How to Increase Laboratory Accuracy with Direct HbA1c Testing !

HbA1c:

Diabetes is a global epidemic affecting in the region of 425 million people according to the International Diabetes Federation. Worryingly, this figure is on the rise with forecasts suggesting diabetes will affect up to 629 million people globally by 2045. Such a dramatic increase highlights the fundamental need for better disease management. When we look at the worldwide prevalence of diabetes, the United States is one of the most prominent countries affected.

HbA1c - an important biomarker for diabetes management and control !

HbA1c, also known as hemoglobin A1c or glycated hemoglobin, is an important blood test used to determine how well diabetes is being controlled. It develops when hemoglobin, a protein within the red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming “glycated.” The concentration of HbA1c in the blood of diabetic patients increases with rising blood glucose levels and is representative of the mean blood glucose level over the preceding six to eight weeks. HbA1c can therefore be described as a long-term indicator of diabetic control, unlike blood glucose which is only a short-term indicator of diabetic control. It is recommended that HbA1c levels are monitored every three to four months.

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Tumor Marker Tests Overused in Primary and Secondary Care !

A tumor marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. The vast majority of tumor marker tests in primary and secondary care may not be necessary as the tests assisted with a cancer diagnosis in just 2% of patients.

Tumor markers are molecules, which may be present in higher than usual concentrations in the tissue, serum or other body fluids of patients with cancer. There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer. A tumor marker can be used to aid diagnosis in specific situations but testing for more than one marker is not recommended.

Scientists at South West Wales Cancer Centre (Cardiff, UK) examined the number of multiple tumor marker requests from primary and secondary care over a six-month period within Abertawe Bro Morgannwg University Health Board (Bagain, Neath Port Talbot, Wales). Multiple requests were defined as more than one tumors marker for a patient in a two-week period. The team looked at how many patients with multiple tumor markers measured were subsequently diagnosed with cancer, and whether the markers assisted with the diagnosis.

Common tumor markers used in the diagnosis of cancer

Read more: Tumor Marker Tests Overused in Primary and Secondary Care !

Source: LabMedica

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High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Troponin is a widely used biomarker in patients with cardiac disease. The use of troponin is well established in patients with suspected acute myocardial infarction (AMI), but troponin measurement is also used in other acute and nonacute settings. In patients with suspected AMI, early decision-making is crucial to allow rapid treatment and further diagnostic evaluation. Current guidelines recommend serial measurements of troponin with a cut-off concentration at the 99th percentile to triage patients in the emergency department.

Newer, high-sensitivity assays for troponin enable the detection of distinctly lower concentrations. Using these assays and very low cut-off concentrations, several rapid diagnostic strategies have been reported to improve diagnosis in acute cardiac care. Furthermore, noncoronary and non-acute applications of troponin assays — for example as a biomarker in patients with heart failure, pulmonary embolism, or stable coronary artery disease — are on the horizon and might improve individual risk stratification.

In this Review, we provide an overview on the development of high-sensitivity assays for troponin, and their application in patients with cardiac disease.

Pathophysiological background of troponin and troponin release

in different settings. A schematic overview of myocardial structure

related to troponin (inset), as well as the plasma troponin concentrations 

in different clinical settings (young and healthy, elderly or chronic diseases,

myocardial injury, and myocardial infarction).

Read more: High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Source: NatureReviewsCadiology

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Serum Level Measurements Improve Disease Risk Prediction.

Results obtained by using a commercially available uromodulin ELISA kit to analyze serum samples from individuals at risk for heart and circulatory system diseases indicated that this kidney-specific protein is a biomarker not only for kidney disease but also for cardiovascular diseases.

The glycoprotein uromodulin, also known as Tamm-Horsfall protein (THP), is synthesized exclusively in the kidneys and subsequently secreted. Low uromodulin concentrations in serum are a sensitive indicator for a loss of kidney function and thus play a role in the diagnosis of various renal diseases (nephropathies). When renal function is impaired, the uromodulin concentration in the serum sinks rapidly. Therefore, renal functional disorders can be identified at a very early stage of kidney damage, even in cases with few symptoms.

Uromodulin -a biomarker not only for kidney disease but also for cardiovascular diseases.

Read more: Serum Level Measurements Improve Disease Risk Prediction.

Source: LabMedica

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Study Finds Potential New Biomarker For Cancer Patient Prognosis

To treat or not to treat? That is the question researchers at the Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab) hope to answer with a new advance that could help doctors and their cancer patients decide if a particular therapy would be worth pursuing.

Berkeley Lab researchers identified 14 genes regulating genome integrity that were consistently overexpressed in a wide variety of cancers. They then created a scoring system based upon the degree of gene overexpression. For several major types of cancer, including breast and lung cancers, the higher the score, the worse the prognosis. Perhaps more importantly, scores could accurately predict patient response to specific cancer treatments.

The researchers said the findings, to be published Wednesday, Aug. 31, in the journal Nature Communications, could lead to a new biomarker for the early stages of tumor development. The information obtained could help reduce the use of cancer treatments that have a low probability of helping.

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The centromeres and kinetochores of a chromosome play critical roles during cell division. In mitosis,
microtubule spindle fibers attach to the kinetochores, pulling the chromatids apart. A breakdown in this
process causes chromosome …more

Source: medicalxpress

Biomarker Predicts Risk of Preterm Birth Earlier

A standard biomarker test offered earlier in pregnancy could potentially help doctors to better identify women at risk of giving birth prematurely, thus enabling health services to focus treatments on women at highest risk.

A number of factors are used to determine if a woman is at risk of giving birth prematurely, including a history of preterm births or late miscarriages. Two further factors which clinicians normally consider are the length of cervix and levels of a biomarker found in vaginal fluid known as fetal fibronectin.

Scientists at King's College London (London, UK) compared measurements of a new fetal fibronectin test in the cervicovaginal fluid of women at 18 to 21 weeks of gestation with measurements made at 22 to 27 weeks of gestation, to see which time period offered the best prediction of spontaneous preterm birth. They also explored whether using a low (10 ng/mL) and high (200 ng/mL) threshold would more accurately classify a women's risk of giving birth prematurely.

Read more: Biomarker Predicts Risk of Preterm Birth Earlier

Fetal fibronectin is a “glue-like” protein that holds the developing baby in the womb

Source: Hologic Inc.

Novel Biomarker Predicts Breast Cancer Risk in Asymptomatic Women

A biomarker has been identified that may allow clinicians to predict the risk of an asymptomatic woman eventually developing breast cancer.

To identify this disease indicator, investigators at Harvard Medical School studied the association between breast cancer risk and the frequency of mammary epithelial cells expressing the proteins p27 (Cyclin-dependent kinase inhibitor 1B), estrogen receptor (ER), and Ki67 (Marker of proliferation Ki-67) in normal breast tissue from 302 women (69 breast cancer cases, 233 controls) who had been initially diagnosed with benign breast disease.

Immunofluorescence assays for p27, ER, and Ki67 were performed on tissue microarrays constructed from benign biopsies containing normal mammary epithelium and scored by computational image analysis.

Read more: Novel Biomarker Predicts Breast Cancer Risk in Asymptomatic Women

Source: gettyimages