Detection of DLIS in Human Body Fluids

DLIS can be detected in serum and other body fluids by using commercial immunoassays for digoxin, taking advantage of the cross-reactivity of DLIS with anti-digoxin antibody. Apparent digoxin concentrations as detected by radioimmunoassay (RIA) digoxin assays had been reported in the 1980s by several investigators in patients not receiving digoxin (9,10). Some of those RIA digoxin assays were later discontinued because of high interference with DLIS. Early reports also indicated cross-reactivity of DLIS with the fluorescence polarization immunoassay (FPIA) marketed by the Abbott Laboratories (Abbott Park, IL) (11). Many investigators used commercially available digoxin assays for detecting DLIS in body fluid. However, other approaches have also been reported. Panesar (12) used bufalin as an antigen and developed polyclonal antisera for detecting DLIS. Lin et al. developed a polyclonal antibody-based ouabain enzyme immunoassay for detecting DLIS. The authors also developed a Fab fragment of the anti-digoxin antibody-based enzyme immunoassay for this purpose. The authors concluded that a polyclonal antibody-based ouabain assay was more efficient to detect DLIS in human blood (13). More specific high-performance liquid chromatographic techniques using reverse phase columns had also been used for detecting DLIS in biological fluid (14,15). However, these techniques are time consuming and technically more difficult than automated immunoassays.

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