FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc2021; 34(1); 42-53; doi: 10.1177/10406387211056029

Comparison of a point-of-care serum amyloid A analyzer frequently used in equine practice with 2 turbidimetric immunoassays used in human and veterinary medicine.

Abstract: Rapid, accurate detection of serum amyloid A (SAA) is needed in equine practice. We validated a patient-side point-of-care (POC) assay (Stablelab; Zoetis) compared to the turbidimetric immunoassays LZ-SAA (TIA-Hum) and VET-SAA (TIA-Vet; both Eiken Chemical). Analytical performance was assessed at 3 different concentration ranges and with interferences. Inter-method comparison using 49 equine serum samples revealed a significant difference between median SAA results ( < 0.0001), with the strongest bias between the POC and TIA-Vet (median 1,093 vs. 578 mg/L). The median SAA value obtained with the TIA-Hum method was 752 mg/L. Correlation between POC/TIA-Hum and between POC/TIA-Vet was fair (r = 0.77 and 0.69) and excellent between both TIAs (r = 0.93). Bias between POC/TIA-Hum, POC/TIA-Vet, and TIA-Hum/TIA-Vet was -56.7%, -80.9%, and -28.2%, respectively. POC intra- and inter-assay CVs (16.1-30% and 19.8-35.5%) were higher than TIA CVs (generally 3,000 mg/L for the POC assay. Equine serum SAA was stable over a median period of 2.5 y when stored at -80°C. Overall, there was excellent-to-moderate correlation between tests, but imprecision and hook effect of the POC, as well as bias between the methods, must be considered.
Get Full Text
Publication Date: 2021-11-11 PubMed ID: 34763564PubMed Central: PMC8688985DOI: 10.1177/10406387211056029Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research paper investigates the performance of a point-of-care assay (Stablelab; Zoetis) for detecting serum amyloid A (SAA) in horses, comparing it with two turbidimetric immunoassays (LZ-SAA and VET-SAA), and reveals a significant difference between the two. It also points out various factors that could influence the tests’ accuracy like bilirubin, hemoglobin, and intralipid.

Study Design and Comparison

  • The researchers focused on validating a specific point-of-care (POC) assay, comparing its performance against two other tests used in both veterinary and human medicine. The tests were: LZ-SAA (Human Turbidimetric Immunoassay – TIA-Hum) and VET-SAA (Veterinary Specific Turbidimetric Immunoassay – TIA-Vet).
  • The analytical performance of these methods was evaluated across different concentration ranges.
  • A total of 49 equine serum samples were used for the inter-method comparison.

Findings and Observations

  • The research demonstrated a significant difference between the median SAA results produced by the different methods, indicating that the results produced by the POC and TIA-Vet are consistently different.
  • Statistical analysis showed fair correlation between the results of POC/TIA-Hum and POC/TIA-Vet and excellent correlation between those of both TIAs.
  • However, there was a “bias” between all combinations of the methods, meaning that one consistently estimated higher or lower than the others.
  • POC had a higher variability in terms of intra- and inter-assay CVs (Coefficient of Variation) compared to the TIAs.
  • They also found that bilirubin and hemoglobin have a negative impact on the results of the POC and TIA-Vet tests, while the addition of intralipid showed a positive bias.
  • The overall linearity of the SAA concentrations was good for POC up to 10,312 mg/L, but a hook effect was found at concentrations of SAA greater than 3,000 mg/L.
  • Stability testing found horse serum SAA to remain stable over a period of 2.5 years when stored at -80°C.

Conclusion and Implications

  • While there is a moderate to excellent correlation between the different tests, the study underscores multiple considerations. This includes the imprecision and hook effect of the POC when SAA concentration is high, and the discrepancies (or biases) among the three methods.
  • The insights might caution the interpretation of absolute SAA values acquired from different methods and potential interferences that can impact it.

Cite This Article

APA
Kiemle J, Hindenberg S, Bauer N, Roecken M. (2021). Comparison of a point-of-care serum amyloid A analyzer frequently used in equine practice with 2 turbidimetric immunoassays used in human and veterinary medicine. J Vet Diagn Invest, 34(1), 42-53. https://doi.org/10.1177/10406387211056029

Publication

Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
ISSN: 1943-4936
NlmUniqueID: 9011490
Country: United States
Language: English
Volume: 34
Issue: 1
Pages: 42-53

Researcher Affiliations

Kiemle, Julia
  • Clinic for Horses, Department of Equine Surgery and Orthopaedics, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
Hindenberg, Sarah
  • Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
Bauer, Natali
  • Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
Roecken, Michael
  • Clinic for Horses, Department of Equine Surgery and Orthopaedics, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany.

MeSH Terms

  • Animals
  • Horses
  • Humans
  • Immunoturbidimetry / veterinary
  • Point-of-Care Systems
  • Serum Amyloid A Protein

Conflict of Interest Statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

This article includes 35 references
  1. Andreasson U, Perret-Liaudet A, van Waalwijk van Doorn LJ, Blennow K, Chiasserini D, Engelborghs S, Fladby T, Genc S, Kruse N, Kuiperij HB, Kulic L, Lewczuk P, Mollenhauer B, Mroczko B, Parnetti L, Vanmechelen E, Verbeek MM, Winblad B, Zetterberg H, Koel-Simmelink M, Teunissen CE. A Practical Guide to Immunoassay Method Validation.. Front Neurol 2015;6:179.
    pmc: PMC4541289pubmed: 26347708doi: 10.3389/fneur.2015.00179google scholar: lookup
  2. Arnold JE, Camus MS, Freeman KP, Giori L, Hooijberg EH, Jeffery U, Korchia J, Meindel MJ, Moore AR, Sisson SC, Vap LM, Cook JR. ASVCP Guidelines: Principles of Quality Assurance and Standards for Veterinary Clinical Pathology (version 3.0): Developed by the American Society for Veterinary Clinical Pathology's (ASVCP) Quality Assurance and Laboratory Standards (QALS) Committee.. Vet Clin Pathol 2019 Dec;48(4):542-618.
    pubmed: 31889337doi: 10.1111/vcp.12810google scholar: lookup
  3. Cerón JJ, Martinez-Subiela S, Ohno K, Caldin M. A seven-point plan for acute phase protein interpretation in companion animals.. Vet J 2008 Jul;177(1):6-7.
    pubmed: 18294886doi: 10.1016/j.tvjl.2007.12.001google scholar: lookup
  4. Christensen M, Jacobsen S, Ichiyanagi T, Kjelgaard-Hansen M. Evaluation of an automated assay based on monoclonal anti-human serum amyloid A (SAA) antibodies for measurement of canine, feline, and equine SAA.. Vet J 2012 Dec;194(3):332-7.
    pubmed: 22704135doi: 10.1016/j.tvjl.2012.05.007google scholar: lookup
  5. Coutinho da Silva MA, Canisso IF, MacPherson ML, Johnson AE, Divers TJ. Serum amyloid A concentration in healthy periparturient mares and mares with ascending placentitis.. Equine Vet J 2013 Sep;45(5):619-24.
    pubmed: 23432049doi: 10.1111/evj.12034google scholar: lookup
  6. d'Eril GM, Anesi A, Maggiore M, Leoni V. Biological variation of serum amyloid A in healthy subjects.. Clin Chem 2001 Aug;47(8):1498-9.
    pubmed: 11468251
  7. Eckersall PD, Bell R. Acute phase proteins: Biomarkers of infection and inflammation in veterinary medicine.. Vet J 2010 Jul;185(1):23-7.
    pubmed: 20621712doi: 10.1016/j.tvjl.2010.04.009google scholar: lookup
  8. Flatland B, Freeman KP, Vap LM, Harr KE. ASVCP guidelines: quality assurance for point-of-care testing in veterinary medicine.. Vet Clin Pathol 2013 Dec;42(4):405-23.
    pubmed: 24320778doi: 10.1111/vcp.12099google scholar: lookup
  9. Fransson BA, Bergström A, Wardrop KJ, Hagman R. Assessment of three automated assays for C-reactive protein determination in dogs.. Am J Vet Res 2007 Dec;68(12):1281-6.
    pubmed: 18052731doi: 10.2460/ajvr.68.12.1281google scholar: lookup
  10. Harr KE, Flatland B, Nabity M, Freeman KP. ASVCP guidelines: allowable total error guidelines for biochemistry.. Vet Clin Pathol 2013 Dec;42(4):424-36.
    pubmed: 24320779doi: 10.1111/vcp.12101google scholar: lookup
  11. Hillström A, Tvedten H, Lilliehöök I. Evaluation of an in-clinic Serum Amyloid A (SAA) assay and assessment of the effects of storage on SAA samples.. Acta Vet Scand 2010 Feb 2;52(1):8.
    pmc: PMC2831015pubmed: 20122257doi: 10.1186/1751-0147-52-8google scholar: lookup
  12. Hillström A, Hagman R, Söder J, Häggström J, Ljungvall I, Kjelgaard-Hansen M. Validation and application of a canine-specific automated high-sensitivity C-reactive protein assay.. J Vet Diagn Invest 2015 Mar;27(2):182-90.
    pubmed: 25776543doi: 10.1177/1040638715575751google scholar: lookup
  13. Hindenberg S, Klenner-Gastreich S, Kneier N, Zielinsky S, Gommeren K, Bauer N, Moritz A. Evaluation of a species-specific C-reactive protein assay for the dog on the ABX Pentra 400 clinical chemistry analyzer.. BMC Vet Res 2017 May 30;13(1):146.
    pmc: PMC5450169pubmed: 28558755doi: 10.1186/s12917-017-1065-9google scholar: lookup
  14. Hindenberg S, Keßler M, Zielinsky S, Langenstein J, Moritz A, Bauer N. Evaluation of a novel quantitative canine species-specific point-of-care assay for C-reactive protein.. BMC Vet Res 2018 Mar 20;14(1):99.
    pmc: PMC5859731pubmed: 29554960doi: 10.1186/s12917-018-1415-2google scholar: lookup
  15. Ishioka K, Hayakawa N. Serum amyloid A concentrations in cats measured using a newly developed feline-specific latex agglutination immunoassay. Jpn J Vet Res 2019;67:145–150.
  16. Jacobsen S, Andersen PH. The acute phase protein serum amyloid A (SAA) as a marker of inflammation in horses. Equine Vet Educ 2007;19:38–46.
  17. Jacobsen S, Kjelgaard-Hansen M, Hagbard Petersen H, Jensen AL. Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations.. Vet J 2006 Sep;172(2):315-9.
    pubmed: 15950503doi: 10.1016/j.tvjl.2005.04.021google scholar: lookup
  18. Jacobsen S, Vinther AM, Kjelgaard-Hansen M, Nielsen LN. Validation of an equine serum amyloid A assay with an unusually broad working range.. BMC Vet Res 2019 Dec 19;15(1):462.
    pmc: PMC6923866pubmed: 31856804doi: 10.1186/s12917-019-2211-3google scholar: lookup
  19. Jasensky AK, Klenner S, Einspanier R, Kohn B. Evaluation of three different point-of-care tests for quantitative measurement of canine C-reactive protein.. Vet Clin Pathol 2015 Jun;44(2):205-14.
    pubmed: 25962332doi: 10.1111/vcp.12264google scholar: lookup
  20. Jensen AL, Kjelgaard-Hansen M. Method comparison in the clinical laboratory.. Vet Clin Pathol 2006 Sep;35(3):276-86.
    pubmed: 16967409doi: 10.1111/j.1939-165x.2006.tb00131.xgoogle scholar: lookup
  21. Jensen AL, Kjelgaard-Hansen M. Diagnostic test validation. In: Weiss DJ, Wardrop KJ, eds. Schalm’s Veterinary Hematology. 6th ed. Wiley Blackwell, 2010:1027–1033.
  22. Karam B, Hines S, Skipper L, Pusterla N. Whole-Blood Validation of a New Point-of-care Equine Serum Amyloid A Assay.. J Equine Vet Sci 2020 Nov;94:103222.
    pubmed: 33077080doi: 10.1016/j.jevs.2020.103222google scholar: lookup
  23. Kjelgaard-Hansen M, Jacobsen S. Assay validation and diagnostic applications of major acute-phase protein testing in companion animals.. Clin Lab Med 2011 Mar;31(1):51-70.
    pubmed: 21295722doi: 10.1016/j.cll.2010.10.002google scholar: lookup
  24. Klenner S, Bauer N, Moritz A. Evaluation of three automated human immunoturbidimetric assays for the detection of C-reactive protein in dogs.. J Vet Diagn Invest 2010 Jul;22(4):544-52.
    pubmed: 20622224doi: 10.1177/104063871002200408google scholar: lookup
  25. Marjani A. Effect of storage time and temperature on serum analytes. Am J Appl Sci 2008;5:1047–1051.
  26. Nunokawa Y, Fujinaga T, Taira T, Okumura M, Yamashita K, Tsunoda N, Hagio M. Evaluation of serum amyloid A protein as an acute-phase reactive protein in horses.. J Vet Med Sci 1993 Dec;55(6):1011-6.
    pubmed: 7509640doi: 10.1292/jvms.55.1011google scholar: lookup
  27. Papasouliotis K, Cue S, Crawford E, Pinches M, Dumont M, Burley K. Comparison of white blood cell differential percentages determined by the in-house LaserCyte hematology analyzer and a manual method.. Vet Clin Pathol 2006 Sep;35(3):295-302.
    pubmed: 16967412doi: 10.1111/j.1939-165x.2006.tb00134.xgoogle scholar: lookup
  28. Pepys MB, Baltz ML, Tennent GA, Kent J, Ousey J, Rossdale PD. Serum amyloid A protein (SAA) in horses: objective measurement of the acute phase response.. Equine Vet J 1989 Mar;21(2):106-9.
    pubmed: 2539996doi: 10.1111/j.2042-3306.1989.tb02108.xgoogle scholar: lookup
  29. Schwartz D, Pusterla N, Jacobsen S, Christopher MM. Analytical validation of a new point-of-care assay for serum amyloid A in horses.. Equine Vet J 2018 Sep;50(5):678-683.
    pubmed: 29344980doi: 10.1111/evj.12807google scholar: lookup
  30. Stack JD, Cousty M, Steele E, Handel I, Lechartier A, Vinardell T, David F. Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment.. Front Vet Sci 2019;6:325.
    pmc: PMC6779708pubmed: 31632987doi: 10.3389/fvets.2019.00325google scholar: lookup
  31. Tape C, Kisilevsky R. Apolipoprotein A-I and apolipoprotein SAA half-lives during acute inflammation and amyloidogenesis.. Biochim Biophys Acta 1990 Apr 17;1043(3):295-300.
    pubmed: 2108727doi: 10.1016/0005-2760(90)90030-2google scholar: lookup
  32. Verma M. Effect of blood storage on complete biochemistry. J Blood Disord Transfus 2015;6:329.
  33. Viner M. Comparison of serum amyloid A in horses with infectious and noninfectious respiratory diseases. J Equine Vet Sci 2017;49:11–13.
  34. Westgard JO, Carey RN, Wold S. Criteria for judging precision and accuracy in method development and evaluation.. Clin Chem 1974 Jul;20(7):825-33.
    pubmed: 4835236
  35. Witkowska-Piłaszewicz OD, Żmigrodzka M, Winnicka A, Miśkiewicz A, Strzelec K, Cywińska A. Serum amyloid A in equine health and disease.. Equine Vet J 2019 May;51(3):293-298.
    pmc: PMC7163734pubmed: 30565319doi: 10.1111/evj.13062google scholar: lookup

Citations

This article has been cited 7 times.
  1. Pelander L, Bach MBT, Ljungvall I, Willesen JL, Koch J, Dreimanis K, Telling A, Damsgard RM, Ohlsson Å, Häggström J, Langhorn R. Evaluation of cardiac troponin I as a predictor of death in critically ill cats. J Vet Intern Med 2023 Mar;37(2):403-411.
    doi: 10.1111/jvim.16635pubmed: 36708236google scholar: lookup
  2. Pohanka M. Diagnoses Based on C-Reactive Protein Point-of-Care Tests. Biosensors (Basel) 2022 May 17;12(5).
    doi: 10.3390/bios12050344pubmed: 35624645google scholar: lookup
  3. Arakawa N, Otsuka M, Hamano T, Kumagai M, Kato S, Hirai T, Yabuki A, Yamato O. Serum Concentrations of Imidazole Dipeptides and Serum Amyloid A in a Bottlenose Dolphin (Tursiops truncatus) with Rhabdomyolysis: Potential Biomarkers for Muscular Damage. Animals (Basel) 2025 Jul 2;15(13).
    doi: 10.3390/ani15131950pubmed: 40646849google scholar: lookup
  4. Souto PC, Santos MR, Orozco AMO, Bento LD, Ramirez-Lopez CJ, Girardi FM, Machado JCA, de Oliveira LL, da Fonseca LA. Enzyme-Linked Immunosorbent Assay (ELISA) Development for Equine Serum Amyloid A (SAA) Determination Using Recombinant Proteins. Methods Protoc 2025 Apr 7;8(2).
    doi: 10.3390/mps8020037pubmed: 40278511google scholar: lookup
  5. Sidwell AE, Duz M, Khan A, Bodnàr R, Hole SL. Effect of Simple Oral Dental Extraction on Systemic Serum Amyloid A Concentrations in Horses. Vet Med Sci 2024 Nov;10(6):e70104.
    doi: 10.1002/vms3.70104pubmed: 39508719google scholar: lookup
  6. Bradley Z, Bhalla N. Combating Prozone Effects and Predicting the Dynamic Range of Naked-Eye Nanoplasmonic Biosensors through Capture Bioentity Optimization. ACS Meas Sci Au 2024 Aug 21;4(4):452-458.
    doi: 10.1021/acsmeasuresciau.4c00010pubmed: 39184359google scholar: lookup
  7. Kreutzfeldt N, Chambers TM, Reedy S, Spann KM, Pusterla N. Effect of dexamethasone on antibody response of horses to vaccination with a combined equine influenza virus and equine herpesvirus-1 vaccine. J Vet Intern Med 2024 Jan-Feb;38(1):424-430.
    doi: 10.1111/jvim.16978pubmed: 38141173google scholar: lookup
Subscribe to our newsletter
Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.