Erfahrungen bei der Evaluierung von ABICAP® – Hand-Held-Testkits zum Nachweis von Francisella tularensis und Ebolavirus

In unseren Untersuchungen haben wir das säulenchromatographische Verfahren ABICAP® (Antibody Immuno Column for Analytical Processes) der Firma Senova, Jena, hinsichtlich seiner Eignung als Ultraschnelltest für den Nachweis von Francisella tularensis und Ebolavirus geprüft. In beiden Assays konnte eine vergleichbare Spezifität und Sensitivität wie mit den Referenzmethoden auf Grundlage der entsprechenden Capture-ELISA (Enzyme-linked immunosorbent assay) erzielt werden. Der Einfluss von Störgrößen in Probenmatrizen beim Nachweis der Antigene war unterschiedlich hoch, führte jedoch in den meisten Fällen kaum zu einer Veränderung des Ergebnisses. Insgesamt wurde geschlussfolgert, dass sich der ABICAP® für die untersuchten Antigene als präsumtiver Schnelltest eignet und weitere Validierungsarbeiten in der Praxis durchgeführt werden sollten

Transaminase concentrations cannot separate non-alcoholic fatty liver and non-alcoholic steatohepatitis in morbidly obese patients irrespective of histological algorithm

$\bf Background:$ In current general practice, elevated serum concentrations of liver enzymes are still regarded as an indicator of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). In this study, we analyzed if an adjustment of the upper limit of normal (ULN) for serum liver enzymes can improve their diagnostic accuracy. $\bf Methods:$ Data from 363 morbidly obese patients (42.5 $\pm$ 10.3 years old; mean BMI: 52 $\pm$ 8.5 kg/m$^{2}$), who underwent bariatric surgery, was retrospectively analyzed. NAFL and NASH were defined histologically according to non-alcoholic fatty liver activity score (NAS) and according to steatosis activity fibrosis (SAF) score for 2 separate analyses, respectively. $\bf Results:$ In 121 women (45%) and 45 men (46%), elevated values for at least one serum parameter (ALT, AST, $\gamma$GT) were present. The serum concentrations of ALT ($\it p$ < 0.0001), AST ($\it p$ < 0.0001) and $\gamma$GT ($\it p$ = 0.0023) differed significantly between NAFL and NASH, irrespective of the applied histological classification method. Concentrations of all 3 serum parameters correlated significantly positively with the NAS and the SAF score, with correlation coefficients between 0.33 (ALT/NAS) and 0.40 ($\gamma$GT/SAF). The area under the curves to separate NAFL and NASH by liver enzymes achieved a maximum of 0.70 (ALT applied to NAS-based classification). For 95% specificity, the ULN for ALT would be 47.5 U/L; for 95% sensitivity, the ULN for ALT would be 17.5 U/L, resulting in 62% uncategorized patients. $\bf Conclusion:$ ALT, AST, and γGT are unsuitable for non-invasive screening or diagnosis of NAFL or NASH. Utilizing liver enzymes as an indicator for NAFLD or NASH should generally be questioned

Lipoprotein and Metabolic Profiles Indicate Similar Cardiovascular Risk of Liver Steatosis and NASH

$\textit {Background and Aim}$: Nonalcoholic fatty liver disease (NAFLD) affects about 25% of the global population, with no reliable noninvasive tests to diagnose nonalcoholic steatohepatitis (NASH) and to differentiate between NASH and nonalcoholic fatty liver (NAFL) (steatosis alone). It is unclear if NAFL and NASH differ in cardiovascular risk for patients. Here, we compared obese NAFLD patients with a healthy cohort to test whether cholesterol compounds could represent potential noninvasive markers and to estimate associated risks. $\it Method:$ Serum samples of 46 patients with histologically confirmed NAFLD (17 NAFL, 29 NASH) who underwent bariatric surgery were compared to 32 (9 males, 21 females) healthy controls (HCs). We analyzed epidemiological data, liver enzymes, cholesterol and lipid profile, and amino acids. The latter were analyzed by nuclear magnetic resonance spectroscopy. $\it Results:$ Total serum and high-density lipoprotein (HDL) cholesterol were significantly lower in the NAFLD group than in HCs, with a stronger reduction in NASH. Similar observations were made for sub-specification of HDL-p, HDL-s, SHDL-p, and LHDL-p cholesterols. Low-density lipoprotein (LDL)-s and LLDL-p cholesterol were significantly reduced in NAFLD groups. Interestingly, SLDL-p cholesterol was significantly higher in the NAFL group with a stronger elevation in NASH than in HCs. The amino acids alanine, leucin, and isoleucine were significantly higher in the NAFL and NASH groups than in HCs. $\it Conclusion:$ We show in this study that cholesterol profiles, apolipoproteins, and amino acids could function as a potential noninvasive test to screen for NAFLD or even NASH in larger populations. However, few differences in cholesterol profiles were identified between the NAFL and NASH groups, indicating similar cardiovascular risk profiles