Evaluation of Laboratory Diagnostic Methods

该项目的目标是改善临床实验室诊断疾病的方法。 研究包括临床实验室实践的分析，实验室测试的准确性分析，以及新的测试和测试技术的开发。在过去的一年中，主要的努力是继续工作的影响采血管的化验，以表征尿蛋白的潜在诊断意义，并评估同型半胱氨酸的分布在不同的血浆蛋白组分。 1)对采血管影响的分析发现，与游离脂肪酸分析的复杂相互作用可能是由于样本的修改，而不是与测定的直接相互作用。 这些努力有助于确定用于游离脂肪酸分析的标本采集的最佳采集程序和试管，并指出可能影响实验室结果的新机制。 2)对尿蛋白的研究主要集中在尿白蛋白的分析上，尿白蛋白是早期肾小球损伤最广泛使用的标志物之一。 我们的实验室已经检查了临床试验如何测量可能出现在尿液中的白蛋白修饰形式，并已努力表征尿液中白蛋白的修饰形式。 这些努力预计将有助于更好的临床应用和解释尿白蛋白测量检测肾损伤。 3)血浆同型半胱氨酸作为心血管疾病和血栓形成的潜在危险因素已引起人们极大的兴趣。 我们研究了同型半胱氨酸通过二硫键与血浆蛋白的连接。 我们的分析可以细分的总同型半胱氨酸含量为不同的亚组分结合不同的蛋白质，我们已经研究了不同的交换同型半胱氨酸结合不同的蛋白质组分。 这些研究试图了解同型半胱氨酸与血浆蛋白的相互作用，并确定同型半胱氨酸的亚组分，可能作为心血管疾病的更好指标。

Goals of this project are to improve clinical laboratory methods for diagnosis of disease. Studies include analysis of clinical laboratory practices, analysis of the accuracy of laboratory tests, and development of new tests and testing technologies. The major efforts over the past year have been to continue work on the effect of blood collection tubes on assays, to characterize urinary proteins of potential diagnostic significance, and to evaluate the distribution of homocysteine between different plasma protein fractions. 1) Analyses of effects of blood collection tubes found complex interactions with the analysis of free fatty acids probably due to modification of the specimen rather than direct interaction with the assay. These efforts help identify optimal collection procedures and tubes for collection of specimens for free fatty acid analysis and point to new mechanisms by which laboratory results may be affected by collection tubes. 2) Studies of urinary proteins have focused mainly on analysis of urinary albumin which serves as one of the most widely used markers for early glomerular injury. Our laboratory has examined how clinical assays measure modified forms of albumin that may occur in urine and have undertaken efforts to characterize the modified forms of albumin in urine. These efforts are expected to contribute to better clinical application and interpretation of urinary albumin measurements for the detection of kidney injury. 3) Plasma homocysteine has been of great interest as a potential risk factor for cardiovascular disease and thrombosis. We have examined the linkage of homocysteine to plasma proteins via disulfide bonds. Our analyses may subdivide the total homocysteine content into different subfractions bound to different proteins, and we have examined the differential exchange of homocysteine bound to different protein fractions. These studies seek to understand the interactions of homocysteine with plasma proteins and to identify subfractions of homocysteine that may serve as better indicators of cardiovascular disease.