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001-es BibID:	BIBFORM072384
Első szerző:	Csongrádi Alexandra (molekuláris biológus)
Cím:	Optimized angiotensin-converting enzyme activity assay for the accurate diagnosis of sarcoidosis / Alexandra Csongrádi, Attila Enyedi, István Takács, Tamás Végh , Ivetta S. Mányiné, Zsófia Pólik, István Tibor Altorjay, József Balla, György Balla, István Édes, János Kappelmayer, Attila Tóth, Zoltán Papp, Miklós Fagyas
Dátum:	2018
Megjegyzések:	Background:Serum angiotensin-converting enzyme (ACE) activity determination can aid the early diagnosis of sarcoidosis. We aimed to optimize a fluorescent kinetic assay for ACE activity by screening the confounding effects of endogenous ACE inhibitors and interfering factors. Genotype-dependent and genotype-independent reference values of ACE activity were established, and their diagnostic accuracies were validated in a clinical study.Methods:Internally quenched fluorescent substrate, Abz-FRK(Dnp)P-OH was used for ACE-activity measurements. A total of 201 healthy individuals and 59 presumably sarcoidotic patients were enrolled into this study. ACE activity and insertion/deletion (I/D) genotype of the ACE gene were determined.Results:Here we report that serum samples should be diluted at least 35-fold to eliminate the endogenous inhibitor effect of albumin. No significant interferences were detected: up to a triglyceride concentration of 16 mM, a hemoglobin concentration of 0.71 g/L and a bilirubin concentration of 150 ?M. Genotype-dependent reference intervals were considered as 3.76?11.25 U/L, 5.22?11.59 U/L, 7.19?14.84 U/L for II, ID and DD genotypes, respectively. I/D genotype-independent reference interval was established as 4.85?13.79 U/L. An ACE activity value was considered positive for sarcoidosis when it exceeded the upper limit of the reference interval. The optimized assay with genotype-dependent reference ranges resulted in 42.5% sensitivity, 100% specificity, 100% positive predictive value and 32.4% negative predictive value in the clinical study, whereas the genotype-independent reference range proved to have inferior diagnostic efficiency.Conclusions:An optimized fluorescent kinetic assay of serum ACE activity combined with ACE I/D genotype determination is an alternative to invasive biopsy for confirming the diagnosis of sarcoidosis in a significant percentage of patients.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban ACE angiotensin-converting enzyme genotype reference interval sarcoidosis
Megjelenés:	Clinical chemistry and laboratory medicine. - 56 : 7 (2018), p. 1117-1125. -
További szerzők:	Enyedi Attila (1975-) (sebész) Takács István (1963-) (sebész) Végh Tamás (1975-) (aneszteziológus, intenzív terápiás szakorvos) Mányiné Siket Ivetta (1962-) (laborasszisztens) Pólik Zsófia Altorjay István (1991-) (orvos, kardiológus) Balla József (1959-) (belgyógyász, nephrológus) Balla György (1953-) (csecsemő és gyermekgyógyász, neonatológus) Édes István (1952-) (kardiológus) Kappelmayer János (1960-) (laboratóriumi szakorvos) Tóth Attila (1971-) (biológus) Papp Zoltán (1965-) (kardiológus, élettanász) Fagyas Miklós (1984-) (orvos)
Pályázati támogatás:	PD 116212 NKFIH K 116940 OTKA ÚNKP-17-4-I-DE-40 ÚNKP GINOP-2.3.2-15-2016-00043 GINOP
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