Anti-interference hemoglobin analysis system by high performance liquid chromatography / 生物医学工程学杂志

High performance liquid chromatography (HPLC) is currently the mainstream technology for detecting hemoglobin. Glycated hemoglobin (HbA1c) is a gold indicator for diagnosing diabetes, however, the accuracy of HbA1c test is affected by thalassemia factor hemoglobin F (HbF)/hemoglobin A2 (HbA2) and variant hemoglobin during HPLC analysis. In this study, a new anti-interference hemoglobin analysis system of HPLC is proposed. In this system, the high-pressure three-gradient elution method was improved, and the particle size and sieve plate aperture in the high-pressure chromatography column and the structure of the double-plunger reciprocating series high-pressure pump were optimized. The system could diagnose both HbA1c and thalassemia factor HbF/HbA2 and variant hemoglobin, and the performance of the system was anti-interference and stable. It is expected to achieve industrialization. In this study, the HbA1c and thalassemia factor HbF/HbA2 detection performance was compared between this system and the world's first-line brand products such as Tosoh G8, Bio-Rad Ⅶ and D10 glycosylated hemoglobin analysis system. The results showed that the linear correlation between this system and the world-class system was good. The system is the first domestic hemoglobin analysis system by HPLC for screening of HbA1c and thalassemia factor HbF/HbA2 rapidly and accurately.

Pattern of hemoglobinopathies and thalassemia in Manipur, India

Background: Hemoglobinopathies are the commonest genetic disorders worldwide. Thalassemia Major, Thalassemia Intermedia and Sickle Cell Disease are the major disorders that require lifelong management and are to be considered for prevention. In India, Beta-Thalassemia is prevalent across the country, with an average frequency of carriers being 3-4%.Methods: This is a cross sectional study conducted between June 2016 - May 2017 in the Department of Medicine, RIMS Imphal in 453 patients as a workup for anemia and clinically suspected cases of Hemoglobinopathy or beta thalassemia. Blood samples were collected and sent for Haemoglobin Electrophoresis using cellulose alkaline technique.Results: Among the 453 cases of the population surveyed, 35% showed the presence of abnormal hemoglobin. 16% were found to be beta thalassemia carrier, 11.69% HbE trait, 6.62% Homozygous HbE, 0.4% beta thalassemia and 0.7% had Hereditary persistence of HbF.Conclusions: High prevalence of Beta Thalassemia trait occurred more frequently than other Hemoglobinopathies. The study concludes that it is immensely important epidemiologically to explore the haemoglobin variants in Manipur so that the carriers can be detected for prevention of more serious disorder in the future generations.

Effect of Elevated levels of Hemoglobin F on HbA1c Measurements: Evaluation of Three HbA1c Assays.

Introduction: Accurate measurement of HbA1c is crucial in the diabetic control and diagnosis. Elevated levels of HbF are reported to falsely decrease the HbA1c result and effect is very much method dependent. Material & Methods: Commercial assay methods G8 HPLC analyzer and DCA 2000 were evaluated. G8 is an ion exchange, high performance liquid chromatography (HPLC) method that measures the HbA1c as a percentage of total amounts of hemoglobin present in the sample. Two whole blood EDTA patient pools were prepared with HbA1c concentrations in the normal (5% to 7%) and abnormal range (7% to 8%). All chromatograms from G8 were reviewed for any change in the peak resolution time due HbF concentrations. Results: The mean value for normal and abnormal pool was 5.8% and 7.5% resp. HbF showed no interference on Tosoh HbA1c results up to 30% in normal pool and up to 25% in abnormal pool. Observed difference between G8 and both Dimension EXL and DCA 2000 was clinically significant beyond 10% HbF. Conclusion: Accurate measurement of HbA1c is crucial for the decision making for diabetic control and diagnosis. The allowable error proposed by College of American Pathologist (CAP) is 6% therefore, appropriate knowledge about factors interfering with HbA1c results is absolutely important.

Agentes indutores da síntese de hemoglobina fetal / Fetal hemoglobin inducing factors

Anemia falciforme é uma doença heterogênea caracterizada por uma grande variabilidade clínica. Desde as primeiras observações desta doença, foi visto que aumento no nível de hemoglobina fetal (HbF) estava associado com manifestações clínicas mais brandas, já que a HbF interfere na polimerização da HbS. A hidroxiuréia é um agente citotóxico que causa vários efeitos nos pacientes com anemia falciforme, tais como: aumento da produção de HbF, aumento do volume corpuscular médio, aumento da hidratação do glóbulo vermelho, melhora da hemoglobina, mielossupressão, produção de óxido nítrico e diminuição de moléculas de adesão. Até o momento, ela é considerada a terapia de maior sucesso para a anemia falciforme e seu uso nesta doença é descrito neste artigo.

Sickle cell anemia is a heterogeneous disorder with variable severity. Initial observations showed that a high level of fetal hemoglobin (HbF) was associated with minor clinical manifestations, as HbF interferes with HbS polymerization. Hydroxyurea, a cytotoxic agent, has several effects on sickle cell patients, such as: increased HbF production, increased mean corpuscular volume, improved red blood cell hydration, improved hemoglobin, myelosuppression, production of nitric oxide and decreases in adhesion molecules. Till now, hydroxyurea is considered the most successful drug therapy for sickle cell anemia and its use is described in this article.

Hydroxyurea appears beneficial in patients with beta-thalassaemia major and intermedia.

Patients with severe inherited β-globin chain disorders may have milder illness if they produce high levels of fetal hemoglobin (HbF). Hydroxyurea (HU) has been shown to enhance HbF levels in patients with sickle cell disease and may be useful in β-thalassemias. We administered HU to 13 patients with β-thalassemia intermedia or major, including 6 splenectomized patients. The patients received escalating doses (10 to 25 mg/kg/d) of HU for around 2 years (median: 21 months, range: 8 - 55 months). Eleven patients responded with an increase in the pre-transfusion HbF levels, from a base line median of 8.0% (2.5 - 61.3%) to 28.0% (6.6 - 49.2%) and 40.7% (4.8 - 72.3%) at 3 months and 18 months post-HU, respectively. A concomitant increment in median hemoglobin levels was noted at 1, 3 and 18 months of HU therapy. Six of 7 transfusion-dependent patients who had an increment of HbF (one with β-thalassemia major) also had reduced transfusion requirement over the 2-year period of HU therapy. Response to HU was also shown by a reduction in spleen size. Apart from oral ulcers that resolved upon dose reduction of HU, no significant toxicity was noted. We conclude that increased HbF production in β-thalassemia patients, with an improvement in erythropoiesis, can be achieved using HU with minimal toxicity.

Liver Circulation Obstruction in Advanced Chronic Cor Pulmonale in the Acute Attack Period / 中国医师杂志

Objective To study the change of live circulation in advanced chronic cor pulmonale.Methods Determination of blood gas,liver function and rheohepatogram were performed in twenty-eight patients with chronic cor pulmonale in acute attack period before treatment,and accounted for the cardiac output(CO),hepatic blood flow(HBF),hepatic artery blood flow(HABF) and portal vein blood flow(PVBF).Results The experimental group was compared with the control group,the HBF,HABF and PVBF were decreased,which was more dramatic in the patients with chronic cor pulmonale,who had right ventricular failure complication in the acute attack period.Conclusion In acute attack period of chronic cor pulmonale,the liver circulation obstruction occurs early,and it is the main cause of liver damage for the patients.