Evaluation of the technical performance of novel holotranscobalamin (holoTC) assays in a multicenter European demonstration project
-
Anne L. Morkbak
Abstract
A commercially available holotranscobalamin (holo-TC) radioimmunoassay (RIA) (Axis-Shield, Dundee, Scotland) was evaluated in four laboratories and compared with a holoTC ELISA run in one laboratory. The performance of the holoTC RIA assay was comparable in three of the four participating laboratories. The results from these three laboratories, involving at least 20 initial runs of “low”, “medium” and “high” serum-based controls (mean holoTC concentrations 34, 60 and 110pmol/L, respectively) yielded an intra-laboratory imprecision of 6–10%. No systematic inter-laboratory deviations were observed on runs involving 72 patient samples (holoTC concentration range 10–160pmol/L). A fourth laboratory demonstrated higher assay imprecision for control samples and systematic deviation of results for the patient samples. Measurement of holoTC by ELISA showed an imprecision of 4–5%, and slightly higher mean values for the controls (mean holoTC concentrations 40, 70 and 114pmol/L, respectively). Comparable results were obtained for the patient samples. The long-term intra-laboratory imprecision was 12% for the holoTC RIA and 6% for the ELISA. In conclusion, it would be prudent to check the calibration and precision prior to starting to use these holoTC assays in research or clinical practice. The results obtained using the holoTC RIA were similar to those obtained using the holoTC ELISA assay.
References
1. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol 1990; 34:99–107.10.1002/ajh.2830340205Search in Google Scholar PubMed
2. Carmel R. Pernicious anemia. The expected findings of very low serum cobalamin levels, anemia, and macrocytosis are often lacking. Arch Intern Med 1988; 148:1712–4.10.1001/archinte.1988.00380080016007Search in Google Scholar
3. Green R. Screening for vitamin B12 deficiency: caveat emptor. Ann Intern Med 1996; 124:509–11.10.7326/0003-4819-124-5-199603010-00009Search in Google Scholar PubMed
4. Moelby L, Rasmussen K, Jensen MK, Pedersen KO. The relationship between clinically confirmed cobalamin deficiency and serum methylmalonic acid. J Intern Med 1990; 228:373–8.10.1111/j.1365-2796.1990.tb00248.xSearch in Google Scholar PubMed
5. Clarke R, Refsum H, Birks J, Evans JG, Johnston C, Sherliker P, et al. Screening for vitamin B12 and folate deficiency in older people. Am J Clin Nutr 2003; 77:1241–7.10.1093/ajcn/77.5.1241Search in Google Scholar PubMed
6. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr 1999; 19:357–77.10.1146/annurev.nutr.19.1.357Search in Google Scholar PubMed
7. Rasmussen K. P-Methylmalonate and P-homocysteine: metabolic markers of vitamin deficiencies. Background, validity and applications. Ugeskr Laeger 1996; 158:3913–8.Search in Google Scholar
8. Jacob E, Baker SJ, Herbert V. Vitamin B12-binding proteins. Physiol Rev 1980; 60:918–60.10.1152/physrev.1980.60.3.918Search in Google Scholar PubMed
9. Ulleland M, Eilertsen I, Quadros EV, Rothenberg SP, Fedosov SN, Sundrehagen E, et al. Direct assay for cobalamin bound to transcobalamin (holo-transcobalamin) in serum. Clin Chem 2002; 48:526–32.10.1093/clinchem/48.3.526Search in Google Scholar
10. Nexo E, Christensen AL, Hvas AM, Petersen TE, Fedosov SN. Quantification of holo-transcobalamin, a marker of vitamin B12 deficiency. Clin Chem 2002; 48:561–2.10.1093/clinchem/48.3.561Search in Google Scholar
11. Nexo E, Christensen AL, Petersen TE, Fedosov SN. Measurement of transcobalamin by ELISA. Clin Chem 2000; 46:1643–9.10.1093/clinchem/46.10.1643Search in Google Scholar
12. Nexo E, Engbaek F, Ueland PM, Westby C, O'Gorman P, Johnston C, et al. Evaluation of novel assays in clinical chemistry: quantification of plasma total homocysteine. Clin Chem 2000; 46:1150–6.10.1093/clinchem/46.8.1150Search in Google Scholar
13. Hvas AM, Gravholt CH, Nexo E. Circadian variation of holotranscobalamin (holo-TC) and related markers. Clin Chem Lab Med 2005; 43:760–4.10.1515/CCLM.2005.130Search in Google Scholar PubMed
14. McCaddon A, Hudson P, McCracken C, Ellis R, McCaddon A. Biological variation of holo-transcobalamin in elderly individuals. Clin Chem 2003; 49:1542–4.10.1373/49.9.1542Search in Google Scholar PubMed
15. Bor MV, Nexo E, Hvas AM. Holo-transcobalamin concentration and transcobalamin saturation reflect recent vitamin B12 absorption better than does serum vitamin B12. Clin Chem 2004; 50:1043–9.10.1373/clinchem.2003.027458Search in Google Scholar PubMed
16. Nexo E, Hvas AM, Bleie O, Refsum H, Fedosov SN, Vollset SE, et al. Holo-transcobalamin is an early marker of changes in cobalamin homeostasis. A randomized placebo-controlled study. Clin Chem 2002; 48:1768–71.10.1093/clinchem/48.10.1768Search in Google Scholar
17. Herrmann W, Obeid R, Schorr H, Geisel J. Functional vitamin B12 deficiency and determination of holotranscobalamin in populations at risk. Clin Chem Lab Med 2003; 41:1478–88.10.1515/CCLM.2003.227Search in Google Scholar PubMed
18. Hvas AM, Nexø E. Holotranscobalamin – a first choice assay for diagnosing vitamin B12 deficiency? J Intern Med 2005; 257:289–98.10.1111/j.1365-2796.2004.01437.xSearch in Google Scholar PubMed
19. Miller JW, Ramos MI, Garrod MG, Flynn MA, Green R. Transcobalamin II 775G>C polymorphism and indices of vitamin B12 status in healthy older adults. Blood 2002; 100:718–20.10.1182/blood-2002-01-0209Search in Google Scholar PubMed
20. Zetterberg H, Nexo E, Regland B, Minthon L, Boson R, Palmer M, et al. The transcobalamin (TC) codon 259 genetic polymorphism influences holo-TC concentration in cerebrospinal fluid from patients with Alzheimer disease. Clin Chem 2003; 49:1195–8.10.1373/49.7.1195Search in Google Scholar PubMed
21. Wans S, Schuttler K, Jakubiczka S, Muller A, Luley C, Dierkes J. Analysis of the transcobalamin II 776C>G (259P>R) single nucleotide polymorphism by denaturing HPLC in healthy elderly: associations with cobalamin, homocysteine and holo-transcobalamin II. Clin Chem Lab Med 2003; 41:1532–6.10.1515/CCLM.2003.235Search in Google Scholar PubMed
22. Geisel J, Hübner U, Bodis M, Schorr H, Knapp JP, Obeid R, et al. The role of genetic factors in the development of hyperhomocysteinemia. Clin Chem Lab Med 2003; 41:1427–34.10.1515/CCLM.2003.219Search in Google Scholar PubMed
23. Loikas S, Lopponen M, Suominen P, Moller J, Irjala K, Isoaho R, et al. RIA for serum holo-transcobalamin: method evaluation in the clinical laboratory and reference interval. Clin Chem 2003; 49:455–62.10.1373/49.3.455Search in Google Scholar PubMed
24. Riedel B, Bjorke Monsen AL, Ueland PM, Schneede J. Effects of oral contraceptives and hormone replacement therapy on markers of cobalamin status. Clin Chem 2005; 51:778–81.10.1373/clinchem.2004.043828Search in Google Scholar PubMed
25. Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset SE, Orning L, et al. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr 2001; 74:233–41.10.1093/ajcn/74.2.233Search in Google Scholar PubMed
26. Obeid R, Schorr H, Eckert R, Herrmann W. Vitamin B12 status in the elderly as judged by available biochemical markers. Clin Chem 2004; 50:238–41.10.1373/clinchem.2003.021717Search in Google Scholar PubMed
27. Herrmann W, Schorr H, Obeid R, Geisel J. Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am J Clin Nutr 2003; 78:131–6.10.1093/ajcn/78.1.131Search in Google Scholar PubMed
28. Refsum H, Smith AD. Low vitamin B-12 status in confirmed Alzheimer's disease as revealed by serum holotranscobalamin. J Neurol Neurosurg Psychiatry 2003; 74:959–61.10.1136/jnnp.74.7.959Search in Google Scholar PubMed PubMed Central
29. Obeid R, Jouma M, Herrmann W. Cobalamin status (holo-transcobalamin, methylmalonic acid) and folate as determinants of homocysteine concentration. Clin Chem 2002; 48:2064–5.10.1093/clinchem/48.11.2064Search in Google Scholar
30. Lloyd-Wright Z, Hvas AM, Moller J, Sanders TA, Nexo E. Holotranscobalamin as an indicator of dietary vitamin B12 deficiency. Clin Chem 2003; 49:2076–8.10.1373/clinchem.2003.020743Search in Google Scholar PubMed
31. Burman JF, Mollin DL, Sourial NA, Sladden RA. Inherited lack of transcobalamin II in serum and megaloblastic anaemia: a further patient. Br J Haematol 1979; 43:27–38.10.1111/j.1365-2141.1979.tb03716.xSearch in Google Scholar PubMed
32. Rana SR, Colman N, Goh KO, Herbert V, Klemperer MR. Transcobalamin II deficiency associated with unusual bone marrow findings and chromosomal abnormalities. Am J Hematol 1983; 14:89–96.10.1002/ajh.2830140111Search in Google Scholar PubMed
33. Fehr J, De Vecchi P. Transcobalamin II: a marker for macrophage/histiocyte proliferation. Am J Clin Pathol 1985; 84:291–6.10.1093/ajcp/84.3.291Search in Google Scholar PubMed
34. Carmel R, Tatsis B, Baril L. Circulating antibody to transcobalamin II causing retention of vitamin B12 in the blood. Blood 1977; 49:987–1000.10.1182/blood.V49.6.987.987Search in Google Scholar
35. Nilsson K, Isaksson A, Gustafson L, Hultberg B. Clinical utility of serum holotranscobalamin as a marker of cobalamin status in elderly patients with neuropsychiatric symptoms. Clin Chem Lab Med 2004; 42:637–43.10.1515/CCLM.2004.109Search in Google Scholar PubMed
©2005 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Homocysteine research – where do we stand and where are we going?
- Hyperhomocysteinemia and arteriosclerosis: historical perspectives
- Homocysteine and heart failure: a review of investigations from the Framingham Heart Study
- Homocysteine and vascular disease in diabetes: a double hit?
- Reduced adenosine receptor stimulation as a pathogenic factor in hyperhomocysteinemia
- Effects of homocysteine on vascular and tissue adenosine: a stake in homocysteine pathogenicity?
- Anti-N-homocysteinylated protein autoantibodies and cardiovascular disease
- Carotid narrowing degree and plasma thiol levels in carotid endarterectomy patients
- Impairment of homocysteine metabolism in patients with retinal vascular occlusion and non-arteritic ischemic optic neuropathy
- Hyperhomocysteinaemia in chronic kidney disease: focus on transmethylation
- Hyperhomocysteinemia and macromolecule modifications in uremic patients
- Hyperhomocysteinemia and response of methionine cycle intermediates to vitamin treatment in renal patients
- Vitamin B12 deficiency is the dominant nutritional cause of hyperhomocysteinemia in a folic acid-fortified population
- Homocysteine, folic acid and vitamin B12 in relation to pre- and postnatal health aspects
- Evaluation of the technical performance of novel holotranscobalamin (holoTC) assays in a multicenter European demonstration project
- A laboratory algorithm with homocysteine as the primary parameter reduces the cost of investigation of folate and cobalamin deficiency
- Betaine: a key modulator of one-carbon metabolism and homocysteine status
- Molecular targeting by homocysteine: a mechanism for vascular pathogenesis
- Anti-inflammatory compound resveratrol suppresses homocysteine formation in stimulated human peripheral blood mononuclear cells in vitro
- Homocysteine in relation to cognitive performance in pathological and non-pathological conditions
- Homocysteine and B vitamins in mild cognitive impairment and dementia
- Homocysteine, type 2 diabetes mellitus, and cognitive performance: The Maine-Syracuse Study
- Plasma homocysteine levels in L-dopa-treated Parkinson's disease patients with cognitive dysfunctions
- Homocysteine – a newly recognised risk factor for osteoporosis
- Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post-menopausal women
- Elevated levels of asymmetric dimethylarginine (ADMA) as a marker of cardiovascular disease and mortality
- Measurement of asymmetric dimethylarginine in plasma: methodological considerations and clinical relevance
- Concentrations of homocysteine, related metabolites and asymmetric dimethylarginine in preeclamptic women with poor nutritional status
- Asymmetric dimethylarginine, homocysteine and renal function – is there a relation?
- Interactions between folate and aging for carcinogenesis
- The potential cocarcinogenic effect of vitamin B12 deficiency
- The vegetarian lifestyle and DNA methylation
Articles in the same Issue
- Homocysteine research – where do we stand and where are we going?
- Hyperhomocysteinemia and arteriosclerosis: historical perspectives
- Homocysteine and heart failure: a review of investigations from the Framingham Heart Study
- Homocysteine and vascular disease in diabetes: a double hit?
- Reduced adenosine receptor stimulation as a pathogenic factor in hyperhomocysteinemia
- Effects of homocysteine on vascular and tissue adenosine: a stake in homocysteine pathogenicity?
- Anti-N-homocysteinylated protein autoantibodies and cardiovascular disease
- Carotid narrowing degree and plasma thiol levels in carotid endarterectomy patients
- Impairment of homocysteine metabolism in patients with retinal vascular occlusion and non-arteritic ischemic optic neuropathy
- Hyperhomocysteinaemia in chronic kidney disease: focus on transmethylation
- Hyperhomocysteinemia and macromolecule modifications in uremic patients
- Hyperhomocysteinemia and response of methionine cycle intermediates to vitamin treatment in renal patients
- Vitamin B12 deficiency is the dominant nutritional cause of hyperhomocysteinemia in a folic acid-fortified population
- Homocysteine, folic acid and vitamin B12 in relation to pre- and postnatal health aspects
- Evaluation of the technical performance of novel holotranscobalamin (holoTC) assays in a multicenter European demonstration project
- A laboratory algorithm with homocysteine as the primary parameter reduces the cost of investigation of folate and cobalamin deficiency
- Betaine: a key modulator of one-carbon metabolism and homocysteine status
- Molecular targeting by homocysteine: a mechanism for vascular pathogenesis
- Anti-inflammatory compound resveratrol suppresses homocysteine formation in stimulated human peripheral blood mononuclear cells in vitro
- Homocysteine in relation to cognitive performance in pathological and non-pathological conditions
- Homocysteine and B vitamins in mild cognitive impairment and dementia
- Homocysteine, type 2 diabetes mellitus, and cognitive performance: The Maine-Syracuse Study
- Plasma homocysteine levels in L-dopa-treated Parkinson's disease patients with cognitive dysfunctions
- Homocysteine – a newly recognised risk factor for osteoporosis
- Relation between homocysteine and biochemical bone turnover markers and bone mineral density in peri- and post-menopausal women
- Elevated levels of asymmetric dimethylarginine (ADMA) as a marker of cardiovascular disease and mortality
- Measurement of asymmetric dimethylarginine in plasma: methodological considerations and clinical relevance
- Concentrations of homocysteine, related metabolites and asymmetric dimethylarginine in preeclamptic women with poor nutritional status
- Asymmetric dimethylarginine, homocysteine and renal function – is there a relation?
- Interactions between folate and aging for carcinogenesis
- The potential cocarcinogenic effect of vitamin B12 deficiency
- The vegetarian lifestyle and DNA methylation