Labile glycated haemoglobin and carbamylated haemoglobin are still critical points for HbA1c measurement

IntroductionHaemoglobin A1c (HbA1c) is a key analyte for the monitoring of glycemic balance in diabetic patients and is used for diabetes diagnosis in many countries. The potential interference of carbamylated haemoglobin (cHb) and labile glycated haemoglobin (LA1c) on HbA1c assays must remain a matter of vigilance. Such a situation has occurred in our laboratory with a kit replacement on the Bio-Rad Variant™ II testing system, a cation-exchange high performance liquid chromatography (HPLC) system. With this method, LA1c and cHb coeluted in a same peak which may have different consequences on HbA1c values. Materials and methodsThe influence of increasing LA1c and cHb values on HbA1c results was studied with in vitro glycation and carbamylation of samples. Samples from patients with high and normal blood urea concentrations were assayed by HPLC and immunological assay. ResultsWe observed that the degree of interference greatly varied depending on the nature of the interfering Hb fractions found under the so-called “LA1c peak”. Thus, we have decided to apply a decision tree using “LA1c” thresholds depending on: (i) the retention time, (ii) the shape of the peak, (iii) other analytes, like urea. If the peak recognized as “LA1c” is mainly formed by LA1c, we consider that there is no interference until 4%. If the peak is mainly formed by cHb, we consider an interference threshold equal to 2%. ConclusionsThis situation reminds that cHb and LA1c remain critical issues in chromatography-based HbA1c assays and that adapted criteria must be set up for result interpretation

Evaluation of the analytical performances of the Cobas c513 analyser for HbA1c assay

Introduction: Haemoglobin A1c (HbA1c) is considered to be the gold standard for the follow-up of glycaemic control in patients with diabetes mellitus and is also a diagnostic tool. Accordingly, reliable and efficient methods must be used for its quantification. Roche Diagnostics have recently adapted the Tina-quant® HbA1c Third Generation immunoassay on a fully dedicated analyser, the Cobas c513, which allows a high throughput of up to 400 samples per hour. The present article deals with the evaluation of the analytical performances of this system which has been recently introduced to the market. Materials and methods: Precision, comparison with two ion-exchange high-performance liquid chromatography (HPLC) methods (Variant II and D-100 systems, BioRad Laboratories) using Passing Bablok and Bland-Altman analyses, accuracy and interference of the most frequent haemoglobin (Hb) variants on HbA1c measurement were evaluated. Results: Precision was high, with coefficients of variation lower than 1.1% (HbA1c values expressed in National Glycohemoglobin Standardization Program units, 1.7% for values expressed in International Federation of Clinical Chemistry and Laboratory Medicine [IFCC] units). The comparison study showed similar results with the two HPLC systems. The analysis of samples with IFCC-assigned values showed high methodological accuracy. Finally, no interference of bilirubin, triglycerides and common Hb variants (Hb AC, AD, AE, AS) was observed. Conclusions: This evaluation showed that the analytical performance of the Cobas c513 analyser for HbA1c assay makes it suitable for a routine use in clinical chemistry laboratories

Study of intracellular metabolism of carbamylated proteins

La réaction de carbamylation, comme les réactions de glycation, d’oxydation ou de carbonylation, fait partie des modifications post-traductionnelles non enzymatiques des protéines. Elle correspond à la fixation d’acide isocyanique sur les groupements aminés des protéines et conduit à la formation de produits de carbamylation, dont fait partie l’homocitrulline. Des études in vitro ont mis en évidence le caractère délétère de la carbamylation des protéines sur leur structure et leur fonction. Des études in vivo ont montré l’accumulation tissulaire des produits de carbamylation au cours de l’insuffisance rénale chronique et du vieillissement. Cependant, peu de travaux ont porté sur la carbamylation des protéines intracellulaires.Ce travail a porté sur l’étude de la carbamylation des protéines intracellulaires, leur impact sur la cellule ainsi que leur devenir. De plus, un mécanisme de réparation des protéines carbamylées a été recherché.Nous avons montré, par une approche quantitative et qualitative, que les protéines intracellulaires pouvaient être carbamylées dans des conditions physiologiques et que leur carbamylation était augmentée en présence de cyanate ou d’urée. Nous avons également montré que les cellules étaient capables d’éliminer les protéines carbamylées, en impliquant le protéasome. Un phénomène de décarbamylation a été mis en évidence, ce qui ouvre des possibilités pour la mise en place de stratégies visant à limiter ou à inverser la carbamylation.The carbamylation reaction, like glycation, oxidation or carbonylation reactions, is a non-enzymatic post-translational modification of proteins. It corresponds to the binding of isocyanic acid to protein amino groups and leads to the formation of carbamylation-derived products (CDPs), such as homocitrulline. In vitro studies have demonstrated the deleterious effect of carbamylation of proteins on their structure and function. In vivo studies have shown tissue accumulation of CDPs during chronic kidney disease and aging. However, studies on the carbamylation of intracellular proteins are lacking.This work was devoted to the study of the carbamylation of intracellular proteins, their impact on cell and their fate. In addition, a mechanism for repairing carbamylated proteins has been investigated.Our results showed, by quantitative and qualitative approaches, that intracellular proteins were carbamylated in physiological conditions and that their carbamylation rate was increased in the presence of cyanate or urea. We also have shown that cells were able to remove carbamylated proteins by a mechanism involving the proteasome. A phenomenon of decarbamylation has been highlighted, which opens up possibilities for the implementation of strategies to limit or reverse carbamylation

Intérêt du dosage de l'homocitrulline comme biomarqueur au cours de l'insuffisance rénale aiguë

REIMS-BU Santé (514542104) / SudocSudocFranceF

Vieillissement moléculaire des protéines

Le vieillissement moléculaire des protéines correspond aux modifications non enzymatiques que subissent celles-ci au cours de leur vie biologique et qui conduisent à l’altération de leurs propriétés structurales et fonctionnelles. Ce phénomène participe aux vieillissements cellulaire et tissulaire et, par conséquent, au vieillissement général de l’organisme. Il est également accentué au cours de maladies chroniques comme le diabète ou l’insuffisance rénale chronique, où il participe au développement de complications à long terme. Cette synthèse décrit les principales réactions responsables du vieillissement moléculaire des protéines, leurs conséquences ainsi que les facteurs influençant ce phénomène. Enfin, un schéma général exposant son rôle en physiopathologie est proposé

Modulation of the Bile Acid Enterohepatic Cycle by Intestinal Microbiota Alleviates Alcohol Liver Disease

Reshaping the intestinal microbiota by the ingestion of fiber, such as pectin, improves alcohol-induced liver lesions in mice by modulating bacterial metabolites, including indoles, as well as bile acids (BAs). In this context, we aimed to elucidate how oral supplementation of pectin affects BA metabolism in alcohol-challenged mice receiving feces from patients with alcoholic hepatitis. Pectin reduced alcohol liver disease. This beneficial effect correlated with lower BA levels in the plasma and liver but higher levels in the caecum, suggesting that pectin stimulated BA excretion. Pectin modified the overall BA composition, favoring an augmentation in the proportion of hydrophilic forms in the liver, plasma, and gut. This effect was linked to an imbalance between hydrophobic and hydrophilic (less toxic) BAs in the gut. Pectin induced the enrichment of intestinal bacteria harboring genes that encode BA-metabolizing enzymes. The modulation of BA content by pectin inhibited farnesoid X receptor signaling in the ileum and the subsequent upregulation of Cyp7a1 in the liver. Despite an increase in BA synthesis, pectin reduced BA serum levels by promoting their intestinal excretion. In conclusion, pectin alleviates alcohol liver disease by modifying the BA cycle through effects on the intestinal microbiota and enhanced BA excretion

SARS-CoV-2 infection in nonhuman primates alters the composition and functional activity of the gut microbiota

International audienceThe current pandemic of coronavirus disease (COVID) 2019 constitutes a global public health issue. Regarding the emerging importance of the gut-lung axis in viral respiratory infections, analysis of the gut microbiota's composition and functional activity during a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection might be instrumental in understanding and controling COVID 19. We used a nonhuman primate model (the macaque), that recapitulates mild COVID-19 symptoms, to analyze the effects of a SARS-CoV-2 infection on dynamic changes of the gut microbiota. 16S rRNA gene profiling and analysis of β diversity indicated significant changes in the composition of the gut microbiota with a peak at 10-13 days post-infection (dpi). Analysis of bacterial abundance correlation networks confirmed disruption of the bacterial community at 10-13 dpi. Some alterations in microbiota persisted after the resolution of the infection until day 26. Some changes in the relative bacterial taxon abundance associated with infectious parameters. Interestingly, the relative abundance of Acinetobacter (Proteobacteria) and some genera of the Ruminococcaceae family (Firmicutes) was positively correlated with the presence of SARS-CoV-2 in the upper respiratory tract. Targeted quantitative metabolomics indicated a drop in short-chain fatty acids (SCFAs) and changes in several bile acids and tryptophan metabolites in infected animals. The relative abundance of several taxa known to be SCFA producers (mostly from the Ruminococcaceae family) was negatively correlated with systemic inflammatory markers while the opposite correlation was seen with several members of the genus Streptococcus. Collectively, SARS-CoV-2 infection in a nonhuman primate is associated with changes in the gut microbiota's composition and functional activity