Effect of Blood Cell Subtypes Lysis on Routine Biochemical Tests

Abstract

SummaryBackground: The aim of this study is to establish the contribution of blood cells subtypes on hemolysis. Methods: Separated blood cell subtype suspensions prepared with blood from 10 volunteers were serially diluted to obtain different concentrations of cell suspensions. The cells were fully lysed and cell hemolysates were added (1:20) to aliquots of serum pool. Thus, seven serum pools with different concentrations of interferent were obtained for each blood cell subtype. Biochemical parameters and serum indices were measured by an autoanalyzer. As cell lysis markers, free hemoglobin was measured by spectrophotometry while myeloperoxidase and b-thromboglobulin were measured by enzyme immunoassay. The percent changes in analyte levels of the serum pools were evaulated by Wilcoxon Signed Rank Test and compared with clinical thresholds defined for each test. Results: The clinical thresholds were exceeded in lactate dehydrogenase, potassium, aspartate aminotransferase, creatine kinase, magnesium, total protein, total cholesterol, inorganic phosphate, glucose for red blood cells (RBC); lactate dehydrogenase, aspartate aminotransferase, total protein, inorganic phosphate and glucose for platelets (PLT). Free hemoglobin was significantly correlated with RBC (r=0.999; p=0.001), while myeloperoxidase and b thromboglobulin showed no significant correlation to white blood cells (WBC) and PLT, respectively. Conclusions: The effect of RBC hemolysis in serum on the routine biochemical tests are clearly established, yet, additional studies are required in order to verify this kind of effects of PLT and WBC hemolysis.

Evaluation of neutrophil-lymphocyte and platelet-lymphocyte ratios as predictors of 30-day mortality in patients hospitalized for an episode of acute decompensated heart failure

“…Several lines of evidence attest that cell-mediated immune response, inflammation and oxidative stress are strongly implicated in the pathogenesis of cardiovascular disease (9, 12, 21). In effect, classic biomarkers of inflammation such as C-reactive protein, interleukin (IL)-1 and IL-6 has been largely associated with an increased risk of cardiovascular events (24, 25, 26).…”

“…In effect, classic biomarkers of inflammation such as C-reactive protein, interleukin (IL)-1 and IL-6 has been largely associated with an increased risk of cardiovascular events (24, 25, 26). Nonetheless, among the most recent inflammatory biomarkers proposed as potential predictors of outcome in clinical practice (27, 28), NLR and PLR are quick and inexpensive tests, and have been convincingly associated with the outcome of cardiovascular diseases managed in the ED (21, 22).…”

“…The role of inflammation in HF (15, 16), and more specifically its contribution to episodes of acute decompensation is still largely debated (17, 18). Evidence collected during the last 30 years from in vitro and in vivo studies have helped to elucidate the different immune mechanisms that contribute to triggering systolic dysfunction and progressive alteration of heart structure in patients with chronic HF (5, 19).…”

“…Evidence collected during the last 30 years from in vitro and in vivo studies have helped to elucidate the different immune mechanisms that contribute to triggering systolic dysfunction and progressive alteration of heart structure in patients with chronic HF (5, 19). In acute decompensation, the innate immune response promotes both pro-inflammatory cytokines release and oxidative stress injury, which impair vascular homeostasis and withstand fluid retention (9, 17, 20). Recently, NLR and PLR have been proposed as reliable indicators of immune activation, inflammation and oxidative stress injury, and their measurement has been considered a valuable tool for predicting mortality in patients with cardiovascular disease (21, 22).…”

“…In acute decompensation, the innate immune response promotes both pro-inflammatory cytokines release and oxidative stress injury, which impair vascular homeostasis and withstand fluid retention (9, 17, 20). Recently, NLR and PLR have been proposed as reliable indicators of immune activation, inflammation and oxidative stress injury, and their measurement has been considered a valuable tool for predicting mortality in patients with cardiovascular disease (21, 22).…”