Analytical Interference in Chemiluminescence Assay–Measured Angiotensin I, Angiotensin II, Aldosterone, and Renin

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY Journal of Clinical Laboratory Analysis Pub Date : 2024-06-01 DOI:10.1002/jcla.25045

Xiaohua Xu, Yongzhi Xu, Shengqiang Liang

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Abstract

Background

The interference can be a significant source of laboratory errors with the potential to cause immunoassay results to drift. Therefore, we evaluated the interference in various endogenous and exogenous substances on immunoassay for angiotensin I (Ang I), angiotensin II (Ang II), aldosterone, and renin in vitro.

Methods

Ten endogenous and eight exogenous substances were evaluated at supraphysiologic or supratherapeutic plasma levels using the screening study to identify potential interfering substances. Subsequently, potential interfering substances were further tested within maximum pathological or therapeutic plasma concentration ranges using the dose–response study to determine whether the interference has a significant bias. According to preset acceptance criteria, the interference in potential interfering substances for Ang I, Ang II, and renin and aldosterone assays was determined.

Results

Six potential interfering substances for Ang I immunoassays were identified, namely valsartan, nifedipine, spironolactone, cholesterol, hemoglobin, and triglyceride. Meanwhile, ethanol, nifedipine, spironolactone, heparin sodium, warfarin, hemoglobin, uric acid, cholesterol, and triglyceride appeared to have potential interference in the Ang II assay. Three identified as possible interferents for aldosterone immunoassays were glucose, valsartan, and spironolactone. Moreover, warfarin, valsartan, spironolactone, uric acid, cholesterol, bilirubin unconjugated, triglyceride, and hemoglobin were potential interfering substances for renin immunoassays. However, only spironolactone of these potential interfering substances exceeded preset mean bias limits (less than ±10.0%) in aldosterone immunoassays.

Conclusion

Exogenous spironolactone caused clinically significant interference in aldosterone immunoassays. Moreover, the interference in other substances was acceptable in Ang I, Ang II, and renin and aldosterone immunoassays.

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化学发光测定法测量的血管紧张素 I、血管紧张素 II、醛固酮和肾素的分析干扰。

背景：干扰是实验室误差的一个重要来源，有可能导致免疫测定结果漂移。因此，我们评估了各种内源性和外源性物质对体外血管紧张素 I（Ang I）、血管紧张素 II（Ang II）、醛固酮和肾素免疫测定的干扰：采用筛选研究法评估了超生理或超治疗血浆水平的 10 种内源性物质和 8 种外源性物质，以确定潜在的干扰物质。随后，利用剂量反应研究在最大病理或治疗血浆浓度范围内对潜在干扰物质进行进一步测试，以确定干扰是否会产生显著偏差。根据预设的接受标准，确定潜在干扰物质对 Ang I、Ang II、肾素和醛固酮测定的干扰：结果：确定了六种潜在干扰物质对 Ang I 免疫测定的干扰，分别是缬沙坦、硝苯地平、螺内酯、胆固醇、血红蛋白和甘油三酯。同时，乙醇、硝苯地平、螺内酯、肝素钠、华法林、血红蛋白、尿酸、胆固醇和甘油三酯似乎对 Ang II 检测有潜在干扰。葡萄糖、缬沙坦和螺内酯可能对醛固酮免疫测定产生干扰。此外，华法林、缬沙坦、螺内酯、尿酸、胆固醇、未结合胆红素、甘油三酯和血红蛋白也是肾素免疫测定的潜在干扰物质。然而，在醛固酮免疫测定中，这些潜在干扰物质中只有螺内酯超过了预设的平均偏差限（小于±10.0%）：结论：外源性螺内酯会对醛固酮免疫测定产生明显的临床干扰。结论：外源性螺内酯会对醛固酮免疫测定产生明显的临床干扰，而其他物质对血管紧张素Ⅰ、血管紧张素Ⅱ、肾素和醛固酮免疫测定的干扰是可以接受的。

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来源期刊

Journal of Clinical Laboratory Analysis 医学-医学实验技术

CiteScore

5.60

自引率

7.40%

发文量

584

审稿时长

6-12 weeks

期刊介绍： Journal of Clinical Laboratory Analysis publishes original articles on newly developing modes of technology and laboratory assays, with emphasis on their application in current and future clinical laboratory testing. This includes reports from the following fields: immunochemistry and toxicology, hematology and hematopathology, immunopathology, molecular diagnostics, microbiology, genetic testing, immunohematology, and clinical chemistry.