Description
The
DHEA-SO4[125I] assay system provides a
quantitative in vitro determination of dehydroepiandrosterone sulphate
in human serum or plasma. DHEA-SO4 can be assayed in the
range 0-30 µmol/L (0-11.05 µg/ml). Each kit contains materials
sufficient for 100 assay tubes, permitting the construction of one
standard curve and the assay of 42 unknowns and 1 control in duplicate.
Introduction
Dehydroepiandrosterone sulphate (DHEA-SO4)
is almost exclusively synthesized by the adrenal cortex, and it is the
most abundant steroid hormone in the peripheral circulation. It is the
main source of the urinary 17-ketosteroids. A single serum DHEA-SO4
measurement eliminates the inconvenience of the urine collection. The
metabolic clearance of DHEA-SO4 is slow and it is converted
mostly to oestrogens. The hormone has a maximum level from puberty until
35-40 years of age, then there is a gradual decrease in the blood
DHEA-SO4 concentration mainly in the menopause of women.
Although the physiological role of dehydroepiandrosterone sulphate is
not well established the serum level of this steroid hormone has an
informative pathophysiological value.
|
1. |
The serum DHEA-SO4 radioimmunoassay seems to
be a reliable tool to assess adrenal androgen function and the
glandular overproduction of androgens. |
|
2. |
High DHEA-SO4 values indicate a virilizing
disorder of adrenal origin in women. This includes mainly
adrenal neoplasms or early or late onset of congenital adrenal
hyperplasia. |
|
3. |
Monitoring the DHEA-SO4 concentration may be
useful to control the adrenal suppressive therapy
(dexamethasone). |
|
4. |
Low DHEA-SO4 levels can be an indicator of
hormone responsive immunological disorders. |
|
5. |
Low levels of DHEA-SO4 may be related to the
development of diseases that increases with age such as cancer
and atherosclerosis. In these circumstances a systematically
repeated assessment of the blood DHEA-SO4 values is
recommended. |
Principle of method
This
assay is based on the competition between unlabelled DHEA-SO4
and a fixed quantity of 125I-labelled DHEA-SO4 for
a limited number of binding sites on DHEA-SO4 specific
antibody. Allowing to react a fixed amount of tracer and antibody with
different amounts of unlabelled ligand the amount of tracer bound by the
antibody will be inversely proportional to the concentration of
unlabelled ligand. Upon addition of magnetizable immunosorbent the
antigen-antibody complex is bound on solid particles which are then
separated by either magnetic sedimentation or centrifugation. Counting
the radioactivity of the solid phase enables a standard curve to be
constructed and samples to be quantitated.
Contents of the kit
|
1 vial |
125I-TRACER, ready to use.
55 ml, containing less than 150 kBq DHEA-SO4[125I]
in buffer and 0.02% NaN3. |
|
6 vials |
STANDARDS, ready to use.
0.5 ml per vial, containing 0, 0.3, 1, 3, 10, 30 µmol/L in serum
with 0.1% NaN3. |
|
1 vial |
ANTISERUM, ready to use.
11 ml, containing polyclonal anti-DHEA-SO4 (rabbit)
IgG in buffer and 0.1 % NaN3. |
|
1 vial |
CONTROL SERUM
Lyophilized human serum with 0.1% NaN3.
The concentration of the serum is specified in the quality
certificate enclosed. |
|
1 bottle |
MAGNETIC IMMUNOSORBENT (MIS), ready to use.
55 ml, containing paramagnetic particles in buffer with 0.1 %
NaN3 |
|
1 pc |
Quality certificate |
|
1 pc |
Pack leaflet |
Materials and equipment required
Round
bottom polystyrene or polypropylene assay tubes, about 12 x 75 mm
Plastic film to cover tubes
Precision pipettes (15, 100 and 500 µl)
Vortex mixer
Magnetic separator (or, alternatively, centrifuge)
Decanting racks
Gamma counter
Recommended tools and equipment
Orbital
shaker
Repeating pipettes
Preparation of reagents
Add 500
µl distilled water to the lyophilised control serum. Mix gently with
shaking or vortexing (foaming should be avoided). Ensure that complete
dissolution is achieved, and allow the solution to equilibrate at room
temperature for at least 20 minutes.
For
repeated use the rest of reagent can be stored at -20 °C for two months.
Specimen collection and storage
Serum
samples can be prepared according to common procedures used routinely in
clinical laboratory practice. Sera can be stored at 2-8 °C for two days
after collection. For later analysis they should be stored deep-frozen.
Repeated freezing and thawing should be avoided.
Do not
use lipemic, hemolyzed or turbid specimens.
Assay procedure
(For a quick guide refer to Table 1)
|
1 |
Equilibrate all reagents to room temperature. |
|
2 |
Label duplicate tubes for total counts (T), zero standard
(Standard 1 = B0), standards (S2-6),
control (C) and samples (Sx). |
|
3 |
Mix all reagents and samples thoroughly before use. Avoid
excessive foaming. |
|
4 |
Pipette 15 µl each of standards, control and samples into
the properly labelled tubes. |
|
5 |
Pipette 500 µl of tracer solution into all tubes. |
|
6 |
Pipette 100 µl of antiserum into all tubes except T. |
|
7 |
Thoroughly vortex mix all tubes except T for 2-5 seconds.
When having an orbital shaker, leave all tubes in the rack
holder, fix the holder onto the plate of the shaker, and shake
it gently for a few seconds. |
|
8 |
Incubate the tubes for 2 hours at room temperature. |
|
9 |
Place T tubes on a separate tube rack. Gently shake and
swirl the bottle containing magnetic immunosorbent until
homogeneity. Add 500 µl to each tube except T. When using a
single pipette, swirl the bottle of MIS after every 15-20 tubes.
With the use of a repeating pipette (e.g. Eppendorf), there is
no need for repeated homogenisation of MIS reagent. |
|
10 |
Thoroughly vortex mix all tubes and incubate them for 15
minutes at room temperature. |
|
11 |
Separate the bound fraction by using one of the following
procedures.
Magnetic separation
Attach the rack on to the magnetic separator base and ensure
that every tube is in contact with the base plate. Let the MIS
particles settle for 5 minutes. Do not remove the rack from the
separator base after the separation of the solid and liquid
phases. Pour off and discard the supernatant. Keeping the
separator inverted, place the tubes on a pad of absorbent tissue
and allow to drain for 2 minutes.
Centrifugation
Centrifuge all tubes for 15 minutes at 1500 g or greater.
Aspirate the supernatant taking care to avoid disturbing the
precipitate. |
|
12 |
Count the radioactivity of all tubes preferably not less
than 60 seconds. |
|
13 |
Calculate the concentrations as described under
Calculation of results. |
Table
1. Assay Protocol, Pipetting Guide (all volumes in microliters)
|
Tubes |
Total
count
T |
Standard
S1-S6 |
Sample
Sx |
Control
C |
|
Standard |
|
15 |
|
|
|
Sample |
|
|
15 |
|
|
Control |
|
|
|
15 |
|
Tracer |
500 |
500 |
500 |
500 |
|
Antiserum |
|
100 |
100 |
100 |
|
Vortex
mix
Incubate for 2 hour at room temperature |
|
Magnetic Immunosorbent |
|
500 |
500 |
500 |
|
Vortex
mix
Incubate for 15 minutes at room temperature |
|
Place the tubes on the magnetic separator for 5 minutes
or centrifuge for 15 minutes at 1500 g |
|
Remove
the supernatant and blot the tubes |
|
Count
all tubes |
Calculation of results
Calculate the average counts per minute (CPM) for each pair of assay
tubes (Table 2.). Calculate the percent B0 / T for zero
standard (S1) by using the following equation:
| |
S1 (cpm) |
|
|
B0 / T % = |
——— |
x 100 |
| |
T (cpm) |
|
Calculate the normalized percent binding for each standard, control and
sample respectively by using the following equation:
| |
S2-6 [C, Mx] (cpm) |
|
|
B / B0 % = |
—————————— |
x 100 |
| |
S1 (cpm) |
|
Using
semi-logarithmic graph paper plot B / B0% for each standard
versus the corresponding concentration of dehydroepiandrosterone
sulphate (Figure 1). Determine the DHEA-SO4 concentration of
the unknown samples by interpolation from the standard curve. Do not
extrapolate values beyond the standard curve range.
Table
2. Typical Assay Data
|
Tubes |
Counts
CPM1 |
Counts
CPM2 |
average CPM |
B/T % |
B/B0
% |
|
T |
56421 |
56677 |
56549 |
|
|
|
S1 |
34094 |
33608 |
33851 |
59.9 |
100.0 |
|
S2 |
26266 |
26732 |
26499 |
46.9 |
78.3 |
|
S3 |
18752 |
19180 |
18966 |
33.5 |
56.0 |
|
S4 |
11823 |
11811 |
11817 |
20.9 |
34.9 |
|
S5 |
6549 |
6636 |
6593 |
11.7 |
19.5 |
|
S6 |
3623 |
3607 |
3615 |
6.4 |
10.7 |
|
C |
8153 |
8108 |
8131 |
14.4 |
24.0 |
|
NSB |
1591 |
1925 |
1758 |
3.11 |
|
Figure 1.
A typical standard curve
(Do not use to calculate sample values)
Conversion of SI units can be performed according to
the following formula:
1 µmol/L = 0.37 µg/ml
1 µg/ml = 2.71 µmol/L
Characterization of the assay
Assay parameters
|
NSB/T |
< 3% |
|
B0 / T |
57 ± 5 % |
|
ED-50 |
1.6 ± 0.4 µmol/L |
Specificity
Different endogen hormones were added to the ”0” standard at two
concentration levels (A = 70 nmol/L, B = 700 nmol/L). The apparent
DHEA-SO4 concentrations measured in these experients are
reported in Table 3.
b:
below detection limit (0.054 µmol/L)
Table 3 (all volumes in µmol/L)
|
COMPOUND |
A |
B |
COMPOUND |
A |
B |
|
Aldosterone |
b |
b |
Estradiol |
b |
b |
|
Androstenedione |
b |
0.26 |
Estriol |
b |
b |
|
5a -Dihydro-testosterone |
b |
b |
Estrone |
b |
0.07 |
|
5ß -Dihydro-testosterone |
b |
b |
Progesterone |
b |
b |
|
Androstanediol |
b |
b |
Pregnenolone |
b |
b |
|
17a -hydroxi-progesterone |
b |
b |
Testosterone |
b |
b |
|
Androstenediol |
b |
0.13 |
DHEA |
0.8 |
7.8 |
|
Cortisol |
b |
b |
|
|
|
Hence
the physiological concentration of dehydroepiandrosterone is around
13-24 nmol/L (literature data) the distortion due to the crossreactivity
is negligible.
Sensitivity
0.09 ±
0.04 µmol/L, defined as the concentration 2 standard deviations from the
zero standard.
Expected reference values
It is
recommended that each laboratory establish its own reference intervals.
Tabulated below are the median and range for the combined data, the
representing the central 95 percent of the observations.
| |
Median |
Range
(Central 95%) |
n |
|
Females |
3.31 µmol/L |
0.24-6.37 µmol/L |
76 |
|
Males |
6.10 µmol/L |
1.52-10.68 µmol/L |
75 |
The
results obtained should only be interpreted in the context of the
overall clinical picture. None of the in vitro diagnostic kits can be
used as the one and only proof of any disease or disorder.
Additional information
Storage
Store
the reagents between 2 and 8 °C. At this temperature each reagent is
stable until expiry date. Pay special attention to preventing magnetic
immunosorbent suspension from freezing.
Availability
From
stock.
Shelf life
The
shelf life of kit reagents is 8 weeks from the date of manufacturing. To
make maximum benefit of long-term stability it is recommended to adjust
the date of ordering to labelling calendar issued each year. The actual
expiry date is given on package label and in the quality certificate.
Components from various lots or from kits of different manufacturers
should not be mixed or interchanged.
Precautions and warnings
Radioactivity
This
kit contains radioactive material. Receipt, acquisition, possession, or
use of radioactive materials are subject to regulations, and a licence
of (inter)national authorizing bodies. It is the responsibility of the
user to ensure that local regulations or codes of practice are
satisfied.
Potentially infectious materials
Human
blood products provided as components of this product have been obtained
from donors tested individually and found negative for Human
Immunodeficiency Virus antibody (HIV-Ab) as well as for Hepatitis B
surface Antigen (HBsAg) using approved EIA methods.
Care
should always be taken when handling human specimens to be tested with
diagnostic kits. Even if the subject has been tested, no method can
offer complete assurance that Hepatitis B Virus, Human Immunodeficiency
Virus (HIV), or other infectious agents are absent, and all human blood
samples should be considered potentially infectious.
Chemical and other hazard
Some
components contain sodium azide (0.1% w/v) as an antimicrobial agent.
Dispose the waste by flushing it with copious amounts of water to avoid
build up of explosive metallic azides in copper and lead plumbing. The
total azide present in each pack is 80 mg.
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Use by |
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In vitro diagnostic medical device |
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Control |
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Batch code |
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Manufacturer |
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Standard |
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Caution, consult accompanying documents |
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Radioactive material |
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Magnetic immunosorbent |
 |
Biological risk |
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Temperature limitation
Store between 2-8 °C |
 |
Tracer |
 |
Consult instructions for use |
 |
Catalogue number |
 |
Antiserum |
|