Advances in Clinical Chemistry (eBook)

Cover Page 1
Contents 6
Contributors 10
Preface 14
Chapter 1: Is Taurine A Biomarker? 15
1. Taurine 15
1.1. Nutrition 17
1.2. Reproduction 18
1.3. Cardiovascular System 19
1.4. CNS 20
1.5. Taurine as an Osmolyte 21
1.6. Pancreas 22
1.7. Taurine as an Immunomodulator 23
1.8. Taurine as a Biomolecule 26
2. Taurine as a Biomarker 27
2.1. Blood and Urine Taurine Levels 27
2.2. Milk Taurine Levels 28
2.3. Tissue Taurine Levels 28
2.4. Aging and Taurine 29
2.5. Myocardial Ischemia and Taurine 30
3. Conclusions 30
References 31
Chapter 2: Application of Nanoscale Bioassemblies to Clinical Laboratory Diagnostics 37
1. Introduction 37
1.1. Nanoscale Bioassemblies 38
1.2. Scaffolds 38
2. Protein Scaffolds 39
2.1. Closed Protein Shells 39
2.2. Linked Protein Domains 41
3. DNA Scaffolds 42
3.1. Single-Stranded Tethers 42
3.2. Open and Closed Edged Assemblies 45
3.3. Ordered Display 46
3.4. Networked Display 49
4. Organic Polymer Scaffolds 50
4.1. Cross-Linked Display 50
4.2. Dendrimer Display 50
5. Inorganic Scaffolds 52
5.1. Quantum Dots 52
5.2. Photonic Crystals 54
6. Discussion 55
7. Conclusions 56
References 56
Chapter 3: Cardiac Troponins: Clinical and Analytical Aspects 63
1. Abstract 64
2. Introduction 64
3. Structure and Biochemistry of Troponins 65
3.1. Troponin C 66
3.2. Troponin I 67
3.3. Troponin T 69
3.4. Implications from the Newly Elucidated Structure of the Core Domain 70
3.5. Coordinated Regulation of Muscle Contraction 71
3.6. Kinetics of Release, Degradation, and Clearance of Troponins 72
3.7. Cardiac Troponin Subunit Release into Serum After Acute Myocardial Infarction 74
3.8. From Structure to Analysis: Implications for Troponin Assay Development 75
4. Clinical Significance of Measured Cardiac Troponins 78
4.1. Role in Diagnosis 78
4.2. Role in Prognosis and Risk Stratification 83
4.3. Role in Guidance of Therapy and Interventions 86
4.4. Role in Other Conditions 88
5. Measurement of Cardiac Troponins 90
5.1. The Ideal Cardiac Biomarker 91
5.2. Cardiac Troponin T 92
5.3. Cardiac Troponin I 93
5.4. Point-of-Care Testing/Near-Patient Testing 97
5.5. Quality Assurance 100
5.6. How to Use the Currently Available Cardiac Troponin Assays 101
6. Factors Affecting the Measurement of Cardiac Troponins 107
6.1. Renal Failure 108
6.2. Sepsis 113
6.3. Heterophilic Antibodies 114
6.4. Rheumatoid Factor 115
6.5. Autoantibodies 116
6.6. Antiphospholipid Antibodies 116
6.7. Proteolysis 117
6.8. Hemolysis 118
6.9. Heparin 118
6.10. Other Conditions and Interferences 119
7. Conclusions and Future Directions 120
References 121
Chapter 4: Leptin Physiology and Pathophysiology in the Elderly 137
1. Abstract 137
2. Introduction 138
3. Background 139
4. Regulation of Leptin Levels in the Elderly 140
4.1. Leptin and Adiposity: Does Aging Change the Association Between Leptin and Fat Content and Distribution? 140
4.2. Leptin and Gender: Is a Sexual Dimorphism in Leptin Levels Still Present in Old Age? 146
4.3. Leptin and Aging: Does Aging have an Independent Effect on Leptin Levels? 148
4.4. Leptin and Hormonal Changes During Aging 150
4.5. Leptin and Nutritional Status 152
4.6. Leptin and Lifestyle Factors 153
5. Clinical Implications of Leptin Physiology in the Elderly 154
6. Leptin and the Anorexia of the Elderly 155
7. Leptin and Glucose Metabolism 156
8. Leptin, Leptin Resistance, and the Metabolic Syndrome 158
9. Leptin and Bone Metabolism 160
9.1. Peripheral Effect of Leptin on Bone Metabolism 161
9.2. Central Effect of Leptin on Bone Metabolism 161
9.3. Clinical Studies 164
10. Conclusions 171
References 172
Chapter 5: Biochemical Pathways of Wound Healing: Implications for Development of Disease-Specific Diagnostics 181
1. Abstract 182
2. Introduction 182
3. Acute Wound Healing 182
3.1. Hemostatic Phase 183
3.2. Inflammatory Phase 187
3.3. Proliferative Phase 189
3.4. Remodeling Phase 192
4. Chronic Wounds: Overview 193
5. Pressure Ulcers 193
5.1. Neutrophils in Pressure Ulcers 194
5.2. Inactivation of PMN Products 194
6. Diabetic Ulcers 195
7. Venous Stasis Ulcers 196
8. Fibrosis 196
9. Modeling 197
10. Summary 199
References 200
Chapter 6: Clinical Laboratory Tools to Diagnose Inflammation 203
1. Abstract 203
2. Introduction 204
2.1. Components of Inflammatory Response 204
2.2. Components of Acute Inflammation 205
3. Mediators of Inflammation 214
3.1. Polyunsaturated Fatty Acids and Their Products 216
3.2. Platelet Activating Factor 220
3.3. Cytokines and Chemokines in Inflammation 220
3.4. Low-Grade Systemic Inflammation in Metabolic Syndrome X 221
3.5. Cytokines and C-Reactive Protein 221
3.6. Chemokines 223
3.7. Nitric Oxide 223
3.8. Leukocyte Lysosomal Enzymes 225
3.9. Reactive Oxygen Species 226
3.10. Neuropeptides in Inflammation 228
4. Clinical Laboratory Tools to Diagnose Inflammation 228
4.1. High-Sensitive CRP 229
4.2. Cytokines and Chemokines 232
4.3. Other but More Conventional Markers of Inflammation 233
5. High Sensitive-CRP and Other Proinflammatory Indices as Markers of Cardiovascular Diseases: But, Why and How? 233
6. Conclusions 236
References 237
Chapter 7: Advances in Prostate-Specific Antigen Testing 245
1. Abstract 246
2. Introduction 246
3. Prostate-Specific Antigen 247
3.1. Biochemistry and Structure of PSA 247
3.2. Expression of PSA 248
3.3. Isoforms of PSA from Seminal Fluid 249
3.4. Biological Functions of PSA 250
4. Measurement of PSA in Circulation 251
4.1. Epitope Mapping 251
4.2. Reference Values for Serum PSA 252
4.3. Measurement of PSA-Inhibitor Complexes 252
4.4. Analysis of Subfractions of Free PSA 255
5. New Approaches for Detection of PSA 256
5.1. Identification of Novel PSA-Binding Ligands 256
5.2. Immunopeptidometric Assay for Active Free PSA 258
5.3. Detection of Protein Analytes by a Nanoparticle-Based Bio-Bar-Code Approach 259
5.4. Detection of Subfractions of Free PSA by Two-Dimensional Gel Electrophoresis 259
6. Detection of Circulating Prostate Cancer Cells by Measurement of PSA mRNA 260
7. Enhancing Utility of PSA by Multivariate Methods 260
7.1. Multivariate Modeling Techniques 260
7.2. Application of PSA Based Multivariate Algorithms 261
7.3. Usefulness and Limitations of Multivariate Models 263
8. Conclusions 264
References 265
Chapter 8: Advances in Prion Disease Surveillance 277
1. Abstract 277
2. Introduction 278
2.1. Human Prion Disease 278
3. Prion Diagnostics 280
3.1. Current Diagnostic Methods 280
3.2. Limitations of Current Methods 288
3.3. The Role of Effective Diagnosis in Prion Disease Surveillance 290
3.4. Emerging Diagnostic Technologies 290
4. Human Prion Disease Surveillance 292
4.1. History of Prion Disease Transmission 292
4.2. Human Prion Disease Surveillance Outside of North America 293
4.3. Human Prion Disease Surveillance in the United States 295
4.4. Epidemiological Data of Prion Disease in the United States 297
5. Conclusions 302
References 303
Index 307