NIH, National Cancer Institute, Division of Cancer Treatment and Diagnosis (DCTD) NIH - National Institutes of Health National Cancer Institute DCTD - Division of Cancer Treatment and Diagnosis

Confounding factors influencing amyloid Beta concentration in cerebrospinal fluid.

Author(s): Bjerke M, Portelius E, Minthon L, Wallin A, Anckarsäter H, Anckarsäter R, Andreasen N, Zetterberg H, Andreasson U, Blennow K

Publication: Int J Alzheimers Dis, 2010, Vol. 2010, Page

PubMed ID: 20798852 PubMed Review Paper? No

Purpose of Paper

The purpose of this paper was to determine the effects of several preanalyical and analytical factors on the measurement of the 42 amino acid form of Beta-amyloid (ABeta42) in cerebrospinal fluid (CSF).

Conclusion of Paper

ABeta42 concentrations were dependent on assay used, however, measurements were strongly correlated between assays. The use of different types of buffer other than the manufacturer provided assay buffer, different concentrations of phosphate buffered saline (PBS), and different pH values of Tris buffer had no effects on CSF ABeta42 levels. Storage of CSF in polystyrene tubes led to decreases in ABeta42 when compared to levels measured in CSF stored in polypropylene tubes. Room temperature storage for up to 24 h, freeze-thaw cycling, delayed freezing, 26 months of storage at -80 degrees C, thawing temperature, freezing method, type of freezer, storage temperature, and collection temperature had no significant influences on ABeta42 concentration. Further, aliquot sequential collection, overnight fasting, and deliberate contamination of CSF with blood had no effects on ABeta42 concentration, but dilution of CSF with serum albumin resulted in significantly decreased ABeta42 concentrations compared to undiluted CSF. A small but significant decrease in CSF ABeta42 concentration was observed in specimens collected 4-6 hours after baseline values were obtained, and CSF pH increased significantly when specimens were stored at room temperature over the course of 5 hours.

Studies

  1. Study Purpose

    The purpose of this study was to determine the effects of method of analysis on the measurement of ABeta42 in CSF from Alzheimer's disease patients and healthy individuals.

    Summary of Findings:

    All assays except the hAmyloid Beta42 ELISA showed significant differences in ABeta42 concentrations between Alzheimer's disease patients and healthy individuals when either CSF or CSF diluted in buffer with detergent was assayed. While absolute measurements of ABeta42 concentrations by the various assays showed large differences, correlations between all pairs of assays were strong for both diluted and undiluted CSF (0.53-0.98). The authors suggest that different sources for the ABeta42 standards used for calibration of the various assays may account for the different measurements.

    Biospecimens
    Preservative Types
    • Frozen
    Diagnoses:
    • Alzheimer's Disease
    • Normal
    Platform:
    AnalyteTechnology Platform
    Protein Immunoassay
    Protein ELISA
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Immunoassay Specific Technology platform INNO-BIA AlzBio3
    INNO-BIA plasma ABeta forms
    MSD Abeta Triplex Ultra-Sensitive Assay
    hAmyloid Beta42 ELISA
    INNOTEST Beta-amyloid1-42 ELISA
    ELISA Specific Detection method 3D6 (amino acid 1-5)
    48G (amino acid 17-24)
    Biospecimen Aliquots and Components Biospecimen components CSF
    CSF diluted in buffer with detergent
  2. Study Purpose

    The purpose of this study was to determine the effects of heat denaturation, centrifugation, storage conditions, storage temperature and duration, delayed freezing, freezing method, and thaw temperature on the measurement of ABeta42 in CSF from Alzheimer's disease patients and healthy individuals.

    Summary of Findings:

    Storage of CSF in polystyrene or glass tubes led to decreases in ABeta42 when compared to levels measured in CSF stored in polypropylene tubes, however the decrease was only significant for polystyrene tubes. Running CSF through a lumbar catheter or a lumbar pressure meter catheter had no effects on measured ABeta42 concentrations. Room temperature storage for up to 24 h, one freeze-thaw cycle, and incubation at room temperature or 4 degrees C for 4, 24, or 72 h prior to freezing had no significant effects on ABeta42 concentrations. Furthermore, thawing temperature, freezing method, type of freezer, frozen storage temperature (-20 or -80 degrees C), and collection temperature (room temperature or on ice), had no significant influences on ABeta42 concentration. The coefficient of variation (CV) for ABeta42 concentration when one CSF sample was measured weekly over the course of 26 months of storage at -80 degrees C was 7.5% and interassay CV was 7.7%. Centrifugation of CSF at room temperature or 4 degrees C decreased ABeta42 concentration compared to uncentrifuged specimens. Heat denaturation caused significant increases in CSF ABeta42 concentrations which were larger for Alzheimer's disease patients (71%) than for healthy individuals (42%).

    Biospecimens
    Preservative Types
    • Frozen
    • Other Preservative
    • None (Fresh)
    Diagnoses:
    • Alzheimer's Disease
    • Normal
    Platform:
    AnalyteTechnology Platform
    Protein ELISA
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Biospecimen Acquisition Pre-preservation condition 100 degrees C heating block for 10 min
    100 degrees C heating block for 15 min
    No heat denaturation
    Storage Type of storage container Glass tubes
    Polypropylene tubes
    Polystyrene tubes
    Run through a lumbar catheter
    Run through a lumbar pressure meter catheter
    Directly transferred to storage tube
    Biospecimen Preservation Type of fixation/preservation Frozen
    None (fresh)
    Refrigeration
    Storage Storage temperature Room temperature
    4 degrees C
    On ice
    -20 degrees C
    -80 degrees C
    Storage Storage duration 0 h
    3 h
    4 h
    24 h
    3 d
    At least 1 week
    26 months
    Biospecimen Preservation Cooling or freezing method/ rate Ethanol dry ice bath
    Direct transfer to freezer
    Storage Storage conditions Stable temperature freezer
    Auto-defrosting freezer
    Storage Thaw temperature/condition 4 degrees C
    Room temperature
    20 degrees C
    Storage Freeze/thaw cycling 0 cycles
    1 cycle
    Biospecimen Aliquots and Components Centrifugation Not centrifuged
    Multiple temperatures compared
  3. Study Purpose

    The purpose of this study was to determine the effects of aliquot sequential collection, time of collection, blood contamination, and blood-brain barrier dysfunction on the measurement of ABeta42 in CSF from Alzheimer's disease patients and healthy individuals. In addition, the influence of overnight fasting on ABeta42 in plasma from healthy individuals was examined.

    Summary of Findings:

    Four sequential collections of CSF from the same individual did not significantly differ in ABeta42 concentration. However, a small but significant decrease in CSF ABeta42 concentration was observed in specimens collected 4-6 hours after baseline values were obtained (-9.3%, p<0.001), but a subsequent tendency of values to return to baseline was observed in specimens collected 24 h after baseline values were obtained (-4.4%, p<0.002). Overnight fasting had no effects on plasma ABeta42 concentrations compared to specimens taken after breakfast was eaten. Deliberate contamination of CSF with blood (200-5000 erythrocytes/uL) had no effects on ABeta42 concentration compared to uncontaminated CSF, but dilution of CSF with serum albumin from added plasma resulted in significantly decreased ABeta42 concentrations compared to undiluted CSF.

    Biospecimens
    Preservative Types
    • Frozen
    Diagnoses:
    • Alzheimer's Disease
    • Normal
    Platform:
    AnalyteTechnology Platform
    Protein ELISA
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Biospecimen Aliquots and Components Biospecimen components CSF plus 200 erythrocytes/uL
    CSF plus 1000 erythrocytes/uL
    CSF plus 5000 erythrocytes/uL
    CSF plus water
    CSF with 0.20 g/L serum albumin
    CSF with 0.25 g/L serum albumin
    CSF with 0.50 g/L serum albumin
    CSF with 1.0 g/L serum albumin
    CSF with 2.0 g/L serum albumin
    Preaquisition Patient diet Nonstandardized breakfast
    Overnight fasting
    Biospecimen Aliquots and Components Aliquot sequential collection 1st collection
    2nd collection
    3rd collection
    4th collection
    Biospecimen Acquisition Time of biospecimen collection Baseline
    4-6 h later
    24 h later
  4. Study Purpose

    The purpose of this study was to determine the effects of time at room temperature on the pH of CSF, as well as to determine the effects of the type, concentration, and pH of dilution buffer, and the addition of detergent on the measurement of ABeta42 in CSF from Alzheimer's patients and normal individuals.

    Summary of Findings:

    The use of PBS, HEPES or Tris buffer rather than the manufacturer provided assay buffer did not affect ABeta42 levels. Further, different concentrations of PBS, and different pH values of Tris buffer had no effects on measured ABeta42 levels in CSF. The authors report that the addition of BSA, Triton100, or Tween20 equally improved the ABeta42 signal. CSF pH increased significantly when specimens were stored at room temperature over the course of 5 hours (from 7.9 to 8.7) compared to starting measurements taken within 30 min of collection.

    Biospecimens
    Preservative Types
    • None (Fresh)
    Diagnoses:
    • Alzheimer's Disease
    • Normal
    Platform:
    AnalyteTechnology Platform
    Small molecule Clinical chemistry/auto analyzer
    Protein ELISA
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Storage Time at room temperature Less than 30 min
    Up to 5 hours
    Biospecimen Preservation Fixative additive/buffer HEPES
    Phosphate buffered saline (PBS)
    Tris buffer
    Multiple concentrations evaluated
    BSA
    Triton100
    Tween20
    Biospecimen Aliquots and Components pH 7.4
    8
    9

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