TGF-beta 1 is crucial for tissue regeneration, cell differentiation, embryonic development, and immune modulation. It is found in hematopoietic tissue and activates a pathway that inhibits early cancer cell progression.
TGF-beta 1 aids in extracellular matrix deposition, wound healing, and cirrhosis development. It is produced by various cells, and most have specific receptors for it.

Preferred Specimen(s)

1 mL platelet-free plasma collected ACD Acid Critic Dextrose (Yellow tube) tube

Minimum Volume:0.25 mL

Collection Instructions

Collect in ACD tube (Yellow Top) tube and immediately centrifuge to prepare platelet-poor plasma. Decant the plasma into another pour-over tube. Centrifuge a second time and pour over plasma. Freeze immediately. Centrifuge for 15 minutes at 1000 X g within 30 minutes of collection. Centrifuge plasma again at 3000 X g for 10 minutes for complete platelet removal. Freeze Immediately.

For fixed speed centrifuges such as 645e: Collect in ACD tube (lYellow-top) tube. Centrifuge 3 times for 10 minutes at 1600 X g while decanting the plasma each time before the next spin within 30 minutes of collection. Freeze immediately.

Transport Container: Transport tube Freeze plasma

Transport Temperature: Refrigerated (cold packs)

Specimen Stability

Room temperature: Not established

Refrigerated: 48 hours

Frozen -20° C: 14 days

Frozen -70° C: 30 days

Reject Criteria:

• Hemolysis
• Grossly lipemic
• Specimens with particulate matter or microbial contamination
• Specimens outside of listed stability

Alpha MSH is a 13-amino acid peptide (1665 kDa) derived from pro-opiomelanocorticotropin, sharing its sequence with ACTH 1-13. It stimulates melanin production and melanosome dispersion in skin melanocytes, and also promotes aldosterone synthesis.

Plasma alpha MSH levels increase during endotoxin-induced fever and are elevated in insulin-resistant obese men and AIDS patients.

Preferred Specimen(s)

3 mL frozen plasma collected in an EDTA (lavender-top) tube

Minimum Volume

1 mL

Transport Container

Transport tube
Freeze plasma or serum before shipping

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 90 days


Reject Criteria

Hemolysis • Grossly lipemic • Specimens with particulate matter or microbial contamination • Specimens outside of listed stability

The Vascular Endothelial Growth Factor (VEGF) ELISA is designated solely for research purposes. It may hold significance in assessing patients with different cancer types who are candidates for anti-angiogenesis therapy.

Preferred Specimen(s)

1 mL plasma collected in an EDTA (lavender-top) tube

Minimum Volume

0.3 mL

Collection Instructions

Mix the sample and centrifuge immediately after collection to separate plasma from cells. Transfer plasma to a plastic specimen transport container and mark the specimen type as plasma on the container. Freeze immediately. Cytokine levels may demonstrate diurnal variation. Recommend cytokine levels be determined at the same time of day for improved longitudinal comparison.

Transport Container

Transport tube
Freeze plasma or serum before shipping

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 4 hours
Refrigerated: 48
hours Frozen: 1 year


Reject Criteria

Hemolysis • Grossly lipemic • Specimens with particulate matter or microbial contamination • Specimens outside of listed stability

MMP participates in inflammation, tissue remodeling, wound healing, and cytokine processing. The expression of MMP-9 is associated with aberrant collagen deposition in pancreatic cancer, as well as the metastasis to lymph nodes by human breast cancer cells and the invasion of regional arteries in giant cell tumors of bone.

Preferred Specimen(s)

1 mL serum

Minimum Volume

0.5 mL

Specimen Container

Plastic screw-cap vial
Freeze plasma or serum before shipping

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 4 hours
Refrigerated: 24 hours
Frozen: 30 days


Reject Criteria

Hemolysis • Grossly lipemic • Specimens with particulate matter or microbial contamination • Specimens outside of listed stability

Collect:
Plasma from a lavender top (K2 - EDTA) tube is the only acceptable sample type. Mix sample thoroughly. Keep tubes cold on wet ice or with a cold pack after collection.

Patient Prep:
Within 30 minutes of venipuncture, centrifuge the collection tube at 1600 (±200) x g (rcf) at 4°C (±2°C) for 15 (±1) minutes. Transfer the cell-free plasma to a clean tube and immediately store samples at -20°C, or freeze at -60°C or below in an ultra-low freezer.

Preferred volume:
1 mL Plasma EDTA

Stability:
-20°C - up to 4 weeks, -60°C or below in an ultra low freezer - up to 2 years

Centrifugation:
Ambient temperature for centrifugation is acceptable provided that the time between collection and storage is minimized (approximately 30 minutes).

Pediatric Collection:
Minimum volume: 0.5 mL plasma, frozen.

Unacceptable Conditions:
Thawed specimen or specimens stored at room temperature prior to shipment.

Storage Transport Temp:
Send frozen plasma Priority Overnight via FedEx and in a well-insulated container on dry ice.

Stability:
Plasma EDTA Stability: -20°C - up to 4 weeks, -60°C or below in an ultra low freezer - up to 2 years

Notes:
Additional testing time may be needed for less than perfect samples or confirmatory testing/reflex testing.

Method: ELISA

Synonyms:
C4a Level, C4ades Arg Level, C4ades Arg Level (C4a Level), C4 (C4a Level), C4 anaphylatoxin (C4a Level), C4a anaphylatoxin, Complement (C4a Level), C4AL

Collection and Shipping: C3a

Collect:
Plasma from a lavender top (K2 - EDTA) tube is the only acceptable sample type. Mix sample thoroughly. Keep tubes cold on wet ice or with a cold pack after collection.

Patient Prep:
Within 30 minutes of venipuncture, centrifuge the collection tube at 1600 (±200) x g (rcf) at 4°C (± 2°C) for 15 (±1) minutes. Transfer the cell-free plasma to a clean tube and immediately store samples at -20°C, or freeze at -60°C or below in an ultra-low freezer.

Preferred volume: 1 mL Plasma EDTA

Stability:
-20°C - up to 4 weeks, -60°C or below in an ultra low freezer - up to 2 years

Centrifugation:
Ambient temperature for centrifugation is acceptable provided that the time between collection and storage is minimized (approximately 30 minutes).

Pediatric Collection:
Minimum volume: 0.5 mL plasma, frozen.

Unacceptable Conditions:
Thawed specimen or specimens stored at room temperature prior to shipment.

Storage Transport Temp:
Send frozen plasma Priority Overnight via FedEx and in a well-insulated container on dry ice.

Stability:
Plasma EDTA Stability: -20°C - up to 4 weeks, -60°C or below in an ultra low freezer - up to 2 years

Notes:
Additional testing time may be needed for less than perfect samples or confirmatory testing/reflex testing.

Method: ELISA

Synonyms:
C3 (C3a Level), C3a anaphylatoxin, C3 anaphylatoxin (C3a Level), Radio Immuno Assay (C3a Level), Complement (C3a Level), C3ades Arg Level (C3a Level), C3a des Arg Level, C3AL

Methodology

Electrochemiluminescence (ECL)

Assay Category

It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Reference Range(s)

Pediatric male and female

5-9.9 Years 0.6-16.8 ng/mL
10-13.9 Years 1.4-16.5 ng/mL
14-17.9 Years 0.6-24.9 ng/mL


Adult Lean Subjects (18-71 Years) with BMI range of 18-25

Male 0.3-13.4 ng/mL
Female 4.7-23.7 ng/mL

Adult Subjects (19-60 Years) with BMI range of 25-30

Male 1.8-19.9 ng/mL
Female 8.0-38.9 ng/mL


Preferred Specimen(s)

1 mL serum

Minimum Volume

0.2 mL

Transport Container

Transport tube

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 8 hours
Refrigerated: 14 days
Frozen: 35 days


Reject Criteria

Moderate hemolysis • Gross hemolysis • Hypericteric specimens

Preferred Specimen

1 mL serum

Minimum Volume

0.5 mL

Other Acceptable Specimens

Plasma collected in: EDTA (lavender-top) tube or sodium heparin (green-top) tube

Transport Temperature

Frozen

Specimen Stability

Room temperature: 24 hours
Refrigerated: 72 hours
Frozen: 28 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis

Methodology

Immunofluorescence Assay (IFA)

FDA Status

This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Reference Range

0-2 Years Not Established
3-17 Years 2.4-26.0 pmol/L
≥18 Years ≤13.7 pmol/L

Specimen Requirements

Serum or plasma

Volume

2 mL

Minimum Volume

0.2 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube
gel-barrier tube or green-top (heparin) tube

Collection

Pediatric: Blood drawn from heelstick for capillary. Separate serum or plasma from cells as soon as possible after clot formation. Transfer specimen to a plastic transport tube.

Storage Instructions

Refrigerate

Stability Requirements

Temperature and Period
Room temperature 14 days
Refrigerated 14 days
Frozen 14 days
Freeze/thaw cycles Stable x3

Causes for Rejection

Hemolysis; EDTA plasma submitted

Test Details

Evaluate electrolyte and water balance, hyperosmolar status, and hydration status; evaluate dehydration, acid-base balance; evaluate seizures; clue to alcoholism, methanol toxicity, ethylene glycol ingestion; evaluate antidiuretic hormone function, liver disease, hyperosmolar coma, evaluate hypernatremia. Osmolarity measures the concentration of particles in solution.

Methodology

Freezing point depression

Reference Interval

Neonatal: may be as low as 266 mOsm/kg
0 to 60 years: 275−295 mOsm/kg
61 years and older: 280−301 mOsm/kg

Information

High serum osmolality can result from hypernatremia, dehydration, hyperglycemia, mannitol therapy, azotemia, ingestion of ethanol, methanol, ethylene glycol. Thus, osmolality has a role in toxicology and in coma evaluation. Elevated serum osmolality with normal sodium suggests possible hyperglycemia, uremia, or alcoholism.
Low serum osmolality may be secondary to overhydration, hyponatremia, syndrome of inappropriate antidiuretic hormone secretion (SIADH) with carcinoma of lung and other entities.

Notes

Weisberg HF. Unraveling the laboratory model of a syndrome: The osmolality model. In: Young DS, Hicks J, Nipper H, et al, eds. Clinician and Chemist. The Relationship of the Laboratory to the Physician. Washington, DC: American Association of Clinical Chemistry;1979:200-243.

The Human Leukocyte Antigen (HLA) system comprises genes located on chromosome 6. These genes encode proteins found on cell surfaces, playing a crucial role in regulating the human immune system. The specific HLA type and the associated immune response play a pivotal role in determining whether a person develops the inflammation that leads to CIRS.

Dr. Shoemaker’s analysis of international gene registries, corroborated by case-controlled studies, indicates that 24% of the population exhibits a “mold susceptible” HLA haplotype. This susceptibility puts them at risk of developing chronic biotoxin-related illnesses from exposure to water-damaged buildings.

Additionally, he observed that 21% of the population has “Lyme susceptible” HLA haplotype, making them more prone to developing chronic illness following exposure to biotoxins after contracting Lyme disease. Depending on their unique HLA gene combinations, individuals may be susceptible to one or more biotoxin-related illnesses.