MeDia Diagnostics manufacture and supply immunoturbidimetric kits for the determination of a wide range of specific proteins.
In recent times Immunoturbidimetric methods have become the main technique for performing protein tests.
The basic principles are the same however nephelometry uses a laser as its light source and places the detection system at a specific angle to the reaction cuvettes whereas in immunoturbidimetry the light source is typically a halogen bulb and the detection system is in line with the reaction cuvette and the original light source.
With the MeDia Diagnostics range of immunoturbidimetric tests laboratories can enjoy comparable test results with greater flexibility.
ü Flexibility – all reagents are suitable for use on a wide range of clinical chemistry analysers
List of Specific Proteins
■ Alpha-1-Acid-Glycoprotein (AAG)
Alpha-1-Acid Glycoprotein (AAG), also known as orosomucoid,is an acute-phase reactant synthesised in the liver in response to inflammation and tissue damage.
The normal range for healthy individuals is 50 - 120 mg/dl.
Markedly higher AAG levels are observed in a number of conditions such as inflammatory disease, acute myocardial infarction, trauma, pregnancy and surgery. AAG concentrations rise rapidly until 48 hours after surgery followed by little change until about 120 hours, regardless of the severity of the injury. Serum AAG levels also provide a useful diagnostic tool in neonates with bacterial infections,
most infected neonates produce increased levels of AAG.
ALPHA-1-ACID GLYCOPROTEIN insert kit IT
Documento Adobe Acrobat [265.0 KB]
■ Anti-streptolysin O
Streptolysin O (SLO) is a lethal, exocellular protein released by Group A Streptococcal bacteria. The release of SLO stimulates the production of Anti-Streptolysin O (ASO) antibodies to neutralise its haemolytic effect.
The ASO test is used to determine recent streptococcal infection and post streptococcal complications including rheumatic fever and glomerulonephritis. The presence and level of ASO antibodies in human serum directly reflects the extent and degree of infection. Elevated levels of ASO may also be present in other conditions including scarlet fever, acute rheumatoid arthritis, tonsillitis and various other streptococcal infections as well as in health carriers.
≤100 IU/ml for preschool children1
≤ 250 IU/ml for school age children1
≤ 200 IU/ml for adults
■ Apolipoprotein A-1
Cholesterol and triglycerides are transported around the body by the lipoproteins: HDL, LDL, IDL, VLDL cholesterol, and chylomicrons.
These lipid-protein complexes have similar structures but different sizes, densities and compositions. The outer shell is a monolayer of polar lipids: phospholipids and free cholesterol. The core contains neutral lipids: triglycerides and cholesterol esters. Apolipoproteins are structural components that can be integral to the outer shell or bind to the outside of the lipoprotein; they interact with transport proteins and lipoprotein receptors as well as being cofactors for lipolytic enzymes.
The main role of APO A-I is in the activation of Lecithin cholesterol acyltransferase (LCAT) and removal of free cholesterol from extra hepatic tissues. APO A-I may therefore be described as non atherogenic, showing an inverse relationship to cardiovascular risk. Studies have shown that there is an inverse relationship between APO A-I and coronary artery disease and a direct relationship with APO B such that patients with coronary artery disease have generally reduced levels of Apo A-i and increased levels of Apo B.
Wide measuring range - 6.5 - 233 mg/dl.
Ceruloplasmin is an alpha 2 globulin synthesised primarily in the liver. It binds to copper after it is absorbed from the gastrointestinal (GI) tract and is responsible for transporting more than 90% of all copper to various tissues within the body. Ceruloplasmin has several important functions including ferroxidase activity, amine oxidase activity and superoxidase activity it is also involved in homeostasis.
The main use of Ceruloplasmin is in the diagnosis of Wilson disease, a rare inherited disorder characterised by liver damage and neurological deterioration. Individuals with Wilson disease often have decreased levels of ceruloplasmin which subsequently leads to a build up of copper in the liver, brain and other organs. If Wilson disease is identified before significant copper deposits affect the function of the major organs, serious damage can be avoided. If left undiagnosed and untreated Wilson disease can be fatal, early detection and treatment is therefore crucial in order to prevent permanent damage and halt disease progression.
As an acute-phase reactant Ceruloplasmin concentrations are also elevated in cases of bacterial infection, stress, pregnancy, leukemia, Hodgkin’s disease, systemic lupus erythematosis and rheumatoid arthritis.
■ Complement C3
Complement C3 is a complex biological system which works in conjunction with antibody and other factors to protect the body from invasion by pathogens. When activated by either the classical or alternative pathway Complement C3 acts on biological membranes and may cause cell death.
The human complement cascade consists of several distinct plasma proteins and C3 is the rate-limiting factor for both the classic and alternative pathways.
Decreased Complement C3 levels are important in determining inherited or acquired deficiencies. Conversely, levels may rise in a variety of inflammatory and necrotic disorders as part of the acute-phase plasma protein response.
■ Complement C4
Complement C4 is a complex biological system which works in conjunction with antibody and other factors to protect the body from invasion by pathogens. When activated by either the classical or alternative pathway Complement C4 acts on biological membranes and may cause cell death.
The human complement cascade consists of several distinct plasma proteins. C4 is activated in the classical pathway.
Decreased Complement C4 levels are important in determining inherited or acquired deficiencies. Conversely, levels may rise in a variety of inflammatory and necrotic disorders as part of the acute-phase plasma protein response.
■ C-Reactive Protein
C-Reactive Protein (CRP) is an acute phase protein produced by the liver in response to inflammation, infection and tissue injury.
Increased CRP concentrations occur much earlier than with other acute phase reactants- within 4 to 6 hours- and this rapid response to trauma or infection is the distinguishing feature of CRP. In addition, CRP levels return to normal quickly at the end of an acute episode making CRP useful for both the detection of acute episodes as well as in treatment monitoring.
CRP can be used to aid in the detection of:
• Viral infections
• Bacterial infections, including those in neonates
• Infectious diseases
• Tissue injury
• Inflammatory conditions
• Myocardial infarction
• Monitoring recovery from surgery, particularly renal transplant patients
Iron is essential for respiration forming part of haemoglobin. It is also found in myoglobin and other proteins and enzymes. Ferritin is a metalloprotein that stores iron intracellularly, mainly in the liver, spleen and bone marrow. Ferritin is a good indicator of the body’s iron stores and levels are measured in iron deficiency and in iron overload.
Anaemia is a shortage of red blood cells with a wide range of causes including excessive bleeding, haemolysis and reduced red blood cell production. Anaemia symptoms tend to be vague, for example fatigue and shortness of breath, therefore anaemia is diagnosed using a full blood count. Tests such as ferritin, glucose and renal function are used to confirm the diagnosis and determine the cause of anaemia. In iron overload, iron accumulates in the body causing organ dysfunction. It is caused by diseases such as haemochromatosis, where there is an increase in iron absorption, and by frequent blood transfusions. Early diagnosis is critical as treatment is relatively simple: periodic phlebotomies and minor dietary changes. Serum iron, total iron-binding capacity and transferrin tests are also used in diagnosis. CRP may be used to rule out elevated ferritin levels due to inflammation.
IgA makes up 15% to 20% of the body’s immunoglobulin pool. Its main role is to provide antibody activity at or near mucosal surfaces, such as in the gastrointestinal system, genitourinary system and respiratory system. For this reason, secretions from these areas contain high levels of IgA (in a specialized secretory IgA form).
Examples of secretions with high IgA levels include saliva, bile, airway secretions, genitourinary secretions and milk. IgA fixes complement via the alternative pathway.
Measurement of IgA is used to diagnose diseases of the respiratory tract e.g. tuberculosis, Chron’s disease and early cirrhosis of the liver. It is also useful in monitoring therapy of IgA myeloma and evaluating IgA immunity. IgA in colostrum and milk is important in neonatal defence against infection.
■ IgE - New Product -
IgE is an immunoglobulin with a molecular weight of approximately 190,000Da and is normally present in the blood in trace amounts. IgE antibodies are the chief immunoglobulin responsible for immediate hypersensitivity reactions in humans.
Continual production of IgE antibodies in response to common naturally occurring allergens and the production of excessive amounts of histamine by the IgE bound mast cells results in the development of such clinically important allergic reactions such as asthma, hay fever, dermatitis and food allergies. Elevated IgE levels are also seen in parasitic diseases, IgE myeloma and in hepatitis.
This is the principle immunoglobulin in normal human serum, and makes up 80% of the total serum immunoglobulin in adult humans. IgG is the main form of antibody produced in response to secondary infections. This immunoglobulin provides one of the body’s major defences against bacterial infection in adults, unborn children and
newborn babies as it can cross the placenta.
Measurement of immunoglobulin G is the basis of the serological diagnosis of several infectious diseases. Uses of IgG measurement include diagnosis of infectious and inflammatory diseases, diagnosis of malignancies, to detect the presence of soluble antigens and monitoring therapy in myeloma.
IgM is the major antibody found in serum in the first week following infection. This antibody is particularly effective in combating bacterial infections because of its high binding affinity for proteins responsible for destroying bacterial cells (complement proteins). IgM is usually present in humans as groups of five molecules. IgM does not cross the placenta.
IgM measurement has the following uses: to establish diagnosis and monitor therapy in Waldenstrom’s macroglobulinemia and plasma cell myeloma, to detect intra-uterine infection by measuring levels in newborn babies, diagnosis of primary biliary cirrhosis, viral hepatitis, rheumatoid arthritis and parasitic infections.
■ Lipoprotein (a) - New Product -
Lp(a) is an LDL like particle with a cholesterol rich core and a molecule of Apo B-100 linked by a disulphide bridge to the glycoprotein Apo(a). Apo (a) is unique in that it is extremely heterogeneous in size due to the kringle 4 type 2 domain which can be present in up to 40 copies. The size heterogeneity of Apo(a) affects to varying degrees the outcome of many commercially available Lp(a) kits resulting in over estimation of samples containing large Apo(a) molecules and an under estimation of samples containing small Apo(a) molecules. Research has documented and shown this method to be one of only few to exhibit minimum size related bias.
Lipoprotein (a) in combination with other lipid tests can provide clinicians with much needed additional information on an individual’s risk of CVD. High levels of Lp(a) are known to occur in individuals with an otherwise normal lipid profile as such it is thought to contribute to an increased risk of cardiovascular disease independent of other lipids. It is also of particular use in assessing the risk of coronary heart disease in specific populations as Lp(a) concentrations are genetically determined and vary with ethnic population.
Kidney function may be assessed through measurement of albumin levels in the urine. Normal kidney function entails filtering of waste products from the blood across tiny capillaries in the glomerulus. Kidney malfunction results when the capillaries become blocked, resulting in a build up of waste products in the blood and a loss of important proteins. Kidney deterioration is progressive and begins with small amounts of albumin leaking into the urine. This is known as microalbuminuria and indicates early signs of nephropathy. The term ‘micro-’ refers to low concentrations of urinary albumin. Progressionof kidney disease will lead to larger amounts of albumin leaking into the urine which may develop further to end stage renal disease. Kidney disease is a major concern in diabetic patients and early detection and treatment may slow the onset and progression of the condition.
condition Albumin levels (mg/day)
Microalbuminuria 2 0-300
Albumin is one of the major plasma proteins. In normal circumstances, albumin molecules are too large to cross the glomerular basement membrane, therefore, albumin is usually present in very low concentrations in urine. Damage to the glomerular basement membrane can alter its permeability allowing albumin to enter the urine. Sustained elevations of urinary albumin concentrations are called Microalbuminuria.
MICROALBUMIN insert kit
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■ Rheumatoid Factor
The agglutination reaction between antibody coated red blood cells and Rheumatoid Arthritis (RA) sera, was first demonstrated by Waaler and Rose in 1940. The reaction has since been shown to be caused by certain factors in the RA sera. These Rheumatoid Factors (RF) are a heterogeneous group of high molecular weight auto-antibodies directed against the body’s own immunoglobulins. They are produced by plasma cells present at sites of tissue injury. The initiating antigen is thought to be one or more viruses or viral antigens that persist in the joint tissues.
Research has shown that both environmental and genetic factors can affect the production of RF with various biological properties. Although they may be found in all immunoglobulin classes, the RF most frequently detected is the IgM type; present in about 75% of adult patients with RA and about 10% of children with juvenile RA. RF have also been observed in the serum of patients with lupus erythematosus, hepatitis, liver cirrhosis, syphilis and various other conditions; but the RF titre is much lower than in RA.
RHEUMATOID FACTOR insert kit
Documento Adobe Acrobat [79.8 KB]
Transferrin (siderophilin) is the principal iron binding and transport protein in human plasma and can bind two molecules of iron. The normal range for healthy adults is 200-400 mg/dl. Iron availability in the plasma regulates transferrin levels which increase when plasma iron is low.
Transferrin levels increase during pregnancy and oestrogen administration and correlate closely with Total Iron Binding Capacity of serum. Plasma transferrin levels are associated with a range of conditions including anaemia, iron deficiency, inflammation or malignancy, liver disease, malnutrition and protein loss.