Rheumatoid Factor: The Most Remarkable Autoantibody in Rheumatoid Arthritis

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Rheumatoid Factor: The Most Remarkable Autoantibody in Rheumatoid Arthritis

Rheumatoid Factor:

The Most Remarkable Autoantibody in Rheumatoid Arthritis

Celebrating World Arthritis Day (WAD)

Rheumatoid Factor: The Most Remarkable Autoantibody in Rheumatoid Arthritis

World Arthritis Day (WAD) is celebrated on 12th October to help raise global awareness of the existence and impact of rheumatic and musculoskeletal diseases (RMDs). It is estimated that over one-hundred million people are currently undiagnosed impacting their quality of life and participation in society – including their ability to work and lead a normal life. As a result this increases dependency on state welfare, the healthcare system and the required support from their family and friends.

The European League Against Rheumatism (EULAR) launched the ‘Don’t Delay, Connect Today’ campaign focusing on the importance of early diagnosis and access to care.

Randox Reagents fully supports the importance of early diagnosis – to aid in the early implementation of effective treatment plans, aiding in improved health outcomes – it’s the ethos of our business. This blog delves deeper into rheumatoid factor (RF), the most remarkable autoantibody in rheumatoid arthritis.

Pathobiology of Rheumatoid Arthritis (RA)

The pathophysiology of RA involves various signaling pathways and immune modulators (effector cells and cytokines) as indicated in figure 1. Joint destruction is caused by the intricate interactions of immune modulators, beginning at the synovial membrane and encompassing most IA structures, with synovitis caused by both or individually, the local activation or influx of mononuclear cells, including: B cells, T cells, dendritic cells, plasma cells, mast cells and macrophages. Consequently, “the synovial lining becomes hyperplastic, and the synovial membrane expands and forms villi”. The neutrophils, chondrocytes and synoviocytes secrete enzymes that degrades the cartilage in the joint whereas the osteoclast-rich area of the synovial membrane destroys the bone 4.

Rheumatoid arthritis (RA), “the most common systemic inflammatory autoimmune disease” affecting 1% of the global population, is characterised by fatigue, synovial joint pain, stiffness, swelling and destruction, with severe symptoms resulting in disability. Whilst the exact cause of RA is unknown, it is believed that genetic and environmental factors play a role in triggering the disease 2, 3.  Differences in the human leukocyte antigen (HLA)-DRB1 alleles (proteins with a critical role in the immune system) have been identified as a genetic variant for RA, observed in >80% of patients, particularly in those testing positive for RF. Moreover, those with variations in the HLA-DRB1 who smoke, increase their risk of RA. As RA is more common in women (2-fold increased risk in women compared to men), hormonal influences are an area of active research, however, an inverse correlation with breastfeeding has been identified. Women who breastfeed for >13 months aids in reducing the risk of RA compared to women who have never breastfed 3, 4.

Figure 1: Schematic view of (a) a normal joint and (b) a joint affected by RA 4 

Clinical Significance of Rheumatoid Factor (RF)

Interestingly, elevated levels of RF have been observed in other autoimmune conditions such as Sjögren syndrome and systemic lupus erythematosus (SLE) as well as non-autoimmune conditions including old age and chronic infections. Despite this, RF in RA patients can be distinguished from RF in healthy individuals. RF in RA patients displays affinity maturation whereas RF in healthy individuals has low affinity and are polyreactive 2.

RF is a class of immunoglobulin (Ig) autoantibodies that are directed against the fragment crystallizable region (Fc region), the tail region of the IgG antibody. In RA, RF are produced by the B cells present in lymphoid follicles and the germinal center(GC)-like structures that mature in inflamed synovium. Most RF are IgM antibodies, but may also be IgG or IgA isoforms. IgM RF are detected in 60% to 80% of RA patients. “RF testing in RA patients has a sensitivity of 60% to 90% and a specificity of 85%” (5). RF is a highly valuable biomarker in RA 5, 2.

Key Features of the Randox Rheumatoid Factor Assay

The Randox automated latex enhanced immunoturbidimetric rheumatoid factor assay provides an accurate assessment of RF titre as the Randox rheumatoid factor calibrator is standardised against the primary WHO material, 1st British Standard 64/2. With a wide measuring range of 6.72 – 104lU/ml for the comfortable detection of clinically important results, the Randox RF assay is available in a liquid ready-to-use format for the comfortable detection of clinically important results. The Randox rheumatoid factor assay does not suffer from interference from C1q complement and is stable until expiry date. With dedicated calibrator and controls for a complete testing package, Randox offer applications, detailing instrument-specific settings for the convenient use of the Randox rheumatoid factor assay on a wide range of clinical chemistry analysers.

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World Heart Day 2021

World Heart Day 2021

World Heart DAy 2021

World Heart Day – Raising awareness of Cardiovascular Diseases

World Heart Day was established by the World Heart Federation in collaboration with the World Health Organization to raise awareness of cardiovascular diseases.

Cardiovascular disease (CVD) is the world’s number one killer, causing over 18.6 million deaths per year, according to the World Heart Federation. 85% of these deaths are due to coronary heart diseases (e.g. heart attacks) and cerebrovascular diseases (e.g. strokes) and mostly affect low-and middle-income countries.

What are cardiovascular diseases?

Cardiovascular diseases (CVDs) are a group of disorders relating to the heart and blood vessels and they include:

  • coronary heart disease – disease of the blood vessels supplying the heart muscle
  • cerebrovascular disease – disease of the blood vessels supplying the brain
  • peripheral arterial disease – disease of blood vessels supplying the arms and legs
  • rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria
  • congenital heart disease – malformations of heart structure existing at birth
  • deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs

How can Randox help with these current global challenges

Cardiovascular disease, including heart disease, is easier to treat when detected early. Here at Randox, we utilise innovative diagnostic tests for early risk assessment capable of diagnosing disease at the earliest possible stages, because we understand that “prevention is better than cure”.

Randox Laboratories is a world leader in innovative diagnostics with 40 years’ experience and a leading provider of diagnostic reagents for the assessment of cardiovascular disease risk. Randox offer an extensive menu of cardiac biomarkers within the cardiology reagents panel including:

Risk Assessment

  • CK-MB – useful in patients with chest pain; Creatine Kinase is an enzyme produced in many different types of cells, of which high levels indicate muscle trauma or damage.
  • Myoglobin – a small protein which leaks out of muscle cells after injury, is also considered a biomarker for the detection of Myocardinal Infraction.
  • Routine lipid tests to determine the patient’s cholesterol and triglyceride levels HDL Cholesterol, LDL Cholesterol, Total Cholesterol and Triglycerides
  • Independent risk assessment tests such as sdLDL Cholesterol and Lipoprotein(a) to determine any genetic factors which may increase their risk of CVD. Please note, this is necessary even for patients who have good cholesterol levels
  • Secondary tests, such as High Sensitivity CRP, in addition to risk assessment markers and lipid evaluation – secondary tests are important in predicting future cardiac events of individuals with no previous history of CVD and those deemed healthy because of primary tests; approximately half of all heart attacks occur in patients classified as low risk. In addition, they can also be used to evaluate the risk of a recurrent cardiac event
  • Homocysteine – elevated levels of homocysteine have been linked to various disease states including CVD. Extremely high levels are found in patients with homocystinuria, of which many suffer from early arteriosclerosis.

More information

If you are a clinician or lab interested in our Cardiology & Lipids Panel, we have a wealth of resources available:

Download our Reagents Brochure 

Download our Cardiology & Lipid Testing Brochure

If you would like to get in touch with a Sales representative please email us reagents@randox.com

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SARS-CoV-2 Vascular & Multi-System Dysfunction Whitepaper

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30 June 2021

SARS-CoV-2 Vascular & Multi-System Dysfunction Whitepaper Download

COVID-19, the disease caused by SARS-CoV-2, is an infectious disease caused by a newly discovered coronavirus. While many of whom become infected by the disease will experience mild to moderate cold or flu-like symptoms, those with health complications – such as autoimmune diseases, asthma, heart disease and diabetes – are at risk of developing serious illness and adverse outcomes.

As of September 2021, over 228 million COVID-19 cases have been confirmed worldwide, with an estimated one in six patients experiencing complications which could be life threatening, with over £116 billion spent by the UK government alone on measures to combat the disease. This drastic spending has been mirrored across the globe, with the significant economic burden expected to be suffered for generations to come.

The whitepaper provides a brief overview of the COVID-19 pandemic, before discussing vascular abnormalities and associated complications brought on by the virus, such as multi-system disfunction, acute respiratory disease syndrome (ARDS) and hepatic, renal & cardiovascular function.

 

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Why does Randox sponsor Equine Sports events?

Why does Randox sponsor Equine Sports?

1 September 2021: Why does Randox sponsor Equine Sports?

Some may be wondering, why is a healthcare company so invested in the equine industry? Why would they sponsor the world’s most famous steeplechase – The Randox Grand National?

It’s a labour of love… Peter FitzGerald’s fond attachment to the equestrian world, together with 40 years’ experience in the in vitro diagnostics industry, was the perfect match.

Clinical diagnostics is at the heart of Randox and our experience and expertise has paved the way for the development of innovative and accurate diagnostic products for Equine Health.

You could say ‘it runs in our blood.’

With 70% of all medical decisions based on the analysis of blood, Randox are set to release the VeraSTAT-V, a stable-side Equine Serum Amyloid A test device designed to detect levels of inflammation in horse blood in a matter of minutes.

The ability to quickly detect and monitor your horse’s health, at the stable side, brings huge benefits to both horse and owner. Early detection of inflammatory states means treatment plans can start sooner, recovery periods are shorter, and the horse can return to work healthy much earlier.

When performance is key, monitoring inflammation is vital.

Whether it’s detecting inflammation related to joint injury, or screening for infection before or after transport, competition or surgery, the VeraSTAT-V is a valuable means to monitor Equine Health.

At Randox, we have enjoyed a long-standing partnership with the Jockey Club and will continue to deliver innovative diagnostics solutions to the Equine Industry for the years ahead.

Interested in finding out more? 

For all Equine SAA and/or Veterinary related inquiries, please email marketing@randox.com or visit www.randox.com/veraSTAT-V for more information.

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Banned substance furazolidone (AOZ) detected in shrimp at French border

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14 April 2021: Banned substance furazolidone (AOZ) detected in shrimp at French border

As per an alert through RASFF – the Rapid Alert System for Food and Feed for the EU, shrimp imported from India has been rejected at the French border in March 2021 for containing a banned substance, known as furazolidone (AOZ). The shrimp product has since been destroyed and did not make it into the market for distribution.

Nitrofuran antibiotics, the parent compound of AOZ, were banned for use in animal food production in the EU in 1995 and 2009 in the US for its reported carcinogenic and mutagenic characteristics. However due to the drugs low cost and effectiveness in controlling disease it is still in use despite the ban.

Randox Food Diagnostics

Randox Food Diagnostics have developed a highly accurate and reliable immunoassay array which detects Nitrofuran residues including AOZ, AMOZ, AHD and SEM.

Available on the Evidence Investigator, our Antimicrobial Array III utilises our patented Biochip Array Technology which provides screening of up to 54 meat and seafood samples. The Evidence Investigator provides results for multiple drug residues and toxins in just 2.5 hours, saving the user both time and money compared to other screening and confirmatory methods.

Randox Food Diagnostics also provide a vast variety of ELISA kits to test for antibiotics in meat and seafood tissue, offering excellent cross-reactivity and unrivalled limits of detection. With results providing great correlation with confirmatory methods, we ensure that better science means safer food.

Want to know more?

For more information on tissue screening methods from Randox Food Diagnostics please visit the links below.

www.randoxfood.com/meat-and-seafood-analysis/

Alternatively contact us via email: info@randoxfooddiagnostics.com

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Record level of alcohol deaths recorded during COVID-19 pandemic

Record level of alcohol deaths recorded during COVID-19 pandemic

22 March 2021

Deaths caused by alcohol consumption hit a new high during the first nine months of 2020, new figures for England and Wales show.

Between January and September, 5,640 deaths were registered with this cause – an increase of 16% on the same period in 2019. This significant increase has been the highest recorded figure since records began in 2001. The high rates spanned the period during and after the first national COVID-19 lockdown, according to new figures from the Office for National Statistics.

As in past years, rates of male alcohol-specific deaths were twice those seen for women. Experts say the coronavirus pandemic will have had little effect on how the data was gathered and recorded. But it is not clear how much it may have contributed to the deaths.

A spokesman for ONS said:

“Today’s data shows that in the first three quarters of 2020, alcohol-specific deaths in England and Wales reached the highest level since the beginning of our data series, with April to September, during and after the first lockdown, seeing higher rates compared to the same period in previous years.”

“The reasons for this are complex and it will take time before the impact the COVID-19 pandemic has had on alcohol-specific deaths is fully understood.”

Effects of Alcohol

Alcohol’s impact on your body starts from the moment of consumption. While an occasional glass of wine or beer isn’t a cause for concern, the cumulative effects of drinking beer, wine or spirits can take its toll.

Excessive consumption can impact various parts of the body. Effects can range from weakening of the immune and digestive system, to inflammation and sugar level issues.

Our ‘Effects Of’ Series provides a range of educational posters that ca be displayed in workplaces. Click here to view them.

Did you know that alcohol misuse at work can:

  • increase sickness and absenteeism
  • harm the reputation of the business
  • decrease productivity
  • put employees and members of the public in unnecessary risk

Breath Testing in the Workplace

Handheld breathalysers are an ideal device for conducting workplace alcohol testing. Quick and easy testing provides an instant readout of the donor’s breath alcohol measurement.  Simply compare the reading to the cutoff defined in your own drug and alcohol testing policy.

Breathalyser devices gauge blood alcohol content (BAC) by measuring deep lung air. This type of testing can accurately determine whether a person has recently consumed alcohol or is currently over the legal or pre-determined limit. Breathalyser calibrations are maintained in accordance with the manufacturers specifications and periodically accuracy checked to ensure results are accurate and reliable.

How Randox Testing Services can help

At Randox Testing Services, we are pleased to offer a range of stand-alone alcohol tests or combinations of tests to meet your needs.

Throughout the COVID-19 pandemic, RTS have continued to provide drug & alcohol testing services. At all times, we have ensured our staff are equipped to provide sensible advice and flexible solutions to drug & alcohol testing.

Whether for use in workplace settings or for use in court proceedings for medico-legal cases, our range of alcohol testing methods will provide you with accurate and reliable results at competitive prices.

For more information on our alcohol testing services, or to request a quote, contact us using any of the below details.

Website: www.randoxtestingservices.com

Email: testingservices@randox.com

Phone: +44 (0) 28 9445 1011

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The Impact of Coronavirus on Drug Use in Europe

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15 March 2021: Impact of Coronavirus on Drug Use in Europe

The effect of COVID-19 on the consumption of drugs in Europe has been varied depending on the drug type concerned. Overall, 51.6% of participants in a survey have increased their drug or alcohol consumption and 57.3% reported taking drugs more frequently. The main explanations for these inclines are due to boredom and anxiety, likely due to the imposed restrictions of strict lockdown measures.

According to Statista, Cannabis remains to be the most popular drug used within Europe as 27.2% of respondents revealed that they have used the drug in their lifetime compared to only 5.4% using cocaine. Since the COVID-19 pandemic began in March 2020, regular users of Cannabis have increased their usage, however it is important to note that this has only affected 10% of respondents.

There has been a major hold on the party lifestyle with the shut-down of nightclubs and lack of festival events. As well as, a decrease in the supply of readily available drugs on the market resulting from transport restrictions at country borders. This has impacted the usage of recreational drugs such as cocaine, LSD and MDMA which have seen a decline. The Global Drug Survey revealed that 40% of respondents have used these drugs less during the pandemic.

This detrimental trend has resulted in the domestic production of synthetic opioids. There is a very high risk that substitutes such as fentanyl will become more common. This prediction is concerning due to the dangers associated with such drugs leading to addiction and overdoses. For instance, fentanyl compared to heroin is 50 times stronger.

Public Health England has also released a warning relating to the rise in illegally produced prescription drugs sold as benzodiazepines. These cause harmful health issues due to the mix of unsafe and unknown components.

Randox Toxicology

Randox Toxicology are helping to fight drug trafficking by continually investing in new technologies to aid in the rapid and large-scale screening for drugs of abuse. We are world leaders in drug screening solutions with the capability of detecting over 500 drug and drug metabolites using our innovative Biochip Array Technology – the most comprehensive on the drug testing market. Our patented Biochip Array Technology works across a variety of matrices including whole blood, urine, oral fluid, meconium, vitreous humor and hair.

Using our revolutionary Biochip Array Technology, the Evidence MultiSTAT is a fully automated benchtop analyser that enables onsite, simultaneous testing for up to 21 classical, synthetic or prescription drugs from a single sample in under 20 minutes. This quick and highly reliable technology makes it perfect for use in non-laboratory settings for people with no lab experience.

To find out more about our Biochip Array Technology and our Evidence Series range of analysers, visit www.randoxtoxicology.com or email info@randoxtoxicology.com

 

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World Kidney Day 2021

World Kidney Day 2021

11th March 2021 is World Kidney Day, a worthy global campaign aimed at tackling “the hot topic everyone’s ignoring”.

Raising awareness of a disease that ‘one in every nine’ people worldwide suffer from, is something we take seriously.

Here at Randox, our vision is to improve healthcare worldwide and ensure patients across the globe have access to the latest advancements in clinical diagnostics to tackle diseases such as Chronic Kidney Disease.

This year World Kidney Day 2021 focuses on being able to live well with kidney disease. Many of us take for granted being able to live a normal life without the side effects such as fatigue, pain, depression, sleep problems etc. However Kidney disease can be huge challenge patients and those around them. The impacts of kidney disease can take a toll of day to day life and the ability to participate in activities such as work, travel, and socialising.

Kidney diseases are very common and can be harmful, but the good news is they are also very treatable!

Randox offer a comprehensive panel of kidney health tests, working to ensure timely and accurate diagnosis of kidney function problems to combat patient challenges early.

For example, low levels of albumin indicate signs of kidney damage in the early stages when diagnosis is key. Testing for albumin can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today.

 

 

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Approaching the Fundamental Impact of STIs Worldwide

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02 March 2021

The Global Economic Burden of STIs & The Impact of the COVID-19 Pandemic on Sexual Health Whitepaper Download 

Sexual Health encompasses; genito-urinary medicine, sexually transmitted infections (STIs), HIV, contraception, psychosexual medicine, abortion services, teenage pregnancy and sexual and reproductive health. It is delivered in various settings, providing care across specialised services as well as through primary and third sector organisations.

Sexual and reproductive health is a fundamental public health issue and is clearly recognised by the World Health Organisation (WHO). This whitepaper focuses on the profound impact of sexually transmitted infections (STIs) worldwide with WHO reporting that more than 1 million STIs are acquired every day (WHO, 2020).

The whitepaper discusses issues such as antimicrobial resistance, in particular gonorrhoea, and the challenges faced in a social and public concept due to the COVID-19 pandemic.

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Biotin supplementation interference in health testing

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12 February 2021

Biotin supplementation interference in health testing

How much do you know about Biotin? Commonly known as Vitamin B7, Biotin is taken by as many as 20% of people, including high profile celebrities like Kylie Jenner, Kim Kardashian and Vanessa Hudgens, for its hair and nail-strengthening properties.

If you take biotin supplements, it is important to know the effects it can have on particular blood tests, should you visit your GP or local hospital.

Whilst there are various diagnostic health tests out there, including fertility hormone tests, prostate tests, and tests for troponin – a marker released into the blood during a heart attack – that are known to be affected by elevated levels of biotin, there are other tests available, including those provided by Randox, that are not impacted.

The reason that so many non-Randox tests are impacted by biotin is that biotin is widely used throughout the biotechnology industry in the development of diagnostic tests.

ELISA tests in particular (tests that measure the reaction of antibodies to identify a substance) often make use of antibodies labelled with biotin, to detect toxins or other foreign substances within the body.

In most instances, the biotin will bind to a protein called streptavidin. This bonding is the strongest non-covalent biological interaction known, and is therefore particularly useful in binding antibodies within diagnostic tests.

But with more and more people exceeding the recommended daily dosage for biotin (30 micrograms) by taking up to 10,000 micrograms of biotin in supplements marketed for beauty reasons, many diagnostic tests are being measured inaccurately. Excess biotin in the blood can block the binding of biotin-labelled antibodies to streptavidin within the tests, and the substance being tested won’t be measured accurately.

Laboratory professionals have known about this potential problem for some time. In late November 2017, the FDA (Food and Drug Administration) published a safety notice to make the public and healthcare practitioners more aware that biotin can “significantly interfere with certain lab tests and cause incorrect test results.”

The FDA even reported on one particular case in which a patient died following falsely low troponin (marker of a heart attack) results when the troponin test used was known to have biotin interference. Biotin supplements masked the true diagnosis of a heart attack.

Many patients taking biotin supplements have also been misdiagnosed with a condition called Graves’ disease, an autoimmune condition characterised by an overactive thyroid. In these cases, biotin supplementation led to falsely low levels of thyroid stimulating hormones, and falsely high levels of other thyroid hormones. This particular profile of hormones led to a Graves’ disease diagnosis, in spite of a lack of symptoms, which in Graves’ disease would usually include muscle weakness, a quickened heartbeat, sleeping problems, diarrhoea, weight loss and poor tolerance of heat.

In pregnant women, tests that are impacted by biotin interference may produce falsely low results of beta HCG, more commonly known as the ‘pregnancy hormone’ as it released by the placenta after conception. With low levels of beta HCG, and therefore no confirmation of pregnancy, pregnant women could be exposed to X-rays and CT scans that may harm the developing foetus.

So, what can be done? Suggestions have been made that patients taking biotin supplements should be made to wait before any diagnostic testing is conducted, so that the biotin clears from their system.

But this “Wait and Watch” approach certainly would not work in emergencies. In the case of a heart attack, testing must be conducted as soon as possible to allow for diagnosis, immediate medical intervention and follow-up testing.

At Randox, we are convinced that the risk of analytic interference by biotin supplementation is a serious problem that needs to be more widely recognised and promptly addressed.

In the GP setting, general practitioners must ask their patients if they are taking any biotin supplements and inform the testing laboratory if interference from biotin is a possibility. They should also consider that lab results not matching with a patient’s signs and symptoms may be caused by biotin interference.

In the acute care setting however, it is imperative that biotin technology is not used in diagnostic testing to protect patients from misdiagnosis and subsequently, further health problems.

This is why Randox’s patented Biochip Array Technology does not use biotin technology in its development. This revolutionary methodology, free from Biotin-Streptavidin is not impacted by elevated levels of biotin from supplementation in the same way as Biotin-Streptavidin tests.

So if you have been taking supplements for hair or nail growth, to ease symptoms associated with Multiple Sclerosis, for epilepsy or for a range of other health conditions, and your diagnostic testing has been conducted using Randox Biochip Array Technology, you can rest assured of true, accurate, and reliable results.

Randox Biochip Array Technology is interference-proof.

For further information on the Randox Biochip, visit https://www.randox.com/multiplex-testing/

For any additional questions, please contact Randox PR by email: randoxpr@randox.com or by phoning 028 9442 2413

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