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 DHEA-SO4 (dehydroepiandrosterone sulphate) RIA test

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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

Typical standard curve for the Dehydroepiandrosterone sulphate (DHEA-SO4) I-125 RIA kit
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.

 

Use by In vitro diagnostic medical device Control
Batch code Manufacturer Standard
Caution, consult accompanying documents Radioactive material Magnetic immunosorbent
Biological risk Temperature limitation
Store between 2-8 °C
Tracer
Consult instructions for use Catalogue number Antiserum

DHEA-SO4 (dehydroepiandrosterone sulphate) RIA test

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