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Absolute or Relative Measurement of Carbohydrate-deficient Transferrin in Serum? Experiences with Three Immunological Assays

Karolinska Institutet, Departments of Clinical Neuroscience and Clinical Chemistry, Alcohol and Drug Dependence Unit at Karolinska Hospital, SE-17176 Stockholm, Sweden, fax 46-8-6721904, e-mail anders.helander@bekl.csso.sll.se

Individuals who have consumed at least 50–80 g of alcohol per day during the previous week(s) often show an abnormal microheterogeneity of the iron-transporting glycoprotein transferrin in serum (1). After chronic exposure to alcohol, the concentrations of transferrin molecules that lack 2–4 of the four normal terminal sialic acid residues (di-, mono-, and asialo transferrin, respectively) (1) or that lack the entire biantennary carbohydrate chain(s) (2)(3) increase. The presence of increased concentrations of this "carbohydrate-deficient" transferrin (CDT) is a specific and sensitive biochemical indicator of recent excessive drinking (1)(4).

Whether the CDT result should be expressed as the absolute amount or as the amount normalized to the total transferrin concentration has been a matter of debate (4). The present study compared three commercial immunological test kits for quantification of the abnormal microheterogeneity of serum transferrin observed after excessive drinking: one kit that measures CDT as an absolute amount (CDTect^TM RIA; Pharmacia & Upjohn Diagnostics),¹ and two kits that measure the result relative to total transferrin [an RIA (%CDT RIA) and a turbidimetric immunoassay (%CDT TIA), both from Axis Biochemicals].

With the CDTect test, the CDT content is expressed as an absolute amount (in units/L, with 1 unit of CDT in the CDTect assay equivalent to ~1 mg of transferrin) of the transferrin isoforms with a pI 5.7. According to a recent report, the CDTect assay measures part of the asialo, monosialo, and disialo isoforms as well as traces of trisialo transferrin (5). In brief, transferrin in the serum sample is saturated with Fe³⁺, and the isoforms are separated on an anion-exchange chromatography microcolumn. Quantification of CDT is carried out by a double antibody RIA. Because of a gender-based difference in the baseline concentrations . . . [Full Text of this Article]

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