Specificity of B-Type Natriuretic Peptide Assays: Cross-Reactivity with Different BNP, NT-proBNP, and proBNP Peptides
Por:
Saenger, AK, Rodriguez-Fraga, O, Ler, R, Ordonez-Llanos, J, Jaffe, AS, Goetze, JP, Apple, FS
Publicada:
1 ene 2017
Resumen:
BACKGROUND: B-type natriuretic peptides (BNPs) are used clinically to diagnose and monitor heart failure and are present in the circulation as multiple proBNP-derived fragments. We investigated the specificity of BNP immunoassays with glycosylated and nonglycosylated BNP, N-terminal proBNP (NT-proBNP), and proBNP peptides to probe the cross-reactivity of each assay.
METHODS: Nine B-type natriuretic peptides were studied, including synthetic and recombinant BNP (Shionogi, Scios, Mayo), human and synthetic glycosylated and nonglycosylated NT-proBNP (HyTest, Roche Diagnostics), and human glycosylated and nonglycosylated proBNP (HyTest, Scios). Five BNP [Abbott, Abbott POC, Alere, Beckman Coulter, Siemens (Centaur)], 9 NT-proBNP [Ortho-Clinical Diagnostics, Roche, Response, bioMerieux, "Siemens (Dimension, Immulite, Stratus CS), Mitsubishi] and 3 research-use-only proBNP immunoassays [Biosite (Alere), Bio-Rad, Goe-tze] were evaluated. Specificity was assessed by calculating the recovery between baseline and peptide-spiked human plasma pools at target concentrations of 100 ng/L BNP, 300 ng/L proBNP, or 450 ng/L NT-proBNP. All assays were performed in duplicate.
RESULTS: BNP and NT-proBNP assays demonstrated substantial cross-reactivity with proBNP peptides. NT-proBNP assays do not detect glycosylated forms of either NT-proBNP or proBNP. proBNP assays preferentially detect the BNP 1-32 peptide and have minimal cross reactivity with BNP peptides and glycosylated proBNP.
CONCLUSIONS: BNP or NT-proBNP results are not transferable among the current existing immunoassays owing to their differences in cross-reactivity and ability to detect various glycosylated forms of proBNP-derived fragments. Opportunities remain to standardize and harmonize BNP and NT-proBNP assays, as well as to develop specific proBNP assays, to widen their clinical scope of use. (C) 2016 American Association for Clinical Chemistry
Filiaciones:
Saenger, AK:
Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA
Rodriguez-Fraga, O:
Hosp Univ La Paz, Dept Lab Med, Madrid, Spain
Ler, R:
Minneapolis Med Res Fdn Inc, Minneapolis, MN USA
Ordonez-Llanos, J:
IIB Hosp Santa Creu & St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Jaffe, AS:
Mayo Clin, Dept Internal Med, Div Cardiol, Rochester, MN USA
Goetze, JP:
Univ Copenhagen, Rigshosp, Copenhagen, Denmark
Apple, FS:
Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA
Hennepin Cty Med Ctr, Dept Lab Med & Pathol, Minneapolis, MN 55415 USA
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