Department of Endocrinology, St. Vincent's University Hospital, Dublin 4, Ireland.
SeLux Diagnostics Inc., Charlestown, MA.
J Appl Lab Med. 2020 May 1;5(3):494-505. doi: 10.1093/jalm/jfaa015.
Macroprolactin is an immunoglobulin-prolactin complex that is not bioactive in vivo but the prolactin component remains immunoreactive. The complex is a universal source of interference in prolactin immunoassays and commonly results in misdiagnosis of hyperprolactinemia with consequent clinical mismanagement of patients. Removal of macroprolactin by precipitation with polyethylene glycol (PEG) is an effective technique for identifying such patients but unfortunately not universally employed due to the manual nature of the procedure.
We developed a modified PEG precipitation technique using magnetic nanoparticles that we termed Magnetically Assisted PEG Precipitation (MAPP). This procedure was verified against an established PEG precipitation procedure.
The MAPP procedure we developed was robust, reproducible, and affords the potential for automation of macroprolactin screening in clinical laboratories. Comparisons of prolactin levels obtained following MAPP in sera from patients with either true hyperprolactinemia or macroprolactinemia generated results comparable to that of conventional PEG precipitation.
The MAPP technique yields results comparable to those of traditional PEG precipitation. Elimination of the need for centrifugation affords the possibility of automation and hence more widespread adoption of routine PEG screening by clinical laboratories.
巨泌乳素是一种免疫球蛋白-泌乳素复合物，在体内没有生物活性，但泌乳素成分仍然具有免疫反应性。该复合物是泌乳素免疫测定中普遍存在的干扰源，通常会导致高泌乳素血症的误诊，从而导致患者的临床管理不当。用聚乙二醇（PEG）沉淀去除巨泌乳素是识别此类患者的有效技术，但由于该过程为手动操作，因此不幸并未得到普遍应用。
我们开发了一种使用磁性纳米粒子的改良 PEG 沉淀技术，我们称之为磁辅助 PEG 沉淀（MAPP）。该程序经过了与已建立的 PEG 沉淀程序的验证。
我们开发的 MAPP 程序稳健、可重复，并且具有在临床实验室中自动化巨泌乳素筛选的潜力。对来自患有真性高泌乳素血症或巨泌乳素血症的患者的血清进行 MAPP 后获得的泌乳素水平的比较，结果与传统 PEG 沉淀相当。
MAPP 技术的结果与传统 PEG 沉淀相当。消除对离心的需求为自动化提供了可能性，从而使临床实验室更广泛地采用常规 PEG 筛选。
