Validation of two multiplex platforms to quantify circulating markers of inflammation and endothelial injury in severe infection

PLoS One. 2017 Apr 18;12(4):e0175130. doi: 10.1371/journal.pone.0175130. eCollection 2017.

Abstract

Biomarkers can prognosticate outcome and enable risk-stratification. In severe infection, focusing on multiple markers reflecting pathophysiological mechanisms of organ injury could enhance management and pathway-directed therapeutics. Limited data exist on the performance of multiplex biomarker platforms. Our goal was to compare endothelial and immune activation biomarkers in severe pediatric infections using two multiplex platforms. Frozen plasma from 410 children presenting to the Jinja Regional Hospital in Uganda with suspected infection was used to measure biomarkers of endothelial (Angiopoietin-2, sFlt-1, sVCAM-1, sICAM-1) and immune (IL-6, IP-10, sTNFR-1, CHI3L1) activation. Two multiplex platforms (Luminex®, EllaTM) based on monoclonal antibody sandwich immunoassays using biotin-streptavidin conjugate chemistry were selected with reagents from R&D Systems. The two platforms differed in ease and time of completion, number of samples per assay, and dynamic concentration range. Intra-assay variability assessed using a coefficient of variation (CV%) was 2.2-3.4 for Luminex® and 1.2-2.9 for EllaTM. Correlations for biomarker concentrations within dynamic range of both platforms were best for IL-6 (ρ = 0.96, p<0.0001), IP-10 (ρ = 0.94, p<0.0001) and sFlt-1 (ρ = 0.94, p<0.0001). Agreement between concentrations obtained by both methods assessed by the Bland-Altman test varied, with best agreement for CHI3L1. Our data suggest that biomarkers of endothelial and immune activation can be readily measured with multiplex platforms. Luminex® and EllaTM produced reliable results with excellent CV% values. The EllaTM platform was more automated and completed in 75 minutes, potentially compatible with near-patient use. Trends in concentrations obtained by these methods were highly correlated, although absolute values varied, suggesting caution is required when comparing data from different multiplex platforms.

Publication types

  • Validation Study

MeSH terms

  • Angiopoietin-2 / blood
  • Biomarkers / blood*
  • Chemokine CXCL10 / blood
  • Child, Preschool
  • Chitinase-3-Like Protein 1 / blood
  • Cohort Studies
  • Endothelium, Vascular / metabolism*
  • Endothelium, Vascular / pathology
  • Humans
  • Immunoassay / methods*
  • Infant
  • Infections / complications*
  • Inflammation / blood*
  • Inflammation / complications
  • Inflammation / diagnosis
  • Intercellular Adhesion Molecule-1 / blood
  • Interleukin-6 / blood
  • Reagent Kits, Diagnostic / standards
  • Receptors, Tumor Necrosis Factor, Type I / blood
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Vascular Cell Adhesion Molecule-1 / blood
  • Vascular Endothelial Growth Factor Receptor-1 / blood

Substances

  • Angiopoietin-2
  • Biomarkers
  • CHI3L1 protein, human
  • CXCL10 protein, human
  • Chemokine CXCL10
  • Chitinase-3-Like Protein 1
  • Interleukin-6
  • Reagent Kits, Diagnostic
  • Receptors, Tumor Necrosis Factor, Type I
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1

Grants and funding

This work was supported by the Canadian Institutes of Health Research (CIHR) grants MOP-13721, MOP-115160, MOP-136813, a CIHR Foundation grant (KCK FDN-148439), the Canada Research Chair Program (KCK), a CIHR Banting fellowship (AL), and donations from Kim Kertland and the Tesari Foundation. MAM has received grants from Amgen for experimental studies on acute lung injury and from GlaxoSmithKline for studies of sepsis in patients; consultancy agreements for ARDS or lung diseases with Boehringer-Ingelheim, Bayer Inc, Cerus Therapeutics, Biomarck Pharmaceuticals, Quark Pharmaceuticals, Thesan Pharmaceuticals, Incardia Inc, Biogen, and GlaxoSmithKline; DSMB Chair for clinical trials for Roche-Genentec. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.