CEUDCH22101 - CMLE - Pretreatment of Body Fluid Specimens Using Hyaluronidase and Ultracentrifugation-CEUDCH22101

CEUDCH22101 - Educational Activity

Pdf Summary

This study evaluates the effectiveness of hyaluronidase (HYAL) and ultracentrifugation (UC) in reducing viscosity in various body fluids—such as biliary, cerebrospinal, pancreatic, and more—before conducting clinical chemistry tests. Viscous body fluids can complicate laboratory testing, often due to hyaluronic acid (HA), and HYAL has been traditionally used to address this by liquefaction. The study examined various analytes including amylase, bilirubin, cancer antigen 19-9, cholesterol, creatinine, glucose, and more.<br /><br />The research involved treating body fluids with HYAL and UC and measuring the percentage differences in analyte levels to determine interference or effectiveness. HYAL treatment showed less than 15% difference for most analytes and effectively reduced fluid viscosity, enabling automated analysis without causing significant interferences. Conversely, UC treatment demonstrated increased variability and was found to be less reliable, with notable discrepancies in certain analytes like cancer antigen 19-9 and carcinoembryonic antigen.<br /><br />The findings suggest that HYAL is a superior method for pretreating viscous body fluids in clinical settings, though laboratories should validate these processes specifically for their conditions. UC was deemed unsuitable for analytes like cancer antigen 19-9, due to high variability.<br /><br />The study emphasizes the need for proper validation and adherence to regulatory standards, such as those from the FDA and Clinical Laboratory Improvement Amendments (CLIA). It also notes that some commercial HYAL powders may contain contaminants like testosterone, underscoring the importance of selecting appropriate reagents.<br /><br />Ultimately, the study concludes HYAL as an effective pretreatment for reducing viscosity in body fluids, facilitating accurate and reliable clinical chemistry analyses, with minimal interference in most assays evaluated. Further studies on UC's inconsistencies and additional pretreatment methods are recommended to optimize laboratory processes for viscous body fluids.

Keywords

hyaluronidase

ultracentrifugation

viscosity reduction

clinical chemistry

body fluids

analytes

laboratory testing

liquefaction

validation

regulatory standards