title: Plasma tissue inhibitor of metalloproteinases-1 as a biological marker? Pre-analytical considerations.
abstract: Tissue Inhibitor of Metalloproteinases-1 (TIMP-1) may be a valuable biological marker in Colorectal Cancer (CRC). However, prospective validation of TIMP-1 as a biological marker should include a series of pre-analytical considerations. TIMP-1 is stored in platelets, which may degranulate during collection and storage. The aim of this study was to evaluate the influence of platelet TIMP-1 contamination on plasma TIMP-1 levels in healthy volunteers.
  
  
  METHODS
  All four parts of this study were done on EDTA-plasma. 1: The effect of stasis was evaluated in plasma collected with and without tourniquet. The collected whole blood was centrifuged at three different g-values. The effect of cellular contamination was evaluated 2: by adding plasma from just above the buffy-coat to one of four tubes containing plasma from the same sample and 3: by separating the plasma into three layers: upper, middle and lower. 4: The effect of temperature was studied by collection and handling of corresponding samples on ice and at room temperature. Prior to analysis samples were stored at -80 degrees C. TIMP-1 was determined using a validated in-house ELISA.
  
  
  RESULTS
  1: TIMP-1 levels in plasma collected with or without stasis were not significantly different. Similarly TIMP-1 levels were not affected by the studied differences in centrifugation force. 2: TIMP-1 levels were significantly increased in plasma potentially contaminated with platelets (p<0.0001). 3: Separation of plasma into an upper, middle and lower layer did not affect the levels of plasma TIMP-1. 4: Samples kept at room temperature following collection showed significantly higher plasma TIMP-1 levels than samples kept on ice (p<0.0001).
  
  
  CONCLUSIONS
  Contamination with platelets during handling and storage of plasma may have significant effect on TIMP-1 levels. The results can define a standard operating procedure for sample collection and handling, which is important in obtaining uniform, comparable and reproducible plasma TIMP-1 levels.
authors.affiliation: Department of Surgical Gastroenterology, 435, Hvidovre University Hospital, Kettegaards Allé 30, DK-2650 Hvidovre, Denmark. annelomholt@hotmail.com
authors.forename: Anne F
authors.initials: AF
authors.lastname: Lomholt
authors.forename: Camilla B
authors.initials: CB
authors.lastname: Frederiksen
authors.forename: Ib J
authors.initials: IJ
authors.lastname: Christensen
authors.forename: Nils
authors.initials: N
authors.lastname: Brünner
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Nielsen
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001792:Blood Platelets / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000201:enzymology*; D006801:Humans; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D019715:Tissue Inhibitor of Metalloproteinase-1