TY - JOUR
T1 - (Pre)analytical considerations concerning the analysis of synovial calprotectin
AU - Alkadhem, Mohammed F.
AU - Wagenmakers-Huizenga, Lucie M.F.
AU - Wouthuyzen-Bakker, Marjan
AU - Muller Kobold, Anneke C.
N1 - Publisher Copyright:
© 2023 the author(s), published by De Gruyter, Berlin/Boston.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Objectives: Several studies have demonstrated that synovial calprotectin is a highly accurate biomarker in diagnosing periprosthetic joint infections (PJI). Assuring reliability is of great importance and coincides with adequate preanalytical handling. This study focuses on potentially interfering factors.Methods: To assess the stability of synovial calprotectin, the effect of time, storage temperature, EDTA, freeze-thaw cycles, viscosity, and blood and lipid contamination was investigated. In the blood and lipid contamination experiments, hemolyzed and non-hemolyzed blood, homogenized adipose tissue, intralipid and chylomicrons were added. The effect of viscosity was investigated using freeze-thaw cycles, enzymatic pretreatment and sonification.Results: No effect on synovial calprotectin levels was observed in synovial samples kept at room temperature compared to samples kept at 4°C for up to seven days of storage. Freeze-thaw cycles did not result in significantly different calprotectin levels, although samples without EDTA resulted in higher recoveries after 1 and 2 freeze-thaw cycles. Blood and lipid contamination did not interfere with accurate synovial calprotectin analysis. Sample pretreatment to reduce sample viscosity by pretreating samples with DNAse and/or hyaluronidase did not influence calprotectin analysis. Sonification, however, resulted in increased calprotectin values.Conclusions: Synovial calprotectin is a stable biomarker and its analysis is not easily influenced by potential interfering factors.
AB - Objectives: Several studies have demonstrated that synovial calprotectin is a highly accurate biomarker in diagnosing periprosthetic joint infections (PJI). Assuring reliability is of great importance and coincides with adequate preanalytical handling. This study focuses on potentially interfering factors.Methods: To assess the stability of synovial calprotectin, the effect of time, storage temperature, EDTA, freeze-thaw cycles, viscosity, and blood and lipid contamination was investigated. In the blood and lipid contamination experiments, hemolyzed and non-hemolyzed blood, homogenized adipose tissue, intralipid and chylomicrons were added. The effect of viscosity was investigated using freeze-thaw cycles, enzymatic pretreatment and sonification.Results: No effect on synovial calprotectin levels was observed in synovial samples kept at room temperature compared to samples kept at 4°C for up to seven days of storage. Freeze-thaw cycles did not result in significantly different calprotectin levels, although samples without EDTA resulted in higher recoveries after 1 and 2 freeze-thaw cycles. Blood and lipid contamination did not interfere with accurate synovial calprotectin analysis. Sample pretreatment to reduce sample viscosity by pretreating samples with DNAse and/or hyaluronidase did not influence calprotectin analysis. Sonification, however, resulted in increased calprotectin values.Conclusions: Synovial calprotectin is a stable biomarker and its analysis is not easily influenced by potential interfering factors.
KW - blood
KW - contamination
KW - sonification
KW - stability
KW - synovial calprotectin
KW - viscosity
UR - https://www.scopus.com/pages/publications/85167682644
U2 - 10.1515/cclm-2023-0484
DO - 10.1515/cclm-2023-0484
M3 - Article
C2 - 37529863
AN - SCOPUS:85167682644
SN - 1434-6621
VL - 62
SP - 199
EP - 206
JO - Clinical chemistry and laboratory medicine
JF - Clinical chemistry and laboratory medicine
IS - 1
ER -