Clinical Chemistry Podcast

High-density lipoprotein or HDL is one of the most important of the lipoproteins in most species and there is evidence that points towards a role of HDL in normal immune function.  A paper appearing in the May 2019 issue of Clinical Chemistry tested the hypothesis that concentrations of HLD cholesterol are associated with risk of autoimmune disease. That study from the Copenhagen General Population Study and the Copenhagen City Heart Study included over 100,000 individuals.  We are pleased to have the senior author of that paper with us today, Dr. Borge Nordestgaard. 

In 2014, the U.S. Congress passed the Protecting Access to Medicare Act (PAMA) which required CMS, the Centers for Medicare & Medicaid Services, to revise the clinical laboratory fee schedule to reflect private sector payment rates.  Many in the laboratory community believed that the cuts are too deep and have urged CMS to recalculate fees to more accurately reflect the spectrum of laboratories that provide testing for patients. To gain greater insight on the potential impact of PAMA, a Q&A feature in the June 2019 issue of Clinical Chemistry asked six experts with different roles in this field to give their opinions on several of the key issues pertaining to the new reimbursement rates, particularly its potential impact on the laboratory marketplace and patient care.

The standard course for academic promotion has primarily been based on the number and quality of peer-reviewed papers published and the number of peer-reviewed grants received.  Other academic activities such as teaching, book editing, mentoring, and service to scientific organizations have also been considered.  But this process often falls short for those whose interests are in biomedical education or in translational and clinical applications. In the June 2019 issue of Clinical Chemistry, Nader Rifai, Brian Smith, and Maureen Connelly published an editorial titled, “A Message to Medical School Promotion Committees:  Proper Credit for Peer-Reviewed Online Educational Materials.”

Non-invasive prenatal testing based on cell-free DNA is now a widely used technique. However, quality control materials that have properties identical to clinical samples and that are applicable to a wide range of procedures are not available to support assay development, internal or external quality control, and proficiency testing. The June 2019 issue of Clinical Chemistry includes a study describing the development of such quality control materials that comprise simulated human plasma and mixtures of mother cell line derived cell-free DNA based on DNA fragmentation factor digestion.

Inborn errors of metabolism are rare diseases in which a single gene defect causes a clinically significant block in a metabolic pathway resulting either in an accumulation of substrate behind the block or a lack or deficiency of the product.  Profiling metabolites in the pathway could allow for accurate and timely identification of patients who have these diseases and help physicians to devise effective treatment.   Congenital disorders of glycosylation represent one of the largest groups of such metabolic disorders.  In May 2019, Clinical Chemistry published a study on the development and validation of a plasma protein N-glycan assay using a flow injection-electrospray ionization-quadrupole time-of-flight mass spectrometry.

For about the past 15 years, the public has become aware that genetic testing can provide medical diagnosis and inform specific medical therapies.  In addition to being used for medical purposes, genetics has also become a popular recreational tool for genealogy and general wellness.  The number of customers for direct-to-consumer genetic testing has now grown to greater than 12 million and continues to rise. In the May 2019 issue of Clinical Chemistry, a Q&A feature titled “Privacy in Direct-to-Consumer Genetic Testing” asked four experts with different roles in this field to discuss the current state of genomics and privacy.

Hospital pneumatic tube systems provide rapid transportation of patient samples to the laboratory.  However, it is known that the physical movement through a pneumatic tube system can agitate blood samples and sometimes cause cells to break open and leak intracellular components.  As a result, multiple laboratory results are susceptible to error. The May 2019 issue of Clinical Chemistry published a paper by Dr. Ann Gronowski and Dr. Christopher Farnsworth and their colleagues at the Washington University School of Medicine in St. Louis that describes parameters for evaluating a hospital pneumatic tube system.