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We’re thrilled to announce that the MedFrontier Intact FGF23 Assay was featured in a recent publication! Details are available via the abstract and full-text access provided below.

Abstract

Multiple myeloma commonly manifests with symptoms arising from the involvement of various organs, particularly the bone and kidneys. In this report, we detail the case of a 44-year-old man who was diagnosed with multiple myeloma associated with reduced bone density. He exhibited clinical findings of osteomalacia due to Fanconi syndrome (characterized clinically by bone pain and proximal weakness and biochemically by elevated serum alkaline phosphatase, hypophosphatemia, hypouricemia, and glucosuria). With phosphate replacement, there was a notable improvement in bone pain, osteomalacia, and bone mineral density. Nevertheless, the patient continued to experience renal wasting of phosphate, uric acid, and glucose despite achieving remission from multiple myeloma for nearly 2 years. Our case highlights several important clinical features of myeloma-associated Fanconi syndrome, including the need to recognize this complication to appropriately treat the underlying bone disease while avoiding osteoclast inhibitors and the long-term persistence of the proximal renal tubulopathy despite achieving remission from myeloma and correction of osteomalacia.

Alireza Zomorodian, Naim M Maalouf, Long-term Evolution of Hypophosphatemia and Osteomalacia in a Patient With Multiple Myeloma, JCEM Case Reports, Volume 2, Issue 7, July 2024, luae137, https://doi.org/10.1210/jcemcr/luae137

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The Niacin Microtiter Plate Assay Kit was utilized in a recent study! Researchers developed a novel approach to study microglia, key immune cells in the CNS, under different conditions. Read on for a summary of this groundbreaking research!

Summary

Microglia are the resident macrophages of the central nervous system (CNS). Their phagocytic activity is central during brain development and homeostasis—and in a plethora of brain pathologies. However, little is known about the composition, dynamics, and function of human microglial phagosomes under homeostatic and pathological conditions. Here, we developed a method for rapid isolation of pure and intact phagosomes from human pluripotent stem cell-derived microglia under various in vitro conditions, and from human brain biopsies, for unbiased multiomic analysis. Phagosome profiling revealed that microglial phagosomes were equipped to sense minute changes in their environment and were highly dynamic. We detected proteins involved in synapse homeostasis, or implicated in brain pathologies, and identified the phagosome as the site where quinolinic acid was stored and metabolized for de novo nicotinamide adenine dinucleotide (NAD+) generation in the cytoplasm. Our findings highlight the central role of phagosomes in microglial functioning in the healthy and diseased brain.

Wogram, E et al. Rapid phagosome isolation enables unbiased multiomic analysis of human microglial phagosomes. Immunity. 57(9)p:2216-2231.e11 doi:10.1016/j.immuni.2024.07.019

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The Aldosterone ELISA Assay Kit was utilized in a recent study! The study looked at how blood flow in the kidneys and biomarker levels relate to kidney and heart problems in children experiencing shock. Access the abstract and full text below.

Abstract

Importance: Pediatric acute kidney injury (AKI) is a prevalent and morbid complication of shock. Its pathogenesis and early identification remain elusive.

Objectives: We aim to determine whether renal blood flow (RBF) measurements by point-of-care ultrasound (POCUS) and renin-angiotensin-aldosterone system (RAAS) hormones in pediatric shock associate with vasoactive requirements and AKI.

Design, Setting, and Participants: This is a single-center prospective, noninterventional observational cohort study in one tertiary PICU in North American from 2020 to 2022 that enrolled children younger than 18 years with shock without preexisting end-stage renal disease.

Main Outcomes and Measures: RBF was measured by POCUS on hospital days 1 and 3 and plasma RAAS hormone levels were measured on day 1. The primary outcome was the presence of AKI by Kidney Disease Improving Global Outcomes criteria at first ultrasound with key secondary outcomes of creatinine, blood urea nitrogen (BUN), Vasoactive-Inotrope Score (VIS), and norepinephrine equivalent dosing (NED) 48 hours after first ultrasound.

Results: Fifty patients were recruited (20 with AKI, mean age 10.5 yr, 48% female). POCUS RBF showed lower qualitative blood flow (power Doppler ultrasound [PDU] score) and higher regional vascular resistance (renal resistive index [RRI]) in children with AKI (p = 0.017 and p = 0.0007). Renin and aldosterone levels were higher in the AKI cohort (p = 0.003 and p = 0.007). Admission RRI and PDU associated with higher day 3 VIS and NED after adjusting for age, day 1 VIS, and RAAS hormones. Admission renin associated with higher day 3 creatinine and BUN after adjusting for age, day 1 VIS, and the ultrasound parameters.

Conclusions and Relevance: In pediatric shock, kidney blood flow was abnormal and renin and aldosterone were elevated in those with AKI. Kidney blood flow abnormalities are independently associated with future cardiovascular dysfunction; renin elevations are independently associated with future kidney dysfunction. Kidney blood flow by POCUS may identify children who will have persistent as opposed to resolving AKI. RAAS perturbations may drive AKI in pediatric shock.

Fisler, Grace et al. Kidney Blood Flow and Renin-Angiotensin-Aldosterone System Measurements Associated With Kidney and Cardiovascular Dysfunction in Pediatric Shock. Critical Care Explorations 6(8):p e1134, August 2024. DOI: 10.1097

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In a recent study, researchers employed the FGF23 C-Terminal ELISA Kit from Biomedica Immunoassays to explore the link between dietary phosphorus and key health markers among Puerto Rican adults. Dive into the findings to learn how phosphorus intake from various foods might impact health!

Abstract

Phosphorus (P) additives may be deleterious for health. We measured the P content of key foods, and associations of P intake with biomarkers in the Boston Puerto Rican Health Study (BPRHS). Direct chemical analysis of 92 foods was done with the molybdenum blue spectrophotometric method and inductively coupled plasma mass spectrometry (ICP-MS). A novel algorithm was used to determine bioavailable, natural, and added P. We estimated P intakes from foods in 1323 participants, aged 45–75 y, and associations of these with serum P, fibroblast growth factor 23 (FGF23), parathyroid hormone (PTH), and Klotho. Relationships between intakes and status markers were assessed with Pearson’s correlations and t-tests. Our food analyses generally support P values in the USDA nutrient database, with the exceptions of American and cheddar cheese, which had more P than in the database. Women had higher added P intake than men, and younger participants had higher added P than those older. Total P intake tended to be positively associated with serum P and klotho, and inversely associated with PTH, but relationships were not strong. Puerto Rican adults have high intake of additive P. Culturally sensitive interventions that highlight dietary quality are needed.

O.J. Akinlawon, et al. Phosphorous intake in foods and phosphorus status markers in circulation in the Boston Puerto Rican Health Study, Journal of Food Composition and Analysis, Volume 136, 2024, 106681, ISSN 0889-1575, https://doi.org/10.1016/j.jfca.2024.106681.

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Researchers recently utilized our Calprotectin ELISA Assay Kit in an innovative study examining a new treatment for cystic fibrosis (CF)! The study focused on how this treatment influenced both the intestinal microbiome and inflammation, alongside important clinical markers in children with CF. Check out the abstract and access the full text of the study below.

Abstract

The intestinal microbiome influences growth and disease progression in children with cystic fibrosis (CF). Elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA), the newest pharmaceutical modulator for CF, restores the function of the pathogenic mutated CF transmembrane conductance regulator (CFTR) channel. We performed a single-center longitudinal analysis of the effect of ELX/TEZ/IVA on the intestinal microbiome, intestinal inflammation, and clinical parameters in children with CF. Following ELX/TEZ/IVA, children with CF had significant improvements in body mass index and percent predicted forced expiratory volume in one second, and required fewer antibiotics for respiratory infections. Intestinal microbiome diversity increased following ELX/TEZ/IVA coupled with a decrease in the intestinal carriage of Staphylococcus aureus, the predominant respiratory pathogen in children with CF. There was a reduced abundance of microbiome-encoded antibiotic resistance genes. Microbial pathways for aerobic respiration were reduced after ELX/TEZ/IVA. The abundance of microbial acid tolerance genes was reduced, indicating microbial adaptation to increased CFTR function. In all, this study represents the first comprehensive analysis of the intestinal microbiome in children with CF receiving ELX/TEZ/IVA.

Reasoner SA, et al. 2024. Longitudinal profiling of the intestinal microbiome in children with cystic fibrosis treated with elexacaftor-tezacaftor-ivacaftor. mBio 15:e01935-23.https://doi.org/10.1128/mbio.01935-23

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Researchers employed the Infliximab ELISA Assay Kit in a new study aimed at uncovering the connection between infliximab concentrations in tissue and plasma and their impact on ulcerative colitis (UC) disease activity. Explore the full abstract and access the detailed research below.

Abstract

Background: We aimed to determine the correlation between tissue and plasma infliximab concentrations in an outpatient ulcerative colitis (UC) cohort based on histologic disease activity in addition to their relationship with long-term clinical outcomes. We assessed intraparticipant variability in infliximab concentrations between adjacent intestinal samples and the correlation between disease activity and tumor necrosis factor-α (TNF-α).

Methods: A prospective cohort study was conducted in participants with UC receiving infliximab. Blood and 2 sigmoid colon biopsies were obtained at the index colonoscopy for infliximab and TNF-α quantification. Histological disease activity was assessed. Participants were followed for 2 years for the occurrence of hospitalization, surgery, disease relapse, and infliximab discontinuation.

Results: A positive correlation was observed between mean plasma and uninflamed tissue infliximab concentrations only (Rs = 0.75, P = .0071). Lower mean tissue infliximab concentrations correlated with a shorter time to disease relapse vs those with higher mean tissue concentrations (Rs = 0.77, P = .032). This was not seen when using plasma infliximab concentrations. Additionally, no significant intraparticipant variability of infliximab concentrations was observed for all participants independent of disease activity. Neither plasma nor tissue TNF-α correlated with disease activity.

Conclusions: These findings support data generated in patients with Crohn’s disease: plasma infliximab concentrations are reflective of infliximab exposure in tissue in the UC patient in remission, but not for those with active disease. Increasing tissue concentrations in the noninflamed tissues may improve durability of infliximab. Neither plasma nor tissue TNF-α appear to correlate with UC disease activity. Larger follow-up studies would be of benefit.

John Choi, Qian Wang, Melanie Beaton, Richard B Kim, Reena Khanna, Aze Wilson, Infliximab Tissue Concentrations in Patients With Stable Ulcerative Colitis Are Correlated With More Durable Infliximab-associated Disease Remission, Inflammatory Bowel Diseases, 2024;, izae097, https://doi.org/10.1093/ibd/izae097

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A new study has featured the Noradrenaline (Norepinephrine) HS ELISA from DLD Diagnostika! Researchers provide mechanistic insights into C. difficile-associated pathogenesis and help illuminate a target for intervention to limit recurrent disease. Check out the summary and full text below.

Summary

Recurrent Clostridioides difficile infection (CDI) results in significant morbidity and mortality. We previously established that CDI in mice does not protect against reinfection and is associated with poor pathogen-specific B cell memory (Bmem), recapitulating our observations with human Bmem. Here, we demonstrate that the secreted toxin TcdB2 is responsible for subversion of Bmem responses. TcdB2 from an endemic C. difficile strain delayed immunoglobulin G (IgG) class switch following vaccination, attenuated IgG recall to a vaccine booster, and prevented germinal center formation. The mechanism of TcdB2 action included increased B cell CXCR4 expression and responsiveness to its ligand CXCL12, accounting for altered cell migration and a failure of germinal center-dependent Bmem. These results were reproduced in a C. difficile infection model, and a US Food and Drug Administration (FDA)-approved CXCR4-blocking drug rescued germinal center formation. We therefore provide mechanistic insights into C. difficile-associated pathogenesis and illuminate a target for clinical intervention to limit recurrent disease.

Norman KM, et al. Clostridioides difficile toxin B subverts germinal center and antibody recall responses by stimulating a drug-treatable CXCR4-dependent mechanism. Cell Reports. 2024. https://doi.org/10.1016/j.celrep.2024.114245.

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