protein preparation

A procedure has been developed for the determination of the dry mass of a pure protein preparation dissolved in one electrolyte. The procedure not only renders the concentration (in g/l), but additionally gives the partial specific volume of the protein (in ml/g). The latter is an important parameter for the characterization of a specific protein. Furthermore, the importance of extensive dialysis against one electrolyte is discussed. For the drying of human serum proteins it is clearly shown that KCl is preferred to NaCl due to its stable temperature curve. By observing the parallel fluctuations in the weight of the empty vials during drying, an average correction factor is introduced, which greatly minimizes these changes. The assay principle is discussed from a mathematical as well as from a practical point of view. A detailed procedure is described and the final results for three primary pure proteins (prealbumin, orosomucoid and transferrin) are presented. Finally, important parameters such as the wavelength of maximum absorbance, the absorption coefficient and the specific refractive increment are discussed and values for the three proteins are presented. When these parameters have been established the future determination of concentration and the characterization of pure protein solutions are greatly facilitated. These procedures were important tools for ascribing mass values for prealbumin, orosomucoid and transferrin to the international reference preparation CRM 470.

Commutability of serum protein values: persisting bias among manufacturers using values assigned from the certified reference material 470 (CRM 470) in the United States

Significant among-manufacturer differences in values for serum proteins persist 7 years after the introduction of the international reference material (Certified Reference Material 470; Reference Preparation for Proteins in Human Serum). In some cases, such as transthyretin and C4, the biases actually continue to increase. Further efforts at standardization are needed in order to improve commutability of results among laboratories and are essential if universal reference intervals are to be developed.

Parvovirus B19 DNA in plasma pools and plasma derivatives

BACKGROUND AND OBJECTIVES

Human parvovirus B19 (B19) has been transmitted by various plasma-derived medicinal products. The aim of this study was to determine the frequency and the level of B19 DNA contamination in plasma pools destined for fractionation and in a broad range of plasma derivatives. In addition, removal of B19 DNA by the manufacturing process was investigated in cases where corresponding samples from plasma pool and product were available.

MATERIALS AND METHODS

Plasma pool samples and blood products were tested for B19 DNA by nested polymerase chain reaction (PCR), and the viral DNA content was determined by TaqMan quantitative PCR.

RESULTS

Two-hundred and twenty two of 372 plasma pools for fractionation contained B19 DNA at concentrations of 10(2)-10(8) genome equivalents/ml (geq/ml). While approximately 65% of the DNA-positive plasma pools were only moderately contaminated (< 10(5) geq/ml), 35% contained > 10(6) geq/ml. High frequencies of contamination were detected in Factor VIII (79 of 91), prothrombin complex concentrates (38 of 43) and Factor IX (41 of 62), where the concentration of B19 DNA ranged between 102 and 107 geq/ml. A lower level of B19 DNA contamination was found in antithrombin III (five of 26 samples), in anti-D immunoglobulins (three of 37 samples) and in albumin (four of 51 samples), with levels ranging between 10(2) and 10(3) geq/ml. Furthermore, investigation of plasma pools for solvent/detergent plasma (S/D plasma), from two manufacturers, revealed B19 DNA in 15 of 66 batches at concentrations of 10(2)-10(8) geq/ml. Similar concentrations were detected in the corresponding final S/D plasma products. Anti-B19 immunoglobulin G (IgG) was found in plasma pools and S/D plasma at concentrations of approximately 40 IU/ml.

CONCLUSION

Although positive PCR results do not necessarily reflect infectivity, these data show that B19 is a common contaminant in plasma pools and in plasma-derived medicinal products. Considering the resistance of animal parvoviruses to inactivation by heat and chemical agents, and the absence of specific information for B19, the risk of B19 transmission by plasma products should be considered. Physicians should be aware of this problem when treating patients of B19-related risk groups. The plasma fractionation industry should continue their efforts to avoid B19 contamination of plasma derivatives and develop methods which are effective in removing/inactivating parvovirus B19.

Using multiples of the median to normalize serum protein measurements

Quantification of serum proteins is useful in the diagnosis and clinical management of many disorders. With the introduction of automated analyzers and standardized reference materials, one of the last barriers to more widespread utilization of these measurements is the lack of availability of reliable and transferable age- and gender-specific reference ranges. One normalization method that deserves consideration is converting values to multiples of the median (MoM) for age and gender. When two analytic methods agree, or differ only by a proportional amount, conversion to MoM can be used to simplify the clinical interpretation of serum protein results. As a test of this method, assay results for IgG, transferrin, and albumin from three Swedish hospitals were normalized using published reference ranges from the United States. All assays were standardized to CRM 470. IgG results were in agreement in mass units, and transferrin measurements were proportionally different. However, there were important, non-proportional differences in albumin measurements. After converting IgG and transferrin measurements to MoM, published reference ranges were appropriate for the Swedish Hospitals.

Standardization of immunoassay for CRM-related proteins in Japan: from evaluating CRM 470 to setting reference intervals

The Japan National Institute of Health (JNIH), in close collaboration with academic societies, commercial companies, and the Japan Society of Medical Technologists, has led in the attempt to standardize plasma protein assays since the mid 1980s. Under a framework of global standardization, they used WHO primary reference materials to reduce discrepancies in values reported for proteins assayed using different systems, thus laying the foundations for a protein immunoassay standardization system in Japan. With the introduction of CRM 470 in 1993, the Japanese Committee for Clinical Laboratory Standards (JCCLS) has taken the initiative in promoting the use of the new material and bringing about the re-evaluation of all systems of quality assurance in clinical laboratories. This eventually led to the establishment of reference intervals in Japanese populations of children and adults after preparation of assigned calibrators from CRM 470 for each assay system. Here we review the history of a series of projects carried out in Japan and describe several remaining problems, through which we will attempt to evaluate the potential value of protein immunoassay standardization.

Protein standardization IV: Value transfer procedure for the assignment of serum protein values from a reference preparation to a target material

A new approach for the assignment of values to serum proteins in a target material using a reference preparation has been developed. The procedure describes the general as well as the practical principles involved in the value assignment (with examples). Two models have been developed: 1) The direct value transfer between serum matrices and 2) the indirect value transfer from a pure protein preparation to a serum protein material. The necessary mathematical equations are developed and explained. The data reduction and statistical evaluation are discussed. The practical procedure (the transfer protocol) is based on six dilutions of the reference preparation assayed together with six dilutions of the target material. In this way imprecision is reduced and the proportionality of the two materials (i.e. the presence or absence of matrix effects) can be assessed directly by evaluating a single regression plot. If no matrix effects are found, the regression line will pass through zero with a slope equal to the ratio of the concentrations of the two materials. The transfer protocol is based on a multiple point value assignment obtained by several measurements a day repeated on several days, an important prerequisite being that all reconstitutions and dilutions are controlled by weighing.

Effect of a new international reference preparation for proteins in human serum (certified reference material 470) on results of the College of American Pathologists Surveys for plasma proteins

OBJECTIVE

To examine the impact of a new international reference preparation for serum proteins on the among-manufacturer variance in the College of American Pathologists Surveys.

DATA SOURCE

The results of the Surveys for the years 1993-1998, supplied by the College of American Pathologists.

DATA EXTRACTION AND SYNTHESIS

Mean values for manufacturers' assays were compared for each protein in the quality control samples. Results were separated by the reported reference material from which values for calibrators had been transferred. Standard statistical parameters (means, standard deviations, and coefficients of variation) were calculated from the reported means.

CONCLUSIONS

Among-manufacturer coefficients of variation have dropped significantly for most serum proteins since the introduction of the new reference material. Possible reasons for continued differences are discussed.

[Audit of labile blood product supplies]

An audit of the quality control system is part of an ongoing improvement process. The hospital-based facilities for the transfusion services not involved in collecting and processing donor blood but issuing blood cell products are expected to achieve quality standards. A quality control audit is considered an essential tool to assess and improve deficiencies or deviations for greater effectiveness. A global approach to transfusion processes added to a strict follow-up by all concerned are necessary for the proper management of transfusion practices and the risks involved. Its function is to achieve a certain quality of health, thus requiring confidence and respect. The end result is to ensure blood transfusion safety.

[Labile blood product traceability: definition, regulation, evaluation, and perspectives]

The traceability of blood products is an essential part of hemovigilance and transfusion safety. Law no 94-68 of 24 January 1994 is the legal foundation of the system of traceability. In this article, the structures of the system and the main actors are discussed. An evaluation of the system of traceability showed that it is both feasible and adaptable. An evaluation process is needed to assess the proper functioning of the system and to detect and prevent possible deficiencies.

Serum protein standardization project in Japan: evaluation of an IFCC reference material (RPPHS/CRM470) and establishment of reference intervals

Reference preparation for proteins in human serum (RPPHS), also called Certified Reference Material 470 (CRM 470), was prepared by the international Federation of Clinical Chemistry (IFCC) and is intended to serve as a new international plasma protein reference material. It is now being introduced into Japan. RPPHS possesses many excellent properties, including safety, stability, and accuracy in value assignment. Moreover, the physicochemical properties of its proteins are identical to those of fresh serum, giving it immunochemical behavior that is commutable with that of existing reference materials and calibrators in given immunoassays. Reference intervals of 13 serum proteins were determined for the first time using nephelometry and a new working calibrator assigned from RPPHS, which seems certain to play a critical role in the global standardization of specific protein immunoassays.

WHO Expert Committee on Biological Standardization. Forty-sixth Report

This report presents the recommendations of a WHO Expert Committee commissioned to coordinate activities leading to the adoption of international requirements for the production and control of vaccines and other biologicals and the establishment of international biological reference materials. The report starts with a discussion of general issues brought to the Committee's attention and provides information on the status and development of reference materials for various antibiotics, antibodies, antigens, blood products, cytokines, endocrinological and related substances and toxins. The second part of the report, of particular relevance to manufacturers and national control authorities, contains the revised list of laboratories approved by WHO for the production of yellow fever vaccine, revised requirements for yellow fever vaccine, an amendment to the General Requirements for the Sterility of Biological Substances, and a summary protocol for the batch release of virus vaccines.

Proteins of rat serum: I. Establishing a reference two-dimensional electrophoresis map by immunodetection and microbore high performance liquid chromatography-electrospray mass spectrometry

In the present investigation, we have identified 56 major spots, or spot rows, corresponding to 22 proteins, in the 2-DE pattern of adult male rats. This was done mainly by applying two complementary techniques, namely immunoblotting and high performance liquid chromatography-mass spectrometry (HPLC-MS) peptide mapping. Glycoproteins were characterized by affinity blotting with six lectins. We have also detailed how rat serum differs from human serum in two main respects: (i) relative abundance of individual proteins, which amounts in some cases to a complete absence in either sample, and (ii) varying molecular parameters for homologous proteins. It was thus possible to establish a first-generation reference map of rat serum proteins, which can be accessed through http://weber.u.washington.edu/ruedilab/aebersold++ +.html. We hope the present database will be a useful reference for the evaluation of changes in serum protein distribution in the course of pharmacological and toxicological studies. The recognition of species-specific proteins appears of special relevance in this respect.

Research and development commitments in an integrated plasma collection and plasma fractionation environment

Plasma fractionation has emerged as one of the most scientifically demanding fields in the biopharmaceutical area. Producing safe plasma derivatives implies the development, use, and proper understanding of sensitive testing technologies to detect infection markers in starting plasma. It also requires the implementation of carefully selected, nondenaturing, efficient plasma protein purification and viral reduction technologies that do not alter the physiological functions and clinical potential of plasma proteins. Success in this field can be achieved only by a strong commitment to sustain constant research and development of projects targeting the production of safer and innovative plasma products.

A survey of the values of clinical chemistry parameters obtained for a common rat blood sample in ninety-eight Japanese laboratories

A control survey was conducted to check the accuracy of automated analyzers used in the evaluation of clinical chemistry parameters in nonclinical toxicology studies. Pooled serum samples from male Sprague-Dawley rats were delivered refrigerated to each facility 98 laboratory facilities throughout Japan within 18 hours after sample preparation and analyzed. Commercially available normal human serum samples from a single lot were also analyzed at the same time. Survey results were divided into three categories. (1) Parameters with small coefficient of variation (CV) values for both rat and human serum samples included protein, glucose, cholesterol (CHO), urea nitrogen (UN), sodium (Na), potassium (K), chloride (Cl), calcium (Ca), and inorganic phosphate (IP). Definition of normal values in rats should be straight forward for these parameters. (2) Parameters with large CV values, but with a relatively good correlation between rat and human values include triglycerides (TG), glutamic oxaloacetic transaminase/aspartate aminotransferase (GOT/AST), glutamic pyruvic transaminase/alanine aminotransferase (GPT/ALT), and alkaline phosphatase (ALP). Measurements based on different principles gave different mean values, and this values contributed to the increase in CV values. Assessment of normal values would require a consideration of the measurement principles. (3) Parameters with large CV values only in rat serum samples included albumin (albumin/globulin ratio: A/G ratio), creatinine (CRE), and total bilirubin(BIL). Reactivity was different in rat albumin (ALB), depending on the reagents used. This difference needs to be corrected with values available by electrophoresis, or adjusted by rat ALB values, because of the lack of an appropriate measurement method. The enzyme method gave low values for rat CRE, which suggests the need for further examination of this method. The BIL values were extremely low in rat samples. It seems to be necessary to select appropriate methods to measure clinical pathology parameters correctly for rats. There was no deviation in values due solely to the mechanical operations of the analytical equipment. Non-standard initial settings of the equipment (equipment originally intended for human samples, but now applied to animal samples) was the main cause of the wide range of analytical values seen.

Value of feather meal in a molasses-based liquid supplement fed to yearling cattle consuming a forage diet

Hydrolyzed feather meal (FM) was compared to other sources of CP to determine its value as a protein source in a molasses-based liquid supplement. Ruminal N escape values (measured in situ) for FM, ring-dried blood meal, cottonseed meal, and soybean meal approximated reported values. Ruminal N escape value for catfish meal was lower than values reported for other fish meals. In two trials (194 d), 84 yearling heifers were allotted to 12 pastures (3 pastures/treatment) and fed one of four supplements (1.7 kg of DM.heifer-1.d-1) containing either molasses and urea; molasses, urea,and FM; molasses, urea, FM, and catfish meal; or molasses, urea, FM, and catfish oil. Heifers were exposed to bulls for 60 d. In two trials, 112 steers were allotted to 16 pastures (4 Pastures/treatment) and fed one of four supplements (1.7 kg of DM.steer-1.d-1) containing molasses and urea; molasses, urea and FM; molasses, urea, FM and ring-dried poultry blood meal; or molasses, urea, and poultry feathers and blood hydrolyzed together. In all trials, cattle fed molasses containing FM had faster gains (P < .05) and heifers had heavier live weights at breeding (P < .05) and higher pregnancy rates (P < .05) than cattle fed molasses and urea. Combining poultry blood with molasses, urea, and FM improved (P < .05) steer gains in one of two trials. Combining catfish meal with molasses, urea, and FM did not improve (P > .05) ADG of pregnancy rate of heifers. Combining catfish oil with molasses, urea, and FM increased (P < .05) ADG in one trial and blood cholesterol and live weight of heifers at breeding in both trials. It is concluded that protein feeds, such as FM, that contain a large portion of ruminally undegradable protein may provide much of the CP in liquid supplements fed to growing cattle consuming moderate-quality forage. Adding catfish oil to a liquid supplement may improve ADG and live weight of yearling heifers at breeding.

Effect of protein supplementation on forage intake and nitrogen balance of lambs fed freshly harvested wheat forage

Wether lambs (mean BW = 32 kg) fed wheat forage freshly harvested daily (Exp. 1, n = 28; Exp. 2, n = 25) were used to evaluate the effects of supplemental energy and protein on forage intake, diet digestibility, and N retention. Experiment 1 was conducted in the winter of 1988 and the four treatments were 1) CONTROL, no supplement; 2) ENERGY, low-protein corn-based supplement; 3) CSM, 22% CP supplement with cottonseed meal; and 4) CGM, 22% CP supplement with corn gluten meal. Experiment 2 was conducted in the spring of 1989, and the five treatments were 1) CONTROL; 2) ENERGY; 3) CSM, 23% CP with cottonseed meal; 4) FTM, 25% CP supplement with feather meal and corn gluten meal; and 5) BM, 25% CP supplement with blood meal and corn gluten meal. All supplements were isoenergetic and composed 22 and 24% of total DMI in Exp. 1 and 2, respectively. In Exp. 1, forage intake was not affected but total and digestible DMI were increased (P < .01) by energy and protein supplementation. Protein supplements did not (P > .10) increase total and digestible DMI compared to ENERGY supplementation but tended (P < .10) to increase N retention (g/d). In Exp. 2, digestible DMI and N retention did not differ among the five treatments. Results suggest that lambs consuming wheat forage in the vegetative stage (Exp. 1) will have greater digestible DMI if supplemental energy or protein is provided. When more mature wheat forage was fed (Exp. 2), energy seemed to limit animal performance.

Added dietary methionine in starter pig diets containing spray-dried blood products

Two experiments were conducted to determine the dietary methionine requirement of weanling pigs fed diets containing spray-dried porcine plasma and(or) blood meal in a phase-feeding program. In Exp. 1, 216 crossbred pigs (21 +/- 2 d of age and 4.9 kg BW) were fed diets (1.6% lysine, .52% cystine) containing 10% spray-dried porcine plasma and 1.75% spray-dried blood meal from d 0 to 21 postweaning. Pigs were fed one of six dietary treatments ranging from .28 to .48% total dietary methionine (.225 to .425% apparent digestible methionine). From d 0 to 14 and d 0 to 21 postweaning, ADG, ADFI, and gain:feed ratio (G:F) increased (quadratic, P < .01) as dietary methionine increased. Inflection point analysis projected .42 and .41% total dietary methionine to maximize ADG and G:F from d 0 to 14 and d 0 to 21 postweaning, respectively. In Exp. 2,216 crossbred pigs (21 +/- 3 d of age and 5.6 kg BW) were used to determine the dietary methionine requirement from d 7 to 28 postweaning. All pigs were fed the same diet (1.6% lysine, .44% methionine, .52% cystine) from d 0 to 7 postweaning. From d 7 to 28, pigs were assigned to one of six dietary treatments (1.3% lysine, .46% cystine) containing 10% dried whey and 3% spray-dried blood meal. Total dietary methionine levels ranged from .27 to .42% (.249 to .399% apparent digestible methionine). From d 7 to 14 postweaning, increasing dietary methionine increased (quadratic, P < .05) ADG, ADFI, and G:F (.34 to .35% total methionine projected by inflection point analysis).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of protein source on nitrogen metabolism in continuous culture and intestinal digestion in vitro

Eight dual flow continuous culture fermenters were used in four replicated periods to study the effects of protein supplements on ruminal fermentation and CP digestion. A basal diet was supplemented with isonitrogenous amounts of urea and tryptone (control; CTRL), soybean meal (SBM), lignosulfonate-treated SBM (LSBM), corn gluten meal (CGM), blood meal (BM), hydrolyzed feather meal (HFM), fish meal (FM), or meat and bone meal (MBM). Digestion of DM, OM, and carbohydrates was not affected by treatment. Ammonia N concentration was highest (P < .05) for CTRL and lowest (P < .05) for LSBM, CGM, BM, HFM, and FM. Nonammonia N flow was lowest (P < .05) for CTRL. Dietary N flow was lowest (P < .05) for CTRL, intermediate for SBM, and highest (P < .05) for LSBM, CGM, BM, HFM, FM, and MBM. Total N flow, bacterial N flow, and efficiency of microbial protein synthesis were not affected by treatment. Protein degradation was highest (P < .05) for CTRL. Flow of total amino acids (AA) was lowest (P < .05) for CTRL, SBM, and MBM. Diets containing BM provided the largest (P < .05) amounts of essential AA and lysine, and FM provided the largest (P < .05) amounts of methionine in fermenter effluent. Supplementation of diets with proteins low in ruminal degradability increased flows of nonammonia N, dietary N, and total and essential AA and modified the AA profile flowing out of fermenters.

Effects of protein concentration and protein source on performance of newly arrived feedlot steers

In Trial 1, 240 crossbred steers (initial BW 243 +/- 8 kg) were used in a 2 x 4 factorial experiment to determine the effects of receiving diet CP concentration (12, 14, 16, or 18%) and source (spray-dried blood meal [SDBM] vs soybean meal [SBM]) on steer performance. There were linear (P < .01) increases in ADG and feed efficiency during wk 1. For the entire trial, there was an increase (P < .01) in feed efficiency with increasing CP concentration and diets containing SDBM compared with those containing SBM. In Trial 2, 240 crossbred steers (initial BW 246 +/- 14 kg) were used in a completely randomized design experiment to determine the effects of receiving diet CP concentration (11, 14, 17, 20, 23, or 26%) on steer performance. Average daily gain and feed efficiency increased (P < .01) with increasing CP concentration during wk 1. There were quadratic (P < .01) responses to CP concentration for final weight, ADG, and feed efficiency. In Trial 3, 216 steers (initial BW 238 +/- 1 kg) were used to determine the effects of receiving diet protein sources on steer performance. The control diet used SBM as the supplemental CP source and was formulated to contain 12.5% CP. The other five protein sources were corn gluten meal (CGM), ring-dried blood meal (RDBM), SDBM, fish meal (FM), and SBM. For these five CP sources, diets were formulated to contain 23% CP during wk 1, 17% CP during wk 2, and 12.5% CP during wk 3 and wk 4. During wk 1, control steers had the lowest ADG (P < .07) and feed efficiency (P < .01) whereas steers fed RDBM and SDBM had the highest (P < .01) feed efficiency. Increased CP concentrations are needed early in the receiving period, when DMI is low.

High-lysine corn as a source of protein and energy for finishing calves

Three trials evaluated the protein and energy value of high-lysine corn for finishing calves. In Trial 1, 60 finishing steer calves were used to evaluate corn source (high-lysine vs control) and protein source (urea, blood meal [BM], corn gluten meal [CGM]) and level (BM and CGM addition; low, medium, high). Calves were individually fed using Calan gates for 102 d, and then were pen-fed (two pens per corn treatment) the remaining 83 d. During the initial 102 d, calves fed high-lysine corn had similar gains but were 6% more efficient (P < .10) compared with calves fed control corn. Performance did not differ (P > .10) among sources or levels of protein supplementation. Over the entire feeding period (185 d), calves fed high-lysine corn were 10% more efficient (P < .10) than calves fed control corn. In the second study, in situ starch disappearance was faster (P < .10) and the proportion of CP degraded by 12 h was 27% greater (P < .10) for high-lysine corn than for control corn. In a metabolism trial, five steers fitted with ruminal, duodenal, and ileal cannulas were used in a randomized block design to evaluate the effect of corn source on site and extent of digestion. Intake and ruminal and total tract digestibility of OM and N did not differ (P > .10) between corn sources. Steers fed high-lysine corn tended to have greater ruminal (P = .23) and postruminal (P = .18) starch digestion, resulting in greater (P < .10) total tract starch digestibility.(ABSTRACT TRUNCATED AT 250 WORDS)

European regulatory issues

Current EU regulations do not cover all aspects of the manufacture and control of blood products. Recent legislation coming into force on 1 January 1995 has established the European Medicines Evaluation Agency and introduced revised systems for approving pharmaceutical products, including blood products. There remains a need for comprehensive harmonized legislation covering plasma collection and screening, virus validation studies, and batch release.

Is self-sufficiency financially viable and ethically justifiable?--the role of the National Blood Authority

The National Blood Authority is committed to the principle of self-sufficiency but also supports the principle of clinical freedom and aims to improve patient care. Methods of increasing plasma yields are being investigated. On-going discussions are being held with the commercial sector concerning the range of products available and methods of improving manufacturing efficiency. It is believed that the NBA can become largely self-sufficient using blood given by the 2,000,000 voluntary donors.

Alfalfa and escape protein supplements for grazed corn residues

Two calf corn-residue grazing trials were conducted to evaluate the effect of supplementing with two alfalfa hays (Medicago sativa), varying in their amount of CP and ADF, with and without escape protein (EP). In Trial 1, heifers (204 kg) grazed (1.36 heifers/ha) non-irrigated fields for 92 d. No difference (P > .05) in ADG was found when medium-protein (16.3% CP) and high-protein (18.0% CP) alfalfa hays were provided at 2.7 kg of DM.heifer-1.d-1. In Trial 2, 60 steers (257 kg) were supplemented individually with medium-protein (17.6% CP) alfalfa hay, 1.86 (MPL) and 2.27 kg DM (MPH), and one level of high-protein (18.7% CP) alfalfa hay, 1.86 kg DM (HPL). In a 2 x 3 factorial arrangement of treatments, steers were fed with or without EP (113 g.steer-1.d-1 from blood meal and corn gluten meal). Steers grazed a non-irrigated corn residue field (2.58 steers/ha) for 57 d and were watered and individually supplemented overnight. Diet quality and composition was estimated by collecting extrusa samples twice each week using four esophageally fistulated steers. No effects of alfalfa protein content or level (P > .05) were reflected in gain: 357, 309, and 326 g.steer-1.d-1 for steers receiving MPL, MPH, or HPL alfalfa treatments, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)