Valdes R
Department of Pathology, University of Louisville, School of Medicine, KY.
Wien Klin Wochenschr Suppl. 1992;191:55-9.
The overall reliability of measuring digoxin in serum improved significantly with the discovery and application of immunoassays. However, because of the low concentration of digoxin being measured, its narrow therapeutic range in serum, and the presence of endogenous digoxin-like immunoreactive factors (DLIF), developing assays for measuring digoxin still pose formidable challenges. In this presentation, recent developments in the characterization of DLIF from bovine adrenal cortex and human serum are described. Data accumulated to date suggest there is one principal endogenous molecular factor (DLIF) in humans that cross-reacts with anti-digoxin antibodies. This factor exists at sufficiently high concentrations in some patients to interfere with measurements of digoxin by most digoxin immunoassays. All digoxin immunoassays should be tested to interference from this endogenous factor. Various techniques for reducing DLIF cross-reactivity are reviewed. The isolation and purification of DLIF now provides new approaches for selecting specific anti-digoxin antibodies used in developing more accurate digoxin immunoassays.
随着免疫测定法的发现和应用，血清中地高辛测量的整体可靠性有了显著提高。然而，由于所测量的地高辛浓度较低，其在血清中的治疗窗较窄，以及存在内源性地高辛样免疫反应因子（DLIF），开发地高辛测量方法仍然面临巨大挑战。在本报告中，描述了从牛肾上腺皮质和人血清中鉴定DLIF的最新进展。迄今为止积累的数据表明，人类中存在一种主要的内源性分子因子（DLIF），它与抗地高辛抗体发生交叉反应。在一些患者中，这种因子以足够高的浓度存在，会干扰大多数地高辛免疫测定法对地高辛的测量。所有地高辛免疫测定法都应检测是否受到这种内源性因子的干扰。综述了减少DLIF交叉反应性的各种技术。DLIF的分离和纯化现在为选择用于开发更准确地高辛免疫测定法的特异性抗地高辛抗体提供了新方法。
