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myeloma, infancy and early childhood lymphoma. Quantified IgM measurements are useful for the detection of frequent chronic or acute infections, suspected immunodeficiency, screening for congenital infections and

 As IgM does not cross the placenta, presence of virus

specific IgM in cord blood or neonatal serum is indicative

of congenital infection. IgM levels may be increased

in chronic liver disease, infections, Waldenström’s

macroglobulinemia, and malignant lymphoma. Decreased

levels are observed in immune deficiency states, non-IgM

myeloma, infancy and early childhood lymphoma.

Quantified IgM measurements are useful for the

detection of frequent chronic or acute infections, suspected

immunodeficiency, screening for congenital infections and

monitoring patients with Waldenström’s macroglobulinemia. Information regarding the concentration of IgM

can be obtained by using QUANTIA-IgM reagents.

TURBIDIMETRIC IMMUNOASSAY FOR

ESTIMATION OF COMPLEMENT C3 IN HUMAN

SERUM

Quantia C3

(Courtesy: Tulip Group of Companies)

Summary

Clinically, complement determination helps to detect

whether the complement system has been activated. A

decrease in complement components due to the activation

of complement system or a hereditary deficiency and/

Diagnostic Immunology 727

or dysfunction of a complement component is of clinical

significance. C3 is a central component of the complement

system. C3 is the rate-limiting factor for both the alternate

and the classical complement pathways. C3 is often

decreased in active forms of SLE and membranoproliferative

glomerulonephritis. C3 fixation on red cells and on tissue

may result in autoimmune hemolytic disorder or severe

tissue damage. Increased levels of C3 are observed in biliary

obstruction, nephrotic syndrome and during corticosteroid

therapy.

Information regarding the concentration of C3 can be

obtained by using QUANTIA-C3 reagents.

TURBIDIMETRIC IMMUNOASSAY FOR

ESTIMATION OF COMPLEMENT C4 IN HUMAN

SERUM

Quantia C4

(Courtesy: Tulip Group of Companies)

Summary

Clinically, complement determination helps to detect

whether the cojmplement system has been activated. A

decrease in complement components due to activation

of complement system or a hereditary deficiency and/or

dysfunction of a complement component is of clinical significance.

C4 is essential for activation of the classical complement

pathway. Most of the conditions, which result in decreased

levels of C3 also, result in decrease of C4. However, in cases

of autoimmune hemolytic anemia (AIHA) and hereditary

angioneurotic edema (HAE), C3 is usually normal while

C4 is decreased.

Information regarding the concentration of C4 can be

obtained by using QUANTIA-C4 reagents.

TURBIDIMETRIC IMMUNOASSAY FOR

ESTIMATION OF ANTITHROMBIN III IN

HUMAN SERUM

Quantia AT III

(Courtesy: Tulip Group of Companies)

Summary

Antithrombin (AT) formerly referred to as antithrombin

III, a proteinase inhibitor is the most important inhibitor

of the plasma coagulation system. The action of AT III

in presence of heparin is directed against thrombin, Xa

and IX leading to an effective inhibition of coagulation.

Concentration of AT III is useful in differential diagnosis of

congenital AT deficiencies. In type I congenital deficiency,

the AT III concentration is reduced, whereas in type II AT

deficiency the AT III concentration is normal. Estimation of

AT III is useful in diagnosis of disseminated intravascular

coagulation (DIC) and monitoring of the course of

treatment of DIC, monitoring of AT III replacement

therapy and in cases of heparin resistance. Information

regarding the concentration of AT III can be obtained by

using QUANTIA-AT III reagents.

QUANTITATIVE IMMUNOTURBIDIMETRIC

ASSAY FOR ESTIMATION OF FIBRINOGEN

Quantia Fibrinogen

(Courtesy: Tulip Group of Companies)

Summary

Fibrinogen (Factor I) is a high molecular weight glycoprotein synthesized in the liver, which plays an important

role in hemostasis. For normal hemostasis to occur

in response to injury or tissue damage, a sufficient

concentration of fibrinogen must be present in plasma.

Low levels of fibrinogen are found in:

¾ Liver disease

¾ Increased fibrinogen consumption due to the prolonged

presence of disseminated intravascular coagulation

¾ Hyperfibrinolysis in patients with neoplasia, acute

promyelocytic leukemias and obstetric complications

such as premature detachment of placenta or abruptio

placentae, amniotic fluid embolism, retention of dead

fetus

¾ Dysfibrinogenemia (functionally defective fibrinogen

due to an abnormal molecular form, but the levels

remain normal) found either congenitally or acquired

in liver disease.

Studies such as the Framingham study and Northwick

Park Heart Study have demonstrated that an increased

fibrinogen concentration is an independent risk factor for

atherosclerotic diseases, e.g. myocardial infarction or stroke.

Quantia-Fibrinogen is an antigen immunoassay for the

quantitative determination of fibrinogen in human plasma.

TURBIDIMETRIC IMMUNOASSAY FOR

ESTIMATION OF LIPOPROTEIN (A) IN HUMAN

SERUM

Quantia LP (a)

(Courtesy: Tulip Group of Companies)

Summary

Coronary artery disease (CAD) is emerging as a major

public health problem. Of all the ethnic groups, people

of Indian origin have one of the highest incidences of

728 Concise Book of Medical Laboratory Technology: Methods and Interpretations CAD and diffuse and severe CAD frequently occurs in

Indians at an early stage. The prevalence of premature

CAD in Indians is upto three times higher when compared with people of similar age group in the Western

world.

Lipoprotein (a) [Lp (a)] is a genetically determined

lipoprotein molecule having a protein moiety apolipoprotein (B)-100 (the protein associated with lowdensity lipoprotein) disulfide linked to apolipoprotein

(a) the distinctive glycoprotein that is homologous

to plasminogen. Lp (a) functions as a dual pathogen

that is highly atherogenic and also prothrombotic. The

Apolipoprotein B-100 part of Lp (a) binds to LDL receptors

and acts as an atherogenic protein. The Apolipoprotein

(a) moiety competes with plasminogen for binding

to fibrinogen and fibrin monomer and thus acts as a

prothrombotic agent.

Several studies have demonstrated that Lp (a), is one

of the most powerful and most prevalent independent

risk factors for premature CAD. Early therapeutic

interventions and lifestyle modifications at lower levels

of total cholesterol and LDL cholesterol, particularly in

persons with a family history of premature CAD and in

persons with high Lp (a) levels has been suggested.

The CHD (Coronary heart disease) risk prediction is

high, especially when Lp (a) and LDL concentrations are

elevated simultaneously. Lp (a) elevations have also been

linked to restenosis after angioplasty and progression of

angiographically documented coronary heart disease.

In normolipidemic subjects those with Lp (a) levels

greater than 30 mg/dL may have a risk for myocardial

infarction 1.7 times that of subjects with LP (a) levels below

this level have been documented.

Information regarding the concentration of Lp (a) can

be obtained by using Quantia-Lp (a) reagents.

QUANTITATIVE TURBIDIMETRIC

IMMUNOASSAY FOR ESTIMATION OF

APOLIPOPROTEIN A-I

Quantia Apo A-I

(Courtesy: Tulip Group of Companies)

Summary

The risk of premature atherosclerotic coronary heart

disease (CHD) has direct correlation with plasma

concentration of LDL cholesterol and inverse correlation

with HDL cholesterol. Apolipoprotein A-I (apo A-I) is

the major anti-atherogenic apolipoprotein found in

HDL cholesterol and plays an important role in HDL

metabolism. Apo A-I is an activator of lecithin cholesterol

acyltransferase (LCAT) enzyme present in HDL, which

catalyzes the reaction forming cholesterol esterase (CE).

This CE rich HDL cleans up the cholesterol from peripheral

tissue and transport it to liver [reverse cholesterol

transport (RCT)]. Increased rate of apo A-I production

causes high plasma HDL concentration and may have a

protective effect from premature CAD. Genetic defects

that cause the inability to synthesize apo A-I cause very

low plasma concentrations of HDL-C thereby increasing

the risk of atherosclerotic CHD.

Estimation of apo A-I levels is useful in determining the

cholesterol clearing capacity of the blood in an individual

and thereby predicting the relative risk of CHD. Studies

have demonstrated that in patients with known CAD

on treatment with lipid lowering drugs, levels of apo

A-I and apo B were a significant perdictor for recurrent

cardiovascular events as compared to plasma LDL-C and

TC (Total cholesterol) levels.

Quantia Apo A-I is a turbidimetric immunoassay for

the quantitative determination of apolipoprotein A-I in

human serum.

QUANTITATIVE TURBIDIMETRIC

IMMUNOASSAY FOR ESTIMATION OF

APOLIPOPROTEIN B

Quantia Apo B

(Courtesy: Tulip Group of Companies)

Summary

The risk of premature atherosclerotic coronary heart disease

(CHD) has direct correlation with plasma concentration

of LDL cholesterol and inverse correlation with HDL

cholesterol. Apolipoprotein B is a major apolipoprotein of

VLDL and LDL the atherogenic lipoproteins. Apo B helps

in solubilizing the cholesterol within the LDL complex,

which in turn increases the transport capacity of LDL for

subsequent deposition of cholesterol on the arterial wall

thereby promoting heart disease. Only one molecule of

apo B exists per lipoprotein particle. The quantity of apo

B is therefore, a direcct measurement of VLDL and LDL

particles. However, due to wide variations in the amount

of cholesterol in these lipoproteins, measurement of apo

B has better relevance to the concentration of atherogenic

lipoprotein particles than LDL cholesterol or non-HDL

cholestrol levels. Subjects with the greatest risk of mortality

from heart attack tend to have the highest ratios of apo B/

apo A-I.

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