1,931 results match your criteria Clinics in Laboratory Medicine [Journal]


Preface.

Authors:
Indira Guleria

Clin Lab Med 2019 Mar;39(1):xiii-xiv

Harvard Medical School, HLA Tissue Typing Laboratory, Renal Transplant Program, Division of Renal Medicine, Transplantation Research Center, Brigham and Women's Hospital, 75 Francis Street, PBB 161G, Boston, MA 02115, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cll.2018.12.001DOI Listing
March 2019
1 Read

The Role of Costimulatory Pathways in Transplant Tolerance.

Clin Lab Med 2019 Mar 22;39(1):87-106. Epub 2018 Dec 22.

Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA. Electronic address:

Costimulation is a critical step in T-cell activation, and costimulatory blockade at the time of T cell activation leads to T-cell anergy and allograft tolerance in animal models of transplantation. CD28:B7 is the most important costimulatory pathway and the balance of signals between CD28 and cytotoxic T-lymphocyte associated protein 4 (CTLA-4) is a central determinant of transplant outcome. Form a clinical standpoint, CTLA-4 Ig is the only approved agent for costimulation blockade in transplantation. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.009DOI Listing
March 2019
1 Read

Biomarkers in Solid Organ Transplantation.

Clin Lab Med 2019 Mar 17;39(1):73-85. Epub 2018 Dec 17.

Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA. Electronic address:

After more than 6 decades of clinical practice, the transplant community continues to research noninvasive biomarkers of solid organ injury to help improve patient care. In this review, we discuss the clinical usefulness of selective biomarkers and how they are processed at the laboratory. In addition, we organize these biomarkers based on specific aims and introduce innovative markers currently under investigation. Read More

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http://dx.doi.org/10.1016/j.cll.2018.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469386PMC
March 2019
1 Read

Biomarkers for Early Complications After Hematopoietic Stem Cell Transplantation.

Clin Lab Med 2019 Mar 18;39(1):61-72. Epub 2018 Dec 18.

Department of Pediatrics, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 1044 West Walnut Street, Room R4-425, Indianapolis, IN 46202, USA; Department of Microbiology Immunology, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 1044 West Walnut Street, Room R4-425, Indianapolis, IN 46202, USA.

Advances in the field of omics have led to a significant expansion in biomarkers identified for complications after hematopoietic stem cell transplantation (HSCT). Biomarkers can offer an effective method for early identification of a specific disease and can be used to guide therapies. Ongoing investigations to discover biomarkers for acute graft-versus-host disease as well as other post-HSCT complications may improve early diagnosis, prognosis, and the development of new therapeutic targets. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.005DOI Listing

Donor-Specific HLA Antibodies as Biomarkers of Transplant Rejection.

Authors:
Olga A Timofeeva

Clin Lab Med 2019 Mar 18;39(1):45-60. Epub 2018 Dec 18.

Pathology and Laboratory Medicine, Temple University and Hospital, Lewis Katz School of Medicine, 3401 North Broad Street, Room A2-F388, Philadelphia, PA 19140, USA. Electronic address:

This article reviews the current evidence to classify donor-specific antibodies (DSAs) using Food and Drug Administration-National Institutes of Health Biomarkers, EndpointS, and other Tools (BEST) resource terms as diagnostic, prognostic, predictive, monitoring, and risk biomarkers for graft rejection. The emphasis is on DSA characteristics, including the DSA levels determined by mean fluorescence intensity and/or titers, the ability to activate a complement cascade (C1q, C3d, and C4d binding), and specific IgG subclasses to define distinct roles of DSAs as biomarkers in clinical practice. In addition, technical limitation of DSA testing is discussed. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.007DOI Listing

Complement and Transplantation: From New Mechanisms to Potential Biomarkers and Novel Treatment Strategies.

Clin Lab Med 2019 Mar 20;39(1):31-43. Epub 2018 Dec 20.

Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029, USA; The Precision Institute of Immunology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029, USA. Electronic address:

The complement system, traditionally considered a component of innate immunity, is now recognized as a crucial mediator of the adaptive immune response in solid organ transplantation. Preclinical and early human trials have demonstrated the importance of complement effector mechanisms in driving allograft injury during specific antigraft immune responses, including ischemia-reperfusion injury, T-cell-mediated rejection, and antibody-mediated rejection, as well as a potential role for complement-derived risk stratification biomarkers. These data support the need for further testing of complement inhibitors in solid organ transplant recipients. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361534PMC

Immunologic Effects of the Microbiota in Organ Transplantation.

Clin Lab Med 2019 Mar 18;39(1):185-195. Epub 2018 Dec 18.

Department of Molecular Biology and Biochemistry, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada; Centre for Cell Biology, Development and Disease, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. Electronic address:

The microbiota is a community of microbes that colonizes body surfaces. It has many effects that influence immune activation and regulation. The success of organ transplantation is limited by rejection of grafts by the immune system so it is important to understand how immunologic responses are controlled in this setting. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.010DOI Listing

Signaling Molecules in Posttransplantation Cancer.

Clin Lab Med 2019 Mar 18;39(1):171-183. Epub 2018 Dec 18.

Division of Nephrology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Electronic address:

Immunosuppression is essential to prevent graft rejection. However, immunosuppression impairs the ability of the host immune system to control viral infection and decreases tumor immunosurveillance. Therefore, immunosuppression after organ transplantation is a major risk factor for posttransplantation cancer. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368395PMC
March 2019
1 Read

Novel Targets of Immunosuppression in Transplantation.

Clin Lab Med 2019 Mar 18;39(1):157-169. Epub 2018 Dec 18.

Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02215, USA. Electronic address:

It is increasingly recognized that calcineurin inhibitors (CNI) such as cyclosporine and tacrolimus are not ideal immunosuppressive agents. Side effects, including increased rates of infection, hypertension, and malignancy, can be severe. Thus, in the past decade, there has been much focus on the development of novel therapeutic agents and strategies designed to replace or minimize CNI exposure in transplant patients. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.008DOI Listing
March 2019
1 Read

Regulatory and Effector B Cells: A New Path Toward Biomarkers and Therapeutic Targets to Improve Transplant Outcomes?

Clin Lab Med 2019 Mar 18;39(1):15-29. Epub 2018 Dec 18.

Departments of Surgery, Medicine and Immunology, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, W1545 Biomedical Science Tower, Pittsburgh, PA 15261, USA. Electronic address:

B cells shape the alloimmune response through polarized subsets. These cells inhibit or promote immune responses by expressing suppressive or proinflammatory cytokines. Their summed activity dictates the influence of B cells on the alloimmune response. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.011DOI Listing
March 2019
1 Read

Biomarkers in Fetomaternal Tolerance.

Clin Lab Med 2019 Mar 17;39(1):145-156. Epub 2018 Dec 17.

HLA Tissue Typing Laboratory, Renal Transplant Program, Division of Renal Medicine, Transplantation Research Center, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, PBB 161G, Boston, MA 02115, USA. Electronic address:

Multiple mechanisms of tolerance operate in the immune cross-talk at the fetomaternal interface, contributing to successful pregnancy outcome. The cross-talk includes interaction between various cell subsets and between cytokines and molecules of the endocrine system. A depiction of how all these components interact with each other and contribute to tolerance of the fetus is not clearly understood. Read More

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http://dx.doi.org/10.1016/j.cll.2018.11.002DOI Listing
March 2019
7 Reads

MicroRNAs and Transplantation.

Clin Lab Med 2019 Mar 22;39(1):125-143. Epub 2018 Dec 22.

Division of Nephrology and Hypertension, Department of Medicine, New York-Presbyterian-Weill Cornell Medicine, 525 East 68th Street, Box 3, New York, NY 10065, USA; Division of Nephrology and Hypertension, Department of Transplantation Medicine, New York-Presbyterian-Weill Cornell Medicine, 525 East 68th Street, Box 3, New York, NY 10065, USA. Electronic address:

miRNAs, ∼20 to 22 nucleotide single-stranded RNA species that play a pivotal role in the regulation of protein-coding genes, are emerging as robust biomarkers for assessing allograft status. Herein, the authors briefly review the biogenesis and function of the miRNAs and provide an overview of the tools to quantify miRNAs in tissues and body fluids. They then review their studies of discovery and validation of alterations in miRNA expression within kidney allografts with or without acute rejection, as well as with or without fibrosis, and summarize published data on miRNA expression patterns in kidney transplant recipients. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369703PMC
March 2019
1 Read

Genetic Polymorphism in Cytokines and Costimulatory Molecules in Stem Cell and Solid Organ Transplantation.

Clin Lab Med 2019 Mar 24;39(1):107-123. Epub 2018 Dec 24.

Department of Surgery, BCM Immune Evaluation Laboratory, One Baylor Plaza, MS: BCM504, Houston, TX 77030, USA.

There is growing evidence supporting the genetic variability outside of HLA system that is contributing to the variation in transplant outcomes. Determining novel predictors could help to identify patients at risk and tailor their immunosuppressive regimens. This article discusses the various single nucleotide polymorphisms in costimulatory molecules and cytokines that have been evaluated for their effect on transplantation. Read More

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http://dx.doi.org/10.1016/j.cll.2018.10.002DOI Listing
March 2019
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Regulatory T Cells for More Targeted Immunosuppressive Therapies.

Clin Lab Med 2019 Mar 20;39(1):1-13. Epub 2018 Dec 20.

Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

There has been a prolific amount of research dedicated to the T-regulatory cells (Tregs) and their role in achieving immune homeostasis. Here, the authors briefly discuss the known biology, utilization, and potential of Tregs, for current trials and future immunotherapy. Most current trials of Treg therapies include either ex vivo expanded Tregs transferred into the peripheral blood of patients with diseases of immunologic origin or interleukin 2 injected to stimulate Tregs directly. Read More

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http://dx.doi.org/10.1016/j.cll.2018.11.001DOI Listing
March 2019
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HLA in Transplantation and Beyond.

Clin Lab Med 2018 12;38(4):xi-xii

Histocompatibility & Immunogenetics Laboratory, University of Utah ARUP Laboratories, 500 Chipeta Way, Salt Lake City, UT 84108, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cll.2018.10.001DOI Listing
December 2018
1 Read

Human Leukocyte Antigen and Disease Associations: A Broader Perspective.

Clin Lab Med 2018 12 5;38(4):679-693. Epub 2018 Oct 5.

Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Abramson Research Center, Room 707A, 3615 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address:

HLA molecules play a significant role in immunity and disease susceptibility. GWAS studies underline the critical role of the MHC region in a wide range of diseases and remind us that the HLA genes, included within the MHC, interact extensively with other genomic regions which influence their functions. Recently, MHC/HLA genomic sequences encoding for miRNAs have been reported to interact with targets within and outside the MHC, influencing the expression of many transcripts. Read More

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http://dx.doi.org/10.1016/j.cll.2018.07.001DOI Listing
December 2018
1 Read

Human Leukocyte Antigen Associations in Drug Hypersensitivity Reactions.

Clin Lab Med 2018 12;38(4):669-677

Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, University of Florida, PO Box 103633, Gainesville, FL 32610-3633, USA. Electronic address:

Severe adverse drug reactions are a common cause of morbidity and mortality. Some of the most severe reactions are immunologically mediated and have been linked to specific HLA alleles. The mechanisms underlying HLA-associated drug hypersensitivity are complex and not fully understood. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02722712183118
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http://dx.doi.org/10.1016/j.cll.2018.08.002DOI Listing
December 2018
7 Reads

The Role of Human Leukocyte Antigen in Celiac Disease Diagnostics.

Clin Lab Med 2018 12 5;38(4):655-668. Epub 2018 Oct 5.

Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.

Celiac disease is an autoimmune disease affecting the small intestine, triggered by gluten sensitization in genetically susceptible individuals worldwide. Celiac disease development is strongly linked to the presence of HLA-DQ2 and/or DQ8, which present the immunogenic gluten peptides and trigger the immune response leading to pathogenesis. Because of the variability of clinical symptoms, the disease is often underdiagnosed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02722712183117
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http://dx.doi.org/10.1016/j.cll.2018.07.007DOI Listing
December 2018
11 Reads

Diversity of Killer Cell Immunoglobulin-Like Receptors and Disease.

Authors:
Raja Rajalingam

Clin Lab Med 2018 12;38(4):637-653

Department of Surgery, Immunogenetics and Transplantation Laboratory, University of California San Francisco, 3333 California Street, Suite 150, San Francisco, CA 94118, USA. Electronic address:

Natural killer (NK) cells are bone marrow-derived large granular lymphocytes defined by CD3CD56 and represent 5% to 25% of peripheral blood mononuclear cell fraction of the healthy humans. NK cells have a highly specific and sophisticated target cell recognition receptor system arbitrated by the integration of signals triggered by a multitude of inhibitory and activating receptors. Human NK cells express distinct families of receptors, including (1) killer cell immunoglobulin-like receptors, (2) killer cell lectin-like receptors, (3) leukocyte immunoglobulin-like receptors, and (4) natural cytotoxicity receptors. Read More

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http://dx.doi.org/10.1016/j.cll.2018.08.001DOI Listing
December 2018
22 Reads

Recent Advancements in the Assessment of Renal Transplant Dysfunction with an Emphasis on Microarray Molecular Diagnostics.

Clin Lab Med 2018 12 5;38(4):623-635. Epub 2018 Oct 5.

Division of Nephrology and Transplant Immunology, Department of Medicine, University of Alberta, Alberta Transplant Applied Genomics Center, 250 Heritage Medical Research Centre, Edmonton, Alberta T6G 2S2, Canada; Transcriptome Sciences Inc, Edmonton, Alberta, Canada.

Conventional assessment of renal transplant rejection and injury through use of histology, C4d staining, and HLA antibody testing, has been the standard approach to transplant management. By many measures, these methods of conventional assessment may be considered flawed, particularly with the subjective nature of histologic diagnoses. The Alberta Transplant Applied Genomics Center has developed the Molecular Microscope diagnostic system, which uses microarrays to measure gene expression. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02722712183116
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http://dx.doi.org/10.1016/j.cll.2018.07.005DOI Listing
December 2018
6 Reads

Maintaining the Health of the Renal Allograft: Laboratory and Histologic Monitoring After Kidney Transplantation.

Clin Lab Med 2018 12 5;38(4):607-621. Epub 2018 Oct 5.

Division of Transfusion Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.

Advances in posttransplant care, including new immunosuppressive medications have led to excellent short-term renal allograft survival. However, there is a small therapeutic window within which the patient and the clinician must balance the risk of rejection, with side effects such as infection, malignancy, and toxicity. Laboratory testing plays a key role in this ongoing monitoring, which includes relatively simple tests, such as serum creatinine, to complex tests, such as solid-phase assays, used to monitor for donor-specific antibody and surveillance allograft biopsies. Read More

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http://dx.doi.org/10.1016/j.cll.2018.07.003DOI Listing
December 2018
3 Reads

Human Leukocyte Antigen Epitope Matching in Solid Organ Transplantation.

Clin Lab Med 2018 12 5;38(4):595-605. Epub 2018 Oct 5.

Department of Surgery, Immune Evaluation Laboratory, Baylor College of Medicine, One Baylor Plaza, MS:BCM 504, Houston, TX 77030, USA.

HLA epitope matching provides a better approach to stratify patients at risk of developing antibody-mediated rejection compared with counting HLA mismatches. However, several immunologic parameters are not incorporated into these algorithms used to assess HLA epitopes, raising questions about the predictive value of these programs. Therefore, it is imperative to obtain more 3D structural data of antibody-antigen binding to "train" these computer algorithms. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02722712183116
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http://dx.doi.org/10.1016/j.cll.2018.07.004DOI Listing
December 2018
16 Reads

Technical Aspects of Crossmatching in Transplantation.

Clin Lab Med 2018 12 5;38(4):579-593. Epub 2018 Oct 5.

Histocompatibility Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.

The presence of antibodies directed against HLA molecules expressed on the donor's cells is one the most important risk factor for serious clinical complications after transplantation. The lymphocyte crossmatch is one of the most important tests available to the laboratory as this assay detects the presence of donor-specific anti-HLA antibodies in potential allograft recipients. Early crossmatch methods used a complement-dependent cytotoxicity test, which was useful for detecting anti-HLA antibodies responsible for hyperacute graft rejection but lacked adequate sensitivity and specificity. Read More

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http://dx.doi.org/10.1016/j.cll.2018.07.002DOI Listing
December 2018
2 Reads

Human Leukocyte Antigen Typing by Next-Generation Sequencing.

Clin Lab Med 2018 12 5;38(4):565-578. Epub 2018 Oct 5.

ARUP Institute for Clinical and Experimental Pathology, Department of Pathology, University of Utah School of Medicine, 500 Chipeta Way, Salt Lake City, UT 84108, USA.

Human leukocyte antigen (HLA) allele ambiguities are the result of limitations of current HLA typing methodologies. Ambiguities maybe due to polymorphisms in unsequenced regions of HLA genes or cis/trans variants that cannot be distinguished by Sanger sequencing. Next generation sequencing (NGS) can resolve these two sources of ambiguity because the entire gene can be sequenced. Read More

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http://dx.doi.org/10.1016/j.cll.2018.07.006DOI Listing
December 2018
1 Read

It's Mass Spectrometry's Turn to Change Clinical Practice.

Authors:
Geza S Bodor

Clin Lab Med 2018 09 20;38(3):ix-xi. Epub 2018 Jul 20.

Department of Pathology, University of Colorado Anschutz Medical Campus, Leprino Building, Room 229, Mail Stop A022, 12401 East 17th Avenue, Aurora, CO 80045, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cll.2018.06.001DOI Listing
September 2018
2 Reads

Development of a 25-Hydroxyvitamin D Liquid Chromatography-Tandem Mass Spectrometry Assay, Cleared by the Food and Drug Administration, via the De Novo Pathway.

Authors:
Nicole V Tolan

Clin Lab Med 2018 09;38(3):553-564

Department of Anatomic and Clinical Pathology, Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USA; SCIEX Diagnostics, 500 Old Connecticut Path, Framingham, MA 01701, USA. Electronic address:

Despite great improvement in vitamin D assay standardization, inaccurate recoveries of 25(OH)D remain for immunoassays and many laboratory-developed LC-MS/MS methods don't separate out the 3-epimer interferents. Through the process of obtaining FDA-clearance, we learned that communication is key. Mass spectrometry-based assays raise different questions of safety and efficacy than the predicate immunoassays, with fewer risks due to increased accuracy. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.006DOI Listing
September 2018
2 Reads

Special Considerations for Liquid Chromatography-Tandem Mass Spectrometry Method Development.

Authors:
Brian A Rappold

Clin Lab Med 2018 09 20;38(3):539-551. Epub 2018 Jul 20.

Mass Spectrometry Laboratory Corporation of America, 1904 TW Alexander Drive, Durham, NC 27703, USA. Electronic address:

Method development for diagnostic liquid-chromatography-tandem mass spectrometry (LC-MS/MS) assays are not broadly discussed in publications. Certain aspects of the development process are thus learned via experience. This article touches on a number of aspects that should be contemplated during method development for LC-MS/MS tests beyond sample preparation, chromatographic separation, and mass spectrometric detection. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.003DOI Listing
September 2018
1 Read

Liquid Chromatography-Mass Spectrometry Education for Clinical Laboratory Scientists.

Clin Lab Med 2018 09 20;38(3):527-537. Epub 2018 Jul 20.

Department of Pathology, University of California, San Diego, CA, USA.

This article describes the need for, stratifies the complexity of, and proposes detailed lists of training competencies for diagnostic laboratory personnel using quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) for patient care. Although quantitative LC-MS/MS is evolving toward greater automation with less need for technical expertise, gaps remain in resources for training and assessment. Read More

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http://dx.doi.org/10.1016/j.cll.2018.04.002DOI Listing
September 2018
1 Read

Accreditation and Quality Assurance for Clinical Liquid Chromatography-Mass Spectrometry Laboratories.

Authors:
Kara L Lynch

Clin Lab Med 2018 09 20;38(3):515-526. Epub 2018 Jul 20.

Department of Laboratory Medicine, Clinical Laboratory, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue. Building. 5 2M, San Francisco, CA 94110, USA. Electronic address:

For mass spectrometry (MS) testing in the clinical laboratory, postimplementation monitoring for quality is just as important as method development and validation but often receives less attention. Quality-assurance monitoring for liquid chromatography-tandem MS (LC-MS/MS) testing should be proactive rather than reactive and should monitor the entire testing process. An LC-MS/MS quality-assurance plan should cover overall batch review parameters, individual peak review parameters, system and reagent changes, and assessment of long-term accuracy. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.002DOI Listing
September 2018
3 Reads

Harmonization of Liquid Chromatography-Tandem Mass Spectrometry Protein Assays.

Clin Lab Med 2018 09;38(3):499-513

Research and Development, Cleveland HeartLab, 6701 Carnegie Avenue, Suite 500, Cleveland, OH 44103, USA.

Harmonization of diagnostic test results is fundamental to the effective use of laboratory testing in the diagnosis, treatment, and monitoring of disease. Formal approaches to harmonization and standardization provide a rigorous and high-quality roadmap to this end, although the formal harmonization process can be long and complex. In the meantime, more informal approaches to harmonization can provide a useful pathway to improved harmonization in the short term. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.004DOI Listing
September 2018
1 Read

Proteoform Analysis to Fulfill Unmet Clinical Needs and Reach Global Standardization of Protein Measurands in Clinical Chemistry Proteomics.

Clin Lab Med 2018 09 20;38(3):487-497. Epub 2018 Jul 20.

Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center (LUMC), PO Box 9600, Leiden 2300 RC, The Netherlands.

In clinical testing of protein markers, structure variants of the measurand are often not taken into account. This heterogeneous character of protein measurands in immunoassays often renders test standardization impossible. Consequently, test results from different methods can lead to underdiagnosis or overdiagnosis and, thus, undertreatment or overtreatment of patients. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.001DOI Listing
September 2018
2 Reads

Matrix-Assisted Laser Desorption Time of Flight Mass Spectrometry.

Clin Lab Med 2018 09;38(3):471-486

Department of Veterinary Science and Microbiology, University of Arizona, Tucson, AZ 85721, USA.

Matrix-assisted laser desorption time of flight mass spectrometry (MALDI-TOF MS), adapted for use in clinical microbiology laboratories, challenges current standards of microbial detection and identification. This article summarizes the capabilities of MALDI-TOF MS in diagnostic clinical microbiology laboratories and describes the underpinnings of the technology, highlighting topics such as sample preparation, spectral analysis, and accuracy. The use of MALDI-TOF MS in the clinical microbiology laboratory is growing, and, when properly deployed, can accelerate diagnosis and improve patient care. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.008DOI Listing
September 2018
30 Reads

Pain Management Testing by Liquid Chromatography Tandem Mass Spectrometry.

Authors:
Geza S Bodor

Clin Lab Med 2018 09 20;38(3):455-470. Epub 2018 Jul 20.

Department of Pathology, University of Colorado Anschutz Medical Campus, University of Colorado, Leprino Building, Room 229, Mail Stop A022, 12401 East 17th Avenue, Aurora, CO 80045, USA. Electronic address:

For appropriate pain medication monitoring, the analytical method must be sensitive enough to detect the prescribed medication and metabolites at a sufficiently low concentration to recognize compliance, even with a low-dose prescription. The method must also provide excellent selectivity to identify simultaneously present drugs even with similar chemical structures. The analytical method should uncover common illicit drugs/nonprescribed medications. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.005DOI Listing
September 2018
11 Reads

25-Hydroxyvitamin D Testing: Immunoassays Versus Tandem Mass Spectrometry.

Authors:
Uttam Garg

Clin Lab Med 2018 09 20;38(3):439-453. Epub 2018 Jul 20.

Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, University of Missouri School of Medicine, 2401 Gillham Road, Kansas City, MO 64108, USA. Electronic address:

Vitamin D has been associated with many health conditions. Because of widespread deficiency in the general population, laboratory testing of vitamin D has increased exponentially in recent years. Currently, 25-hydroxyvitamin D (25[OH]D) is considered the best marker of vitamin D status. Read More

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http://dx.doi.org/10.1016/j.cll.2018.05.007DOI Listing
September 2018
6 Reads

Looking Good in Your Genes: Maximizing One's Personalized Molecular Fingerprint for Optimal Health.

Authors:
Martin H Bluth

Clin Lab Med 2018 06;38(2):xiii-xvi

Bluth Bio Industries, Southfield, MI 48034, USA; Wayne State University School of Medicine, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, Warren, MI 48091, USA; Kids Kicking Cancer, Southfield, MI 48034, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cll.2018.04.001DOI Listing
June 2018
2 Reads

Gynecologic Cancers: Molecular Updates 2018.

Clin Lab Med 2018 06;38(2):421-438

Department of Pathology, Detroit Medical Center Harper University Hospital, Wayne State University, 3990 John R Detroit, MI 48201, USA.

Ovarian carcinoma continues to be a concern for woman and maintains significant morbidity and mortality. Emerging molecular markers are providing additional opportunities for effective diagnosis and prognosis of disease. An integrated clinicopathologic and molecular classification of gynecologic malignancies has the potential to refine the clinical risk prediction of patients with cancer and to provide more tailored treatment recommendations. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.007DOI Listing
June 2018
3 Reads

Breast Carcinoma: Updates in Molecular Profiling 2018.

Clin Lab Med 2018 06;38(2):401-420

Department of Pathology, Detroit Medical Center, Harper University Hospital 3990 John R, Detroit, MI 48201, USA.

The most significant contribution of molecular subtyping of breast carcinomas has been the identification of estrogen-positive and estrogen-negative tumor subtypes. Knowledge of genetic alterations in these tumors will help clinicians identify novel therapeutic targets. Understanding the progression pathways involved in the transition of in situ carcinoma to invasive carcinoma might lead to efficient risk stratification in these patients. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.006DOI Listing
June 2018
3 Reads

An Update Regarding the Molecular Genetics of Melanocytic Neoplasms and the Current Applications of Molecular Genetic Technologies in Their Diagnosis and Treatment.

Clin Lab Med 2018 06;38(2):385-399

Department of Pathology, Wayne State University, 4160 John R Street, Detroit, MI 48201, USA; Department of Pathology and Laboratory Medicine, Detroit Medical Center University Laboratories, 4160 John R Street, Detroit, MI 48201, USA. Electronic address:

Molecular genetic technologies are used to aid in diagnosis and treatment of borderline melanocytic tumors as an adjuvant to the gold standard histopathologic evaluation. A specific set of fluorescence in situ hybridization probes is widely used to aid in diagnosing challenging melanocytic lesions. New melanoma probe cocktails have revealed increased sensitivity and specificity in ambiguous melanocytic cases. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.002DOI Listing
June 2018
2 Reads

Molecular Diagnostics in the Neoplasms of the Pancreas, Liver, Gallbladder, and Extrahepatic Biliary Tract: 2018 Update.

Clin Lab Med 2018 06;38(2):367-384

Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-SUNY, Buffalo General Hospital A-701, 100 High Street, Buffalo, NY 14203, USA. Electronic address:

Pancreatic neoplasms, including ductal adenocarcinoma, solid pseudopapillary neoplasm, pancreatic endocrine neoplasms, acinar cell carcinoma, and pancreatoblastoma, are associated with different genetic abnormalities. Hepatic adenomas with beta-catenin exon 3 mutation are associated with a high risk of malignancy. Hepatic adenoma with arginosuccinate synthetase 1 expression or sonic hedgehog mutations are associated with a risk of bleeding. Read More

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http://dx.doi.org/10.1016/j.cll.2018.03.003DOI Listing
June 2018
12 Reads

Molecular Diagnostics in Esophageal and Gastric Neoplasms: 2018 Update.

Clin Lab Med 2018 06;38(2):357-365

Department of Pathology and Anatomical Sciences, Jacobs School of Buffalo, 955 Main Street, Buffalo, NY 14203, USA.

Esophageal cancer (EC) is rapidly increasing in incidence in the United States. Genetic changes associated with the development of EC involve the p16, p53, and APC genes. Human epidermal growth factor 2 (HER-2) overexpression is seen in gastroesophageal junction carcinoma and a subset gastric carcinoma (GC). Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.009DOI Listing
June 2018
4 Reads

Molecular Diagnostics in the Neoplasms of Small Intestine and Appendix: 2018 Update.

Clin Lab Med 2018 06;38(2):343-355

Department of Pathology, Harper University Hospital, Detroit Medical Center, 3990 John R Street, Detroit, MI 48201, USA.

Neoplasms of the small intestine are rare in comparison with colorectal tumors. The most common tumor types arising in the small intestine are adenocarcinomas, well-differentiated neuroendocrine tumors, gastrointestinal stromal tumors, and lymphoma. Primary appendiceal neoplasms are rare and found in less than 2% of appendectomy specimens with an incidence of approximately 1. Read More

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http://dx.doi.org/10.1016/j.cll.2018.03.002DOI Listing
June 2018
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Molecular Diagnostics in Colorectal Carcinoma: Advances and Applications for 2018.

Clin Lab Med 2018 06;38(2):311-342

Department of Pathology, Wayne State University School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, 21230 Dequindre Road, Warren, MI 48091, USA.

The molecular pathogenesis and classification of colorectal carcinoma are based on the traditional adenomaecarcinoma sequence, serrated polyp pathway, and microsatellite instability (MSI). The genetic basis for hereditary nonpolyposis colorectal cancer is the detection of mutations in the MLH1, MSH2, MSH6, PMS2, and EPCAM genes. Genetic testing for Lynch syndrome includes MSI testing, methylator phenotype testing, BRAF mutation testing, and molecular testing for germline mutations in MMR genes. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.008DOI Listing
June 2018
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Molecular Diagnosis of Hematopoietic Neoplasms: 2018 Update.

Clin Lab Med 2018 06;38(2):293-310

Wayne State University, School of Medicine, Department of Pathology, Karmanos Cancer Center, Detroit Medical Center, 3990 John R, Detroit, MI 48201, USA. Electronic address:

Diagnosis of hematologic malignancies have matured to encompass molecular as well as phenotypic characteristics. Cytogenetic abnormalities are considered common events in this regard. These abnormalities generally consist of structural chromosomal abnormalities or gene mutations, which often are integral to the pathogenesis and subsequent evolution of an individual malignancy. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.005DOI Listing
June 2018
4 Reads

Molecular Pathology in Transfusion Medicine: New Concepts and Applications.

Clin Lab Med 2018 06;38(2):277-292

Department of Pathology, Wayne State University, School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, 21230 Dequindre Road, Warren, MI 48091, USA.

Virtually all the red blood cell and platelet antigen systems have been characterized at the molecular level. Highly reliable methods for red blood cell and platelet antigen genotyping are now available. Genotyping is a useful adjunct to traditional serology and can help resolve complex serologic problems. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.001DOI Listing
June 2018
2 Reads

Diagnostic Molecular Microbiology: A 2018 Snapshot.

Clin Lab Med 2018 06;38(2):253-276

Department of Pathology, Wayne State University School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Clinical Microbiology Laboratories, DMC University Laboratories, 4201 St. Antoine Street, Detroit, MI 48201, USA.

Molecular biological techniques have evolved expeditiously and in turn have been applied to the detection of infectious disease. Maturation of these technologies and their coupling with related technological advancement in fluorescence, electronics, digitization, nanodynamics, and sensors among others have afforded clinical medicine additional tools toward expedient identification of infectious organisms at concentrations and sensitivities previously unattainable. These advancements have been adapted in select settings toward addressing clinical demands for more timely and effective patient management. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.004DOI Listing
June 2018
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Clinical Implication of MicroRNAs in Molecular Pathology: An Update for 2018.

Clin Lab Med 2018 06;38(2):237-251

Department of Pathology, Wayne State University, School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, 21230 Dequindre Road, Warren, MI 48091, USA.

MicroRNAs (miRNAs) are poised to provide diagnostic, prognostic, and therapeutic targets for several diseases including malignancies for precision medicine applications. The miRNAs have immense potential in the clinical arena because they can be detected in the blood, serum, tissues (fresh and formalin-fixed paraffin-embedded), and fine-needle aspirate specimens. The most attractive feature of miRNA-based therapy is that a single miRNA could be useful for targeting multiple genes that are deregulated in cancers, which can be further investigated through systems biology and network analysis that may provide cancer-specific personalized therapy. Read More

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http://dx.doi.org/10.1016/j.cll.2018.02.003DOI Listing
June 2018
3 Reads

Molecular Pathology Techniques: Advances in 2018.

Clin Lab Med 2018 06;38(2):215-236

Department of Pathology, Wayne State University, School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, 21230 Dequindre Road, Warren, MI 48091, USA.

Molecular pathology techniques continue to evolve. Although polymerase chain reaction (PCR) remains the cornerstone methodology for nucleic acid amplification, improvements in nucleic acid detection methodologies (i.e. Read More

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http://dx.doi.org/10.1016/j.cll.2018.03.004DOI Listing
June 2018
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Introduction: Molecular Medicine in the Common Era: Applications and Impact of Molecular Pathology in Health and Disease.

Authors:
Martin H Bluth

Clin Lab Med 2018 06;38(2):209-213

Department of Pathology, Wayne State University School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA; Pathology Laboratories, Michigan Surgical Hospital, 21230 Dequindre Road, Warren, MI 48091, USA. Electronic address:

The unprecedented expansion of molecular pathology continues to affect and influence the clinical laboratory. Technological advances in high-throughput automation, cost containment, and refined methodology have improved the understanding of pathobiology through application of molecular pathology to multiple disease spaces. Incorporation of this field to emerging omics platforms, pharmacovigilance and biomarker discovery, and accessibility by lay consumers demonstrates the widespread reach of molecular pathology in the clinical marketplace. Read More

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http://dx.doi.org/10.1016/j.cll.2018.03.001DOI Listing
June 2018
2 Reads

Pathology: Central and Essential.

Authors:
Danny A Milner

Clin Lab Med 2018 03 12;38(1):xv-xvi. Epub 2017 Dec 12.

American Society for Clinical Pathology, Harvard T. H. Chan School of Public Health, 33 West Monroe Street, Suite 1600, Chicago, IL 60603, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cll.2017.11.001DOI Listing
March 2018
3 Reads

Lymphoma and Pathology in Sub-Saharan Africa: Current Approaches and Future Directions.

Clin Lab Med 2018 03 13;38(1):91-100. Epub 2017 Dec 13.

Department of Pathology and Laboratory Medicine, The University of North Carolina School of Medicine, CB 7525, Chapel Hill, NC 27599-7525, USA; Lineberger Comprehensive Cancer Center, CB 7295, Chapel Hill, NC 27599-7295, USA. Electronic address:

The care of patients with lymphoma relies heavily on accurate tissue diagnosis and classification. In sub-Saharan Africa, where lymphoma burden is increasing because of population growth, aging, and continued epidemic levels of human immunodeficiency virus infection, diagnostic pathology services are limited. This article summarizes lymphoma epidemiology, current diagnostic capacity, and obstacles and opportunities for improving practice in the region. Read More

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http://dx.doi.org/10.1016/j.cll.2017.10.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999328PMC
March 2018
5 Reads