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Clinical Chemistry 47: 569-574, 2001;
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(Clinical Chemistry. 2001;47:569-574.)
© 2001 American Association for Clinical Chemistry, Inc.


Articles

Homogeneous Enzyme Immunoassay for Triiodothyronine in Serum

Christina D. Karapitta1,2, Theodore G. Sotiroudis1,a, Athanassios Papadimitriou3 and Aristotelis Xenakis1

1 Industrial Enzymology Unit, Institute of Biological Research & Biotechnology, The National Hellenic Research Foundation, 48 Vassileos Constantinou Ave., 11635 Athens, Greece.

2 MEDICON S.A., 15344 Gerakas, Greece.

3 Department of Nuclear Medicine, Navy’s Hospital, 11521 Athens, Greece.
a Author for correspondence. Fax 30-1-7273758; e-mail tsotir{at}eie.gr.


   Abstract
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
Background: The concentration of triiodothyronine (T3) in human serum is extremely low and can be determined only by very sensitive methods. We developed a homogeneous enzyme immunoassay for T3 analysis in unextracted serum.

Methods: A T3 derivative was conjugated to the -SH groups of glycogen phosphorylase b (GPb) from rabbit muscle. Conjugation caused inhibition of enzyme activity, and the enzyme conjugate was reactivated upon binding of anti-T3 antibody. Activation was blocked by the presence of non-antibody-bound T3; this was the basis for the development of the homogeneous enzyme immunoassay for T3 by determining GPb activity fluorometrically.

Results: We used furosemide to block the interaction of T3 with serum proteins with T3-binding sites, avoiding any serum treatment step. T3 was measured in the range 0.3–8 µg/L. T3 values obtained by this assay correlated well with those obtained by a RIA (y = 0.97x - 0.07 µg/L; r = 0.96; n = 92). Within- and between-run imprecision (CV) was 5–9% for normal and high concentrations and 16–20% for low concentrations.

Conclusions: Chemical modification of GPb with a T3 derivative allows the development of a simple homogeneous enzyme immunoassay for T3 in unextracted serum.


   Introduction
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
The serum concentration of triiodothyronine (T3)1 is very low [reference interval, 0.7–2.1 µg/L (1)], and it is usually determined by RIA (2)(3), heterogeneous enzyme immunoassays (4), chemiluminescent immunoassays (5)(6), or electrochemiluminescent immunoassays (7). Homogeneous enzyme immunoassays have been developed (8)(9)(10)(11) for various haptens, including thyroxine (10)(12), but no homogeneous enzyme immunoassay for T3 analysis has been reported.

We describe here the development of the first homogeneous enzyme immunoassay for T3, with T3 conjugated to glycogen phosphorylase b (GPb) from rabbit muscle. No other enzyme immunoassay has appeared in the literature that uses hapten conjugated to GP. The binding was carried out using 4-(maleimidomethyl)-cyclohexane-1-carboxylic acid N-hydroxysuccinimide ester (SMCC), a reagent containing a maleimide group that reacts specifically with -SH groups (13). GP is an allosteric enzyme that catalyzes the degradative phosphorolysis of glycogen to glucose 1-phosphate. The rabbit muscle enzyme exists in two interconvertible forms, the phosphorylated form, GPa, and the dephosphorylated form, GPb. GPb is inactive and can be activated either by covalent phosphorylation to form GPa or by no covalent cooperative binding of AMP (14)(15). GPb consists of two identical polypeptide chains. GPb from rabbit muscle contains 842 amino acids per subunit (16) and has nine sulfhydryl groups important for enzyme activity (17). GP exists in human serum of healthy subjects predominantly in the b form at very low concentrations (<5 µg/L) (18)(19).


   Materials and Methods
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
reagents
All chemicals, as well as the polyclonal anti-T3 antibody (T-2777) prepared in rabbits were from Sigma Chemical Co. Sephadex G-25 (fine) was from Amersham Pharmacia Biotech AB. T3 serum calibrators were from Bayer Diagnostics. Silica Gel 60 thin-layer chromatography plates (0.25 mm; cat. no. 5721) were obtained from Merck.

purification of rabbit muscle GPb
Rabbit muscle GPb was prepared according to Fischer and Krebs (20), using 2-mercaptoethanol instead of cysteine, and was recrystallized at least four times before use. The GPb concentration was determined spectrophotometrically using the extinction coefficient E280 nm1% = 13.2 (21).

synthesis and purification of smcc-t3
N-[4-(maleimidomethyl)-cyclohexan-1-yl]triiodothyronyl carboxamide (MCC-T3) was synthesized by mixing 0.11 mL of 9 mmol/L SMCC and 0.67 mL of 1.5 mmol/L T3 in dimethylformamide in a final reaction volume of 1 mL. The reaction was carried out for 90 min at 30 °C. The product MCC-T3 was purified by thin-layer chromatography on Silica Gel 60 plates (0.25 mm; Merck) with ethyl acetate-acetic acid-water (90:10:5 by volume) as mobile phase. The prominent band at Rf = 0.67 was cut out, and the product was extracted with methanol. The sample was filtered, and the filtrate was condensed with a rotary evaporator to a volume of 1 mL. The product was quantified spectrophotometrically. The hormone derivative was stored as a methanol solution in the dark at -20 °C. The above methodology is a modification of similar published procedures (22)(23).

conjugation of mcc-t3 to GPb
The enzyme conjugate was prepared by the chemical coupling of MCC-T3 to GPb. In the coupling procedure, 0.4 mL of GPb (10.3 µmol/L) in 50 mmol/L triethanolamine-HCl buffer (pH 6.8) was mixed with 0.037 mL of 0.222 mmol/L MCC-T3 in methanol. The mixture was incubated at 30 °C for 15 min. The enzyme conjugate was purified on a Sephadex G-25 column equilibrated with 50 mmol/L triethanolamine-HCl buffer (pH 6.8) containing 1 mmol/L EDTA and eluted with the same solution. The enzyme fractions were collected, and the protein concentration was determined spectrophotometrically. The enzyme conjugate was stored at -20 °C after the addition of an equal volume of glycerol containing 2-mercaptoethanol and bovine serum albumin (final concentrations, 0.03 mol/L 2-mercaptoethanol and 1 g/L bovine serum albumin) and could be used for at least 6 months.

determination of GPb activity
GPb activity in the direction of phosphorolysis of glycogen was measured using the auxiliary assay system as described by Helmreich and Cori (24) with some modifications. The final reaction mixture was 0.6 mL and contained 2.5 kU/L glucose-6-phosphate dehydrogenase, 0.6 kU/L phosphoglucomutase, 1 mmol/L NADP+, 1 mmol/L magnesium acetate, 1 µmol/L glucose 1,6-diphosphate, 16 mmol/L sodium phosphate (pH 7), 1 mmol/L AMP, 5 g/L glycogen, 0.15 mmol/L EDTA, and GPb, as indicated, in 20 mmol/L Tris-acetate buffer (pH 7.4), containing 0.03 mol/L NaCl, 0.1 mmol/L MgCl2, 0.1 g/L bovine serum albumin, 0.5 g/L gelatin, 0.1 g/L NaN3, and 0.2 mmol/L N-ethylmaleimide (22). GPb, AMP, and glycogen were preincubated for 15 min at 30 °C before the reaction was initiated with this mixture. The reaction was terminated by the addition of 0.05 mL of 13 g/L sodium dodecyl sulfate. NADPH formed by the reaction was measured fluorometrically at 25 °C in 10-mm pathlength quartz cuvettes using a Perkin-Elmer 650-40 fluorescence spectrophotometer. The excitation and emission wavelengths were set at 340 and 460 nm, respectively. The relevant slits were set at 5 and 10 nm, respectively.

Kinetic data were analyzed by using the nonlinear regression program GraFit (25).

determination of the number of t3 molecules bound to GPb
The number of molecules of T3 conjugated per subunit of GPb was calculated using the method of Saboori et al. (26) for determination of iodine in iodoproteins.

assay of t3
For T3 analysis the followed reagents were used:

The assay was performed as follows: 0.1 mL of calibrator or serum sample and 0.01 mL of antibody or blank antibody reagent were incubated at 30 °C for 30 min. Enzyme reagent (0.04 mL) was then added, and the mixture was incubated for 15 min at 30 °C. Finally, 0.45 mL of the substrate reagent was added. After an additional incubation at 30 °C for 1 h, the reaction was stopped by the addition of 0.05 mL of 13 g/L sodium dodecyl sulfate, and the NADPH formed was determined fluorometrically as described above.

For each sample, the fluorescence intensity in the presence (F; addition of 0.01 mL of antibody reagent) and absence of antibody (Fo; addition of 0.01 mL of blank antibody reagent) was measured. The calibration curve was constructed by plotting F - Fo vs the concentrations of the T3 calibrator.

ria
For comparison, we assayed T3 using the T3-solid-RIA reagent set (3), from the Institute of Radioisotopes and Radiodiagnostic Products.

subjects
Sera from blood samples without anticoagulant were obtained from patients who had attended Navy’s Hospital, Athens, Greece. Ninety-two consecutive routine patients (41 men and 51 women) who required laboratory thyroid testing were used for the precision and method comparison study, following the procedures approved by the ethics committee of Navy’s Hospital. The mean ages of the total patient group, and the men and the women as separate groups were 42.5 years (range, 19–71 years) for the total patient group, 39.8 years (range, 23–61 years) for the men, and 44.8 years for the women (range, 19–71 years).


   Results
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
GPb reacted with MCC-T3 at a GPb-to-amide mol/mol ratio of 1:2. This reaction ratio was found to be the optimum under the present experimental conditions (data not shown). Determination of iodine indicated that 1.2 molecules of T3 were bound per enzyme subunit. The activity of the enzyme conjugate was ~10% of the original activity prior to conjugation. When excess polyclonal anti-T3 antibody bound to the GPb-T3 conjugate, the enzyme regained activity, reaching ~65% of its original value. This activation of GPb-T3 conjugate was decreased in the presence of non-antibody-bound T3. The observed decrease in activity depended on the T3 concentration. This was the basis for the proposed homogeneous enzyme immunoassay for the determination of T3.

In an effort to understand the mechanism of inhibition of GPb by MCC-T3 conjugation, a comparative study of the kinetic parameters of the native and modified enzyme in presence and absence of polyclonal anti-T3 antibody was undertaken. As shown in Table 1 , the conjugation led to increases in Km values for both substrates, Pi and glycogen, and for AMP. In the presence of anti-T3 antibody, only the Km value for AMP was increased ~1.5-fold. In parallel, the conjugated enzyme lost its allosteric character (Hill coefficient for AMP, n <=1). The binding of anti-T3 antibody to GPb-T3 conjugate induced an enhancement of the Vmax values for Pi, glycogen, and AMP.


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Table 1. Kinetic parameters of native GPb and GPb-T3 conjugate in the absence and presence of polyclonal anti-T3 antibody.1

The present assay for T3 analysis used 0.1 mL of serum in a 0.6-mL final assay volume. The effect of this amount of serum on the activity of the native GPb, the conjugate GPb-T3, and the reactivation of the latter by anti-T3 antibody was examined. In all cases, the presence of serum induced an enzyme activity loss of ~30% compared with the values determined in the absence of serum. It is worth noting that the presence of serum in the assay did not alter the percentage of reactivation of GPb-T3 conjugate upon binding of anti-T3 antibody. Moreover, the small amount of GPb (<5 µg/L) present in human serum (18)(19) did not influence the determination of T3 by the present immunoassay because the T3 concentration was determined by the relative value of increase of the enzyme conjugate activity in the presence of anti-T3 antibody (F - Fo). Both values, Fo and F, included the activity of endogenous serum GP.

Furosemide was used for displacing T3 from serum binding proteins (27). The optimum concentration of furosemide was determined by mixing various concentrations of displacing agent with human serum containing 10 µg/L T3 and measuring the T3 concentration as described previously (27). Furosemide, at a final concentration of 0.1 mmol/L in serum-anti-T3 antibody-furosemide solution, provided maximum T3 displacement without interfering with the phosphorylase assay. T3 displacement was estimated by calculation of the analytical recovery. The mean analytical recovery of three separate samples was 96% (range, 95–98%).

To select the optimum concentration ratio of enzyme conjugate to anti-T3 antibody that could be used to determine the T3 concentration with the desired sensitivity and accuracy, an optimization procedure similar to the one applied for the analysis of theophylline in serum (11) was performed. We first followed the time course of the activation of GPb-T3 conjugate by polyclonal anti-T3 antibody. Activation of GPb-T3 was complete after incubation of the conjugate and the anti-T3 antibody for 30 min at 30 °C (data not shown). Preliminary experiments using various concentrations of GPb-T3 conjugate (0.03–0.2 mg/L) indicated that 0.09 mg/L was the optimal concentration under the chosen conditions. The GPb-T3 conjugate (0.09 mg/L) was then mixed with gradually increasing amounts of polyclonal anti-T3 antibody, and the enzyme reactivation was determined. As shown in Fig. 1 , the enzyme activity increased with increasing antibody concentration. Because the immunoassay must be able to discriminate among the T3 concentrations likely to be encountered when patient specimens are assayed, the optimum ratio of anti-T3 antibody to enzyme conjugate in the presence of different T3 concentrations within the desired assay range was determined. Fig. 2 illustrates an assessment of the system’s ability to discriminate among hypothyroidic, normothyroidic, and hyperthyroidic T3 concentrations (0.6, 1.8, and 5.5 µg/L T3, respectively). Although the peak antibody signal occurred between 0.1 and 0.2 µL for the given amount of the GPb-T3 conjugate, 0.1 µL of antibody was used for the T3 immunoassay. Fig. 3 shows a representative calibration curve for the homogeneous enzyme immunoassay for T3 using the six T3 serum calibrators.



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Figure 1. Activation of GPb-T3 activity by various concentrations of polyclonal anti-T3 antibody.

Activity of the enzyme conjugate was measured using a final GPb-T3 conjugate concentration of 0.09 mg/L and anti-T3 antibody as indicated. F and Fo, fluorescence intensity in the presence or absence of antibody, respectively.



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Figure 2. Determination of optimum anti-T3 antibody:enzyme conjugate ratio.

Activity of enzyme conjugates was measured as described in the legend for Fig. 1Up . Each curve represents the assay response (F - FT3), when 0.36 mg/L GPb-T3 conjugate interacted with various concentrations of anti-T3 antibody in the absence (F) and presence (FT3) of three T3 concentrations as indicated: 0.6 µg/L ({circ}), 1.8 µg/L (•), and 5.5 µg/L ({blacktriangleup}). F and FT3, fluorescence intensity in the absence and presence of T3, respectively.



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Figure 3. Calibration curve for T3.

Activity of enzyme conjugate was measured using a final concentration of 0.09 mg/L GPb-T3 conjugate and 0.1 µL of polyclonal anti-T3 antibody. The T3 assay was performed as described in Materials and Methods.

The detection limit of the present immunoassay was 0.15 µg/L T3. This value was determined by calculating the concentration of T3 that would give a response equal to 2 SD above that of T3 zero calibrator (0.0 µg/L).

Within-run imprecision was estimated by analyzing three samples with low, normal, and above-normal T3 concentrations, eight times each; the CVs were 5.0–21%. Between-run imprecision was measured in duplicate for three samples with low, normal, and above-normal T3 concentrations on 6 different days; the CVs were 6.1–16% (Table 2 ).


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Table 2. Precision of triiodothyronine assay.1

Analytical recovery studies were carried out by adding T3 to T3-free human sera (28) to give samples with T3 concentrations of 0.5, 1.3, 3.5, 4.5, and 6.5 µg/L. Analytical recoveries were 93%, 107%, 108%, 102%, and 106%, respectively.

To evaluate the applicability of the present immunoassay, we compared the values for 92 serum samples as measured with our homogeneous enzyme immunoassay with the values obtained by a RIA (Fig. 4 ). The regression equation of the obtained plot was: y = 0.97x - 0.07 µg/L (range examined, 0.3–8 µg/L T3); the correlation coefficient (r) was 0.96.



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Figure 4. Comparison between the present homogeneous enzyme immunoassay and RIA for T3.


   Discussion
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
 
The development of the first homogeneous enzyme immunoassay for the determination of T3 concentrations in human serum was based on the conjugation of T3 to GPb. MCC-T3 was covalently bound to the -SH groups of GPb. This modification induced inhibition of the enzyme activity, whereas binding of excess polyclonal anti-T3 antibody to the modified enzyme led to reactivation. One -SH group was modified per enzyme subunit. The enzyme lost its allosteric character, and the Km values for AMP and Pi were increased 13- and 11-fold, respectively. It is known that cysteine-318 is near the allosteric binding site, and its accessibility was calculated to be 77.8% in the GPb dimer by the program NACCESS (29). The -SH group of cysteine-318 is 9.03 Å from atom N1 of adenosine and 14.7 Å from the phosphorus of the phosphate group in AMP [the distances were calculated using the program CONTACT (30)]. All of the above, in addition to the fact that the conjugation reaction was instantaneous, led to the conclusions that cysteine-318 was the target of modification by MCC-T3 and that this modification was the cause of the observed enzyme inhibition. The binding of anti-T3 antibody to the conjugate caused conformational changes that led to an ~1.3- to 1.4-fold increase in the Vmax values for AMP and Pi.

The advantage of the present homogeneous enzyme immunoassay is its simplicity: homogeneous enzyme immunoassays do not require physical separation of free and antibody-bound components to determine the fraction of bound conjugate (31). Moreover, it is sufficiently sensitive and accurate for determining serum T3 concentrations between 0.3 and 8 µg/L, as do other currently available immunoassays for T3 analysis. In addition, it could be adapted to an automated analyzer. In this case, the storage characteristics and stability of the reagents should be determined over a wide range of laboratory conditions and a long period of time. Our results compare favorably with those obtained by a RIA. Furosemide was successfully used for blocking the binding of T3 to serum proteins (27)(32). The compound used most frequently to block the binding of T3 to these proteins, 8-anilino-1-naphthalenesulfonic acid, was excluded because it could interfere in the absorbance measurements (33) and inhibit GPb (34). Serum contains a small amount of GPb, <5 µg/L, which does not influence the determination of T3 with our enzyme immunoassay. The measurement of T3 is not affected by serum volume and serum components, which may cause inhibition of GPb, because the T3 concentration is determined by the relative increase in the enzyme conjugate activity in the presence of anti-T3 antibody.

In conclusion, modification of the -SH groups of GPb from rabbit muscle by a T3 derivative led to the development of the first homogeneous enzyme immunoassay for T3 analysis. The binding of MCC-T3 to GPb inhibited the enzyme activity, whereas binding of anti-T3 antibody to the GPb-T3 led to reactivation. The activation of GPb-T3 was gradually decreased in the presence of increasing concentrations of non-antibody-bound T3. More robust clinical investigation of this potential novel immunoassay is necessary to demonstrate its clinical utility because several medications or abnormal serum constituents might distort the assay signal.


   Acknowledgments
 
This work was supported by the Greek General Secretariat of Research and Technology (Grant Y{Pi}EP 55) and by MEDICON S.A. We thank Dr. N.G. Oikonomakos for valuable suggestions.


   Footnotes
 
1 Nonstandard abbreviations: T3, triiodothyronine; GP, glycogen phosphorylase; SMCC, 4-(maleimidomethyl)-cyclohexane-1-carboxylic acid N-hydroxysuccinimide ester; and MCC-T3, N-[4-(maleimidomethyl)-cyclohexan-1-yl]triiodothyronyl carboxamide.


   References
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Abstract
Introduction
Materials and Methods
Results
Discussion
References
 

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