Dasgupta Amitava, Kang Edward, Datta Pradip
Department of Pathology and Laboratory Medicine, University of Texas-Houston Medical School, Houston, TX 77030, USA.
Ther Drug Monit. 2006 Apr;28(2):282-5. doi: 10.1097/01.ftd.0000195616.69721.ec.
Despite known toxicity of oleander, this product is used in herbal preparations. Oleander interferes with various digoxin immunoassays. It is possible that a person taking digoxin also may take oleander-containing herbal products, and digoxin immunoassays interfering with oleander cannot be used for therapeutic monitoring of digoxin. Recently, Bayer Diagnostics introduced a new enzyme-linked chemiluminescent immunosorbent digoxin assay for application on the ADVIA IMS System (ECLIA-digoxin). We studied potential interference of oleander with this new digoxin assay and found that this assay is virtually free from oleander interference. When aliquots of drug-free serum pools were supplemented with ethyl alcohol extract of oleander leaf or pure oleandrin standard, we observed significant apparent digoxin concentration when measured by the fluorescence polarization immunoassay (FPIA) but minimal digoxin-like immunoreactivity using the ECLIA digoxin assay. Because cross-reactivity should be studied in the presence of primary analyte, we prepared 2 serum pools using sera from patients receiving digoxin. Then aliquots of first digoxin pool were supplemented with oleandrin standard and aliquots of second digoxin pool with oleander extract. We observed significant increases in apparent digoxin concentration in the presence of both oleandrin and oleander extract using the FPIA. However, we observed no statistically significant change in digoxin concentration when ECLIA digoxin assay was used, indicating that this assay is virtually free from oleander interference.
尽管夹竹桃具有已知的毒性，但该产品仍用于草药制剂中。夹竹桃会干扰各种地高辛免疫测定法。服用地高辛的人也有可能同时服用含夹竹桃的草药产品，而受夹竹桃干扰的地高辛免疫测定法不能用于地高辛的治疗监测。最近，拜耳诊断公司推出了一种新的酶联化学发光免疫吸附法地高辛测定法，用于ADVIA IMS系统（ECLIA-地高辛）。我们研究了夹竹桃对这种新的地高辛测定法的潜在干扰，发现该测定法几乎不受夹竹桃干扰。当向无药血清库的等分试样中添加夹竹桃叶的乙醇提取物或纯夹竹桃苷标准品时，我们通过荧光偏振免疫测定法（FPIA）测量时观察到明显的地高辛浓度升高，但使用ECLIA地高辛测定法时观察到的地高辛样免疫反应性最小。由于交叉反应性应在存在主要分析物的情况下进行研究，我们使用接受地高辛治疗的患者的血清制备了2个血清库。然后，向第一个地高辛库的等分试样中添加夹竹桃苷标准品，向第二个地高辛库的等分试样中添加夹竹桃提取物。使用FPIA时，我们观察到在夹竹桃苷和夹竹桃提取物存在的情况下，表观地高辛浓度显著增加。然而，使用ECLIA地高辛测定法时，我们观察到地高辛浓度没有统计学上的显著变化，表明该测定法几乎不受夹竹桃干扰。
