David H Ducroq | University College, Cardiff, Wales United Kingdom (original) (raw)

Papers by David H Ducroq

and certification of four frozen human serum certified

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2013

Background Considerable intermethod bias has been observed between cortisol immunoassays, with so... more Background Considerable intermethod bias has been observed between cortisol immunoassays, with some also displaying a gender difference. Cortisol immunoassay performance is affected by serum matrix effects such as changes in steroid binding proteins and presence of interfering steroids which can be altered in various clinical settings. This study investigates cortisol immunoassay bias in pregnancy, renal failure and intensive care patients. Methods Serum remaining after routine analysis from pregnant patients, patients on the intensive care unit and patients with renal failure were obtained prior to disposal and used to create 20 anonymous samples per group. A male and female serum pool was prepared and spiked with cortisol. Samples were aliquoted and distributed to four hospitals for cortisol analysis by immunoassays from four different manufacturers. Cortisol was also measured by an isotope dilution-gas chromatography–mass spectrometry method for comparison of assay bias. Results ...

... Birmingham, UK 11 April 2011 - 14 April 2011 Society for Endocrinology British Endocrine Soci... more ... Birmingham, UK 11 April 2011 - 14 April 2011 Society for Endocrinology British Endocrine Societies. ... Endocrine Abstracts (2011) 25 OC3.2. Determination of method-specific normal cortisol responses to the short Synacthen test. Nadia El-Farhan 1, 2 , Alan Pickett 1 , David ...

Accreditation and Quality Assurance, 2004

Wales External Quality Assessment Scheme (WEQAS) is one of the largest external quality assessmen... more Wales External Quality Assessment Scheme (WEQAS) is one of the largest external quality assessment (EQA) providers in the United Kingdom, with over 600 participants. Over the last two and a half years, reference target values have been used for the electrolyte panel in the WEQAS General Chemistry scheme. Reference methods have a vital role in that they ensure the transfer

Journal of Virology, 1994

Viruses which cause persistence in the naturally infected host are predicted to have evolved immu... more Viruses which cause persistence in the naturally infected host are predicted to have evolved immune evasion mechanisms. Human cytomegalovirus (HCMV) causes significant morbidity and mortality in immunocompromised patients yet persists without clinical manifestations in seropositive individuals who have normal immune function. We report that HCMV infection in vitro impairs major histocompatibility complex class I (MHC-I) assembly accompanied by resistance to killing by cytotoxic CD8+ T lymphocytes. Pulse-chase metabolic labelling experiments show that MHC-I complexes continue to be assembled by both uninfected and HCMV-infected cells. However, MHC-I molecules are unstable in HCMV-infected cells and are rapidly broken down. Endoglycosidase H treatment of immunoprecipitates indicates that the breakdown of MHC-I complexes in HCMV-infected cells occurs primarily in a pre-Golgi compartment. Interference with normal MHC-I assembly and expression, if relevant in vivo, may have implications ...

Clinical Endocrinology, 2013

ABSTRACT We write with respect to the recent article by Chitale et al. (1) Determining the utilit... more ABSTRACT We write with respect to the recent article by Chitale et al. (1) Determining the utility of the 60 min cortisol measurement in the short synacthen test. The authors suggest that a significant proportion of people undergoing short Synacthen tests (SST) may be inappropriately diagnosed as having adrenal insufficiency if a 30-minute cut off of 550 nmol/L is used, and that a 60 minute sample is required to improve the specificity of the SST. However, the authors have not considered the effect of cortisol immunoassay bias when interpreting their results. This article is protected by copyright. All rights reserved.

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2013

Background LC-MS/MS is rapidly becoming the technology of choice for measuring steroid hormones. ... more Background LC-MS/MS is rapidly becoming the technology of choice for measuring steroid hormones. We have developed a rapid LC-MS/MS assay for the routine analysis of serum cortisol. We have used this assay to investigate the effects of gender and exogenous steroid interference on the immunoassay measurement of serum cortisol. Methods Zinc sulphate (40 µL) was added to 20 µL of sample. This was vortexed for 10 s followed by the addition of 100 µL of internal standard in methanol. Following mixing and centrifugation, 10 µL of sample was injected into an Acquity LC system coupled to a Quattro Premier tandem mass spectrometer. Serum samples ( n = 149) were analysed by LC-MS/MS and two commercial immunoassays. Results were then compared for all samples and for gender differences. A further set of serum samples ( n = 171) was analysed by the LC-MS/MS assay and a GC-MS assay. Results Cortisol had a retention time of 0.98 min and the assay had an injection-to-injection time of 2.6 min p...

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2010

Background WEQAS, one of the largest EQA (External Quality Assessment) providers in the UK, offer... more Background WEQAS, one of the largest EQA (External Quality Assessment) providers in the UK, offers a bile acid EQA scheme, with linear serum pools containing cholic acid, deoxycholic acid and chenodeoxycholic acid, reflecting levels observed in obstructive cholestasis. Total bile acids are currently measured routinely by non-specific enzymatic methods. Traceability of results to the SI unit utilizing reference target values is the preferred method of comparison of returned results where available, ensuring the transfer of accuracy from definitive methods to routine methods. Methods Target values have been assigned to EQA material utilizing isotope dilution gas chromatography mass spectrometry (ID-GCMS). The methodology was based on published routine methods and adapted for use as a ID-GCMS target method. The total bile acid target value was reported as the sum of the three major bile acids measured: cholic acid, deoxycholic acid and chenodeoxycholic acid. Results The produced target...

Annals of clinical biochemistry, 2018

Clinical Endocrinology, 2013

The serum cortisol response to the adrenocorticotrophin (ACTH) test is known to vary significantl... more The serum cortisol response to the adrenocorticotrophin (ACTH) test is known to vary significantly by assay, but lower reference limits (LRL) for this response have not been established by the reference gas chromatography-mass spectrometry (GC-MS) method or modern immunoassays. We aimed to compare the normal cortisol response to ACTH stimulation using GC-MS with five widely used immunoassays. An ACTH test (250 μg iv ACTH1-24 ) was undertaken in 165 healthy volunteers (age, 20-66 years; 105 women, 24 of whom were taking an oestrogen-containing oral contraceptive pill [OCP]). Serum cortisol was measured using GC-MS, Advia Centaur (Siemens), Architect (Abbott), Modular Analytics E170 (Roche), Immulite 2000 (Siemens) and Access (Beckman) automated immunoassays. The estimated LRL for the 30 min cortisol response to ACTH was derived from the 2·5th percentile of log-transformed concentrations. The GC-MS-measured cortisol response was normally distributed in males but not females, with no significant gender difference in baseline or post-ACTH cortisol concentration. Immunoassays were positively biased relative to GC-MS, except in samples from women on the OCP, who showed a consistent negative bias. The LRL for cortisol was method-specific [GC-MS: 420 nm; Architect: 430 nm; Centaur: 446 nm; Access 459 nm; Immulite (2000) 474 nm] and, for the E170, also gender-specific (female: 524 nm; male 574 nm). A separate LRL is necessary for women on the OCP. Normal cortisol responses to the ACTH test are influenced significantly by assay and oestrogen treatment. We recommend the use of separate reference limits in premenopausal women on the OCP and warn users that cortisol measurements in this subgroup are subject to assay interference.

Annals of Clinical Biochemistry, 2008

Background: This paper describes the preparation, analysis and certification of four frozen human... more Background: This paper describes the preparation, analysis and certification of four frozen human serum certified reference materials (CRMs) containing creatinine and the electrolytes calcium, lithium, magnesium, potassium and sodium. These materials have been prepared to give concentrations of these analytes that cover the currently accepted analytical range. Methods: The analysis of the materials for certification purposes has been carried out using methodology traceable to primary standards, and which is acceptable as a reference method. The certification methods include liquid chromatography-mass spectrometry (LC-MS) with exact-matching isotope dilution calibration (EM-IDMS) for creatinine, inductively-coupled plasma optical emission spectroscopy (ICP-OES), ICP-MS and isotope-dilution inductively-coupled plasma mass spectroscopy (ID-ICP-MS) for the electrolytes. Results: The uncertainties estimated for these certified values include a component from the characterization measurements, as well as contributions from possible inhomogeneity and long-term instability. The certified values have been corroborated by measurements obtained in a major UK External Quality Assessment scheme, which have, with the exception of the determination of creatinine at a particularly low concentration, given excellent agreement. Conclusions: The materials are intended for use by pathology laboratories and manufacturers of in vitro diagnostic (IVD) kits for validation of existing routine methodology to a traceable standard, which will promote harmonization between the different methods, instruments and IVD kits used in these laboratories.

Annals of Clinical Biochemistry, 2008

Determination of urinary free cortisol (UFC) is an important adjunct for the assessment of adrena... more Determination of urinary free cortisol (UFC) is an important adjunct for the assessment of adrenal function. In this study, we have analysed cortisol concentrations in urine samples by gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS/MS) and two immunoassays. The results were compared with GC-MS. The interference of cortisol ring-A metabolites in immunoassays was also assessed. The GC-MS technique involved solvent extraction, LH-20 clean-up and derivatization. Only solid-phase extraction procedure was used for LC-MS/MS. The samples were analysed in positive electro-spray ionization mode, monitoring the transitions for cortisol and deuterated-cortisol at m/z 363.3 > 121.2 and m/z 365.3 > 122.2, respectively. Immunoassays were performed according to the manufacturer's instructions. When compared with GC-MS results both immunoassays (Coat-A-Count; approximately 1.9-fold, Centaur; approximately 1.6-fold) overestimated UFC concentrations. Cortisol ring-A dihydro- and tetrahydrometabolites contribute significantly to this overestimation. There was no interference by these metabolites in either GC-MS or LC-MS/MS methods. The sensitivity of the LC-MS/MS procedure was 2 nmol/L and the intra- and inter-assay variations were <5% in each quality-control sample. The comparison of the UFC results achieved by assaying the study samples with GC-MS and LC-MS/MS indicated that the agreement between the two methods was excellent (LC-MS/MS = 1.0036GC-MS - 0.0841; r2 = 0.9937). The interference of cortisol ring-A metabolites in immunoassays contribute to overestimation of UFC concentrations. The LC-MS/MS procedure had the sensitivity, specificity, linearity, precision and accuracy for the determination of UFC concentrations. The method is suitable for routine use provided that method-dependant reference values are established.

Annals of Clinical Biochemistry, 2008

Background: This paper describes the preparation, analysis and certification of four frozen human... more Background: This paper describes the preparation, analysis and certification of four frozen human serum certified reference materials (CRMs) containing creatinine and the electrolytes calcium, lithium, magnesium, potassium and sodium. These materials have been prepared to give concentrations of these analytes that cover the currently accepted analytical range. Methods: The analysis of the materials for certification purposes has been carried out using methodology traceable to primary standards, and which is acceptable as a reference method. The certification methods include liquid chromatography-mass spectrometry (LC-MS) with exact-matching isotope dilution calibration (EM-IDMS) for creatinine, inductively-coupled plasma optical emission spectroscopy (ICP-OES), ICP-MS and isotope-dilution inductively-coupled plasma mass spectroscopy (ID-ICP-MS) for the electrolytes. Results: The uncertainties estimated for these certified values include a component from the characterization measurements, as well as contributions from possible inhomogeneity and long-term instability. The certified values have been corroborated by measurements obtained in a major UK External Quality Assessment scheme, which have, with the exception of the determination of creatinine at a particularly low concentration, given excellent agreement. Conclusions: The materials are intended for use by pathology laboratories and manufacturers of in vitro diagnostic (IVD) kits for validation of existing routine methodology to a traceable standard, which will promote harmonization between the different methods, instruments and IVD kits used in these laboratories.

and certification of four frozen human serum certified

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2013

Background Considerable intermethod bias has been observed between cortisol immunoassays, with so... more Background Considerable intermethod bias has been observed between cortisol immunoassays, with some also displaying a gender difference. Cortisol immunoassay performance is affected by serum matrix effects such as changes in steroid binding proteins and presence of interfering steroids which can be altered in various clinical settings. This study investigates cortisol immunoassay bias in pregnancy, renal failure and intensive care patients. Methods Serum remaining after routine analysis from pregnant patients, patients on the intensive care unit and patients with renal failure were obtained prior to disposal and used to create 20 anonymous samples per group. A male and female serum pool was prepared and spiked with cortisol. Samples were aliquoted and distributed to four hospitals for cortisol analysis by immunoassays from four different manufacturers. Cortisol was also measured by an isotope dilution-gas chromatography–mass spectrometry method for comparison of assay bias. Results ...

... Birmingham, UK 11 April 2011 - 14 April 2011 Society for Endocrinology British Endocrine Soci... more ... Birmingham, UK 11 April 2011 - 14 April 2011 Society for Endocrinology British Endocrine Societies. ... Endocrine Abstracts (2011) 25 OC3.2. Determination of method-specific normal cortisol responses to the short Synacthen test. Nadia El-Farhan 1, 2 , Alan Pickett 1 , David ...

Accreditation and Quality Assurance, 2004

Wales External Quality Assessment Scheme (WEQAS) is one of the largest external quality assessmen... more Wales External Quality Assessment Scheme (WEQAS) is one of the largest external quality assessment (EQA) providers in the United Kingdom, with over 600 participants. Over the last two and a half years, reference target values have been used for the electrolyte panel in the WEQAS General Chemistry scheme. Reference methods have a vital role in that they ensure the transfer

Journal of Virology, 1994

Viruses which cause persistence in the naturally infected host are predicted to have evolved immu... more Viruses which cause persistence in the naturally infected host are predicted to have evolved immune evasion mechanisms. Human cytomegalovirus (HCMV) causes significant morbidity and mortality in immunocompromised patients yet persists without clinical manifestations in seropositive individuals who have normal immune function. We report that HCMV infection in vitro impairs major histocompatibility complex class I (MHC-I) assembly accompanied by resistance to killing by cytotoxic CD8+ T lymphocytes. Pulse-chase metabolic labelling experiments show that MHC-I complexes continue to be assembled by both uninfected and HCMV-infected cells. However, MHC-I molecules are unstable in HCMV-infected cells and are rapidly broken down. Endoglycosidase H treatment of immunoprecipitates indicates that the breakdown of MHC-I complexes in HCMV-infected cells occurs primarily in a pre-Golgi compartment. Interference with normal MHC-I assembly and expression, if relevant in vivo, may have implications ...

Clinical Endocrinology, 2013

ABSTRACT We write with respect to the recent article by Chitale et al. (1) Determining the utilit... more ABSTRACT We write with respect to the recent article by Chitale et al. (1) Determining the utility of the 60 min cortisol measurement in the short synacthen test. The authors suggest that a significant proportion of people undergoing short Synacthen tests (SST) may be inappropriately diagnosed as having adrenal insufficiency if a 30-minute cut off of 550 nmol/L is used, and that a 60 minute sample is required to improve the specificity of the SST. However, the authors have not considered the effect of cortisol immunoassay bias when interpreting their results. This article is protected by copyright. All rights reserved.

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2013

Background LC-MS/MS is rapidly becoming the technology of choice for measuring steroid hormones. ... more Background LC-MS/MS is rapidly becoming the technology of choice for measuring steroid hormones. We have developed a rapid LC-MS/MS assay for the routine analysis of serum cortisol. We have used this assay to investigate the effects of gender and exogenous steroid interference on the immunoassay measurement of serum cortisol. Methods Zinc sulphate (40 µL) was added to 20 µL of sample. This was vortexed for 10 s followed by the addition of 100 µL of internal standard in methanol. Following mixing and centrifugation, 10 µL of sample was injected into an Acquity LC system coupled to a Quattro Premier tandem mass spectrometer. Serum samples ( n = 149) were analysed by LC-MS/MS and two commercial immunoassays. Results were then compared for all samples and for gender differences. A further set of serum samples ( n = 171) was analysed by the LC-MS/MS assay and a GC-MS assay. Results Cortisol had a retention time of 0.98 min and the assay had an injection-to-injection time of 2.6 min p...

Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 2010

Background WEQAS, one of the largest EQA (External Quality Assessment) providers in the UK, offer... more Background WEQAS, one of the largest EQA (External Quality Assessment) providers in the UK, offers a bile acid EQA scheme, with linear serum pools containing cholic acid, deoxycholic acid and chenodeoxycholic acid, reflecting levels observed in obstructive cholestasis. Total bile acids are currently measured routinely by non-specific enzymatic methods. Traceability of results to the SI unit utilizing reference target values is the preferred method of comparison of returned results where available, ensuring the transfer of accuracy from definitive methods to routine methods. Methods Target values have been assigned to EQA material utilizing isotope dilution gas chromatography mass spectrometry (ID-GCMS). The methodology was based on published routine methods and adapted for use as a ID-GCMS target method. The total bile acid target value was reported as the sum of the three major bile acids measured: cholic acid, deoxycholic acid and chenodeoxycholic acid. Results The produced target...

Annals of clinical biochemistry, 2018

Clinical Endocrinology, 2013

The serum cortisol response to the adrenocorticotrophin (ACTH) test is known to vary significantl... more The serum cortisol response to the adrenocorticotrophin (ACTH) test is known to vary significantly by assay, but lower reference limits (LRL) for this response have not been established by the reference gas chromatography-mass spectrometry (GC-MS) method or modern immunoassays. We aimed to compare the normal cortisol response to ACTH stimulation using GC-MS with five widely used immunoassays. An ACTH test (250 μg iv ACTH1-24 ) was undertaken in 165 healthy volunteers (age, 20-66 years; 105 women, 24 of whom were taking an oestrogen-containing oral contraceptive pill [OCP]). Serum cortisol was measured using GC-MS, Advia Centaur (Siemens), Architect (Abbott), Modular Analytics E170 (Roche), Immulite 2000 (Siemens) and Access (Beckman) automated immunoassays. The estimated LRL for the 30 min cortisol response to ACTH was derived from the 2·5th percentile of log-transformed concentrations. The GC-MS-measured cortisol response was normally distributed in males but not females, with no significant gender difference in baseline or post-ACTH cortisol concentration. Immunoassays were positively biased relative to GC-MS, except in samples from women on the OCP, who showed a consistent negative bias. The LRL for cortisol was method-specific [GC-MS: 420 nm; Architect: 430 nm; Centaur: 446 nm; Access 459 nm; Immulite (2000) 474 nm] and, for the E170, also gender-specific (female: 524 nm; male 574 nm). A separate LRL is necessary for women on the OCP. Normal cortisol responses to the ACTH test are influenced significantly by assay and oestrogen treatment. We recommend the use of separate reference limits in premenopausal women on the OCP and warn users that cortisol measurements in this subgroup are subject to assay interference.

Annals of Clinical Biochemistry, 2008

Background: This paper describes the preparation, analysis and certification of four frozen human... more Background: This paper describes the preparation, analysis and certification of four frozen human serum certified reference materials (CRMs) containing creatinine and the electrolytes calcium, lithium, magnesium, potassium and sodium. These materials have been prepared to give concentrations of these analytes that cover the currently accepted analytical range. Methods: The analysis of the materials for certification purposes has been carried out using methodology traceable to primary standards, and which is acceptable as a reference method. The certification methods include liquid chromatography-mass spectrometry (LC-MS) with exact-matching isotope dilution calibration (EM-IDMS) for creatinine, inductively-coupled plasma optical emission spectroscopy (ICP-OES), ICP-MS and isotope-dilution inductively-coupled plasma mass spectroscopy (ID-ICP-MS) for the electrolytes. Results: The uncertainties estimated for these certified values include a component from the characterization measurements, as well as contributions from possible inhomogeneity and long-term instability. The certified values have been corroborated by measurements obtained in a major UK External Quality Assessment scheme, which have, with the exception of the determination of creatinine at a particularly low concentration, given excellent agreement. Conclusions: The materials are intended for use by pathology laboratories and manufacturers of in vitro diagnostic (IVD) kits for validation of existing routine methodology to a traceable standard, which will promote harmonization between the different methods, instruments and IVD kits used in these laboratories.

Annals of Clinical Biochemistry, 2008

Determination of urinary free cortisol (UFC) is an important adjunct for the assessment of adrena... more Determination of urinary free cortisol (UFC) is an important adjunct for the assessment of adrenal function. In this study, we have analysed cortisol concentrations in urine samples by gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS/MS) and two immunoassays. The results were compared with GC-MS. The interference of cortisol ring-A metabolites in immunoassays was also assessed. The GC-MS technique involved solvent extraction, LH-20 clean-up and derivatization. Only solid-phase extraction procedure was used for LC-MS/MS. The samples were analysed in positive electro-spray ionization mode, monitoring the transitions for cortisol and deuterated-cortisol at m/z 363.3 > 121.2 and m/z 365.3 > 122.2, respectively. Immunoassays were performed according to the manufacturer's instructions. When compared with GC-MS results both immunoassays (Coat-A-Count; approximately 1.9-fold, Centaur; approximately 1.6-fold) overestimated UFC concentrations. Cortisol ring-A dihydro- and tetrahydrometabolites contribute significantly to this overestimation. There was no interference by these metabolites in either GC-MS or LC-MS/MS methods. The sensitivity of the LC-MS/MS procedure was 2 nmol/L and the intra- and inter-assay variations were <5% in each quality-control sample. The comparison of the UFC results achieved by assaying the study samples with GC-MS and LC-MS/MS indicated that the agreement between the two methods was excellent (LC-MS/MS = 1.0036GC-MS - 0.0841; r2 = 0.9937). The interference of cortisol ring-A metabolites in immunoassays contribute to overestimation of UFC concentrations. The LC-MS/MS procedure had the sensitivity, specificity, linearity, precision and accuracy for the determination of UFC concentrations. The method is suitable for routine use provided that method-dependant reference values are established.

Annals of Clinical Biochemistry, 2008

Background: This paper describes the preparation, analysis and certification of four frozen human... more Background: This paper describes the preparation, analysis and certification of four frozen human serum certified reference materials (CRMs) containing creatinine and the electrolytes calcium, lithium, magnesium, potassium and sodium. These materials have been prepared to give concentrations of these analytes that cover the currently accepted analytical range. Methods: The analysis of the materials for certification purposes has been carried out using methodology traceable to primary standards, and which is acceptable as a reference method. The certification methods include liquid chromatography-mass spectrometry (LC-MS) with exact-matching isotope dilution calibration (EM-IDMS) for creatinine, inductively-coupled plasma optical emission spectroscopy (ICP-OES), ICP-MS and isotope-dilution inductively-coupled plasma mass spectroscopy (ID-ICP-MS) for the electrolytes. Results: The uncertainties estimated for these certified values include a component from the characterization measurements, as well as contributions from possible inhomogeneity and long-term instability. The certified values have been corroborated by measurements obtained in a major UK External Quality Assessment scheme, which have, with the exception of the determination of creatinine at a particularly low concentration, given excellent agreement. Conclusions: The materials are intended for use by pathology laboratories and manufacturers of in vitro diagnostic (IVD) kits for validation of existing routine methodology to a traceable standard, which will promote harmonization between the different methods, instruments and IVD kits used in these laboratories.