Advances and challenges in the measurement of 1,25-dihydroxyvitamin D: a comprehensive review.

IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Critical reviews in clinical laboratory sciences Pub Date : 2023-11-01 Epub Date: 2023-06-05 DOI:10.1080/10408363.2023.2212765
Zhicheng Jin, Roger L Bertholf, Xin Yi
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Abstract

Vitamin D has received significant attention from clinical societies, researchers, and the general population in recent years. While 25-hydroxyvitamin D (25(OH)D) is the most commonly-used biomarker of vitamin D status, 1α,25-dihydroxyvitamin D (1,25(OH)2D), its bioactive form, plays a critical role in regulating calcium and phosphorus homeostasis and is also involved in the immune system and cellular differentiation. Consequently, accurate measurements of 1,25(OH)2D can aid in the differential diagnosis of calcium-related disorders such as hypocalcemia in vitamin D-dependent rickets and hypercalcemia due to inappropriate increase of serum 1,25(OH)2D in granulomatous diseases. However, due to its lipophilicity and very low circulating concentration, the measurement of 1,25(OH)2D is particularly challenging. Over the past several decades, numerous efforts have been made to develop sensitive, specific, and practical laboratory methods for measuring 1,25(OH)2D. Methods using radioreceptor assay, radioimmunoassay, enzyme immunoassay, enzyme-linked immunosorbent assay, automated chemiluminescent immunoassay, and liquid chromatography-tandem mass spectrometry have been described. Each of these methods has unique advantages and limitations, and some are no longer used. Despite the sophisticated methods in use today, substantial variations between methods still exist. A concerted effort toward standardization of 1,25(OH)2D measurement is needed to ensure accurate and reliable results across laboratories and methods.

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1,25-二羟基维生素D测定的进展和挑战:综述。
近年来,维生素D受到了临床学会、研究人员和普通人群的极大关注。虽然25-羟基维生素D(25(OH)D)是维生素D状态最常用的生物标志物,但其生物活性形式1α,25-二羟维生素D(1,25(OH)2D)在调节钙和磷稳态方面发挥着关键作用,还参与免疫系统和细胞分化。因此,1,25(OH)2D的准确测量有助于钙相关疾病的鉴别诊断,如维生素D依赖性软骨病的低钙血症和肉芽肿性疾病中由于血清1,25。然而,由于其亲脂性和非常低的循环浓度,1,25(OH)2D的测量特别具有挑战性。在过去的几十年里,已经做出了许多努力来开发用于测量1,25(OH)2D的灵敏、特异和实用的实验室方法。介绍了放射受体测定法、放射免疫测定法、酶联免疫吸附测定法、自动化学发光免疫测定法和液相色谱-串联质谱法。每种方法都有其独特的优点和局限性,有些方法已不再使用。尽管目前使用的方法很复杂,但方法之间仍然存在很大的差异。需要共同努力实现1,25(OH)2D测量的标准化,以确保实验室和方法的结果准确可靠。
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来源期刊
CiteScore
20.00
自引率
0.00%
发文量
25
审稿时长
>12 weeks
期刊介绍: Critical Reviews in Clinical Laboratory Sciences publishes comprehensive and high quality review articles in all areas of clinical laboratory science, including clinical biochemistry, hematology, microbiology, pathology, transfusion medicine, genetics, immunology and molecular diagnostics. The reviews critically evaluate the status of current issues in the selected areas, with a focus on clinical laboratory diagnostics and latest advances. The adjective “critical” implies a balanced synthesis of results and conclusions that are frequently contradictory and controversial.
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