Effect of blood collection and processing on radioimmunoassay results for apolipoprotein B in plasma

We studied the effects of different blood collection and processing procedures on quantification of apolipoprotein (apo) B by radioimmunoassay. High-density lipoprotein subfractions HDL3 and HDL2 and isolated apoA-I did not cross-react in the assay. Analytical recovery of apoB at different doses of very-low- and low-density lipoproteins were complete. Inter- and intra-assay coefficients of variation (CVs) averaged 7.4% and 6.0%, respectively. Blood from 20 subjects was collected into tubes containing EDTA alone or EDTA with antiproteolytic and antioxidant agents; one half of each plasma was separated immediately, half after 3 h at 4 degrees C. Regardless of the addition of protective agents or the time difference in separating plasma from other blood elements, freezing plasma at -70 degrees C decreased apoB content a similar amount, an average of 6.8%. This loss of apoB immunoreactivity was not related to apoB content in fresh plasma. Analysis of variance showed no differential effect on apoB content by the various additions to whole blood or plasma. No additional apoB content was lost in once-frozen aliquots of three human plasma pools during storage at -70 degrees C for up to 18 months. We conclude that concentrations of apoB in human plasma can be measured reliably after long-term storage, although the absolute value may decrease slightly as a result of freezing.     

Effects of temperature on stability of blood homocysteine in collection tubes containing 3-deazaadenosine

BACKGROUND: The accuracy of homocysteine (Hcy) results is currently compromised by the requirement to separate the plasma within 1 h of sample collection. We studied the effect of temperature on the stability of plasma Hcy over a 72-h time course in blood collected into evacuated tubes containing either EDTA alone or both EDTA and 3-deazaadenosine (3DA). METHODS: We recruited 100 volunteers, including both diseased and healthy individuals with a range of baseline plasma Hcy values, from two centers. Blood samples were collected into tubes containing EDTA, and EDTA plus 3DA and stored at ambient temperature (20-25 degrees C) or refrigerated (2-8 degrees C). Aliquots of blood were centrifuged at various times up to 72 h, the plasma was removed, and Hcy was measured by HPLC. RESULTS: Plasma Hcy measurement covering the sample collection and storage conditions during the whole time course was possible on samples from 59 of those recruited. One-way ANOVA for repeated measures within subjects revealed that only samples that were collected into tubes containing EDTA plus 3DA and stored refrigerated were stable over 72 h (P = 0.2761). CONCLUSIONS: A combination of 3DA and storage at 2-8 degrees C will allow collection of samples for plasma Hcy measurement outside of the hospital setting and wider population screening.     

Hormone stability in human whole blood

OBJECTIVE: To determine whether significant changes in the plasma concentrations of 17 hormones occur when human whole blood is held at 4 or 24 degrees C for up to 24 h before separation of the plasma fraction. DESIGN AND METHODS: Blood samples (EDTA) from healthy human volunteers were held at 4 degrees C or 24 degrees C for 0.5, 6 or 24 h before separation. Plasma concentrations of ACTH, aldosterone, gonadotrophin alpha-subunits, AVP, C-peptide, estradiol, FSH, GH, glucagon, IGF-1, IGFBP3, insulin, leptin, LH, prolactin, PTH and VIP were measured and the results compared to baseline values. Nonlinear regression was used to test for a significant mean rate of change. The time interval for median concentrations to change by 10% was determined. RESULTS: Significant changes were observed for ACTH (decrease at 18.6 hr, 4 degrees C; 17.5 hr, 24 degrees C); AVP (increase at 2.6 h, 24 degrees C); insulin (decrease at 16.8 hr, 4 degrees C; 16.9 hr, 24 degrees C) and VIP (increase at 18.6 h, 24 degrees C). No changes were detected for the remaining analytes.B CONCLUSIONS: The measurement of some hormones is compromised by a delay in plasma separation from normal human blood. While many hormones appear stable in normal whole blood, we recommend that processing occurs without delay.     

Effect of collection tube type and preanalytical handling on myeloperoxidase concentrations

BACKGROUND: Myeloperoxidase (MPO) has shown potential as a marker for cardiovascular disease. Limited studies have been published with a variety of sample types, resulting in a wide range of MPO values. Little is known or understood about the impact of collection tube type and preanalytical handling of specimens for MPO determination. METHOD: MPO concentration was determined by use of the ARCHITECT(R) MPO research use assay, which is currently under development. Samples were collected into multiple anticoagulant collection tubes from donors and patients presenting to the emergency department with symptoms of acute coronary syndromes. Whole blood was stored on ice or at room temperature for predetermined time periods. We also evaluated serum and plasma after centrifugation followed by storage at room temperature, 2-8 degrees C, and below -10 degrees C. RESULTS: Baseline sample concentrations were dependent on collection tube type as well as handling conditions. MPO concentrations were consistently higher in samples collected in serum and heparin plasma tubes than in samples in EDTA or citrate tubes. Spike recovery was acceptable in all sera and plasma tested, indicating that the increased MPO concentrations were not due directly to an anticoagulant interference. CONCLUSIONS: The collection tube type and preanalytical handling are critical for accurate and consistent MPO measurement. The preferred anticoagulant and tubes are the EDTA or EDTA plasma preparation tube. MPO concentrations in samples collected in these tubes are stable before centrifugation as whole blood as well as plasma after processing.     

Stability of YKL-40 concentration in blood samples

The stability of YKL-40, a mammalian member of the family of 18 glycosylhydrolases, in blood samples handled under different temperatures and different time intervals before centrifugation was studied in paired serum and plasma samples from 25 healthy premenopausal Danish women. Significant elevations of YKL-40 were found in 8 paired serum samples left on the clot for more than 3 h at room temperature compared to paired serum samples left on the clot for 3 h or less. Significant elevations of YKL-40 were found in 8 paired plasma (EDTA) samples left on the blood cells for more than 8 h at room temperature compared to paired plasma (EDTA) samples left on the blood cells for 8 h or less. No elevations were found in YKL-40 levels in serum samples left on the clot at 4 degrees C for 24 h or in plasma (EDTA) samples left on the blood cells for 72 h before centrifugation. Significantly lower concentrations of YKL-40 were measured in plasma (EDTA) compared with paired serum samples with a serum/plasma ratio of 1.4 in samples left on the clot or on blood cells at 4 degrees C for up to 24 h. Repetitive freezing and thawing had no significant effect on the measured YKL-40 concentrations. In conclusion, we have shown that YKL-40 is very dependent on the handling procedures. All the blood samples must be processed into plasma (EDTA) within 8 h at room temperature or into serum in less than 3 h at room temperature. If this is not possible, the blood samples must be stored at 4 degrees C until processed.     

不同处理和保存条件下体外HCV RNA稳定性研究

对献血者或病人进行HCV核酸检测时，如果标本的采集、处理、保存不当，会造成病毒核酸降解，从而影响检测结果的真实性。本研究的目的是对不同抗凝剂、不同温度、不同保存时间下的HCV RNA病毒稳定性进行研究，以考察常规采供血过程中，标本采集及保存方式对NAT检测的影响。采集7例HCV RNA阳性献血者的血样，采用不同的抗凝剂、经不同的温度和不同的时间保存后，采用荧光定量PCR方法测定HCV RNA病毒含量，考察HCV RNA的稳定性。结果表明：①不同抗凝剂抗凝的全血于4℃保存48小时过程中，病毒含量下降至原滴度的42．7％；EDTA抗凝组各时间点的滴度均低于其它3组（分别相当于其它3组的67．6％-25．1％）。②ACD抗凝的全血在4、25和37℃保存48小时．病毒含量分剐下降到原滴度的53．8％、72．5％、29．8％。③ACD抗凝的全血离心分离出血浆，4℃或25℃继续保存7天，病毒含量分别下降至原滴度的70．9％和25．1％。④ACD抗凝的全血分离的血浆，反复冻融4次，病毒含量下降到原滴度的38．9％。结论：①用于核酸检测的标本应该用无菌采血管采样；②在无菌采血管采样的前提下，核酸检测标本用未抗凝血、EDTA、ACD、CPDA抗凝血均可；③采集的全血应避免放置37℃以上，ACD抗凝全血在4℃、25℃保存48小时内、37℃保存14小时内，HCV RNA病毒仍较为稳定；④分离后的血浆应避免放置25℃以上，ACD抗凝全血分离后的血浆在4℃保存7天，25℃保存3天，HCV RNA病毒仍比较稳定；⑤血浆标本应避免多次冻融，但冻融3次的血浆HCV RNA病毒含量仍然较为稳定；⑥无菌采样对维持病毒的稳定性非常重要；单纯的机械性溶血并不会明显导致病毒的降解；只要注意无菌的问题和有合适的核酸提取方法去除血红素，HCV RNA病毒实际上比以前认为的要稳定得多。     

Serum cystatin C in renal transplant patients

BACKGROUND: Waiting temperature before centrifugation and anticoagulants used, markedly effect total homocysteine concentrations. The aim of this study was to investigate the effect of different anticoagulants and temperature on plasma homocysteine levels. METHODS: We studied total homocysteine concentrations in 23 healthy subjects. Blood was drawn in K(3)EDTA, sodium citrate- or sodium fluoride-containing tubes, and kept at 0 degrees C or 22 degrees C for 3 h. Total homocysteine measurements were performed with fluorescence polarization immunoassay (FPIA) method. We compared all results with baseline EDTA values (samples put on crushed ice and centrifuged immediately) recommended in literature for reference handling. RESULTS: At 22 degrees C, the tubes containing sodium citrate and sodium fluoride showed significantly higher total homocysteine concentrations than their respective baseline values (p=0.000). However, sodium fluoride tubes were not significantly different than baseline EDTA levels. Waiting 3 h at 0 degrees C did not effect sodium citrate and EDTA plasma total homocysteine concentrations when compared to baseline EDTA, but sodium fluoride-containing plasma levels were significantly decreased (p=0.000). CONCLUSIONS: According to our results, the most available and practical temperature and anticoagulant for total homocysteine determination is sodium fluoride at room temperature up to 3 h.     

Measurement of acetate in human blood by gas chromatography: effects of sample preparation, feeding, and various diseases.

We measured acetate concentrations in whole blood, serum, and plasma by a modification of a previously described method involving vacuum distillation and gas chromatography. The mean acetate concentration of fresh venous plasma from 27 normal subjects was 51 +/- 5 mumol/L (95% confidence limits ranged from 0 to 103 mumol/L). The acetate concentrations of serum and plasma incubated for 2 h at either 4 degrees C or 27 degrees C were the same. The acetate concentration of whole blood incubated at 27 degrees C was significantly greater than that of blood incubated at 4 degrees C. This change may have resulted from the production of acetate by erythrocytes or from the hydrolysis of acetate esters. Storage of plasma at -20 degrees C for 24 h significantly increased acetate concentrations from 26 +/- 6 mumol/L to 63 +/- 4 mumol/L. After the subjects consumed a standard breakfast, venous plasma acetate concentrations increased from 58 to 97 mumol/L at 30 min. Acetate concentrations in arterial plasma exceeded those in venous plasma. Plasma acetate concentrations were not significantly altered in patients with malignancy or diabetes mellitus, but severe liver disease and severe acidosis were both associated with increased acetate concentrations. These preliminary observations suggest that plasma acetate concentrations may be altered in several disease states.     

On the fluorometric assay of circulating lipoperoxides

The methodology for the measurement of circulating thiobarbituric acid (TBA)-reactive products of lipid peroxidation in human plasma by means of fluorometry has been reinvestigated. The lipid precipitation of plasma with phosphotungstic acid, which step is laid down in the standard assay method, strongly increases the apparent TBA-reactivity. However, subsequent washing of the precipitate may reduce the apparent levels of lipoperoxide to values close to those obtained by using untreated plasma. Also, short-time storage of plasma at either 4 degrees C or -20 degrees C induces large day to day variations in assay results. This phenomenon may be prevented almost completely by the addition of glutathione plus EDTA. It is proposed to use untreated plasma and to perform the assay immediately after collection of plasma or to add both glutathione and EDTA before storage.     

Assessment of the stability of N-terminal pro-brain natriuretic peptide in vitro: implications for assessment of left ventricular dysfunction.

Plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) are raised in patients with left ventricular dysfunction. Measurement of this peptide has a potential diagnostic role in the identification and assessment of patients with heart failure. The stability of this peptide over time periods and conditions pertaining to routine clinical practice has not been reported previously. Blood samples were obtained from 15 subjects. One aliquot was processed immediately, and the remaining portions of the blood samples were stored for 24 h or 48 h at room temperature or on ice prior to processing. Plasma concentrations of NT-proBNP were measured with a novel immunoluminometric assay developed within our laboratory. Mean plasma concentrations of NT-proBNP were not significantly different whether blood samples were centrifuged immediately and stored at -70 degrees C or kept at room temperature or on ice for 24 h or 48 h. The mean percentage differences from baseline (reference standard) were +5.2% (95% confidence interval +18.2 to -7.8%) and +0.8% (+15.2 to -13.7%) after storage for 24 h at room temperature or on ice respectively, and +8.9% (+24.2 to -6. 5%) and +3.2% (+15.1 to -0.9%) for storage for 48 h at room temperature or on ice respectively. Pearson correlation coefficients for baseline NT-proBNP concentrations compared with levels at 48 h at room temperature or on ice were r=0.89 and r=0.83 respectively (both P<0.0001). Thus NT-proBNP extracted from plasma samples treated with EDTA and aprotinin is stable under conditions relevant to clinical practice.     

Effect of delayed blood processing on the yield of factor VIII in cryoprecipitate and factor VIII concentrate

Current standards for the preparation of factor VIII (FVIII) concentrates from human plasma recommend separation of plasma from red cells (RBCs) within 6 hours of blood donation, thereby reducing the volume of plasma from donated whole blood available for processing to FVIII concentrate. The decay of FVIII clotting activity (FVIII:C) in whole blood and plasma stored at 22 and 4 degrees C and the recovery of FVIII:C in cryoprecipitate and FVIII concentrate prepared from plasma separated from whole blood stored overnight at 4 degrees C were investigated. In whole blood stored at 22 degrees C and plasma stored at either 4 or 22 degrees C, 90 percent of the original FVIII:C was present at 6 hours, 80 percent at 12 hours, and 65 to 70 percent at 18 hours. At these times lower levels of FVIII:C were recovered from whole blood stored at 4 degrees C, that is, 84, 68, and 56 percent, respectively. In cryoprecipitates prepared from plasma separated from RBCs after 18 hours' storage at 4 degrees C (18-hour plasma), 43 percent of FVIII:C activity was recovered, as compared with 61 percent recovered from standard plasma separated within 6 hours of donation (6-hour plasma), p less than 0.05. With large-scale preparation of FVIII concentrates, however, the yield of FVIII:C was similar whether 18- or 6-hour plasma was used. Thus FVIII concentrates--but not cryoprecipitates--can be prepared from plasma separated from whole blood stored at 4 degrees C for up to 18 hours without undue loss of potency.     

Optimal conditions for collection of blood samples for assay of α2-macroglobulin trypsin complex-like substance (MTLS)

We have developed an enzyme-linked immunosorbent assay (ELISA) for the specific quantification of α2-macroglobulin-trypsin complex-like substance (MTLS). To exclude artifacts in measured values of MTLS, the conditions for collection of blood samples are critical. In the present study, we have determined the optimal conditions for blood collection and investigated the role of MTLS as a clinical tool for diagnosis in pancreatitis. Results obtained are as follows: (1) MTLS levels of all sera were more than 10-fold higher than the corresponding plasma; (2) MTLS levels of heparinized plasma were the lowest among plasma with three anticoagulants (sodium citrate, sodium EDTA and heparin); (3) some kinds of blood collection tubes containing heparin were not suitable for the sampling; (4) MTLS values of plasma obtained by blood collection tubes containing Trasylol® and sodium EDTA were demonstrated more stable and lower than those obtained by heparin tubes; and (5) under these conditions, we can exclude elevation of MTLS values caused by inappropriate blood sampling and find the time course of the elevation reflecting clinical course of a patient with acute pancreatitis and a patient after endoscopic retrograde cholangiopan-creatography (ERCP). The optimal conditions for collection of blood samples were as follows. Blood sampling should be performed by blood collection tubes containing Trasylol® (50 μl/ml blood) and sodium EDTA (1.5 mg/ml blood). The samples were immediately stored at 4°C and centrifuged at 3,000 rpm for 15 min. The plasma were stored in plastic tubes at 4°C until assayed. © 1996 Wiley-Liss, Inc.     

Stability of YKL-40 concentration in blood samples

The stability of YKL-40, a mammalian member of the family of 18 glycosyl-hydrolases, in blood samples handled under different temperatures and different time intervals before centrifugation was studied in paired serum and plasma samples from 25 healthy premenopausal Danish women. Significant elevations of YKL-40 were found in 8 paired serum samples left on the clot for more than 3 h at room temperature compared to paired serum samples left on the clot for 3 h or less. Significant elevations of YKL-40 were found in 8 paired plasma (EDTA) samples left on the blood cells for more than 8 h at room temperature compared to paired plasma (EDTA) samples left on the blood cells for 8 h or less. No elevations were found in YKL-40 levels in serum samples left on the clot at 4°C for 24 h or in plasma (EDTA) samples left on the blood cells for 72 h before centrifugation. Significantly lower concentrations of YKL-40 were measured in plasma (EDTA) compared with paired serum samples with a serum/plasma ratio of 1.4 in samples left on the clot or on blood cells at 4°C for up to 24 h. Repetitive freezing and thawing had no significant effect on the measured YKL-40 concentrations. In conclusion, we have shown that YKL-40 is very dependent on the handling procedures. All the blood samples must be processed into plasma (EDTA) within 8 h at room temperature or into serum in less than 3 h at room temperature. If this is not possible, the blood samples must be stored at 4°C until processed.     

Effects of sample preparation on concentrations of cyclosporin A measured in plasma

Because cyclosporin A rapidly changes its distribution in blood with changes in temperature, sample preparation affects results for it as measured in plasma. If whole blood is stored at either 4 degrees C or room temperature, results for cyclosporin A in the plasma are lower than in whole blood stored at 37 degrees C and centrifuged at this temperature. Re-equilibration of the former to 37 degrees C before cells are removed increases the analytical recovery of cyclosporin A in plasma; the optimal equilibration interval is 30 min. Use of such re-equilibration, followed by immediate centrifugation at room temperature, increases values obtained for cyclosporin in plasma by 60 to 65% over those determined after non-temperature-standardized collection procedures, but does not significantly improve the correlation between values for plasma and whole blood. Hematocrit and concentrations of cyclosporin A in plasma are inversely related. Correction for hematocrit improves the correlation between results for plasma and whole blood.     

Plasma amino-acids analysis: effects of delayed samples preparation and of storage

This paper describes changes occurring in plasma amino-acid concentrations of: samples which are not prepared for analysis immediately after blood collection and samples stored for 5 to 6 months in the form of either plasma, or of deproteinized plasma, or of deproteinized and at pH 2.2 buffered plasma. Results showed that in order to avoid these changes, plasma should be deproteinized and buffered as soon as possible after blood collection. When analysis could not be performed immediately, storage of samples in a freezer at -18 degrees C in the form of deproteinized and at pH 2.2 buffered plasma showed after 5 to 6 months the best recovery of the initial concentrations, but did not exclude all changes.     

Effects of storage and handling conditions on concentrations of individual carotenoids, retinol, and tocopherol in plasma

We investigated the effects of storage and handling on measured values for carotenoids, retinol, and tocopherol in plasma. We found no significant differences in the concentrations of these analytes measured in plasma samples that were frozen immediately after separation as compared with replicate samples maintained at room temperature in the dark for 24 h. Analytes were stable in solvents for at least 18 h at 23 degrees C after extraction. Purging samples with nitrogen gas before freezing had no detectable beneficial effects. All analytes were stable in plasma stored at -70 degrees C for at least 28 months or at -20 degrees C for five months. By 15 months the concentrations of carotenoids were significantly less (P less than 0.05) in plasma stored at -20 degrees C than in plasma stored at -70 degrees C, while retinol and tocopherol concentrations were not significantly different. Concomitant with the decrease in carotenoids was the appearance of unidentified peaks in the ultraviolet. Adding ascorbic acid or butylated hydroxytoluene antioxidants to the precipitating solvent did not alter the losses of carotenoids or alter the appearance of unidentified peaks. Under appropriate conditions, plasma carotenoids, retinol, and tocopherol are stable for more than two years.     

Improved in vitro stability of serum osteocalcin by using a new commercially available antiproteolytic compound

The effect of a commercially available antiproteolytic compound (OSCAstabil) on the degradation in vitro of serum osteocalcin (Oc) was investigated in serum samples stored at 22, 4 or -30 degrees C (n = 20) or subjected to repeated freeze-thaw cycles (n = 8). The addition of the stabilizing agent immediately after serum preparation increased the Oc stability from < 3 to 6 h at 22 degrees C, from < 3 h to 3 days at 4 degrees C and from 1 day to more than 3 days at -30 degrees C. Up to three freeze-thaw cycles had no influence on the Oc stability, either with or without the stabilizer. The obviously prolonged Oc stability at 22 and 4 degrees C offers a more convenient and reliable Oc estimation procedure for clinical practice. The use of this antiproteolytic agent can be recommended in order to retard the in vitro degradation of serum Oc, not only for clinical routine, but also for studies on metabolic bone diseases.     

Effect of anticoagulants and storage temperatures on stability of plasma and serum hormones

OBJECTIVES: To determine the effect of different anticoagulants and storage conditions on the stability of hormones in plasma and serum. DESIGN AND METHODS: Human blood samples were collected from volunteers into EDTA, lithium heparin, sodium fluoride/potassium oxalate, or tubes without anticoagulant, plasma and serum left at -20 degrees C, 4 degrees C or 30 degrees C for 24 and 120 hours then assayed for ACTH, aldosterone, alpha-subunit, AVP, CRH, C-peptide, estradiol, FSH, glucagon, GH, IGF-1, IGFBP-3, insulin, leptin, LH, PPP, PTH, prolactin and VIP, or at room temperature for 0 to 72 hours (BNP, NT-BNP)(n = 6 per condition). RESULTS: The anticoagulant altered the measured concentrations for 9 hormones when compared to EDTA. All hormones except ACTH were stable for > 120 hours in EDTA or fluoride at 4 degrees C, but only 13 hormones were stable in all anticoagulants. At 30 degrees C, 8 hormones were stable for > 120 hours in EDTA, and 3 hormones in all anticoagulants. BNP and NT-BNP were stable for < 24 hours when stored in EDTA or heparin at room temperature. DISCUSSION: Storage of samples in EDTA plasma at 4 degrees C is suitable for most hormones (except ACTH) for up to 120 hours.