Carbohydrate-Deficient Transferrin

Heinemann, A.; Sterneck, Martina; Kuhlencordt, R.; Rogiers, X.; Schulz, Karl‐Heinz; Queen, B.; Wischhusen, F.; P??schel, K.

doi:10.1097/00000374-199811000-00028

Cited by 35 publications

(3 citation statements)

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“…Of note, our lab rarely sees this pattern in populations where liver disease has been vigorously excluded (e.g., clinical trial subjects), but frequently in patients whose samples come from liver clinics and acute care hospitals. In testing for heavy drinking, di-tri bridging could lead to false positive results for alcohol use if not interpreted correctly, and this phenomenon may underlie prior findings on low specificity of alternative CDT immunoassays for heavy drinking among liver disease patients (DiMartini et al, 2001; Heinemann et al, 1998). However, as the HPLC assay enables detection of this effect, proper interpretation will minimize false positive results associated with liver disorders.…”

Section: Discussionmentioning

confidence: 99%

Liver Disease and HPLC Quantification of Disialotransferrin for Heavy Alcohol Use: A Case Series

Stewart

Comte‐Walters

Bowen

et al. 2010

Alcoholism Clin & Exp Res

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Background It had previously been suggested that individuals with cirrhosis may have a pattern of transferrin glycosylation that interferes with the interpretation of carbohydrate-deficient transferrin (CDT) testing for heavy alcohol use. The goal of this case series was to evaluate the prevalence of liver disease among individuals with poor resolution of transferrin glycoforms by high performance liquid chromatography. Methods We reviewed the electronic medical records of 35 consecutive patients with poor chromatographic resolution of disialotransferrin from trisialotransferrin, and recorded information on diagnosed liver disease, liver function testing, and other factors. Results Thirty of the 35 subjects with poor chromatographic resolution of the transferrin glycoforms had sufficient data in the medical record for some estimation of liver function. Of these 30 subjects, 25 had previously diagnosed liver pathology. Of the remaining 5 subjects, 2 had liver imaging results suggestive of benign tumor; the remaining 3 had mildly elevated bilirubin and aminotransferase activity, and low albumin. Conclusions Liver abnormalities, but not necessarily cirrhosis, are common in individuals with poor chromatographic separation of transferrin glycoforms, which might lead to false positive results on CDT testing. However, the chromatographic-based assay can detect this issue, minimizing the reporting of false positives, but not necessarily assisting in valid detection of heavy drinking.

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Section: Discussionmentioning

confidence: 99%

Liver Disease and HPLC Quantification of Disialotransferrin for Heavy Alcohol Use: A Case Series

Stewart

Comte‐Walters

Bowen

et al. 2010

Alcoholism Clin & Exp Res

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“…This group of Tf isoforms is referred to as the carbohydrate-deficient Tf's (CDT) and the correlation of their increased levels with chronic alcoholism has been reported to be the most specific biomarker for this condition [89][90][91]. However, other conditions such as inherited forms of glycoprotein metabolism (carbohydrate-deficient glycoprotein (CDG) syndrome) [92,93], the existence of rare Tf isoforms [94,95], and certain end-stage liver diseases may also result in increased CDT [96]. It is also important to note that several studies have found that increases in CDT are less pronounced in females with long-term alcohol consumption [97,98].…”

Section: Carbohydrate-deficient Transferrins (Tf's)mentioning

confidence: 99%

Capillary electrophoresis and the clinical laboratory

et al. 2006

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Over the past 15 years, CE as an analytical tool has shown great promise in replacing many conventional clinical laboratory methods, such as electrophoresis and HPLC. CE's appeal was that it was fast, used very small amounts of sample and reagents, was extremely versatile, and was able to separate large and small analytes, whether neutral or charged. Because of this versatility, numerous methods have been developed for analytes that are of clinical interest. Other than molecular diagnostic and forensic laboratories CE has not been able to make a major impact in the United States. In contrast, in Europe and Japan an increasing number of clinical laboratories are using CE. Now that automated multicapillary instruments are commercially available along with cost-effective test kits, CE may yet be accepted as an instrument that will be routinely used in the clinical laboratories. This review will focus on areas where CE has the potential to have the greatest impact on the clinical laboratory. These include analyses of proteins found in serum and urine, hemoglobin (A1c and variants), carbohydrate-deficient transferrin, forensic and therapeutic drug screening, and molecular diagnostics.

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“…These provide a single value for the collective CDT level (CDT defined as di-, mono-, asialo-and, in some cases, 50% of trisialo-Tf), but fail to define the relative concentrations of the individual Tf sialoforms which may bear clinically relevant information [16,17]. Separation and quantitation using anion exchange columns is better suited to routine analyses; however, recovery of the CDT sialoforms (< 30 mg/L) in a primarily non-CDT matrix (approximately 3000 mg/L) is crucial for accurate results [18].…”

Section: Introductionmentioning

confidence: 99%

Direct capillary electrophoretic detection of carbohydrate-deficient transferrin in neat serum

et al. 2000

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Transferrin, an iron transport protein found in serum and cerebrospinal fluid, is known to be microheterogeneous with respect to its carbohydrate and sialic acid content. The forms of transferrin deficient in sialic acid and/or carbohydrate, termed carbohydratedeficient transferrin (CDT), have been of clinical interest for almost two decades as a result of the initial finding that elevated CDT concentrations are associated with chronic, excessive alcohol abuse. We demonstrate the utility of capillary electrophoresis for examining the CDT sialoform profile via the direct electrophoresis of serum. The need for negligible preelectrophoresis sample preparation and absence of postelectrophoresis processing dramatically decreases analysis time compared to slab gel-based separations. Using a fluorocarbon-coated capillary containing a hydroxyethyl cellulose/ borate buffer, the high resolution separation of serum components is effected in less than 30 min. Under these conditions, the beta region proteins (including transferrin) are well resolved from the alpha-2 and gamma zone proteins in a window where the individual transferrin sialoforms can be detected. The usefulness of this method is demonstrated with the electrophoresis of serum from subjects known to be either nonalcoholic and alcoholic.Abbreviations: CDT, carbohydrate deficient transferrin; HEC, hydroxyethyl cellulose; If, transferrin 2376

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Carbohydrate-Deficient Transferrin

Cited by 35 publications

References 0 publications

Liver Disease and HPLC Quantification of Disialotransferrin for Heavy Alcohol Use: A Case Series

Liver Disease and HPLC Quantification of Disialotransferrin for Heavy Alcohol Use: A Case Series

Capillary electrophoresis and the clinical laboratory

Direct capillary electrophoretic detection of carbohydrate-deficient transferrin in neat serum

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