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Human Plasma and Recombinant Hemopexins: Heme Binding Revisited
International Journal of Molecular Sciences Article Human Plasma and Recombinant Hemopexins: Heme Binding Revisited Elena Karnaukhova 1,*, Catherine Owczarek 2, Peter Schmidt 2, Dominik J. Schaer 3 and Paul W. Buehler 4,5,* 1 Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, USA 2 CSL Limited, Bio21 Institute, Parkville, Victoria 3010, Australia; [email protected] (C.O.); [email protected] (P.S.) 3 Division of Internal Medicine, University Hospital of Zurich, 8091 Zurich, Switzerland; [email protected] 4 Department of Pathology, The University of Maryland School of Medicine, Baltimore, MD 21201, USA 5 The Center for Blood Oxygen Transport and Hemostasis, Department of Pediatrics, The University of Maryland School of Medicine, Baltimore, MD 21201, USA * Correspondence: [email protected] (E.K.); [email protected] (P.W.B.) Abstract: Plasma hemopexin (HPX) is the key antioxidant protein of the endogenous clearance pathway that limits the deleterious effects of heme released from hemoglobin and myoglobin (the term “heme” is used in this article to denote both the ferrous and ferric forms). During intra-vascular hemolysis, heme partitioning to protein and lipid increases as the plasma concentration of HPX declines. Therefore, the development of HPX as a replacement therapy during high heme stress could be a relevant intervention for hemolytic disorders. A logical approach to enhance HPX yield involves recombinant production strategies from human cell lines. The present study focuses on a biophysical assessment of heme binding to recombinant human HPX (rhHPX) produced in the Expi293FTM (HEK293) cell system. -
MASSHEALTH TRANSMITTAL LETTER LAB-22 July 2002 TO
Commonwealth of Massachusetts Executive Office of Health and Human Services Division of Medical Assistance 600 Washington Street Boston, MA 02111 www.mass.gov/dma MASSHEALTH TRANSMITTAL LETTER LAB-22 July 2002 TO: Independent Clinical Laboratories Participating in MassHealth FROM: Wendy E. Warring, Commissioner RE: Independent Clinical Laboratory Manual (Laboratory HCPCS) The federal government has revised the HCFA Common Procedure Coding System (HCPCS) for MassHealth billing. This letter transmits changes for your provider manual that contain the new and revised codes. The revised Subchapter 6 is effective for dates of service on or after April 30, 2002. The codes introduced under the 2002 HCPCS code book are effective for dates of service on or after April 30, 2002. We will accept either the new or the old codes for dates of service through July 28, 2002. For dates of service on or after July 29, 2002, you must use the new codes to receive payment. If you wish to obtain a fee schedule, you may purchase Division of Health Care Finance and Policy regulations from either the Massachusetts State Bookstore or from the Division of Health Care Finance and Policy (see addresses and telephone numbers below). You must contact them first to find out the price of the publication. The Division of Health Care Finance and Policy also has the regulations available on disk. The regulation title for laboratory is 114.3 CMR 20.00: Laboratory. Massachusetts State Bookstore Division of Health Care Finance and Policy State House, Room 116 Two Boylston Street -
The Role of the Laboratory in Treatment with New Oral Anticoagulants
Journal of Thrombosis and Haemostasis, 11 (Suppl. 1): 122–128 DOI: 10.1111/jth.12227 INVITED REVIEW The role of the laboratory in treatment with new oral anticoagulants T. BAGLIN Department of Haematology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK To cite this article: Baglin T. The role of the laboratory in treatment with new oral anticoagulants. J Thromb Haemost 2013; 11 (Suppl. 1): 122–8. tion of thromboembolism in patients with atrial fibrilla- Summary. Orally active small molecules that selectively tion. For some patients, these drugs offer substantial and specifically inhibit coagulation serine proteases have benefits over oral vitamin K antagonists (VKAs). For the been developed for clinical use. Dabigatran etexilate, majority of patients, these drugs are prescribed at fixed rivaroxaban and apixaban are given at fixed doses and doses without the need for monitoring or dose adjustment. do not require monitoring. In most circumstances, these There are no food interactions and very limited drug inter- drugs have predictable bioavailability, pharmacokinetic actions. The rapid onset of anticoagulation and short half- effects, and pharmacodynamic effects. However, there life make the initiation and interruption of anticoagulant will be clinical circumstances when assessment of the therapy considerably easier than with VKAs. As with all anticoagulant effect of these drugs will be required. The anticoagulants produced so far, there is a correlation effect of these drugs on laboratory tests has been deter- between intensity of anticoagulation and bleeding. Conse- mined in vitro by spiking normal samples with a known quently, the need to consider the balance of benefit and risk concentration of active compound, or ex vivo by using in each individual patient is no less important than with plasma samples from volunteers and patients. -
Approach to Coagulopathy in the Icu Dic and Thrombotic Emergencies
APPROACH TO COAGULOPATHY IN THE ICU DIC AND THROMBOTIC EMERGENCIES NEIL KUMAR, MD UNIVERSITY OF ROCHESTER MEDICAL CENTER Disclosures u I have no financial disclosures u I am NOT A HEMATOLOGIST Outline u Review of hemostasis and coagulopathy u Discuss laboratory markers for coagulopathy u Discuss an approach to a few specific coagulopathies and thrombotic emergencies Outline u Review of hemostasis and coagulopathy u Discuss laboratory markers for coagulopathy u Discuss an approach to a few specific coagulopathies and thrombotic emergencies Coagulation u Coagulation is the process in which blood clots u Fibrinolysis is the process in which clot dissolves u Hemostasis is the stopping of bleeding or hemorrhage. u Ideally, hemostasis is a balance between coagulation and fibrinolysis Coagulation (classic pathways) Michael G. Crooks Simon P. Hart Eur Respir Rev 2015;24:392-399 Coagulation (another view) Gando, S. et al. (2016) Disseminated intravascular coagulation Nat. Rev. Dis. Primers doi:10.1038/nrdp.2016.37 Coagulation (yet another view) u Inflammation and coagulation intersect with platelets in the middle u An example of this is Disseminated Intravascular Coagulation. Gando, S. et al. (2016) Disseminated intravascular coagulation Nat. Rev. Dis. Primers doi:10.1038/nrdp.2016.37 Outline u Review of hemostasis and coagulopathy u Discuss laboratory markers for coagulopathy u Discuss an approach to a few specific coagulopathies and thrombotic emergencies PT / INR u Prothrombin Time u Test of Extrinsic Pathway u Take plasma (blood without cells) and re-add calcium u Calcium was removed with citrate in tube u Add tissue factor u See how long it takes to clot and normalize PT to get INR Coagulation (classic pathways) Michael G. -
Pathological Conditions Involving Extracellular Hemoglobin
Pathological Conditions Involving Extracellular Hemoglobin: Molecular Mechanisms, Clinical Significance, and Novel Therapeutic Opportunities for alpha(1)-Microglobulin Gram, Magnus; Allhorn, Maria; Bülow, Leif; Hansson, Stefan; Ley, David; Olsson, Martin L; Schmidtchen, Artur; Åkerström, Bo Published in: Antioxidants & Redox Signaling DOI: 10.1089/ars.2011.4282 2012 Link to publication Citation for published version (APA): Gram, M., Allhorn, M., Bülow, L., Hansson, S., Ley, D., Olsson, M. L., Schmidtchen, A., & Åkerström, B. (2012). Pathological Conditions Involving Extracellular Hemoglobin: Molecular Mechanisms, Clinical Significance, and Novel Therapeutic Opportunities for alpha(1)-Microglobulin. Antioxidants & Redox Signaling, 17(5), 813-846. https://doi.org/10.1089/ars.2011.4282 Total number of authors: 8 General rights Unless other specific re-use rights are stated the following general rights apply: Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Read more about Creative commons licenses: https://creativecommons.org/licenses/ Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. -
Study of Plasma Glycoglobulin Hemochromogens
Proceedings of the National Academy of Sciences Vol. 68, No. 3, pp. 609-613, March 1971 Heme Binding and Transport-A Spectrophotometric Study of Plasma Glycoglobulin Hemochromogens DAVID L. DRABKIN Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa. 19104 Communicated by Britton Chance, December 16, 1970 ABSTRACT A hitherto unreported phenomenon is the content was only 0.004-0.007 mmol/liter (or 0.04-0.07% of immediate production of the spectrum of ferrohemo- the hemoglobin content of whole blood). At this concentration chromogens (in the presence of sodium dithionite) upon the addition in vitro of hydroxyhemin (pH 7.6-7.8) to the all of the hemoglobin present was probably in the form of plasmas or sera, as well as to certain Cohn plasma protein hemoglobin-haptoglobin (11). In most cases the serum was fractions, of all mammalian species thus far examined. used directly; in some it was found desirable to dilute the This distinctive reaction is characteristic of a coordination serum 1:1 with 0.2 M phosphate buffer, pH 7.6, prior to the complex with heme iron, and is ascribed to a remarkable affinity for heme of certain plasma glycoglobulins, which addition of heme and reductant. Plasma protein fractions IV-1, include hemopexin. Spectrophotometry has permitted IV4, IV-7, and VI of most of the above species [prepared by estimations of the specific heme-binding capacity (as the alcohol-low temperature technique (12-15) and obtained ferrohemochromogen) of the plasmas, the rate of removal mainly from the Nutritional Biochemical Corp. ] were also ex- from plasma of injected heme, and the production of bile amined. -
Methemalbumin. Ii. Effect of Pamaquine and Quinine on Pathways of Hemoglobin Metabolism
METHEMALBUMIN. II. EFFECT OF PAMAQUINE AND QUININE ON PATHWAYS OF HEMOGLOBIN METABOLISM William D. Blake J Clin Invest. 1948;27(3):144-150. https://doi.org/10.1172/JCI101954. Research Article Find the latest version: https://jci.me/101954/pdf METHEMALBUMIN. II. EFFECT OF PAMAQUINE AND QUININE ON PATHWAYS OF HEMOGLOBIN METABOLISM 1, 2 By WILLIAM D. BLAKE 8 (From the Department of Medicine, New York University College of Medicine, and the Research Service, Third [New York University] Medical Division, Goldwater Memorial Hospital, New York City) (Received for publication March 12, 1947) INTRODUCTION laria during the study but the period immediately fol- lowing malaria was avoided because of the questionable Methemalbuminemia has been described in as- status of certain functions of the liver (10, 11, 12). sociation with massive intravascular hemolysis Serunm bilirubin and bromsulfalein retention tests were (1, 2, 3, 4) or with limited hemolysis in the pres- normal, unless specifically mentioned. ence of liver disease (1, 5). Similarly, the in- Pamaquine naphthoate and quinine sulfate were admin- istered orally, the dosage in each case being expressed jection of large amounts of hemoglobin may result in terms of the free base. Plasma pamaquine (13) and in methemalbuminemia (1), whereas smaller quinine concentrations (14) were estimated at intervals amounts do so only in the presence of a damaged to ascertain reliability of drug intake. Pamaquine dosage liver (6). Hematin injected intravenously rapidly regimens were either 15 mg. every four hours or 10 mg. combines with serum albumin to form methemal- every eight hours. Quinine was given as the sulfate in 0.6 gram doses every eight hours. -
Updates on Anticoagulation and Laboratory Tools for Therapy Monitoring of Heparin, Vitamin K Antagonists and Direct Oral Anticoagulants
biomedicines Review Updates on Anticoagulation and Laboratory Tools for Therapy Monitoring of Heparin, Vitamin K Antagonists and Direct Oral Anticoagulants Osamu Kumano 1,2,* , Kohei Akatsuchi 3 and Jean Amiral 1 1 Research Department, HYPHEN BioMed, 155 Rue d’Eragny, 95000 Neuville sur Oise, France; [email protected] 2 Protein Technology, Engineering 1, Sysmex Corporation, Kobe 651-2271, Japan 3 R&D Division, Sysmex R&D Center Americas, Inc., Mundelein, IL 60060, USA; [email protected] * Correspondence: [email protected]; Tel.: +81-78-991-2203 Abstract: Anticoagulant drugs have been used to prevent and treat thrombosis. However, they are associated with risk of hemorrhage. Therefore, prior to their clinical use, it is important to assess the risk of bleeding and thrombosis. In case of older anticoagulant drugs like heparin and warfarin, dose adjustment is required owing to narrow therapeutic ranges. The established monitoring methods for heparin and warfarin are activated partial thromboplastin time (APTT)/anti-Xa assay and pro- thrombin time – international normalized ratio (PT-INR), respectively. Since 2008, new generation anticoagulant drugs, called direct oral anticoagulants (DOACs), have been widely prescribed to prevent and treat several thromboembolic diseases. Although the use of DOACs without routine monitoring and frequent dose adjustment has been shown to be safe and effective, there may be clinical circumstances in specific patients when measurement of the anticoagulant effects of DOACs Citation: Kumano, O.; Akatsuchi, K.; is required. Recently, anticoagulation therapy has received attention when treating patients with Amiral, J. Updates on Anticoagulation coronavirus disease 2019 (COVID-19). In this review, we discuss the mechanisms of anticoagulant and Laboratory Tools for Therapy drugs—heparin, warfarin, and DOACs and describe the methods used for the measurement of Monitoring of Heparin, Vitamin K their effects. -
Dietary and Lifestyle Factors Modulate the Activity of the Endogenous
antioxidants Article Dietary and Lifestyle Factors Modulate the Activity of the Endogenous Antioxidant System in Patients with Age-Related Macular Degeneration: Correlations with Disease Severity Zofia Ula ´nczyk 1 , Aleksandra Grabowicz 2, El˙zbietaCecerska-Hery´c 3, Daria Sleboda-Taront´ 3, El˙zbietaKrytkowska 2, Katarzyna Mozolewska-Piotrowska 2, Krzysztof Safranow 4 , Miłosz Piotr Kawa 1, Barbara Doł˛egowska 3 and Anna Machali ´nska 2,* 1 Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland; zofi[email protected] (Z.U.); [email protected] (M.P.K.) 2 First Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] (A.G.); [email protected] (E.K.); [email protected] (K.M.-P.) 3 Department of Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] (E.C.-H.); [email protected] (D.S.-T.);´ [email protected] (B.D.) 4 Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] * Correspondence: [email protected] Received: 17 August 2020; Accepted: 2 October 2020; Published: 5 October 2020 Abstract: Age-related macular degeneration (AMD) is a common cause of blindness in the elderly population, but the pathogenesis of this disease remains largely unknown. Since oxidative stress is suggested to play a major role in AMD, we aimed to assess the activity levels of components of the antioxidant system in patients with AMD. We also investigated whether lifestyle and dietary factors modulate the activity of these endogenous antioxidants and clinical parameters of disease severity. -
The Surgical Significance of Methaemalbuminaemia
Gut: first published as 10.1136/gut.12.12.995 on 1 December 1971. Downloaded from Gut, 1971, 12, 995-1000 The surgical significance of methaemalbuminaemia CAMERON BATTERSBY AND MARJORIE K. GREEN From the Department ofSurgery, University of Queensland, and Royal Brisbane Hospital, Brisbane, Australia SUMMARY A quantitative estimation of plasma methaemalbumin can be useful. In pancreatitis, it usually indicates severe and haemorrhagic disease, and is thus of prognostic importance, as well as indicating the need for the full therapeutic regime for conservative management of the disease. It may be helpful diagnostically in some patients with pancreatitis in whom it remains elevated after the serum amylase has returned to normal. Raised levels may indicate laparotomy in patients in whom the diagnosis of pancreatitis is con- sidered but who are not responding to conservative measures. Such patients may occasionally be suffering from intestinal infarction or other surgically remediable condition. However, it has been found that the level of methaemalbumin in the plasma may be raised above the upper limit of the normal range of 5.5 mg % in occasional cases of gastrointestinal bleeding and soft tissue trauma and is not always raised in haemorrhagic pancreatitis. Northam, Rowe, and Winstone (1963) suggested that the presence ofa raised level ofmethaemalbumin in the plasma may be helpful in the differential * Spontancotus llaeiiolysis (binds with diagnosis between haemorrhagic and oedematous * Proteolytic enzymes ho globin) http://gut.bmj.com/ pancreatitis. About the same time, a spectrometric method yielding quantitative results was described for HB-HAPTOGLOBIN| methaemalbumin estimation in plasma (Shinowara COMPLEX. and Walters, 1963) to supplement the older methods S | ~~~~~~HAEM-HAEMOPEXIN| of direct spectroscopic examination, the Schumm HAIEATIN | binds with haemnopexin COMPLEX reaction, and paper electrophoresis (Winstone, 1965). -
Regina Qu'appelle Health Region Tests
Regina Qu'Appelle Health Region Tests Acetaminophen Haptoglobin Alpha-Feto Protein (AFP) HbA1C AGBM Hemoglobin Electrophoresis Albumin Hemosiderin (urine) Alkaline Phosphatase (ALP) Kleihauer-Betke Test Alpha-1 Antitrypsin Lactate Alanine Aminotransferase (ALT) Luteinizing Hormone (LH) Amylase Lipid Panel (Chol, Trig, HDL, LDL ) Anti-mitochondrial antibodies Lithium Anti-RNP Liver Panel (Bili, ALT, ALP) Anti-scleroderma-70 antibodies Magnesium Anti-smooth muscle antibodies Malaria Blood Smear APTT - fresh specimen Methemalbumin Aspartate aminotransferase (AST) Microalbumin Bence Jones Protein (50-100mls 24 hour urine) Microalbumin/Creatinine Ratio Beta HCG Hypercoagulation Studies Direct Bilirubin Osmolality (Serum and Urine) Total Bilirubin Peripheral Smear review by pathologist CA-125 Phenobarbital Calcium Phenytoin (Dilantin) Carbamazepine (Tegretol) Phosphorus CBC Prolactin Carcinoembryonic Antigen (CEA) Prostate Specific Antigen (PSA) Cholinesterase w/ Dibucaine # Prothrombin Time Creatine kinase (CK) Protein Electrophoresis (PE, SPE) Creatinine (Serum and Urine) Protein Creatinine Clearance Renal Panel Cryoglobulin Reticulocyte Count Cyclosporin Sickle Cell Screen D-Dimer Sirolimus Digoxin (Lanoxin) Tacrolimus Electrolytes Theophylline Estradiol Thyroid Screen (TSH) Ferritin Tobramycin FSH Urea G-6-PD Uric Acid Gentamycin Valproic Acid (Epival, Depakene) G-Glutamyl Transferase (GGT) Vancomycin Glucose Viscosity Frozen Specimens Amikacin Factor Assays Lupus Anticoagulant Ammonia Fibrinogen Protein C Anticardiolipin Ab Heparin Assay Protein S Antiphospholipid Ab Hypercoagulation Screen Von Willebrand's Factor Anti-thrombin III H. Pylori Beta-2 Microglobulin Lactic Acid For more information refer to the RQHR Laboratory Services Manual or access the link below: RQHR Laboratory Specimen Requirements LABLisOP2002A3 RQHR Tests Laboratory Services, Regina Qu'Appelle Health Region 03/05/2016. -
15-7022 Quick Guide 115X200 2015.Indd
H A E M O S T A S tPA FDP I S -1 D-Dimer PAI Plasminogen Plasmin Fibrin T M Fibrinogen IIa PC IIa T A APC PS II PS AP T V C A Activated Va Xa Platelet vWF X A T XI IXa VIIIa APC PS VIII XIa IX T A Activation pathways Inhibition pathways Coagulation PAI-1 AT All rights reserved - 04/2013 Ref. 27646 VIIa AT AGO - Fibrinolysis Xa TFPI T S APC PS Xa TFPI A TF © 2009 DIAGNOSTIC 4614 Diagnostica Stago S.A.S. RCS Nanterre B305 151 409 9, rue des Frères Chausson 92600 Asnières sur Seine (France) AT THE HEART OF HAEMOSTASIS Ph.: +33 (0)1 46 88 20 20 Quick Guide Fax: +33 (0)1 47 91 08 91 [email protected] At the Heart of Haemostasis www.stago.com To Haemostasis Screening assays in Haemostasis Anticoagulant therapy monitoring (1): Vitamin K antagonists Anticoagulant therapy monitoring (2): Heparin Assays for other anticoagulant therapy (3) Disseminated Intravascular Coagulation (DIC) Thrombophilia D-Dimer assay for the exclusion of venous thromboembolism (VTE) Lupus anticoagulants / Antiphospholipid antibodies For more information, visit our website at www.stago.com Screening assays in Haemostasis 1) Questionnaire l Personal and familial history l Treatments l Diseases l Clinical symptoms 2) Physical examination 3) Pre-operative Haemostasis screening assays l Prothrombin time (PT) n Screening test for the extrinsic and common pathways of coagulation (factors II, V, VII, X). Limited sensitivity to fibrinogen. n Usual normal ranges: 12 - 13 sec (may vary between reagents, please refer to manufacturer’s insert) l Activated Partial Thromboplastin Time (aPTT) n Screening test for the intrinsic and common coagulation pathways of coagulation (factors VIII, IX, XI, XII, V and II).