Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood

Background: The Roche CARDIAC proBNP point-of-care (POC) test is the first test intended for the quantitative determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) in whole blood as an aid in the diagnosis of suspected congestive heart failure, in the monitoring of patients with compensated left-ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes. Methods: A multicentre evaluation was carried out to assess the analytical performance of the POC NT-proBNP test at seven different sites. Results: The majority of all coefficients of variation (CVs) obtained for within-series imprecision using native blood samples was below 10% for both 52 samples measured ten times and for 674 samples measured in duplicate. Using quality control material, the majority of CV values for day-to-day imprecision were below 14% for the low control level and below 13% for the high control level. In method comparisons for four lots of the POC NT-proBNP test with the laboratory reference method (Elecsys proBNP), the slope ranged from 0.93 to 1.10 and the intercept ranged from 1.8 to 6.9. The bias found between venous and arterial blood with the POC NT-proBNP method was ≤5%. All four lots of the POC NT-proBNP test investigated showed excellent agreement, with mean differences of between −5% and +4%. No significant interference was observed with lipaemic blood (triglyceride concentrations up to 6.3mmol/L), icteric blood (bilirubin concentrations up to 582μmol/L), haemolytic blood (haemoglobin concentrations up to 62mg/L), biotin (up to 10mg/L), rheumatoid factor (up to 42IU/mL), or with 50 out of 52 standard or cardiological drugs in therapeutic concentrations. With bisoprolol and BNP, somewhat higher bias in the low NT-proBNP concentration range (<175ng/L) was found. Haematocrit values between 28% and 58% had no influence on the test result. Interference may be caused by human anti-mouse antibodies (HAMA) types 1 and 2. No significant influence on the results with POC NT-proBNP was found using volumes of 140-165μL. High NT-proBNP concentrations above the measuring range of the POC NT-proBNP test did not lead to false low results due to a potential high-dose hook effect. Conclusions: The POC NT-proBNP test showed good analytical performance and excellent agreement with the laboratory method. The POC NT-proBNP assay is therefore suitable in the POC setting. Clin Chem Lab Med 2006;44:1269-7

Determinants of tumor cell migration

Hyaluronsäure (HS) ist ein weit verbreitetes Glykosaminoglykan in der Extrazellulärmatrix vieler Gewebe und tritt in erhöhten Konzentrationen in der Umgebung solider Tumore auf. Es ist bekannt, daß HS die Zellmigration vieler Zellarten stimuliert. Im ersten Teil dieser Arbeit wurde die Rolle der HS in der Tumorzellmigration auf der Basis eines dreidimensionalen Fibringel-Systems, in welches Tumorzell-bedeckte Microcarrier eingebettet wurden, untersucht. Ein Vergleich zwischen zwei- und dreidimensionaler Migration unterverschiedenen Bedingungen ergab, daß die dreidimensionale Migration nicht von HS-spezifischen Oberflächenrezeptoren abhängt, sondern hauptsächlich von der Porosität der Matrix. In zweidimensionalen Systemen war die Migration durch Antikörper gegen den HS-Rezeptor CD44 inhibierbar, unter dreidimensionalen Bedingungen jedoch nicht. Zur Bestimmung der strukturellen Eigenschaften der Fibringele wurden spektrometrische Messungen, konfokale Mikroskopie, Kompaktionsmessungen und Flüssigkeitspermeation herangezogen. Eine weitere Lokalisation ergab ein intrazelluläres Auftreten von HS vorwiegend perinukleär mit dem Zytoskelett assoziiert. Ein direkter Einfluß auf die Aktinpolymerisation konnte ausgeschlossen werden. Im zweiten Teil der Arbeit wurde die direktionale Migration von Tumorzellen auf Endothelzellen sowohl in dreidimensionalen Fibringelsystemen als auch unter zweidimensionalen Bedingungen untersucht. Endothelzell-konditioniertes Medium wurde weiter aufgereinigt und es konnten massenspektrometrisch mehrere potentiell chemotaktisch aktive Moleküle im Medium bestimmt werden.Hyaluronic acid (HA) is a glycosaminoglycan which is ubiquitously present in the extracellular matrix of many tissues and increased concentrations are found in the environment of solid tumors. In the first part of this work the role of HA in tumor cell migration based on a three-dimensional fibrin gel-sytem was investigated. The comparison of two- and threedimensional migration resulted in the conclusion that threedimensional migration mainly depends on the porosity of the matrix and not on specific HA-receptors. The HA-induced migration could be inhibited under two-dimensional conditions by antibodies to the HA-receptor CD44 while in three-dimensional systems the migration was unaffected by these antibodies. The structural properties of the fibrin gels were analyzed by turbidity measurement, confocal microscopy, compaction assay and liquid permeation. Further experiments resulted in perinuclear localization of this macromolecule. A direct mechanical influence of HA on actin polymerization could not be detected. The second part of this work concentrated on the directional migration of tumor cells to endothelial cells. In three-dimensional cocultures of tumor cells and endothelial cells it was found that the tumor cells were chemotactically attracted by endothelial cells. This effect could be verified in two-dimensional Boyden chamber assays. Endothelial-derived conditioned medium was further purified and possible chemotaxins for tumor cell migration could be identified by mass spectrometry