Automated Chemiluminescence-Immunoassay for Aldosterone during Dynamic Testing: Comparison to Radioimmunoassays with and without Extraction Steps

Schirpenbach, Caroline; Seiler, Lysann; Maser-Gluth, Christiane; Beuschlein, Felix; Reincke, Martín; Bidlingmaier, Martin

doi:10.1373/clinchem.2006.068502

Cited by 131 publications

(86 citation statements)

References 20 publications

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“…Differences in the specificity of antibodies as well as several other factors may contribute, one important issue arising from the difference in calibration of assays which often generates higher values in some compared with lower values in others. Major differences in mean aldosterone values despite high inter-assay correlations are common and have previously been described (Schirpenbach et al 2006). It was our finding that the DPC kit systematically measures samples w30% higher than the assay developed here.…”

Section: Figuresupporting

confidence: 74%

“…Comparison of aldosterone levels before and after chromatographic purification was carried out using partition chromatography with celite as the inert support (Celite 545 AW, SigmaAldrich) according to a modified version of the method described in Abraham et al (1972) and used for comparison of chemiluminescence immunoassay in Materials and Methods in Schirpenbach et al (2006). Briefly, the stationary phase consisted of 30% formamide in water, while the mobile phase consisted of a mixture of ethyl acetate in n-hexane with increasing polarity in a stepwise fashion.…”

Section: Chromatographic Separation Of Aldosterone For Use In Immunoamentioning

confidence: 99%

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A highly sensitive immunofluorometric assay for the measurement of aldosterone in small sample volumes: validation in mouse serum

Manolopoulou¹,

Bielohuby²,

Caton³

et al. 2007

Journal of Endocrinology

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Data on the involvement of aldosterone in the regulation of the renin-angiotensin-aldosterone system (RAAS) in rodents are still scarce, partly due to the high sample volumes needed by commercially available assays and to the very low aldosterone concentrations present. We have developed a highly sensitive and non-isotopic immunoassay, requiring a volume of only 50 ml serum for a duplicate measurement, employing a highly specific monoclonal antibody against aldosterone. The assay was validated in human and mouse samples and exhibited a linear working range from 10 to 1000 pg/ml. Values obtained after a chromatographic purification step correlated significantly to the dichloromethane extraction ordinarily used. Basal aldosterone values were measured in 75 mouse hybrids and found within the linear range (173G21 pg/ml), with no significant difference between males and females. Additionally, we show an increase in serum aldosterone in mice from 3 to 11 weeks of age. Mice of the same genetic background were treated with dexamethasone intraperitoneally (nZ7), resulting in significantly decreased concentrations (35G3 vs 114G33 pg/ml in controls; P!0 . 001). In contrast, adrenocorticotropic hormone resulted in significantly increased serum aldosterone (603G119 pg/ml; nZ7; P!0 . 001), as did the physiological stimulation of the RAAS by a high K C /low Na C diet (1369G703 vs 172G36 pg/ml). In conclusion, we have developed and validated an extremely sensitive assay for determination of aldosterone concentrations from very small serum samples, which could be especially useful in pharmacological intervention studies in rodent models.

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Section: Figuresupporting

confidence: 74%

Section: Chromatographic Separation Of Aldosterone For Use In Immunoamentioning

confidence: 99%

A highly sensitive immunofluorometric assay for the measurement of aldosterone in small sample volumes: validation in mouse serum

Manolopoulou¹,

Bielohuby²,

Caton³

et al. 2007

Journal of Endocrinology

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“…Limitations of the study include the sensitivity of the aldosterone assays, making reproducibility and agreement at low aldosterone concentrations questionable. Such limitations have been reported for plasma aldosterone concentrations before [17], but might be even more important for salivary aldosterone concentrations, which are even lower than those found in plasma. …”

Section: Salivary Aldosterone Profilingmentioning

confidence: 83%

The Clinical Value of Salivary Aldosterone in Diagnosis and Follow-Up of Primary Aldosteronism

et al. 2016

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Primary aldosteronism (PA), the most common form of secondary hypertension, causes relevant morbidity. The value of salivary measurements of aldosterone in clinical routine in PA so far has not been assessed. First, we analyzed salivary and plasma aldosterone concentrations of 42 patients with PA and 37 hypertensive controls (HC) during a sodium infusion test prospectively. Second, morning salivary and plasma aldosterone concentrations as well as diurnal saliva aldosterone profiles were analyzed in 115 patients treated for PA (46 adrenalectomy, 56 spironolactone, 13 eplerenone). Salivary aldosterone was substantially elevated in PA patients compared to HC at baseline (106?119 vs. 40?21?ng/l, p=0.01), and after 4-h sodium infusion test (60?36 vs. 23?14, p=0.01). Positive correlation between salivary and plasma aldosterone levels was evident, with exception of concentrations in or below the lower normal range. Applying a salivary aldosterone cutoff of 51.2?ng/l, found by ROC curve analysis, rendered a sensitivity of 81% and a specificity of 73% for PA. The diurnal rhythm of aldosterone was preserved in untreated PA patients, but concentrations were higher in the context of PA, and normalized after surgery (118?57 vs. 31?18?ng/l, p<0.01). Taken together, salivary aldosterone measurements correlate with plasma levels, allowing simple and cost effective assessments of aldosterone secretion in an outpatient setting. Nevertheless, as this method alone cannot replace other plasma parameters, and as aldosterone profiling would not alter diagnostic or treatment strategies, salivary aldosterone measurements in routine practice are of limited clinical value.

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“…Schirpenbach et al (22) clearly demonstrated markedly different results in a comparison of four different aldosterone assays. It is possible in some cases that a poor comparability of laboratory methods (22,23) for the determination of aldosterone and renin activity accounted for non-confirmation of mineralocorticoid hypersecretion. However, it has to be underlined that only one out of the eight cases retested with the same method as at diagnosis had PA confirmed, suggesting that changing of the analytical method was probably not a major problem.…”

Section: Nc-pa (Nz26)mentioning

confidence: 99%

Long-term re-evaluation of primary aldosteronism after medical treatment reveals high proportion of normal mineralocorticoid secretion

Lucatello

Benso²,

Tabaro³

et al. 2013

European Journal of Endocrinology

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Objective: In most cases of primary aldosteronism (PA), an adrenal aldosterone-secreting tumor cannot be reasonably proven, so these patients undergo medical treatment. Controversial data exist about the evolution of PA after medical therapy: long-term treatment with mineralocorticoid antagonists has been reported to normalize aldosterone levels but other authors failed to find remission of mineralocorticoid hypersecretion. Thus, we planned to retest aldosterone secretion in patients with medically treated PA diagnosed at least 3 years before. Design: Retrospective, cross-sectional study. Methods: The same workup for PA as at diagnosis (basal aldosterone to renin activity ratio (ARR) and aldosterone suppression test) was performed after stopping interfering drugs and low-salt diet, in 34 subjects with PA diagnosed between 3 and 15 years earlier, by case finding from subgroups of hypertensive patients at high risk for PA. Criteria for persistence of PA were the same as at diagnosis (ARR (pg/ml per ng per ml per h) O400, aldosterone O150 pg/ml basally, and O100 pg/ml after saline infusion) or less restrictive. Results: PA was not confirmed in 26 (76%) of the patients and also not in 20 (59%) using the least restrictive criteria suggested by international guidelines. Unconfirmed PA was positively associated with female sex, higher potassium levels, longer duration of hypertension, and follow-up, but not with adrenal mass, aldosterone levels at diagnosis, and treatment with mineralocorticoid antagonists. Conclusions: This study suggests that mineralocorticoid hyperfunction in patients with PA after medical treatment may decline spontaneously. Higher potassium concentration and duration of treatment seem to increase the probability of this event.

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Automated Chemiluminescence-Immunoassay for Aldosterone during Dynamic Testing: Comparison to Radioimmunoassays with and without Extraction Steps

Cited by 131 publications

References 20 publications

A highly sensitive immunofluorometric assay for the measurement of aldosterone in small sample volumes: validation in mouse serum

A highly sensitive immunofluorometric assay for the measurement of aldosterone in small sample volumes: validation in mouse serum

The Clinical Value of Salivary Aldosterone in Diagnosis and Follow-Up of Primary Aldosteronism

Long-term re-evaluation of primary aldosteronism after medical treatment reveals high proportion of normal mineralocorticoid secretion

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