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Licensed Unlicensed Requires Authentication Published by De Gruyter April 22, 2020

Biotin interference: evaluation of a new generation of electrochemiluminescent immunoassays for high-sensitive troponin T and thyroid-stimulating hormone testing

  • Samy Mzougui , Julien Favresse ORCID logo , Reza Soleimani ORCID logo , Catherine Fillée and Damien Gruson EMAIL logo

Abstract

Background

Biotin is currently a matter of concern for laboratories using biotin-streptavidin-based immunoassays. Biotin interferences have been reported for high-sensitive troponin T (hsTnT) and thyroid-stimulating hormone (TSH) assays. We aimed to evaluate the new generation of hsTnT and TSH electrochemiluminescent immunoassays announced to be less sensitive to biotin.

Methods

Firstly, we assessed the analytical performances of new generation assays (imprecision, bias, total error, limit of quantification) and compared previous and new generation assays in the absence of biotin. Secondly, we challenged both generations of assays with samples spiked with seven different biotin levels. The efficiency of new generation assays was also compared to the streptavidin beads treatment.

Results

New generation assays presented suitable analytical performances. Previous and new generations of hsTnT and TSH assays were commutable in the absence of biotin. In the presence of biotin, we confirmed that previous generation assays were affected by biotin concentration as low as 40.5 ng/mL and that new generation assays were not affected up to the announced tolerance threshold of 1200 ng/mL. After the streptavidin beads treatment, we observed a higher imprecision for both parameters and a constant 10% negative bias for TSH compared to new generation assays.

Conclusions

New generation of electrochemiluminescent immunoassays appears as a reliable systematic solution to prevent biotin interference for hsTnT and TSH testing.


Corresponding author: Prof. Damien Gruson, Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium; and Pôle de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Tour Claude Bernard, 54 Avenue Hippocrate, 1200 Brussels, Belgium, Phone: +32-(0)2-7646747, Fax: +32-(0)2-7646930

Acknowledgments

The authors would like to thank the laboratory technicians of the Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, without whom this work would not have been possible.

  1. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: Authors state no conflict of interest.

  6. Informed consent: Informed consent was obtained from all individuals included in this study.

  7. Ethical approval: The research related to human use complied with all the relevant national regulations, institutional policies and in accordance with the tenets of the Helsinki Declaration.

References

1. European Medicines Agency. Pharmacovigilance Risk Assessment Committee Recommendations on Signals 2019. https://www.ema.europa.eu/en/documents/prac-recommendation/prac-recommendations-signals-adopted-14-17-january-2019-prac-meeting_en.pdf.Search in Google Scholar

2. Food and Drug Administration. Biotin Interference with Troponin Lab Tests – Assays Subject to Biotin Interference 2019. https://www.fda.gov/medical-devices/vitro-diagnostics/biotin-interference-troponin-lab-tests-assays-subject-biotin-interference.Search in Google Scholar

3. Food and Drug Administration. Testing for Biotin Interference in In Vitro Diagnostic Devices, Draft Guidance for Industry 2019. https://www.fda.gov/media/127915/download.Search in Google Scholar

4. Food and Drug Administration. Update: The FDA Warns that Biotin May Interfere with Lab Tests: FDA Safety Communication 2019. https://www.fda.gov/medical-devices/safety-communications/update-fda-warns-biotin-may-interfere-lab-tests-fda-safety-communication.Search in Google Scholar

5. Bayart J-L, Favresse J, Stoefs A, Closset M, Roy T, Fillée C, et al. Biotin interferences: have we neglected the impact on serological markers? Clin Chim Acta 2020;503:107–12.10.1016/j.cca.2020.01.012Search in Google Scholar

6. McMahon RJ. Biotin in metabolism and molecular biology. Annu Rev Nutr 2002;22:221–39.10.1146/annurev.nutr.22.121101.112819Search in Google Scholar

7. Zempleni J, Mock DM. Biotin biochemistry and human requirements. J Nutr Biochem 1999;10:128–38.10.1016/S0955-2863(98)00095-3Search in Google Scholar

8. Samarasinghe S, Meah F, Singh V, Basit A, Emanuele N, Emanuele MA, et al. Biotin interference with routine clinicalimmunoassays: understand the causes and mitigate the risks. Endocr Pract 2017;23:989–98.10.4158/EP171761.RASearch in Google Scholar PubMed

9. Katzman BM, Lueke AJ, Donato LJ, Jaffe AS, Baumann NA. Prevalence of biotin supplement usage in outpatients and plasma biotin concentrations in patients presenting to the emergency department. Clin Biochem 2018;60:11–6.10.1016/j.clinbiochem.2018.07.004Search in Google Scholar PubMed

10. Wolf B. High doses of biotin can interfere with immunoassays that use biotin-strept (avidin) technologies: implications for individuals with biotin-responsive inherited metabolic disorders. Mol Genet Metab 2019;127:321.10.1016/j.ymgme.2019.07.003Search in Google Scholar PubMed

11. Sedel F, Papeix C, Bellanger A, Touitou V, Lebrun-Frenay C, Galanaud D, et al. High doses of biotin in chronic progressive multiple sclerosis: a pilot study. Mult Scler Relat Disord 2015;4:159–69.10.1016/j.msard.2015.01.005Search in Google Scholar PubMed

12. Tourbah A, Lebrun-Frenay C, Edan G, Clanet M, Papeix C, Vukusic S, et al. MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: a randomised, double-blind, placebo-controlled study. Mult Scler 2016;22:1719–31.10.1177/1352458516667568Search in Google Scholar PubMed PubMed Central

13. Dundas CM, Demonte D, Park S. Streptavidin-biotin technology: improvements and innovations in chemical and biological applications. Appl Microbiol Biotechnol 2013;97:9343–53.10.1007/s00253-013-5232-zSearch in Google Scholar PubMed

14. Trambas C, Lu Z, Yen T, Sikaris K. Characterization of the scope and magnitude of biotin interference in susceptible Roche Elecsys competitive and sandwich immunoassays. Ann Clin Biochem 2018;55:205–15.10.1177/0004563217701777Search in Google Scholar PubMed

15. Avery G. Biotin interference in immunoassay: a review for the laboratory scientist. Ann Clin Biochem 2019;56:424–30.10.1177/0004563219842231Search in Google Scholar PubMed

16. Piketty ML, Polak M, Flechtner I, Gonzales-Briceno L, Souberbielle JC. False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences. Clin Chem Lab Med 2017;55:780–8.10.1515/cclm-2016-0606Search in Google Scholar PubMed

17. Favresse J, Burlacu MC, Maiter D, Gruson D. Interferences with thyroid function immunoassays: clinical implications and detection algorithm. Endocr Rev 2018;39:830–50.10.1210/er.2018-00119Search in Google Scholar PubMed

18. Holmes EW, Samarasinghe S, Emanuele MA, Meah F. Biotin interference in clinical immunoassays: a cause for concern. Arch Pathol Lab Med 2017;141:1459–60.10.5858/arpa.2017-0107-LESearch in Google Scholar PubMed

19. Piketty ML, Prie D, Sedel F, Bernard D, Hercend C, Chanson P, et al. High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. Clin Chem Lab Med 2017;55:817–25.10.1515/cclm-2016-1183Search in Google Scholar PubMed

20. Roche Diagnostics. Elecsys Troponin T hs STAT (Previous Generation Assay) – Method Sheet. 2019.Search in Google Scholar

21. Roche Diagnostics. Elecsys Troponin T hs STAT (New Generation Assay) – Method Sheet. 2019.Search in Google Scholar

22. Roche Diagnostics. Elecsys TSH (Previous Generation Assay) – Method Sheet. 2019.Search in Google Scholar

23. Roche Diagnostics. Elecsys TSH (New Generation Assay) – Method Sheet. 2019.Search in Google Scholar

24. Clinical, Institute LS. User verification of precision and estimation of bias; approved guideline. Wayne, PA: CLSI, 2014.Search in Google Scholar

25. European Federation of Clinical Chemistry and Laboratory Medicine. EFLM Biological Variation Database 2020. https://biologicalvariation.eu/.Search in Google Scholar

26. Westgard. Desirable Biological Variation Database specifications 2019. https://www.westgard.com/biodatabase1.htm.Search in Google Scholar

27. International Federation of Clinical Chemistry and Laboratory Medicine. Cardiac Troponin Assay Interference Table Designated by Manufacturer: Hemolysis and Biotin 2019. https://www.ifcc.org/media/477402/ifcc-cardiac-troponin-interference-table-v072618.pdf.Search in Google Scholar

28. Grimsey P, Frey N, Bendig G, Zitzler J, Lorenz O, Kasapic D, et al. Population pharmacokinetics of exogenous biotin and the relationship between biotin serum levels and in vitro immunoassay interference. Int J Pharmacokinet 2017;2:247–56.10.4155/ipk-2017-0013Search in Google Scholar

29. Peyro Saint Paul L, Debruyne D, Bernard D, Mock DM, Defer GL. Pharmacokinetics and pharmacodynamics of MD1003 (high-dose biotin) in the treatment of progressive multiple sclerosis. Expert Opin Drug Metab Toxicol 2016;12: 327–44.10.1517/17425255.2016.1136288Search in Google Scholar PubMed

30. Favresse J, Bayart J-L, Stoefs A, Gheldof D, Douxfils J, Dogné J-M, et al. Neutralization of biotin interference: preliminary evaluation of the VeraTest Biotin™, VeraPrep Biotin™ and BioT-Filter®. Clin Chem Lab Med 2020;58:e130–3.10.1515/cclm-2019-1121Search in Google Scholar PubMed

31. Bevins NJ, Hubbard JA, Fitzgerald RL, Kelner MJ. A dilution method to mitigate biotin interference in cardiac troponin T testing. J Appl Lab Med 2019;4:415–21.10.1373/jalm.2018.028589Search in Google Scholar PubMed

32. Gifford JL, de Koning L, Sadrzadeh SM. Strategies for mitigating risk posed by biotin interference on clinical immunoassays. Clin Biochem 2019;65:61–3.10.1016/j.clinbiochem.2018.12.007Search in Google Scholar PubMed

33. Ranaivosoa MK, Ganel S, Agin A, Romain S, Parent X, Reix N. Chronic kidney failure and biotin: a combination inducing unusual results in thyroid and parathyroid investigations, report of 2 cases. Nephrol Ther 2017;13:553–8.10.1016/j.nephro.2017.02.016Search in Google Scholar PubMed

34. Vroemen WH, van Doorn W, Kimenai DM, Wodzig W, de Boer D, Bekers O, et al. Biotin interference in high-sensitivity cardiac troponin T testing: a real-world evaluation in acute cardiac care. Cardiovasc Res 2019;115:1950–1.10.1093/cvr/cvz277Search in Google Scholar PubMed

35. Zerback R, Imdahl R, Albert G, Kunzelmann S, Rank C, Von Meyer A. Performance evaluation of a new troponin T-high sensitive assay with increased tolerance to biotin. Clin Chim Acta 2019;493:S197.10.1016/j.cca.2019.03.409Search in Google Scholar

36. Trambas C, Lu Z, Yen T, Sikaris K. Depletion of biotin using streptavidin-coated microparticles: a validated solution to the problem of biotin interference in streptavidin–biotin immunoassays. Ann Clin Biochem 2018;55:216–26.10.1177/0004563217707783Search in Google Scholar PubMed

37. Rulander NJ, Cardamone D, Senior M, Snyder PJ, Master SR. Interference from anti-streptavidin antibody. Arch Pathol Lab Med 2013;137:1141–6.10.5858/arpa.2012-0270-CRSearch in Google Scholar PubMed

38. Ruth I, Mathieu E, Burniat A, Fage D, Cotton F, Wolff F. Interferences in free thyroxine concentration using the Roche analytical platform: improvement of the third generation? Clin Chem Lab Med 2020;58:e36–9.10.1515/cclm-2019-0525Search in Google Scholar PubMed

Received: 2020-02-27
Accepted: 2020-03-20
Published Online: 2020-04-22
Published in Print: 2020-11-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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