Spironolactone metabolite causes falsely increased progesterone in the Abbott Architect immunoassay

IF 2.5 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Clinical biochemistry Pub Date : 2024-03-12 DOI:10.1016/j.clinbiochem.2024.110747
Kwabena A.N. Sarpong , Su Hee Kim , Christopher R. McCartney , Joesph R. Wiencek , Lindsay A.L. Bazydlo
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Abstract

Background

Immunoassays are important for routine clinical testing and medical diagnosis. However, they are limited by cross-reactivity especially at low analyte concentrations. There is a critical need to investigate compounds that can interfere with immunoassays. Herein, we describe the identification of canrenone, a spironolactone metabolite that falsely increases progesterone concentrations on the Abbott Architect i2000 Immunoassay.

Methods

Serum samples and assay diluents were spiked with spironolactone or canrenone and progesterone concentrations were measured on the Architect i2000 and Immulite XPi immunoassay platforms. Blood samples from patients taking spironolactone were analyzed with liquid chromatography-tandem mass spectrometry to evaluate the intrinsic response of progesterone concentrations to the presence of canrenone.

Results

We measured approximately 10-fold higher progesterone concentrations on the Abbott Architect i2000 compared to reference immunoassay analyzers (Siemens Immulite XPi and Roche Cobas e601/602), suggesting an analytical error which is unique to the Architect i2000 antibody and/or assay conditions. By measuring serum progesterone after addition of spironolactone or canrenone to serum samples, we found that canrenone falsely increased progesterone on the Architect i2000 immunoassay. However, this interference was more pronounced at low serum progesterone concentrations. Moreover, a strong positive correlation was seen between canrenone and measured serum progesterone concentrations.

Conclusions

Our investigations are important for individuals who require progesterone measurements using the Architect i2000 immunoassay, especially because it is unlikely for clinicians to order canrenone measurements alongside progesterone measurements for individuals taking spironolactone. Further research is needed to determine whether canrenone can influence progesterone measurements on other immunoassay systems.

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螺内酯代谢物会导致雅培 Architect 免疫测定法中孕酮的假性升高。
背景:免疫测定对于常规临床检测和医学诊断非常重要。然而,它们受到交叉反应的限制,尤其是在分析物浓度较低时。研究可能干扰免疫测定的化合物迫在眉睫。在此,我们描述了对坎利酮的鉴定,坎利酮是一种螺内酯代谢物,会错误地增加雅培 Architect i2000 免疫分析仪上的孕酮浓度:方法:在血清样本和检测稀释液中添加螺内酯或坎利酮,并在 Architect i2000 和 Immulite XPi 免疫测定平台上测量孕酮浓度。使用 LC-MS/MS 对服用螺内酯的患者的血液样本进行分析,以评估孕酮浓度对坎利酮存在的内在反应:与参考免疫测定分析仪(西门子 Immulite XPi 和罗氏 Cobas e601/602)相比,我们在雅培 Architect i2000 上测得的孕酮浓度高出约 10 倍,这表明存在 Architect i2000 抗体和/或测定条件所特有的分析误差。通过在血清样本中加入螺内酯或坎利酮后测量血清孕酮,我们发现坎利酮会错误地增加 Architect i2000 免疫测定中的孕酮。不过,这种干扰在血清孕酮浓度较低时更为明显。此外,还发现坎利酮与所测得的血清孕酮浓度之间存在很强的正相关性:我们的研究对于需要使用 Architect i2000 免疫测定法测定孕酮的人来说非常重要,特别是因为临床医生不太可能在测量服用螺内酯的人的孕酮时同时测量坎利酮。还需要进一步研究,以确定坎利酮是否会影响其他免疫测定系统的孕酮测量结果。
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来源期刊
Clinical biochemistry
Clinical biochemistry 医学-医学实验技术
CiteScore
5.10
自引率
0.00%
发文量
151
审稿时长
25 days
期刊介绍: Clinical Biochemistry publishes articles relating to clinical chemistry, molecular biology and genetics, therapeutic drug monitoring and toxicology, laboratory immunology and laboratory medicine in general, with the focus on analytical and clinical investigation of laboratory tests in humans used for diagnosis, prognosis, treatment and therapy, and monitoring of disease.
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