title: Automated determination of serum alpha1-antitrypsin by antitryptic activity measurement.
abstract: BACKGROUND
  Alpha1-Antitrypsin (A1AT) deficiency is currently detectable by protein immunoassay, phenotyping, and genotyping of the S and Z mutations, but no fully automated method for standard biochemical analyzers is yet available. Here, we present a method that measures the antitryptic activity in serum. This method is rapid, automated, and allows the easy evaluation of a large cohort of patients.
  
  
  METHODS
  Our automated assay involves determining serum antitryptic capacity on the Olympus AU 400 autoanalyzer by using trypsin and succinylated gelatin as substrate in the presence of trinitrobenzene sulfonic acid. The results are expressed as a percentage of inhibition of the reaction of trypsin with succinylated gelatin. After we performed analytical validation studies and reference-interval determination based on serum samples from 120 healthy persons, we tested the assay on deidentified samples from 120 patients with various pathologies (primarily pulmonary) of unexplained origin and normal A1AT concentrations and phenotypes.
  
  
  RESULTS
  The analysis rate was up to 120 samples per hour. Intraassay CVs ranged from 3.1%-16.2%, and interassay CV was 7.5%. The reference population showed mean (SD) 58.4 (6.7)% inhibition. The detection limit was 9.5% inhibition. The 120 studied patients displayed significantly lower mean activity than 120 healthy individuals (P < 0.0001).
  
  
  CONCLUSIONS
  This assay is stable, reliable, and easily automated by use of open-system analyzers, allowing for the rapid evaluation of patients. After further validation on a larger randomized cohort, this new approach should function as a useful method to explore A1AT deficiency, especially in large-scale studies.
authors.affiliation: AP-HP, Hôpital Européen Georges Pompidou, Service de Biochimie, 75015 Paris, France. denis.roche@egp.aphp.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Roche
authors.forename: Alexandra
authors.initials: A
authors.lastname: Mesner
authors.forename: Malik
authors.initials: M
authors.lastname: Al Nakib
authors.forename: Frederic
authors.initials: F
authors.lastname: Leonard
authors.forename: Philippe
authors.initials: P
authors.lastname: Beaune
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D014361:Trypsin Inhibitors / Q000097:blood* / Q000494:pharmacology*; D000515:alpha 1-Antitrypsin / Q000097:blood*
chemical_list: D014361:Trypsin Inhibitors; D000515:alpha 1-Antitrypsin