title: Circulating concentrations of growth-differentiation factor 15 in apparently healthy elderly individuals and patients with chronic heart failure as assessed by a new immunoradiometric sandwich assay.
abstract: BACKGROUND
  Growth-differentiation factor 15 (GDF15) is a member of the transforming growth factor beta (TGF-beta) cytokine superfamily. There has been increasing interest in using circulating GDF15 as a biomarker in patients, for example those with cardiovascular disease.
  
  
  METHODS
  We developed an IRMA that uses a polyclonal, affinity chromatography-purified goat antihuman GDF15 IgG antibody, assessed the preanalytic characteristics of GDF15, and determined circulating GDF15 concentrations in 429 apparently healthy elderly individuals and 153 patients with chronic heart failure (CHF).
  
  
  RESULTS
  The assay had a detection limit of 20 ng/L, an intraassay imprecision of < or =10.6%, and an interassay imprecision of < or =12.2%. Specificity was demonstrated with size-exclusion chromatography, parallel measurements with polyclonal and monoclonal anti-GDF15 antibody, and lack of cross-reactivity with TGF-beta. The assay was not appreciably influenced by the anticoagulant matrix or unrelated biological substances. GDF15 was stable at room temperature for 48 h and resistant to 4 freeze-thaw cycles. Apparently healthy, elderly individuals presented with a median GDF15 concentration of 762 ng/L (25th-75th percentiles, 600-959 ng/L). GDF15 concentrations were associated with age and with cystatin C and C-reactive protein concentrations. CHF patients had increased GDF15 concentrations that were closely related to disease severity.
  
  
  CONCLUSIONS
  The IRMA can detect GDF15 in human serum and plasma with excellent sensitivity and specificity. The reference limits and confounding variables defined for apparently healthy elderly individuals and the favorable preanalytic characteristics of GDF15 are expected to facilitate future studies of GDF15 as a biomarker in various disease settings, including CHF.
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: Tibor
authors.initials: T
authors.lastname: Kempf
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Horn-Wichmann
authors.forename: Georg
authors.initials: G
authors.lastname: Brabant
authors.forename: Timo
authors.initials: T
authors.lastname: Peter
authors.forename: Tim
authors.initials: T
authors.lastname: Allhoff
authors.forename: Gunnar
authors.initials: G
authors.lastname: Klein
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.forename: Nina
authors.initials: N
authors.lastname: Johnston
authors.forename: Lars
authors.initials: L
authors.lastname: Wallentin
authors.forename: Kai C
authors.initials: KC
authors.lastname: Wollert
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D055436:Growth Differentiation Factor 15; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15