5th Generation Bile Acids Assay

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5th Generation Bile Acids Assay

5th Generation Bile Acids

A Superior Method for Intrahepatic Cholestasis of Pregnancy (ICP) Testing

Benefits of the Randox 5th Generation Bile Acids Assay

Superior Performance

Superior methodology

Utilising the advanced enzyme cycling method, the Randox 5th generation bile acids assay displayed outstanding sensitivity and precision when compared to the traditional enzymatic based tests.

 

Measuring range

Excellent measuring range

The Randox 5th generation bile acids assay has a measuring range of 2.16 – 238µmol/l for the comfortable detection of clinically important results.

 

Correlation

Exceptional correlation

A correlation coefficient of r=0.99 was displayed when the Randox method was compared against other commercially available methods.

 

Liquid ready-to-use

Liquid ready-to-use

The Randox 5th generation bile acids is available in a liquid ready-to-use format for convenience and ease-of-use.

 

Calibrator & Controls

Calibrator and controls available

Calibrator and controls are available offering a complete testing package.

 

Applications available

Applications available detailing instrument-specific settings for the convenient use of the Randox 5th generation bile acids assay on a variety of clinical chemistry analysers.

 

A 4th generation method for bile acids testing is also available which offers an excellent linearity up to 150µmol/l. Applications available detailing instrument-specific settings for the convenient use of the Randox 4th generation bile acids assay on a variety of clinical chemistry analysers.

 

  • Ordering Information
  • INTRAHEPATIC CHOLESTASIS OF PREGNANCY
  • TRADITIONAL DIAGNOSTIC TESTING
  • THE FIFTH GENERATION TEST
Cat NoSize    
BI7982R1 6 x 50ml
R2 6 x 18ml
EnquireKit Insert RequestMSDSBuy Online
BI3863R1 2 x 18ml
R2 2 x 8ml
EnquireKit Insert RequestMSDSBuy Online

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

Intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis is a pregnancy-specific liver disorder. ICP, characterised by maternal pruritus in the absence of a rash and increased total bile acids (TBA) levels, is a severe form, yet reversible, cholestasis commonly occurring in the second and third trimester of pregnancy. Diagnostic and therapeutic guidelines are lacking for ICP which is of concern as ICP can have significant foetal risks 1, 2.

ICP restricts the flow of bile through the gallbladder causing bile acids to build-up in the liver 2. Due to the build-up, bile acids leak into the bloodstream where they are detected at concerning levels.  It has been documented that TBA levels in ICP can reach as high as 100 times the upper limit of a normal pregnancy. Moreover, a doubling in maternal serum TBA levels, results in a 200% increased risk of stillbirth. Additionally, elevated serum bile acids can affect the foetal cardiovascular system causing issues such as cardiac rhythm disturbances 3.

Whilst other liver function tests exist, including: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT) and bilirubin; TBA testing is thought to be the most beneficial method for the diagnosis and monitoring ICP. Moreover, TBA measurements are believed to be the most beneficial when tested in conjunction with standard liver tests, offering unrivalled sensitivity enabling the identification of early stage hepatic dysfunction 3.

The enzyme cycling method enables signal amplification through cycled regeneration reactions. In the presence of Thio-NAD, the enzyme 3-α hydroxysteroid dehydrogenase (3-α HSD) converts bile acids to 3-keto steroids and Thio-NADH (Fig. 1).  The reaction is reversible and 3-α HSD can convert 3-keto steroids and Thio-NADH to bile acids and Thio-NAD.  In the presence of excess NADH, the enzyme cycling occurs efficiently and the rate of formation of Thio-NADH is determined by measuring specific change of absorbance at 405nm 5.

Fig 1: Enzyme cycling assay principle 5
Fig 1: Enzyme cycling assay principle (5th Generation Bile Acids)

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Featured Reagent – Cystatin C

Featured Reagent | Cystatin C

Kidney Disease

Kidney disease is a huge global health crisis, increasing healthcare costs, mortality and morbidity rates.  The global prevalence of chronic kidney disease (CKD) has continued to rise during a short lifespan.  In 2016, 1 in 10, equivalent to 10 percent of the global population were identified with having CKD with the highest prevalence’s reported in Europe, the Middle East, East Asia and Latin America, estimated at 12 per cent and the lowest in South Asia, estimated at 7 percent1.

The early risk assessment of renal function is vital.  In 1990, CKD was ranked the 27th leading cause of death in the Global Burden of Disease study2, rising to 18th 3 in 2010, 13th in 20132 and 12th by 2015.  From 2005-2015, the overall CKD mortality rate has risen by 31.7 percent, accounting for 1.1 million deaths globally in 20154.

Inadequacies of Traditional CKD Biomarkers

The most commonly used screening test for renal impairment is creatinine.  When testing for CKD using creatinine, certain factors must be taken into consideration, including: age, gender, ethnicity, and muscle mass.  As such, black men and black women will present with higher creatinine levels compared to white men and white women respectively5.

Serum creatinine is not an adequate screening test for renal impairment in the elderly (65 years of age and over) due to their decreased muscle mass.  As such, patients are misdiagnosed, thus, patients with severe renal failure are receiving suboptimal care6.

The main disadvantage of using creatinine to screen for renal impairment is that up to 50 percent of renal function can be lost before significant creatinine levels become detectable as creatinine is insensitive to small changes in the glomerular filtration rate (GFR).  Consequently, treatment is not provided at the appropriate time which can be fatal, thus, an earlier and more sensitive biomarker for renal function is vital7.

Biological Significance

Cystatin C is a small (13 kDa) cysteine proteinase inhibitor, produced by all nucleated cells at a constant rate.  Cystatin C travels through the bloodstream to the kidneys where it is freely filtered by the glomerular membrane, resorbed and fully catabolised by the proximal renal tubes.  Consequently, cystatin C is the ideal biomarker of GFR function8.

Clinical Significance of Cystatin C

The National Institute for Health and Care Excellence (NICE) (2014) guidelines recommend cystatin C testing due to its higher specificity for significant disease outcomes than those based on creatinine. As such, eGFR cystatin C measurements will significantly reduce the number of misdiagnosed patients, thus reducing the overall CKD burden9.

In 2017, a systematic literature search found 3,500 investigations into cystatin C as a marker of GFR. The study concluded that eGFRcystatinc was a significantly more superior than eGFRcreatinine10.

Benefits of Cystatin C

The Randox cystatin C assay utilises the latex enhanced immunoturbidimetric method offering numerous key features:

A niche product from Randox meaning that Randox are one of the only manufacturers to provide the cystatin C test in an automated biochemistry format

An automated assay which removes the inconvenience and time consumption associated with traditional ELISA testing

Applications are available detailing instrument-specific settings for the convenient use of the Randox cystatin C assay on a wide range of biochemistry analysers

Liquid ready-to-use reagents for convenience and ease-of-use

Latex enhanced immunoturbidimetric method delivering high performance

Extensive measuring range for the detection of clinically important results

Complementary controls and calibrators available offering a complete testing package

Limited interference from Bilirubin, Haemoglobin, Intralipid® and Triglycerides

Cystatin C does not suffer from a ‘blind area’ like creatinine due to cystatin C’s sensitivity to small changes in GFR enabling the early detection renal impairment

An exceptional correlation coefficient of r=1.00 when compared against standard methods

References

[1] Bello, AK, et al. Global Kidney Health Atlas: A report by the Internal Society of Nephrology on the current state of organization and structures for kidney care across the globe. Brussels : Internal Society of Nephrology, 2017.

[2] Bikbov, Boris. Chronic kidney disease: impact on the global burden of mortality and morbidity. The Lancet. [Online] 2015. http://www.thelancet.com/campaigns/kidney/updates/chronic-kidney-disease-impact-on-global-burden-of-mortality-and-morbidity.

[3] National Kidney Foundation. Global Facts: About Kidney Disease. National Kidney Foundation. [Online] National Kidney Foundation, 2015. https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease#_ENREF_1.

[4] Neuen, Brendon Lange, et al. Chronic kidney disease and the global NCDs agenda. s.l. : BMJ Global Health, 2017.

[5] Lascano, Martin E and Poggio, Emilio D. Kidney Function Assessment by Creatinine-Based Estimation Equations. Cleveland Clinic. [Online] August 2010. [Cited: May 16, 2018.] http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/kidney-function/.

[6] Swedko, Peter J, et al. Serum Creatinine Is an Inadequate Screening Test for Renal Failure in Elderly Patients. Research Gate. [Online] February 2003. [Cited: May 6, 2018.] https://www.researchgate.net/publication/8243393_Serum_Creatinine_Is_an_Inadequate_Screening_Test_for_Renal_Failure_in_Elderly_Patients.

[7] Mishra, Umashankar. New technique developed to detect chronic kidney disease. Business Line. [Online] May 07, 2018. [Cited: May 17, 2018.] https://www.thehindubusinessline.com/news/science/new-technique-to-detect-chronic-kidney-disease/article23803316.ece.

[8] Chew, Janice SC, et al. Cystatin C-A Paradigm of Evidence Based Laboratory Medicine. NCBI. [Online] May 29, 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533150/.

[9] National Institute for Health and Care Excellence. Chronic kidney disease in adults: assessment and management: 2 Implementation: getting started. NICE. [Online] January 2015. [Cited: April 19, 2018.] https://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-started.

[10] Grubb, Anders. Cystatin C is Indispensable for Evaluation of Kidney Disease. NCBI. [Online] December 28, 2017. [Cited: April 19, 2018.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746836/.

MORE FEATURED REAGENTS

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Title


Superoxide Dismutase (Ransod)

Superoxide Dismutase (Ransod)

The Most Important Antioxidant Against Oxidative Stress

Benefits of the Randox Ransod Assay

Excellent correlation

A correlation coefficient of r=0.965 was displayed when the Randox Ransod assay was compared against commercially available methods.

Precision

Excellent precision

The Randox Ransod assay displayed a within run precision of <4.65% CV.

Measuring range

Excellent measuring range

The Randox Ransod assay has a measuring range of 0.06 – 4.52U/ml for the comfortable detection of clinically important results.

Standard or Calibrator

Standard included in kit

The standard is supplied with the Ransod kit, simplifying the ordering process.

Calibrator & Controls

Dedicated Ransod control available

A dedicated Ransod control is available offering a complete testing package.

Applications available

Applications available detailing instrument-specific settings for the convenient use of the Randox Ransod assay on a variety of clinical chemistry analysers.

  • Ordering Information
  • PHYSIOLOGICAL SIGNIFICANCE
  • Clinical Significance
Cat NoSize    
SD1255 x 20ml (S)EnquireKit Insert RequestMSDSBuy Online
(S) Indicates standard included in kit

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

Superoxide dismutase (SOD) are a group of metalloenzymes, the first line of defence against reactive oxygen species (ROS)-medicated injury. SOD is responsible for catalysing the dismutation of the superoxide anion free radical (O2) into molecular oxygen and hydrogen peroxide (H2O2). The aim of this process is to reduce the levels of O2 as it damages cells at excessive concentrations 1.

SOD is the most important antioxidant defence against oxidative stress. SOD is a severe anti-inflammatory agent and can prevent precancerous cell changes. Reduced SOD levels have been observed in older generations as SOD levels drop as the body ages and so are more prone to oxidative related diseases. Reduced SOD activity has been identified as having a strong correlation with Alzheimer’s Disease. The overexpression of SOD-2 reduces hippocampal superoxide, preventing memory defects 1. Moreover, SOD has been identified as a potential diagnostic and prognostic marker in patients with gastric cancer 2. SOD has also been linked to other health conditions, including: rheumatoid arthritis, RBC-related disorders, Crohn’s Disease, cystic fibrosis, malignant breast cancer and neuronal apoptosis 1, 3.

Fig. 1. Pathological effects associated with SOD gene mutation or SOD deficiency 4
Pathological effects associated with SOD gene mutation or SOD deficiency - Ransod

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Contact us or download the superior performance & unique tests brochure to learn more.

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Ransod Control

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Aldolase Assay

Aldolase

A Myositis Biomarker

Benefits of the Randox Aldolase Assay

Exceptional correlation

A correlation coefficient of r=0.9917 was displayed when the Randox methodology was compared against commercially available methods.

Excellent measuring range

The Randox aldolase assay has a measuring range of 1.73 – 106U/l for the comfortable detection of clinically important results.

Lyophilised reagents

Lyophilised reagents offer enhanced stability, reducing wastage.

Excellent precision

The Randox assay displayed a within run precision < 4.47% CV.

Dedicated calibrator and controls available

Randox offer a dedicated aldolase calibrator and controls for a complete testing package.

Applications available

Applications available detailing instrument-specific settings for the convenient use of the Randox aldolase assay on a variety of clinical chemistry analysers.

  • Ordering Information
  • PHYSIOLOGICAL SIGNIFICANCE
  • Clinical Significance
Cat NoSize    
AD1895 x 20mlEnquireKit Insert RequestMSDSBuy Online

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

Aldolase is a glycolytic enzyme responsible for catalysing the conversion of fructose 1-6-diphosphate to glyceraldehyde 3-phosphate and dihydroxyacetone phosphate via the glycolysis metabolic pathway. This enzyme is present in all bodily cells, more commonly in the nucleus and cytoplasm. It has been identified as having three isoforms: A, B and C. Isoform A is found bound to the actin-containing filament of the cytoskeleton. By binding (reversible) to these filaments, aldolase aids in regulating cell contractions. The highest concentrations of this enzyme are present in the brain, liver and muscles 1.

Elevated levels of aldolase are detected in myotonic muscular disease, including: polymyositis and progressive muscular dystrophy. Elevated levels of this enzyme have been observed in acute coronary syndromes 1. This enzyme has been identified as a myositis biomarker, a muscle-wasting disease resulting in reduced muscle strength and fatigue 2. Testing this enzyme can be utilised as a marker in the differential diagnosis of muscle weakness as aldolase levels remain consistent where weakness is caused by neurological problems such as multiple sclerosis (MS) 3.

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Anti-Streptolysin O (ASO) Reagent

Reagent | Anti-Streptolysin O (ASO)

Key benefits of the Anti-Streptolysin O reagent

Excellent correlation to standard methods

The Randox methodology was compared against other commercially available methods and the Randox Anti-Streptolysin O assay showed a correlation coefficient of 0.97.

Excellent stability

Stable until expiry date when stored at +2 to +8°C

Specificity

The antiserum of Randox Anti-Streptolysin O is monospecific for human ASO and has not been shown to cross react with other serum proteins.

Other Features of the Anti-Streptolysin (ASO) reagent

  • Immunoturbidimetric
  • Liquid ready-to-use reagents
  • Stable to expiry when stored at +2 to+8⁰C
  • Measuring range 28 – 1314 IU/ml
Cat NoSize    
LO3998R1 2 x 9ml
R2 2 x 14ml
EnquireKit Insert RequestMSDSBuy Online
LO8015R1 2 x 8.7ml
R2 2 x 12ml
EnquireKit Insert RequestMSDSBuy Online
LO8305R1 1 x 7.7ml
R2 1 x 11.2ml
EnquireKit Insert RequestMSDSBuy Online

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

What is the Anti-Streptolysin O (ASO) assay used for?

What is Anti-Streptolysin O (ASO)?

Streptolysin O (SLO) is a toxic and lethal, exocellular immunogenic protein produced and released in response to Group A Streptococcal pyogenes.  For more information on streptococcal infections, please click here [external link].  The release of SLO stimulates the production of Anti-Streptolysin O (ASO) antibodies to neutralise the SLO’s haemolytic effects. The O in the name stands for oxygen-labile.

What is the Anti-Streptolysin O (ASO) assay used for?

The Anti-Streptolysin (ASO) test is used to determine recent streptococcal infection and post streptococcal complications which includes rheumatic fever and glomerulonephritis. The presence and level of ASO antibodies in human serum directly reflects the extent and degree of infection. Elevated levels of ASO may also be present in other conditions including scarlet fever, acute rheumatoid arthritis, tonsillitis and various other streptococcal infections as well as in health carriers.

The Randox Anti-Streptolysin (ASO) assay is used to measure the presence of anti-streptolysin antibodies in the blood to determine if a strep infection is present.

Specific Protein Panel

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Rapid Tests / Serology Panel

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Amylase Reagent

Reagent | Amylase

Key Benefits of the Randox Amylase reagent

Wide measuring range

The healthy range for amylase is 30 – 100 U/l. The Randox reagent can comfortably detect levels outside of this range measuring between 7.3 – 1245 µmol/l.

Excellent stability

Stable to expiry when stored at +2 to +8°C

Liquid ready-to-use reagents

The Randox reagent comes in a liquid ready-to-use format which is more convenient as the reagent does not need to be reconstituted which aids in reducing the risk of errors occurring

Other Features of the Randox Amylase reagent

  • Ethylidene PNPG7 method
  • Liquid and lyophilised reagents available
  • Stable to expiry when stored at +2 to +8°C
  • Measuring range 7.3 – 1245 µmol/l
Cat NoSize    
AY3805R1 4 x 16ml (L)
R2 4 x 5ml (L)
EnquireKit Insert RequestMSDSBuy Online
AY7931R1 6 x 50ml (L)
R2 4 x 18ml
EnquireKit Insert RequestMSDSBuy Online
AY158020 x 5mlEnquireKit Insert RequestMSDSBuy Online
AY8004R1 7 x 18ml (L)
R2 7 x 7.3ml
EnquireKit Insert RequestMSDSBuy Online
AY8335R1 4 x 20ml (L)
R2 4 x 7ml
EnquireKit Insert RequestMSDSBuy Online
(L) Indicates liquid option

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

What is Amylase assay used for?

What is amylase?

It is a digestive enzyme / special protein produced by the pancreas and salivary glands.  Salivary amylase is responsible for breaking down starch in the mouth and converting it into maltose.  Pancreatic amylase passes through a duct from the pancreas to the small intestine where the digestive process is completed through converting starch into glucose.  The glucose is then absorbed into the blood and carried throughout the body.

What is the amylase assay used for?

Damage or inflammation to the pancreas can result in under / over production of amylase which can be a sign of pancreatic disorder which includes pancreatic pseudocyst, pancreatic abscess, pancreatic cancer, gallbladder disease, mumps or ectopic pregnancy.  For more information on pancreatic cancer, please click here [external link]. The Randox assay is used for the quantitative in vitro determination of amylase activity in serum, urine and plasma.

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Antioxidant Reagents

Antioxidant Reagents

The Role of Antioxidants

Antioxidants are important for the body’s immune system and to protect the body against free radical attacks. Randox provides a range of antioxidant reagents to assess all three levels of the body’s defence system (preventative antioxidants, scavenging antioxidants and repair enzymes). Some key tests offered by Randox antioxidant reagents panel include Total Antioxidant Status (TAS), Glutathione Peroxidase (Ransel), Superoxide Dismutase (Ransod) and Glutathione Reductase.

Levels of Antioxidant Defence

Preventative antioxidants – Inhibit the formation of free radicals including metal binding proteins like; Ceruloplasmin, Metallothionine, Albumin, Transferrin, Ferritin and Myoglobin

Scavenging antioxidants – Remove any reactive species once formed.  such as Superoxide Dismutase, Glutathione Peroxidase, Catalase and small molecules including Ascorbate, Tocopherol, Bilirubin, Uric Acid, Carotenoids and Flavonoids

Repair enzymes – Repair damaged biomolecules such as DNA repair enzymes

Randox Assay Benefits

The Randox range of antioxidant reagents are designed for use within a variety of sectors including clinical, research, veterinary, pharma, food and beverages, cosmetics and sports. Our range of antioxidant reagents include routine assays routine antioxidant reagents as well as specialised tests unique to Randox.

  • A range of liquid and lyophilised formats are available
  • A variety of kits, methods and ranges are available
  • Complementary controls and calibrators are available
  • Suitable for a wide variety of sample types, including whole blood (human and animal), serum, plasma, erythrocytes, wine, beer and fruit juice
  • Suitable for automation which removes the inconvenience and time consumption associated with traditional ELISA based testing options
  • Instrument Specific Applications (ISA’s) are available for an extensive range of clinical chemistry analysers which includes detailed instrument specific settings for increased convenience.

Antioxidant General Overview

Antioxidants defend our bodies from free radical damage

As the body’s defence to free radicals, antioxidants are crucial in maintaining our health. Free radicals are highly reactive cells produced during the process of oxidation, a reaction which takes place during many of the body’s natural key processes such as respiration. Free radicals may also be produced when there is inflammation in the body, during exercise, as well as the body responding to environmental factors such as sunlight and pollutants (chemicals, cigarette smoke etc.).

Antioxidants protect the body from free radical damage by inhibiting the formation of free radicals, destroying free radicals, or repairing damaged cells. The presence of antioxidants usually enables the body to handle free radicals, however if antioxidants are unavailable or if oxidative stress occurs, damage to the surrounding cells or tissue can occur. Oxidative stress refers to the imbalance between the production of free radicals and the body’s ability to detoxify them i.e. when there is an excessive production of free radicals. As a result, free radicals have been implicated in many disease states.

Antioxidant benefits against disease

Free radicals have been found to play a role in the development of many diseases including cancer (free radicals are thought to promote cell transformation into a cancer cell), arthritis and inflammatory diseases (increased oxidative stress in rheumatoid arthritis patients suggests antioxidants could have an important role), cardiovascular disease (antioxidants have been found to improve cardiac health), and Alzheimer’s disease (antioxidants have a role in removing deleterious free radicals from the brain).

How you can look after your body’s antioxidant defence

The body’s antioxidant defence system is made up of antioxidants produced by the body naturally, in addition to requiring external sources to obtain antioxidants it cannot produce. The best source of antioxidants includes antioxidant rich foods. Foods high in antioxidants include fruits, vegetables and grains. The body’s natural antioxidant production declines with age, and therefore an antioxidant rich diet is important to ensure a healthy you.

A patient’s antioxidant health can be tested with a simple blood test


Lipase Reagent

Reagent | Lipase

Key Benefits of the Randox Lipase Assay

Excellent precision

The Randox lipase assay displayed a precision of  <5% CV.

Exceptional correlation

The Randox lipase assay displayed an exceptional correlation coefficient of r=1.00 when compared against other commercially available methods.

Fully automated protocols

Fully automated protocols are available for a variety of clinical chemistry analysers.

Further Benefits of the Randox Lipase Assay

Colorimetric method.

Liquid ready-to-use format for convenience and ease-of-use.

Measuring range of 2.0 – 744U/l for the comfortable detection of abnormal levels.

Applications available detailing instrument-specific settings for the convenient use of the Randox lipase assay on a wide range of clinical chemistry analysers.

Cat NoSize    
LI3837R1 3 x 9ml
R2 3 x 6ml
EnquireKit Insert RequestMSDSBuy Online
LI7979R1 6 x 20ml
R2 3 x 20ml
EnquireKit Insert RequestMSDSBuy Online
LI8050R1 4 x 16.2ml
R2 4 x 10ml
EnquireKit Insert RequestMSDSBuy Online
(L) Indicates liquid option

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

About Lipase Testing

  • Clinical Significance
  • Physiological Significance

Elevated lipase concentrations 3-to-4-fold greater than the upper normal limit is indicative of pancreatitis, however, the degree of elevations does not correlate with the severity of the disease 2, 3.

In pancreatic dysfunction, lipase concentrations rise between 4 and 6 hours, peaking at 48 hours and returning to baseline within 8 to 14 days. It has a half-life of 6.7 to 13.7 hours in plasma. The half-life of amylase (another assay utilised in the diagnosis of pancreatic dysfunction) is less, however, lipase is filtered by the glomerulus and reabsorbed by the tubules which may contribute towards the longer half-life of lipase.

Lipase offers a few advantages over amylase including: a slightly better specificity, greater sensitivity for patients presenting late, due to the longer half-life, and greater sensitivity in alcoholic pancreatitis 4.

Furthermore, for prolonged longitudinal injuries, lipase activity tends to be more sensitive compared to amylase as lipase concentrations within the zymogen granules are approximately 4.5 times than those of amylase. Consequently, recurring injuries are more likely to be recognised due to the leakage of lipase into the bloodstream. Moreover, lipase concentrations are less affected by intestinal injury or renal dysfunction compared to amylase 2.

Derived from zymogen granules of pancreatic acinar cells, lipase is involved in the digestion of lipids for the subsequent absorption in the small intestine 1, 2. The pancreas is located in the anterior abdominal cavity adjacent to the liver, duodenum and stomach to allow the secretion of digestive enzymes into the small intestine, and to convert ingesta into absorbable lipids, carbohydrates and proteins. The exocrine pancreas provides a microenvironment for pancreatic islet cells. The pancreatic islet cells provide the embedded endocrine function of the pancreas which in turn enables the hepatic and peripheral tissues to modulate blood glucose levels and other functions 2.

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Featured Reagent – G6PDH

Featured Reagent | G6PDH

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Glucose-6-phosphate dehydorgenase (G6PDH/G6PD) deficiency is an x-linked and sex-linked metabolic disorder, commonly affecting men more so than women1.  The G6PDH enzyme is critical for the proper functioning of red blood cells (RBC’s).  Depleated levels of G6PDH can cause the premature destruction of RBC’s (haemolysis).  If the bone marrow cannot compensate for the reduction in RBC’s, heamolyic anaemia can develop.  It is important to note that a deficiency in the G6PDH enzyme is not enough to promote the onset of haemolysis, but rather additional factors are required to promote the onset of symptoms2.

Some of the common side effects of G6PDH deficiency include: paleness, dark urine, yellowing of the skin and whites of the eyes, a rapid heart rate and shortness of breath.  Common triggers for the development of haemolytic anaemia in those who are G6PDH deficient include: bacterial and viral infections, certain drugs (medications and antibiotics to treat malaria), and favism (inhaling the pollen from fava plants and ingesting fava beans)3

G6PDH deficiency has been recognised as a significant cause of mild to severe jaundice in newborns.  It has been noted that those with this disorder commonly will not experience any signs or symptoms making them unaware that they have the condition3.

Haemolytic Anaemia

Haemolytic anaemia is an umbrella term used to describe the premature destruction of red blood cells (RBC’s). This disorder encompasses numerous conditions including: autoantibodies, medications, underlying malignancy, bone marrow failure, infection and heredity conditions including sickle cell disease or haemoglobinopathies4 5.

The severity of haemolytic anaemia depends on whether the onset of haemolysis is gradual or rapid and on the extent of RBC destruction. Patients with mild haemolysis can be asymptomatic whereas the anaemia in severe haemolysis can be life-threatening and can cause angina and cardiopulmonary decompensation.  Haemolytic anaemia is an intravascular phenomenon meaning that this type of haemolysis occurs within the blood vessels and is caused by the following conditions: prosthetic cardiac valves, glucose-6-phosphate dehydrogenase (G6PDH) deficiency, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, transfusion of ABO incompatible blood and paroxysmal nocturnal haemoglobinuria (PNH)6.

Heredity disorders can also cause haemolysis due to the erythrocyte membrane and haemoglobin abnormalities, and enzymatic defects. Some hereditary disorders include: G6PDH deficiency, hereditary spherocytosis and sickle cell anaemia6.

Glucose-6-phosphate dehydrogenase (G6PDH) is a cytosolic enzyme located on the X-chromosome found in bodily cells.  G6PDH is involved in the normal processing of carbohydrates and plays a critical role in RBC, protecting them from damage and premature destruction.  The two main products of G6PDH are ribose-5-phosphate which is important for DNA, the chemical cousin of RNA. The chemical reaction produces NADPH which protects bodily cells from reactive oxygen species1.

Benefits of the G6PDH Assay

A niche assay from Randox meaning that Randox are one of the only manufacturers to offer a G6PDH assay in an automated biochemistry format.

Superior stability of 4 weeks upon reconstitution and stored at +2°C to +8°C.  Many other commercially available assays offer only 5 days stability, leading to product wastage.

Minimal interference as the sample pre-wash step included in the Randox G6PDH testing method serves to purify the sample, leading to no known interferences being observed.

Excellent correlation coefficient of r=0.99 when compared against other commercially available methods.

Lyophilised reagent for enhanced stability.

UV method

G6PDH controls offering a complete testing package.

Applications available detailing instrument-specific settings for the convenient use of the Randox G6PDH assay on a wide range of clinical chemistry analsyers.

Did you know?

It is estimated that 400 million people globally are G6PDH deficient3.

The condition most commonly occurs in parts of Africa, Asia , the Mediterranean and the Middle East3.

References

[1] Croom, Edward. Progress in Molecular Biology and Translational Science. 2012. ISBN 9780124158139 / ISSN 1877-1173.

[2] National Organization for Rare Disorders. Glucose-6-Phosphate Dehydrogenase Deficiency. [Online] no date. [Cited: January 31, 2019.] https://rarediseases.org/rare-diseases/glucose-6-phosphate-dehydrogenase-deficiency.

[3] U.S. National Library of Medicine. Glucose-6-phosphate dehydrogenase deficiency. [Online] May 2017. [Cited: January 30, 2019.] https://ghr.nlm.nih.gov/condition/glucose-6-phosphate-dehydrogenase-deficiency.

[4] National Heart, Lung, and Blood Institute. Hemolytic Anemia. [Online] no date. [Cited: January 28, 2019.] https://www.nhlbi.nih.gov/health-topics/hemolytic-anemia.

[5] BMJ Publishing Group. Hemolytic anemia. BMJ Best Practice. [Online] March 2018. [Cited: January 28, 2019.] https://bestpractice.bmj.com/topics/en-us/98.

[6] Schick, Paul. Hemolytic Anemia. Medscape. [Online] December 29, 2018. [Cited: Janaury 28, 2018.] https://emedicine.medscape.com/article/201066-overview.

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Niche Reagents – Zinc, Copper & Aldolase

Reagents | Zinc, Copper & Aldolase

Advancing Routine Testing with Randox Reagents

Randox offer an extensive range of 115 third party diagnostic reagents which are internationally recognised as being of the highest quality; producing accurate and precise results. Continually reinvesting in R&D, Randox continue to offer the opportunity to expand your test menu without expanding your lab. Not only does Randox offer superior performance assays, but also niche assays, meaning that Randox are one of the only manufacturers to offer the test in an automated biochemistry format.

Zinc

 

  • Benefits of the Randox Zinc Assay
  • Biological Significance of Zinc
  • Clinical Significance of Zinc

A niche assay from Randox meaning that Randox are one of the only manufacturers to offer a clinical chemistry zinc assay

Strong correlation with standard methods as the Randox zinc assay showed a correlation coefficient of r=0.9946 when compared against standard methods

A measuring range of 11.3 – 159 µmol/l for the comfortable and accurate detection of abnormal levels

Liquid ready-to-use reagents for convenience and ease-of-use

Stable to expiry date when stored at +15 to +25°C

Applications are available detailing instrument-specific settings for the convenient use of the Randox zinc assay on a wide range of clinical chemistry analysers

An essential trace metal and the only metal present in all enzyme classes, zinc is the second most abundant micronutrient in humans after iron. Zinc is required for a healthy immune system, a healthy growth rate during pregnancy, childhood and adolescence, wound health and synthesizing DNA. Zinc can modulate brain excitability and is vital in the synaptic plasticity of the brain which is thought to contribute towards memory and learning. Zinc has also been identified as a neurotoxin which suggests that zinc homeostasis is involved in the normal functioning of the central nervous system and the brain 1.

Zinc deficiency is identified as a malnutrition problem worldwide, especially in areas of high cereal intake and low animal food intake.  However, other factors may contribute to low zinc levels including: the bioavailability of zinc, chronic illnesses such as diabetes, malignancy, hepatic disease and sickle cell disease.  Higher zinc requirements have been identified in infants, children, adolescents, and pregnant and lactating women compared to adults.  During periods of growth, zinc deficiency can result in growth failure.  The most common organs affected by zinc deficiency clinically include: central nervous system, gastrointestinal, epidermal, skeletal, immune, and reproductive systems 2 3.

Copper

 

  • Benefits of the Randox Copper Assay
  • Biological Significance of Copper
  • Clinical Significance of Copper

A niche assay from Randox meaning that Randox are one of the only manufacturers to offer a clinical chemistry copper assay

Exceptional correlation with standard methods as the Randox copper assay showed a correlation coefficient of r=0.99 when compared against standard methods

A wide measuring range of 6.6 – 86 µmol/l for the comfortable and accurate detection of abnormal levels

Lyophilised reagents for enhanced stability

Excellent stability of 2 weeks when stored at +2 to +8°C

Applications are available detailing instrument-specific settings for the convenient use of the Randox copper assay on a wide range of clinical chemistry analysers

An essential trace metal, copper is the third most abundant micronutrient in humans after iron and zinc. Copper is mainly found in the brain, liver, kidneys, heart and skeletal muscle with the highest quantities found in the liver and muscles. It aids in some of the key bodily functions including: the production of red blood cells, the maintenance of nerve cells and the immune system, the formation of collagen to absorb iron for energy production, and the formation of melanin, bone and connective tissue. Ceruloplasmin is the protein responsible for the transportation of copper around the body 4.

 

There are various health problems that can cause abnormal copper levels, however deficiency is less likely than toxicity because a normal diet contains plenty of copper including: organic meats, beans and wholegrains. Deficiency is more likely to occur in those who are malnourished, more likely children.

Deficiency more commonly occurs in premature babies, resulting in bone abnormalities and fractures. Menkes Disease is a rare inherited genetic disorder of copper metabolism and is characterised by sparse and kinky hair as children with this disorder are unable to absorb enough copper 5.

Toxicity can be caused by consuming too many dietary supplements high in copper, from drinking contaminated water, or from fungicides containing copper sulphates. Wilson disease is a rare inherited disorder that prohibits the liver from safely storing and excreting copper resulting in it seeping out of the liver and building up in the eyes, liver, kidneys and brain causing nerve damage, and if untreated, it can be fatal 6.

Aldolase

  • Benefits of the Randox Aldolase Assay
  • Biological Significance of Aldolase
  • Clinical Significance of Aldolase

A niche assay from Randox meaning that Randox are one of the only manufacturers to offer a clinical chemistry aldolase assay

Excellent correlation coefficient of r=0.9917 when compared against other commercially available methods

A wide measuring range of 1.73 – 106 µmol/l for the comfortable and accurate detection of abnormal levels

Lyophilised reagents for enhanced stability

UV Method

Applications are available detailing instrument-specific settings for the convenient use of the Randox aldolase assay on a wide range of clinical chemistry analysers

There are three types of Aldolase enzymes that can be can be found throughout the body: A, B and C.  It is responsible for converting glucose into energy.

A is primarily contained within the muscle and erythrocytes, whereas B is contained within the liver, enterocytes and kidney, and A and C can be found within the brain.  Despite the Aldolase enzyme existing throughout the body, the highest concentration levels of it can be found in the liver and the skeletal muscle, although testing this enzyme is routinely used for skeletal muscle damage 7.

 

Elevated levels of type A aldolase in the blood can be found in patients with damage to the skeletal muscle as the result of a trauma which includes dermatpmyositis, infectious mononucleosis, muscular dystrophy, myocardial infarction, hepatic cancer due to the damaged cells triggering the release of A into the blood. On the other hand, the concentration levels of A in the blood remain normal in situations where weakness is caused as the result of a neurological disease such as multiple sclerosis. Measuring A concentration levels in the blood can therefore be used to determine the root cause of muscle weakness, whether muscle trauma or neurological myopathy, in patients 7.

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Related Products

Aldolase Control

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Resource Hub

  • References

    [1] Osredkar, Josko and Sustar, Natasa. Copper and Zinc, Biological Role and Significance of Copper/Zinc Imbalance. 1, s.l. : Journal of Clinical Toxicology, 2011, Vol. 3.

    [2] Jockers, Dr. David. How To Test Zinc Levels At Home. DrJockers.com. [Online] 2019. [Cited: November 28, 2018.] https://drjockers.com/test-zinc-levels-home/..

    [3] Roohani, Nazanin, et al. Zinc and its importance for human health: An integrative review. National Center for Biotechnology Information. [Online] J Res Med Sci, February 18, 2013. [Cited: November 28, 2018.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724376/..

    [4] Nordqvist, Joseph. What are the health benefits of zinc? Medical News Today. [Online] December 5, 2017. [Cited: November 28, 2018.] https://www.medicalnewstoday.com/articles/263176.php.

    [5] Macfarlane, Susan. Understanding Nutrient Ratios: Zinc/Copper. Susan Macfarlane. [Online] October 29, 2017. [Cited: November 28, 2018.] https://susanmacfarlanenutrition.com/understanding-nutrient-ratios-zinccopper/.

    [6] National Center for Advancing Translational Sciences. Menkes disease. National Center for Advancing Translational Sciences. [Online] Genetic and Rare Disease Information Center, April 7, 2017. [Cited: November 30, 2018.] https://rarediseases.info.nih.gov/diseases/1521/menkes-disease.

    [7] Berridge, Brian R, Van Vleet, John F and Herman, Eugene. Chapter 46 – Cardiac, Vascular, and Skeletal Muscle Systems. 2013.


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