{"title":"Application and insights on patient-based real-time quality control: detecting undetected errors in internal quality control through daily antibody positivity rate analysis.","authors":"Chaochao Ma, Qi Zhang, Yingying Hu, Wenyi Ding, Liangyu Xia, Ling Qiu","doi":"10.11613/BM.2025.020801","DOIUrl":"10.11613/BM.2025.020801","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional internal quality control (IQC) has limitations in detecting systematic errors in clinical laboratories. Patient-Based Real-Time Quality Control (PBRTQC) has emerged as a complementary method, offering new approaches for quality monitoring. Among these, monitoring daily positivity rates provides meaningful insights into laboratory performance.</p><p><strong>Materials and methods: </strong>This study highlights a case in which PBRTQC was implemented to detect and address a reagent batch issue in thyroid peroxidase antibody (TPO-Ab) testing. Over one year (July 2023 to July 2024), daily positivity rates and their fluctuations were retrospectively analyzed and daily positivity rate alarm limits were established for monitoring.</p><p><strong>Results: </strong>A notable increase in the TPO-Ab positivity rate was identified starting in June 2024. For outpatients and inpatients, the positivity rates in June and July 2024 were 46.1% ± 7.8% (N = 9039) and 61.4% ± 12.0% (N = 8735), respectively. For the physical examination population, the positivity rates during the same months were 30.0% ± 11.7% (N = 4754) and 52.5% ± 18.1% (N = 5726), respectively. These rates were significantly higher than the pre-June 2024 average monthly positivity rates of 30.0% ± 2.9% (N = 9070 <i>per</i> month) for patients and 11.0% ± 2.4% (N = 4663 <i>per</i> month) for the physical examination population.</p><p><strong>Conclusions: </strong>PBRTQC, particularly monitoring daily positivity rates, is a valuable tool for early detection of systematic errors. Establishing PBRTQC systems can supplement traditional IQC to improve laboratory test quality.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020801"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15Epub Date: 2025-04-15DOI: 10.11613/BM.2025.020704
Şerif Ercan, Ali Manav
{"title":"Impact of fasting duration on LDL cholesterol concentrations estimated by the Friedewald, Martin-Hopkins, and Sampson/NIH equations.","authors":"Şerif Ercan, Ali Manav","doi":"10.11613/BM.2025.020704","DOIUrl":"10.11613/BM.2025.020704","url":null,"abstract":"<p><strong>Introduction: </strong>A paradigm shift is occurring in lipid testing, as fasting is no longer required. We aimed to determine whether low-density lipoprotein cholesterol (LDL-C) concentrations calculated using three different equations, along with the components used in these calculations, vary with different fasting durations in routine clinical practice.</p><p><strong>Materials and methods: </strong>The concentrations of LDL-C were calculated using the Friedewald, Martin-Hopkins, and Sampson/NIH equations, along with the lipid components involved in these equations, depending on time since the last meal in a cohort of 77,300 outpatients at a community hospital. The study population was divided into groups according to fasting durations by 2-hour intervals. A general linear model was applied to identify differences between fasting and nonfasting groups.</p><p><strong>Results: </strong>Regardless of the calculation method, LDL-C concentrations varied with fasting duration for up to 8-10 hours. The greatest absolute mean differences in LDL-C concentrations between fasting and nonfasting states were - 0.32, - 0.30, and - 0.26 mmol/L when using the Friedewald, Sampson/NIH, and Martin-Hopkins equations, respectively. Among the equation components, triglyceride concentrations were the most sensitive to fasting duration, remaining elevated for 4-6 hours after the last meal, while total cholesterol and non-high-density lipoprotein cholesterol (HDL-C) concentrations decreased for up to 8-10 hours postprandially. However, HDL-C concentrations remained relatively stable.</p><p><strong>Conclusions: </strong>The variation in postprandial LDL-C concentrations was observed not to differ between the three calculation methods and reached negligible concentrations after at least 8 hours of fasting. If LDL-C concentrations measured in a nonfasting state are near clinical decision thresholds, subsequent lipid measurement should be performed in a fasting state.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020704"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15DOI: 10.11613/BM.2025.020901
Claire Claeyssens, Peter Witters, Heidi Segers, Jan De Koster, Elena Levtchenko, Pieter Vermeersch
{"title":"An unusual case of neuroblastoma presenting with prolonged watery diarrhea in a pediatric patient.","authors":"Claire Claeyssens, Peter Witters, Heidi Segers, Jan De Koster, Elena Levtchenko, Pieter Vermeersch","doi":"10.11613/BM.2025.020901","DOIUrl":"10.11613/BM.2025.020901","url":null,"abstract":"<p><p>Neuroblastomas represent a diverse group of neuroblastic tumors characterized by variability in their clinical progression and degree of differentiation. In rare cases, patients with neuroblastoma may present with paraneoplastic syndromes, such as watery diarrhea, hypokalemia, and achlorhydria (WDHA syndrome), linked to the secretion of vasoactive intestinal peptide (VIP). We report a case of a 14-month-old girl presented with a three-week history of watery diarrhea and signs of dehydration with no other symptoms. The patient's medical history was unremarkable, and no medication use was reported. Venous blood gas analysis revealed a normal anion gap metabolic acidosis with severe hypokalemia. The patient was referred to our hospital 48 hours post-admission due to persistent hypokalemic metabolic acidosis, unresponsive to intravenous fluid therapy. The primary causes of normal anion gap metabolic acidosis in young children are gastrointestinal bicarbonate loss due to diarrhea and renal bicarbonate loss. Semi-quantitative urine organic acid analysis, reported 48 hours after admission, revealed increased vanillylmandelic acid (VMA) (89 mmol/mol creatinine) and homovanillic acid (HVA) (21 mmol/mol creatinine), raising the suspicion of a neuroblastoma. Subsequent analysis of an acidified urine sample confirmed a more than threefold increase in VMA, HVA, normetanephrine, norepinephrine, and 3-methoxytyramine concentrations. In addition, VIP was markedly elevated (1994 ng/L) in a blood sample. The diagnosis of neuroblastoma was confirmed through imaging and histological examination. This case illustrates that chronic diarrhea with metabolic dysregulation (<i>e.g.</i> hypokalemia) can be the first and only symptom in patients with VIP-secreting neuroblastoma which can result in delayed diagnosis of neuroblastoma.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020901"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15Epub Date: 2025-04-15DOI: 10.11613/BM.2025.020705
Azra Guzonjić, Dragana Jovanović, Ivana Simić, Vesna Ćeriman Krstić, Natalija Samardzić, Barbara Ostanek, Janja Marc, Miron Sopić, Jelena Kotur Stevuljević
{"title":"Telomere length and oxidative stress in small cell lung cancer patients: changes through chemotherapy cycles compared to healthy controls.","authors":"Azra Guzonjić, Dragana Jovanović, Ivana Simić, Vesna Ćeriman Krstić, Natalija Samardzić, Barbara Ostanek, Janja Marc, Miron Sopić, Jelena Kotur Stevuljević","doi":"10.11613/BM.2025.020705","DOIUrl":"10.11613/BM.2025.020705","url":null,"abstract":"<p><strong>Introduction: </strong>Small cell lung cancer (SCLC) is an aggressive malignant disease with poor survival outcomes. The aim of this study was to investigate leukocyte telomere length (LTL) and redox status parameters during chemotherapy and evaluate their prognostic potential based on the hypothesis that shorter LTL and oxidative stress burden correlate with poorer survival.</p><p><strong>Materials and methods: </strong>This longitudinal study included 60 SCLC patients and 73 healthy controls. Leukocyte telomere length was measured by quantitative PCR (qPCR) method, while redox status parameters (MDA - malondialdehyde, IMA - ischemia-modified albumin, PON1 - paraoxonase 1, redox index) were determined by spectrophotometric methods before, after two and after four cycles of chemotherapy.</p><p><strong>Results: </strong>All measured parameters showed significant differences between patients and controls, except the oxy-score (P < 0.001). Significant differences in IMA, PON1 and redox index were observed between SCLC patient groups at different time points (P < 0.001). Significant differences in IMA and PON1 were observed between SCLC survival groups, with higher values found in survivors after two chemotherapy cycles (P < 0.001). Redox index was the highest in the pre-chemo group (P = 0.019). Among patients who died, PON1 activity differed significantly between those who died within 2 months and after 4 months (P = 0.028). Kaplan-Meier analysis showed that LTL and PON1 were significant predictors of survival, with values below the 25th percentile associated with a higher risk of death.</p><p><strong>Conclusions: </strong>Leukocyte telomere length and PON1 are potential prognostic biomarkers for SCLC survival, suggesting their potential use in non-invasive biomarker panels for improved patient stratification.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020705"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15DOI: 10.11613/BM.2025.020401
Sten Westgard, Hassan Bayat
{"title":"Reply to Christelli <i>et al.</i>: Implementation of new Westgard Rules suggested by the Westgard Advisor software for five immunological parameters. What Six Sigma, quality control, the analytical Sigma-metric, and Westgard Advisor can and cannot do.","authors":"Sten Westgard, Hassan Bayat","doi":"10.11613/BM.2025.020401","DOIUrl":"10.11613/BM.2025.020401","url":null,"abstract":"<p><p>The study of Cristelli <i>et al.</i> attempted to find fault with the rules suggested by Westgard Advisor software, claiming that implementing those rules did not improve the method performance. A fundamental misunderstanding of the utility and purpose of the analytical Sigma-metric and QC rules needs to be clarified.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020401"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15Epub Date: 2025-04-15DOI: 10.11613/BM.2025.020702
Jialu Li, Guoxiang Bao
{"title":"Cumulative IgG reagent carryover detected in carryover evaluation of urinary total protein testing using AU5800 biochemistry analyzer.","authors":"Jialu Li, Guoxiang Bao","doi":"10.11613/BM.2025.020702","DOIUrl":"10.11613/BM.2025.020702","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate measurement of urinary total protein (UTP) is crucial for diagnosing renal and systemic diseases. This study aims to comprehensively evaluate potential carryover scenarios in UTP testing using AU5800 biochemistry analyzer and to identify factors influencing assay accuracy.</p><p><strong>Materials and methods: </strong>High-concentration quality control materials and pure water was used to evaluate specific sample probe carryover. Additionally, 24-hour mixed urine samples from patients were used to evaluate specific carryover from the reagent probe, mixbars, and cuvettes. For cumulative sample carryover evaluation, pure water was used as reagent and mixed serum as sample for continuous testing. During the process, 24-hour urine samples were interspersed, and UTP concentrations were measured at 0, 10, 20, and 30 minutes. Cumulative reagent carryover was evaluated by testing pure water sequentially with eight reagents sharing the same analytical unit and inner cuvettes as UTP, with UTP concentrations of 24-hour urine samples recorded at 0, 10, 20, and 30 minutes.</p><p><strong>Results: </strong>Specific carryover from the sample probe, reagent probe, mixbars, and cuvettes was not detected during carryover evaluation of UTP testing. However, a significant cumulative reagent carryover of Immunoglobulin G (IgG) reagent was observed, while no cumulative sample carryover was identified.</p><p><strong>Conclusions: </strong>The full range of possible carryover scenarios in UTP testing was evaluated using AU5800 biochemistry analyzer. Our data provide valuable references for evaluating carryover in laboratories, ensuring the accuracy and reliability of laboratory results.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020702"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15Epub Date: 2025-04-15DOI: 10.11613/BM.2025.020703
Gemma Solé-Enrech, Ruth Cano-Corres, Raquel Escribano-Tembleque, Eva Martínez-Sevilla, Núria Busquets-Carmona, Carlos García-Miralles
{"title":"Evaluation of the impact of reducing fasting hours on laboratory results in a mediterranean population.","authors":"Gemma Solé-Enrech, Ruth Cano-Corres, Raquel Escribano-Tembleque, Eva Martínez-Sevilla, Núria Busquets-Carmona, Carlos García-Miralles","doi":"10.11613/BM.2025.020703","DOIUrl":"10.11613/BM.2025.020703","url":null,"abstract":"<p><strong>Introduction: </strong>One of the critical points of the preanalytical phase is the patient's adherence to the required fasting duration before undergoing medical analysis. Although many laboratories have already protocols for blood-sample collection that require only a 6-hour fast, clinical guidelines remain unclear on this aspect, and fasting periods of 12 hours are sometimes still recommended. The aim of this study was to evaluate whether there are significant differences between the results obtained in patients' serum samples obtained post-fasting, 4 hours post-meal, and 6 hours post-meal for different predetermined parameters.</p><p><strong>Materials and methods: </strong>30 volunteers (16 females and 14 males) aged between 23 and 62 years were selected for this study. Each participant underwent an initial analysis after a 10-hour fast (baseline), a second analysis 4 hours after a controlled meal, and a third analysis 6 hours after the meal. The parameters studied correspond to previously selected biochemical, hematological, and coagulation tests. To assess if there are significant differences in the results obtained for each analyte, criteria based on the total allowable error (TEa) and the reference change value (RCV) were used.</p><p><strong>Results: </strong>All parameters evaluated in this study met the criteria based on the RCV at both 4 and 6 hours, although some parameters did not meet TEa criteria.</p><p><strong>Conclusions: </strong>The results obtained in this study demonstrated that a fasting period of 4 or 6 hours is sufficient to obtain reliable results. This could significantly improve the quality of life for patients undergoing analysis without compromising the quality of their results.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020703"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15DOI: 10.11613/BM.2025.021001
Ivana Lapić, Dunja Rogić, Dragana Šegulja, Sandra Jakšić Jurinjak, Željka Vogrinc, Sanja Kačkov, Fran Smaić, Indira Imširović, Lovorka Đerek
{"title":"Interfering heterophile antibodies as the cause of persistently falsely elevated high-sensitivity troponin I on Alinity i: a case report.","authors":"Ivana Lapić, Dunja Rogić, Dragana Šegulja, Sandra Jakšić Jurinjak, Željka Vogrinc, Sanja Kačkov, Fran Smaić, Indira Imširović, Lovorka Đerek","doi":"10.11613/BM.2025.021001","DOIUrl":"10.11613/BM.2025.021001","url":null,"abstract":"<p><p>Hereby we describe a case of a 59-year-old female patient with persistently elevated high-sensitivity troponin I (hs-TnI) over the course of almost four years measured on Alinity i with the corresponding assay (Abbott Laboratories, Chicago, USA). The patient underwent multiple extensive cardiological evaluations, but none of them suggested acute or chronic cardiac damage. Therefore, interference in measurement was suspected by the attending cardiologist and a detailed, stepwise laboratory investigation was undertaken in the sample with initial hs-TnI result of 2077 ng/L. Serial sample dilutions (1:2,1:5,1:10) did not match the expected, calculated hs-TnI concentrations, yielding both huge positive biases (62, 109 and 139%, respectively) and absolute differences (639, 453 and 290 ng/L, respectively). Precipitation with polyethylene-glycol, pretreatment in heterophilic blocking tubes (HBT) and immunoglobulin G depletion yielded hs-TnI results below the assay's diagnostic cut-off (< 15.6 ng/L). Alternate hs-TnI immunoassays (Siemens Healthineers, Beckman Coulter and Snibe) and measurement with the high-sensitivity troponin T (hs-TnT) assay yielded results below assays' specific cut-off values. This investigation confirmed that results of hs-TnI obtained by the Abbott assay were spuriously elevated. Significant lowering of hs-TnI after HBT pretreatment indicated that heterophile antibodies are the most probable source of interference. Based on this finding, it was entered in the patient's medical record that future determinations of cardiac troponin should be performed with an alternate hs-TnI or hs-TnT assay. This case emphasizes that analytical interferences are usually immunoassay-dependent. Evaluation of laboratory results in the clinical context and close collaboration between laboratory and clinical staff is crucial for their recognition.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"021001"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15DOI: 10.11613/BM.2025.020706
Ana Kozmar, Andrea Tešija Kuna, Nada Tomić Sremec, Lovorka Đerek, Vedrana Drvar, Katarina Gugo
{"title":"National recommendations of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine: Assessment of antineutrophil cytoplasmic antibodies (ANCA).","authors":"Ana Kozmar, Andrea Tešija Kuna, Nada Tomić Sremec, Lovorka Đerek, Vedrana Drvar, Katarina Gugo","doi":"10.11613/BM.2025.020706","DOIUrl":"10.11613/BM.2025.020706","url":null,"abstract":"<p><p>The family of antineutrophil cytoplasmic antibodies (ANCA) includes autoantibodies targeting proteins within the primary granules of neutrophils and lysosomes of monocytes. So far, proteinase 3 (PR3) and myeloperoxidase (MPO) are considered clinically relevant ANCA specificities. National recommendations for the assessment of ANCA are the outcome of the survey done by the Working group (WG) for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM), where the diversity in the performance of ANCA testing and reporting among the laboratories in Croatia was observed. This document contains recommendations concerning the indications for ANCA testing, preanalytical, analytical and postanalytical issues, including rational algorithm and quality control assurance. The recommendations are based on the International consensus on ANCA testing and reporting as well as other relevant literature in order to help to harmonize ANCA testing. The aim of these recommendations is to improve and harmonize ANCA testing among laboratories in Croatia.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020706"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biochemia medicaPub Date : 2025-06-15Epub Date: 2025-04-15DOI: 10.11613/BM.2025.020501
Ivana Čepelak, Slavica Dodig, Ivan Pavić
{"title":"Bilirubin - new insights into an old molecule.","authors":"Ivana Čepelak, Slavica Dodig, Ivan Pavić","doi":"10.11613/BM.2025.020501","DOIUrl":"10.11613/BM.2025.020501","url":null,"abstract":"<p><p>For decades, bilirubin was thought to be merely a degradation product of the hem, a potentially toxic compound and a molecule with no specific physiological function. Recently, it has been discovered that bilirubin has a strong antioxidant effect and possesses molecular signalling, hormonal and immunomodulatory properties. Numerous studies show that moderately elevated serum bilirubin concentrations correlate with a lower risk of developing pathological conditions mediated by oxidative stress and inflammation. Low concentrations within the current reference interval have been shown to be a potential risk factor for various pathological conditions. It is to be expected that knowledge about bilirubin will lead to the determination of bilirubin concentration gaining new importance in diagnostics, for example as a prognostic marker, but also as a therapeutic molecule.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 2","pages":"020501"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}