High dose ascorbic acid treatment in COVID-19 patients raised some problems in clinical chemistry testing

2020 ◽  
Vol 45 (5) ◽  
pp. 491-498
Author(s):  
Fatih Yesildal ◽  
Ferruh Kemal Isman
Keyword(s):  
Ascorbic Acid ◽  
Ldl Cholesterol ◽  
Clinical Chemistry ◽  
Assay Method ◽  
High Dose ◽  
Serum Samples ◽  
Choice Of Treatment ◽  
High Concentrations ◽  
Clinical Chemistry Tests ◽  
Abbott Architect

AbstractObjectiveCOVID-19 pandemia still continues to threaten the whole world. High dose ascorbic acid (AA) infusion is a choice of treatment and its efficiency is still being investigated. AA interferes with many clinical chemistry tests. However, data about the interference of high concentrations of AA is not sufficient. In this study, we aimed to investigate the interference of AA at high concentrations on commonly used chemistry assays.Materials and MethodsSerum samples at AA concentrations of 200, 150, 100, 75, 50, 25, 10, 5, 2 and 0 mg/dL were prepared by using the stock solution of 15000 mg/dL AA. Each sample was analyzed by using the most common 30 chemistry tests (Abbott Architect C8000, Illinois, USA) and a POCT glucometer (STANDARD GlucoNavii, Gyeonggi-do, Republic of Korea).ResultsCreatinine, sodium and glucose (POCT) tests were found to be positively interfered by increasing AA concentrations; while direct bilirubin, lipase, UIBC, triglyceride, total cholesterol, HDL/LDL cholesterol tests were negatively interfered. Absolute interference (%) increased as the AA concentration increased.ConclusionThis is the largest and first study to investigate the interference of high dose AA, which is used in severe COVID-19 patients nowadays. Manufacturers and clinicians should be aware of the possibility of aberrant results due to high dose AA infusion. Clinicians should not forget to consult a laboratory specialist, since he is the only person to monitor the reactions in all assays, and know the technical subjects like interferences, assay method specifications. This issue is very important for correct decision-making and interpretation of the data-mining studies accurately and efficiently.

scholarly journals Gentamicin and Vancomycin Interference on Results of Clinical Chemistry Parameters on Abbott Architect c8000

2019 ◽  
Vol 143 (6) ◽  
pp. 738-747
Author(s):  
Tina Brencic ◽  
Nora Nikolac
Keyword(s):  
Clinical Chemistry ◽  
Immunoglobulin A ◽  
Direct Bilirubin ◽  
University Hospital ◽  
Serum Samples ◽  
Acceptance Criteria ◽  
Vancomycin Concentration ◽  
Drug Concentrations ◽  
High Concentrations ◽  
Clinical Chemistry Tests

Context.— Gentamicin and vancomycin are nephrotoxic antibiotics. Little is known about the influence of drug concentrations on results of clinical chemistry tests. Objective.— To investigate gentamicin and vancomycin interference on results of 33 commonly measured biochemistry tests. Design.— The study was carried out in the University Department of Chemistry, Medical School University Hospital Sestre Milosrdnice (Zagreb, Croatia). For each drug, 10 aliquots of pooled serum were prepared. In order to cover toxic concentrations, pool serum samples were spiked with drugs to obtain 0 to 50 μg/mL of gentamicin and 0 to 200 μg/mL of vancomycin. Biochemistry tests were measured in duplicate on the Architect c8000 analyzer, and drug concentrations were measured on Architect i2000 SR (both Abbott Laboratories, Abbott Park, Illinois). For each tested concentration, bias was calculated against the initial measurement. Acceptance criteria were defined as measurement uncertainty of the commercial control with the value close to the measured range of the pool sample. Results.— For gentamicin, all bias values were below established criteria. For vancomycin, significant changes were observed for potassium, direct bilirubin, and immunoglobulin A. Significant bias was already detected at low vancomycin concentration (2.98 μg/mL) for direct bilirubin (bias = 9.7%; acceptable = 8%). Potassium bias at the highest vancomycin concentration (204.4 μg/mL) exceeded acceptance criteria (bias = 4.5%; acceptable = 4%). For immunoglobulin A, no apparent trend was observed, and bias is attributed to increased method imprecision. Conclusions.— Gentamicin did not interfere with the results of clinical chemistry tests. Direct bilirubin concentration is falsely increased in the presence of vancomycin, and potassium is affected at high concentrations.

scholarly journals The Influence of Cell Culture Density on the Cytotoxicity of Adipose-Derived Stem Cells Induced by L-Ascorbic Acid-2-Phosphate

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuan-Kun Wu ◽  
Yuan-Kun Tu ◽  
Jiashing Yu ◽  
Nai-Chen Cheng
Keyword(s):  
Stem Cells ◽  
Ascorbic Acid ◽  
Cell Sheet ◽  
Metabolic Stress ◽  
Seeding Density ◽  
Cell Contact ◽  
High Dose ◽  
Adipose Derived Stem Cells ◽  
Enhanced Expression ◽  
High Concentrations

AbstractAscorbic acid-2-phosphate (A2-P) is an oxidation-resistant derivative of ascorbic acid that has been widely employed in culturing adipose-derived stem cells (ASCs) for faster expansion and cell sheet formation. While high dose ascorbic acid is known to induce cellular apoptosis via metabolic stress and genotoxic effects, potential cytotoxic effects of A2-P at high concentrations has not been explored. In this study, the relationship between ASC seeding density and A2-P-induced cytotoxicity was investigated. Spheroid-derived ASCs with smaller cellular dimensions were generated to investigate the effect of cell-cell contact on the resistance to A2-P-induced cytotoxicity. Decreased viability of ASC, fibroblast, and spheroid-derived ASC was noted at higher A2-P concentration, and it could be reverted with high seeding density. Compared to control ASCs, spheroid-derived ASCs seeded at the same density exhibited decreased viability in the A2-P-supplemented medium. The expression of antioxidant enzymes (catalase, SOD1, and SOD2) was enhanced in ASCs at higher seeding densities. However, their enhanced expression in spheroid-derived ASCs was less evident. Furthermore, we found that co-administration of catalase or N-acetylcysteine nullified the observed cytotoxicity. Collectively, A2-P can induce ASC cytotoxicity at higher concentrations, which can be prevented by seeding ASCs at high density or co-administration of another antioxidant.

scholarly journals Measurements for 8 Common Analytes in Native Sera Identify Inadequate Standardization among 6 Routine Laboratory Assays

2014 ◽  
Vol 60 (6) ◽  
pp. 855-863 ◽  
Author(s):  
Hedwig C M Stepman ◽  
Ulla Tiikkainen ◽  
Dietmar Stöckl ◽  
Hubert W Vesper ◽  
Selvin H Edwards ◽  
...  
Keyword(s):  
Uric Acid ◽  
Ldl Cholesterol ◽  
Peer Group ◽  
Clinical Chemistry ◽  
Total Error ◽  
Random Access ◽  
Reference Method ◽  
Hdl Cholesterol ◽  
Serum Samples ◽  
Fresh Frozen

Abstract BACKGROUND External quality assessment (EQA) with commutable samples is essential for assessing the quality of assays performed by laboratories, particularly when the emphasis is on their standardization status and interchangeability of results. METHODS We used a panel of 20 fresh-frozen single-donation serum samples to assess assays for the measurement of creatinine, glucose, phosphate, uric acid, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The commercial random access platforms included: Abbott Architect, Beckman Coulter AU, Ortho Vitros, Roche Cobas, Siemens Advia, and Thermo Scientific Konelab. The assessment was done at the peer group level and by comparison against the all-method trimmed mean or reference method values, where available. The considered quality indicators were intraassay imprecision, combined imprecision (including sample–matrix interference), bias, and total error. Fail/pass decisions were based on limits reflecting state-of-the-art performance, but also limits related to biological variation. RESULTS Most assays showed excellent peer performance attributes, except for HDL- and LDL cholesterol. Cases in which individual assays had biases exceeding the used limits were the Siemens Advia creatinine (−4.2%), Ortho Vitros phosphate (8.9%), Beckman Coulter AU triglycerides (5.4%), and Thermo Scientific Konelab uric acid (6.4%), which lead to considerable interassay discrepancies. Additionally, large laboratory effects were observed that caused interlaboratory differences of >30%. CONCLUSIONS The design of the EQA study was well suited for monitoring different quality attributes of assays performed in daily laboratory practice. There is a need for improvement, even for simple clinical chemistry analytes. In particular, the interchangeability of results remains jeopardized both by assay standardization issues and individual laboratory effects.

Pattern of partitioning of aflatoxins from feed to urine and its effect on serum chemistry in Nili-Ravi buffalo heifers

2014 ◽  
Vol 54 (10) ◽  
pp. 1671
Author(s):  
N. Aslam ◽  
Z. M. Iqbal ◽  
H. M. Warriach ◽  
P. C. Wynn
Keyword(s):  
Total Protein ◽  
High Performance ◽  
Clinical Chemistry ◽  
Serum Glucose ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Serum Samples ◽  
Significant Difference ◽  
High Concentrations ◽  
Group D

The objectives of the present study were (1) to monitor the pattern of excretion of aflatoxinM1 in urine after its conversion from aflatoxinB1 and (2) to observe the effects of different levels of aflatoxinB1 in feed on serum concentrations of key metabolites glucose, total protein, cholesterol and urea as indicators of metabolic status. Nili-Ravi buffalo heifers (n = 12) of similar age and weight were randomly distributed to four groups. Animals in Groups A, B and C were offered a contaminated cottonseed cake-based concentrate ration at 0.5%, 1.0% and 1.5% of bodyweight, respectively. Control animals in Group D were fed with aflatoxinB1-free green fodder. Based on the level of contamination of the concentrate ration with aflatoxinB1 (554 µg/kg), Groups A, B and C consumed 953, 2022, 3202 µg of aflatoxinB1 daily. Feed samples were analysed at Romer Laboratories Pty Ltd, Singapore by high performance liquid chromatography. AflatoxinM1 quantification in urine samples was conducted using a competitive enzyme-linked immunosorbent assay with kits supplied by Helica Biosystems, Inc., USA. Serum samples were analysed for concentrations of glucose, total protein, cholesterol and urea using clinical chemistry kits provided by Human diagnostics (HUMAN, Biochemica und Diagnostica mbH, Germany). Carry-over rate of aflatoxinM1 in urine for Groups A, B and C was 15.51%, 15.44% and 14.04% of aflatoxinB1 while there was no detectable aflatoxinM1 in the urine of the control group (D). There was no significant difference in the concentrations of serum glucose, total protein and cholesterol between treatment groups. However, the concentration of serum urea was significantly higher (P < 0.05) in the group offered the highest level of aflatoxinB1-contaminated concentrate. This result suggests that mycotoxicosis may compromise protein metabolism and accretion in affected animals. This leaves open the possibility that high concentrations of aflatoxins in milk may ultimately affect the health status of human milk consumers.

Two-dimensional centrifugation for desk-top clinical chemistry.

1985 ◽  
Vol 31 (9) ◽  
pp. 1457-1463 ◽  
Author(s):  
S G Schultz ◽  
J T Holen ◽  
J P Donohue ◽  
T A Francoeur
Keyword(s):  
Whole Blood ◽  
Vision System ◽  
Clinical Chemistry ◽  
Spectrophotometric Analysis ◽  
Optical Measurements ◽  
Flash Lamp ◽  
Microprocessor Control ◽  
Serum Samples ◽  
Mixing Chambers ◽  
Clinical Chemistry Tests

Abstract We have developed a new system for clinical chemistry analysis, the Vision System, in which centrifugal force is used to separate whole blood, measure reagent and plasma volumes, and complete all steps required for a spectrophotometric analysis. The system is based on use of a multichambered plastic test pack containing liquid reagents, which can be centrifuged at 500 X g in two planes, oriented at right angles to each other. Alternating centrifugal fields allows liquid reagents and plasma to flow into highly precise measuring and mixing chambers. A unique flash lamp and diode array spectrometer provide for optical measurements of 10 test packs at as many as eight wavelengths simultaneously. The temperature of each individual test pack is controlled by using a flash lamp coupled to a liquid crystal temperature sensor. Microprocessor control allows as many as 10 different chemistry reactions to be measured simultaneously on whole-blood, plasma, or serum samples. Comparison with results by an established batch-photometric analyzer demonstrated excellent precision and accuracy for various clinical chemistry tests.

PLASMA CORTICOSTEROID LEVELS AND ADRENAL ASCORBIC ACID AFTER INTRAVENOUS CORTICOTROPHIN INJECTIONS AND »STRESSFUL« STIMULI IN THE RAT

1962 ◽  
Vol 39 (4) ◽  
pp. 527-538 ◽  
Author(s):  
Pavo Hedner ◽  
Claus Rerup
Keyword(s):  
Ascorbic Acid ◽  
Abdominal Surgery ◽  
Response Curve ◽  
Significant Rise ◽  
Blocking Effect ◽  
High Dose ◽  
Ascorbic Acid Concentration ◽  
Unilateral Adrenalectomy ◽  
Subcutaneous Injections ◽  
Hypophysectomized Rats

ABSTRACT Measurements of plasma corticosteroid levels and adrenal ascorbic acid concentration in steroid blocked and hypophysectomized rats were performed. It was found that prednisolone and dexamethasone were effective in blocking endogenous corticotrophin release within 3–4 hours after subcutaneous injection. These agents also prevented completely the normally occurring rise in plasma corticoid levels after exposure of the rats to ether. Abdominal surgery (unilateral adrenalectomy) resulted in a slight but significant rise in plasma corticoid levels in spite of dexamethasone blockade. The values of adrenal ascorbic acid were not affected significantly. The blocking effect of two daily subcutaneous injections of a high dose of dexamethasone persisted for about one week after the last injection. The sensitivity of the plasma corticoid response was essentially the same in hypophysectomized and dexamethasone blocked rats. The lower part of the log dose response curve was found to be clearly non-linear in the plasma corticoid method following intravenous corticotrophin injection. As a consequence the dose level in quantitative assays of intravenously injected corticotrophin are, in our hands, of the same order as in the adrenal ascorbic acid depletion method.

Elimination of Ascorbic Acid After High-Dose Infusion in Prostate Cancer Patients: A Pharmacokinetic Evaluation

2014 ◽  
Vol 116 (4) ◽  
pp. 343-348 ◽  
Author(s):  
Torben K. Nielsen ◽  
Martin Højgaard ◽  
Jon T. Andersen ◽  
Henrik E. Poulsen ◽  
Jens Lykkesfeldt ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Ascorbic Acid ◽  
Cancer Patients ◽  
High Dose ◽  
Dose Infusion ◽  
Pharmacokinetic Evaluation

scholarly journals Concentration-Dependent Antioxidant/Pro-Oxidant Activity of Ascorbic Acid in Chickens

2012 ◽  
Vol 66 (6) ◽  
pp. 256-260
Author(s):  
Nadežda Berzina ◽  
Jurijs Markovs ◽  
Mirdza Apsīte ◽  
Svetlana Vasiļjeva ◽  
Galina Smirnova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Ascorbic Acid ◽  
Cadmium Concentration ◽  
Dehydroascorbic Acid ◽  
Cadmium Accumulation ◽  
Suppressive Effect ◽  
High Dose ◽  
Dependent Manner ◽  
Treatment Groups ◽  
Liver And Kidney

The effects of ascorbic acid supplementation on biomarkers of oxidative stress, cadmium accumulation in organs, immune system activity and kidney function in chickens were investigated. The treatment groups of chickens were fed either plain diet or diet supplemented with ascorbic acid at 100, 500, 1000 and 2000 mg/kg for four weeks. Liver and kidney tissues were assayed for cadmium concentration, and the hepatic levels of ascorbic acid and dehydroascorbic acid (DHAA; the oxidised form), malondialdehyde, glutathione, activity of glutathione peroxidase, blood serum uric acid, creatinine, lysozyme and circulating immune complexes were measured. Supplementation with a high dose of ascorbic acid (1000 and 2000 mg/kg in the diet) caused an imbalance between pro-oxidative and antioxidative activities, and induced a suppressive effect on innate immunity. The results suggest that oxidative stress compromises renal function. We observed that ascorbic acid increased cadmium accumulation in a dose-dependent manner.

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