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  • 1.
    Andersson, Per
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Karlsson, Jan-Erik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Internal Medicine, County Council of Jönköping, Jönköping.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Festin, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsson, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Norrköping, Sweden.
    Consequences of high-sensitivity troponin T testing applied in a primary care population with chest pain compared with a commercially available point-of-care troponin T analysis: an observational prospective study2015In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:There is a demand for a highly sensitive and specific point-of care test to detect acute myocardial infarction (AMI). It is unclear if a high-sensitivity troponin assay will have enough discriminative power to become a decision support in primary care. The aim of this study was to evaluate a high-sensitivity troponin T assay performed in three primary health care centres in southeast Sweden and to compare the outcome with a point-of-care troponin T test.METHODS:This study included 115 patients who consulted their general practitioner for chest pain, dyspnoea on exertion, unexplained weakness and/or fatigue in the last 7days. Troponin T was analysed by a point-of-care test and a high-sensitivity method together with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatinine. All patients were checked for AMI or unstable angina (UA) within 30days of study enrolment. Univariate and multivariate logistic regression was carried out to examine possible connections between troponin T[greater than or equal to]15ng/L, clinical variables and laboratory findings at baseline. In addition, 21 patients with troponin T[greater than or equal to]15ng/L and no signs of AMI or UA were followed up for 2-3years.RESULTS:Three patients were diagnosed with AMI and three with UA. At the [greater than or equal to]15ng/L cut-off, the troponin T method had 100% sensitivity, 75% specificity for AMI and a positive predictive value of 10%. The troponin T point-of-care test missed one case of AMI and the detection limit was 50ng/L. Troponin T[greater than or equal to]15ng/L was correlated to age [greater than or equal to]65years (odds ratio (OR), 10.9 95% CI 2.28-51.8) and NT-proBNP in accordance with heart failure (OR 8.62 95% CI 1.61-46.1). Fourteen of the 21 patients, without signs of AMI or UA at baseline, still had increased troponin T at follow-up after 2-3years.CONCLUSIONS:A high-sensitivity troponin T assay could become useful in primary care as a point-of-care test for patients <65years. For patients older than 65-70years, a higher decision limit than [greater than or equal to]15ng/L should be considered and used in conjunction with clinical parameters and possibly with NT-proBNP.

  • 2.
    Ekman, Bertil
    et al.
    Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Wahlberg Topp, Jeanette
    Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences.
    Urine oligosaccharide pattern in patients with hyperprolactinaemia2015In: Glycoconjugate Journal, ISSN 0282-0080, E-ISSN 1573-4986, Vol. 32, no 8, p. 635-641Article in journal (Refereed)
    Abstract [en]

    Free milk-type oligosaccharides are produced during pregnancy and lactation and may have an impact on several cells in the immune system. Our aim was to investigate if patients with isolated hyperprolactinaemia, not related to pregnancy, also have increased synthesis and urinary excretion of milk-type oligosaccharides and to compare the excretion pattern with that found during pregnancy. Urine samples were collected as morning sample from 18 patients with hyperprolactinaemia, 13 healthy controls with normal prolactin levels and four pregnant women. After purification, lactose and free oligosaccharides were analysed and quantified by high-performance anion-exchange chromatography with pulsed amperometric detection. The identity of peaks was confirmed by exoglycosidase treatment and comparison with oligosaccharide standards. Prolactin was measured in serum collected between 09 and 11 a.m. by a standardized immunochemical method. Patients with hyperprolactinaemia had higher urinary excretion of lactose than normoprolactinemic controls and urinary lactose correlated positively to prolactin levels (r = 0.51, p less than 0.05). Increased levels of the fucosylated oligosaccharides 2-fucosyl lactose and lacto-di-fucotetraose were found in urine from three and two patients, respectively. The acidic oligosaccharide 3-sialyl lactose was found in high amount in urine from two patients with prolactin of greater than 10,000 mU/l. However, pregnant women in their third trimester had the highest concentration of all these oligosaccharides and excretion increased during pregnancy. This study is first to show that both lactose and certain fucosylated and sialylated milk-type oligosaccharides are increased in some patients with hyperprolactinaemia. It remains to elucidate the functional importance of these findings.

  • 3.
    Gawria, Ghassaan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Tillmar, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    A comparison of stability of chemical analytes in plasma from the BD Vacutainer (R) Barricor (TM) tube with mechanical separator versus tubes containing gel separator2019In: Journal of clinical laboratory analysis (Print), ISSN 0887-8013, E-ISSN 1098-2825, article id e23060Article in journal (Refereed)
    Abstract [en]

    Background: There is a need of prolonged stability of certain chemical analytes in lithium heparin tubes with separators. A new tube with a mechanical separator has recently been launched (Barricor (TM)), which according to the manufacturer may have these benefits. The aim of this study was to evaluate stability performance of this tube in comparison with plasma gel tubes under clinically realistic circumstances. Methods: Blood was collected in tubes containing lithium heparin with different separators; gel separator (Vacutainer (R) PST (TM), Becton Dickinson and Vacuette (R), Greiner bio-one) and mechanical separator (Vacutainer (R) Barricor (TM), Becton Dickinson). All tubes had an aspiration volume of 3 mL and were centrifuged at similar time and force. Tubes were transported manually or by car. Seven analytes from 122 patients were analyzed after 3 to 80 hours by Cobas c701 (Roche). Results The Barricor (TM) tube showed increased stability of phosphate and potassium and similar stability of aspartate aminotransferase, glucose, homocysteine, lactate dehydrogenase, and magnesium compared with gel tubes. Maximal allowable bias for phosphate was exceeded after 68 hours for Barricor (TM) tubes compared with 29 or 35 hours for gel tubes and for potassium after 40 hours for Barricor (TM) tubes vs 9 or 12 hours for gel tubes. Transportation did not affect stability. Hemolysis index was slightly lower in Barricor tubes than in gel tubes (P = .01). Conclusion Implementing the new Barricor (TM) tube will improve stability of potassium and phosphate in plasma. Blood sampling facilities far from the laboratory may benefit from using these tubes, thus diminishing preanalytical errors.

  • 4.
    Landberg, Eva
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Free oligosaccharides and glycosylation of bile salt-stimulated lipase in human milk2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Bile salt-stimulated lipase (BSSL) is a glycosylated protein present in milk at a concentration of 100-200 mg/L. It is an enzyme important for fat digestion in the newborn infant. The protein backbone contains one possible site for N-glyeosylation and several sites for 0-glyeosylation. The glycosylation of BSSL may be important for protection against proteolytic degradation and/or secretion of BSSL. The oligosaeeharides bound to BSSL may also, together with other protein-bound oligosacchatides and free oligosaecharides in milk, play an important role in the defense against pathogenic microorganisms. Human milk contains approximately 5-20 g/L of free milk oligosacchatides, and more than 100 different structures have been identified. There are individual differences in the content of milk oligosaeeharides depending on Lewis and seeretor status.

    Milk samples were collected from healthy donors at different times during lactation. BSSL was purified from the milk of five donors. Structural characterization of BSSL glyeosylation was performed by high-performance anionexchange chromatography (HP AEC), Bio-Gel P-4 chromatography, lectin affinity chromatography, gas chromatography coupled to mass-spectrometry (MS) and mattix assisted laser desorption-ionization time-of-flight MS. Certain carbohydrate epitopes were detected by monoclonal antibodies and lectins. Some of the methods above were used in combination with ptior derivatization, desialylation or digestion with different exo- and endoglycosidases. Thirteen major free oligosaccharides were quantified in milk from five individuals. Free milk oligosacchatides were purified by P4-Gel chromatography and analyzed by HPAEC.

    HP AEC coupled to pulsed amperometric detection is extensively used for analysis and quantification of oligosaccharides. Separation is achieved using highly alkaline conditions that lead to ionization of some of the hydroxyl groups, which can then interact with the anion-exchange matrix. The effect of colunm temperature was examined in a range of 13 to 40 oC. A large variation in retention times was found depending on small differences in colunm temperature. Moreover, individual oligosaccharides did not show the same temperature dependence. By use of different column temperatures, HP AEC could be optimized for analysis of milk oligosaccharides.

    BSSL was found to contain approximately one N-linked and nine O-linked oligosaccharides. The 0-glycans were stmcturally heterogeneous and contained· fucose and/or sialic acid. Each 0-glycan contained an average of eight monosaccharide units. The major N-linked oligosaccharides on human BSSL were mono-sialylated biantennary complex type structures with or without one, two or three fucose residues.

    Recombinant human BSSL expressed in CHO and C-127 cells were analyzed and found to be differently glycosylated than native BSSL. In contrast to native BSSL, recombinant BSSL did not contain fucose. On BSSL expressed in C-127 cells, the O-glycans were shorter and more extensively sialylated than O-glycans on native BSSL. The majority of N-linked oligosaccharides on recombinant BSSL had the same core structure (biantennary complex type) as native BSSL.

    Glycosylation of BSSL changed during lactation. BSSL had a higher carbohydrate and sialic acid content in the first lactation month. There was also a shift from preferentially α2-6 to α2-3 linked sialic acid on the protein-bound oligosaccharides during lactation. This shift was also found for free sialylated milk oligosaccharides, and suggests a change in the activity of certain sialyltransferases during lactation.

    A gradual increase in the expression of the fucosylated carbohydrate epitope Lewis x (Galß1-4[Fucal-3]GlcNAc-) was found on BSSL during the whole lactation period. This was reflected in a higher relative amount of fucosylated N-linked oligosaccharides present on BSSL later in lactation. A similar increase in fucosylation was indicated by analysis of free milk oligosaccharides. One of the major milk oligosaccharides, 3-fucosyllactose (3-FL), also increased in concentration during lactation. However, lacto-N-fucopentaose (LNFIII), the only free milk oligosaccharide containing the Lewis x epitope, showed a constant concentration. This finding does not exclude the possibility that the same fucosyltransferase is involved in the synthesis of Lewis x on BSSL, 3-FL and LNFIII. The precursor of LNFIII, lacto-N-neotetraose (LNnT) showed a marked decrease during lactation, which may explain the different pattem found for LNFIIl. The increase of 3-FL and Lewis x on BSSL was found for all individuals. The other free oligosaccharides studied decreased during lactation, except for lacto-N-fucopentaose li (LNFII), lacto-di-fucotetraose (LDFT) and 3-sialyllactose (3-SL), which showed constant concentrations.

    Total fucosyltransferase activity decreased during lactation in milk from both secretors and non-secretors. The specific α1-3 fucosyl transferase activity toward lactose also decreased during lactation, which indicated that fucosyltransferase activity in milk does not reflect the activity in the mammary epithelial cells.

    In conclusion, there are changes in glycosylation during lactation, which involves both protein-bound and free milk oligosaccharides. The different patterns for individual oligosaccharides indicate both down and up regulation of certain glycosyltransferases in the mammary gland during lactation. The importance of these changes for the infant's adaptation to the environment remains to be elucidated.

    List of papers
    1. Temperature effects in high-performance anion-exchange chromatography of oligosaccharides
    Open this publication in new window or tab >>Temperature effects in high-performance anion-exchange chromatography of oligosaccharides
    1998 (English)In: Journal of Chromatography A, ISSN 0021-9673, E-ISSN 1873-3778, Vol. 814, no 1-2, p. 97-104Article in journal (Refereed) Published
    Abstract [en]

    High-performance anion-exchange chromatography (HPAEC) with pulsed amperometric detection has been widely used for analysis of mono-, oligo- and polysaccharides. Many factors that affect separation of carbohydrates by HPAEC have been evaluated, however effect of temperature has not been carefully studied. In the present study, neutral and sialylated oligosaccharides from human milk and different types of N-linked oligosaccharides were analysed by HPAEC at temperatures ranging from 13 to 30°C. N-Acetyl neuraminic acid, galacturonic acid and stachyose were also analysed since they have been used as internal standards when analysing various oligosaccharides by HPAEC. All oligosaccharides showed decreased retention times with increased temperature. Even small differences in temperature (i.e. ±5°) resulted in considerable changes in retention times. In addition, individual oligosaccharides showed different relative changes in retention time with increased temperature. By changing the temperature, a switch in elution order of individual oligosaccharides were sometimes found. These results show that retention times relative to an internal standard cannot be used for oligosaccharide identification unless temperature is carefully controlled. Regulation of temperature is also a valuable tool in achieving optimal separation of oligosaccharides by HPAEC.

    Keywords
    Temperature effects, Oligosaccharides
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79993 (URN)10.1016/S0021-9673(98)00381-1 (DOI)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2017-12-07Bibliographically approved
    2. Glycosylation of Bile-Salt-Stimulated Lipase from Human Milk: Comparison of Native and Recombinant Forms
    Open this publication in new window or tab >>Glycosylation of Bile-Salt-Stimulated Lipase from Human Milk: Comparison of Native and Recombinant Forms
    Show others...
    1997 (English)In: Archives of Biochemistry and Biophysics, ISSN 0003-9861, E-ISSN 1096-0384, Vol. 344, no 1, p. 94-102Article in journal (Refereed) Published
    Abstract [en]

    Bile-salt-stimulated lipase (BSSL) is an enzyme present in human milk. BSSL is important for fat digestion in infants. It contains one site for N-glycosylation and a serine/threonine-rich domain which is highly O-glycosylated. Both N- and O-linked sugar chains were studied on native BSSL from three donors and compared to the glycosylation of recombinant BSSL produced in Chinese hamster ovary or mouse fibroblast (C-127) cell lines. The carbohydrate composition of oligosaccharides was mapped using sugar and methylation analyses, enzyme-linked immunosorbant assay, and different separation techniques. Native BSSL was found to be highly glycosylated (19–26%). It contained a high amount of fucosylated oligosaccharides and expressed both Lewis a and Lewis b blood group antigens. None of the recombinant BSSL forms contained fucose. N-linked structures on native BSSL were identified as mainly mono- and disialylated biantennary complex type structures with or without fucose substitution. High-pH anion-exchange chromatography analysis indicated that the recombinant forms of BSSL contained similar types ofN-glycan structures differing mainly in their content of sialic acid and by the absence of fucose residues. Native BSSL contained predominantly large O-linked oligosaccharides. This was in contrast to the recombinant forms of BSSL which contained mainly short typeO-glycans with a high content of sialic acid. Interestingly, the estimated number of O-glycans attached to native BSSL was lower than that for the recombinant forms.

    Keywords
    bile-salt-stimulated lipase, glycosylation, high-pH anion-exchange chromatography, human milk, recombinant proteins
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79994 (URN)10.1006/abbi.1997.0188 (DOI)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2017-12-07Bibliographically approved
    3. Changes in Glycosylation of Human Bile-Salt-Stimulated Lipase during Lactation
    Open this publication in new window or tab >>Changes in Glycosylation of Human Bile-Salt-Stimulated Lipase during Lactation
    Show others...
    2000 (English)In: Archives of Biochemistry and Biophysics, ISSN 0003-9861, E-ISSN 1096-0384, Vol. 377, no 2, p. 246-254Article in journal (Refereed) Published
    Abstract [en]

    Bile-salt-stimulated lipase (BSSL) is an enzyme in human milk, which is important for the fat digestion in the newborn infant. BSSL is highly glycosylated and includes one site for N-glycosylation and several sites for O-glycosylation. BSSL has previously been found to express Lewis a, Lewis b, and Lewis x carbohydrate antigens. In this study, glycosylation of BSSL was studied at different times during lactation. BSSL was purified from milk collected individually from four donors at several different times during the first 6 months of lactation. The BSSL glycans were characterized through monosaccharide analysis, high-pH anion-exchange chromatography, matrix-assisted laser desorption–ionization mass spectrometry, and ELISA. Both total carbohydrate content and relative amount of sialic acid were higher in BSSL from the first lactation month as compared to BSSL from milk collected later in lactation. BSSL from the first lactation month also showed a different composition of sialylated O-linked glycans and the N-linked oligosaccharides consisted of lower amounts of fucosylated structures compared to later in lactation. We also found a gradual increase in the expression of the carbohydrate epitope Lewis x on BSSL throughout the lactation period. This study shows that glycosylation of BSSL is dependent on blood group phenotype of the donor and changes substantially during the lactation period.

    Keywords
    bile-salt-stimulated lipase, glycosylation, Lewis x, human milk
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-25198 (URN)10.1006/abbi.2000.1778 (DOI)9637 (Local ID)9637 (Archive number)9637 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    4. Quantitative changes of fucosylated human milk oligosaccharides during lactation in comparison to milk fucosyltransferase activity
    Open this publication in new window or tab >>Quantitative changes of fucosylated human milk oligosaccharides during lactation in comparison to milk fucosyltransferase activity
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Human milk contains 7-20 g/L of free oligosaccharides. The oligosaccharides show large variations in size and structure. It has been suggested that milk oligosaccharides can prevent pathogenic microorganisms from attaching to the gastrointestinal epithelium by blocking bacterial adhesins. However, the biological role of milk oligosaccharides is far from understood. In this study, the major fucosylated oligosaccharides in milk were followed during six to nine months of lactation. Individual oligosaccharides were separated and quantified by high-performance anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD). The fucosylated oligosaccharides 2-fucosyl lactose, lacto-N-fucopentaose I and lacto-N-di-fucohexaose I showed decreasing concentrations in milk during lactation. The concentrations of lacto-difucotetraose, lacto-N-fucopentaose II and Ill remained constant, while 3-fucosyl lactose (3-FL) showed increasing concentrations during lactation. The increase of 3-FL was found for all individuals independent of secretor status, but did not correlate to milk fucosyltransferase activity when the product 3-FL was measured separately. Instead all individuals showed a decrease in fucosyltransferase activity during lactation, indicating that fucosyltransferase activity in milk does not reflect the biosynthetic activity in the mammary gland. This study shows that the composition of fucosylated oligosaccharides vary considerably during the first six months of lactation. This may reflect unique biological roles of certain oligosaccharides in the infant's adaptation to the environment.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-79998 (URN)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2012-08-17Bibliographically approved
    5. Changes in the relative amounts of α2-3 and α2-6 linked sialic acid on free and protein-bound milk oligosaccharides during lactation
    Open this publication in new window or tab >>Changes in the relative amounts of α2-3 and α2-6 linked sialic acid on free and protein-bound milk oligosaccharides during lactation
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Human milk contains large amounts of oligosaccharides, both in free and protein-bound forms. Sialic acid is a common constituent of milk oligosaccharides and is present α2-3 or α2-6 linked to galactose, α2-6 to N-acetyl glucosamine or α2-6 to N-acetyl galactosamine. High-performance anionexchange chromatography with pulsed amperometric detection (HPAEC-PAD) was used to quantify four major sialylated milk oligosaccharides. The concentrations of the individual oligosaccharides were analyzed in milk from five donors, followed separately during six to nine months of lactation. The oligosaccharides containing sialic acid a2-6 linked to galactose ( 6-sialyl lactose and LSTc) decreased more than tenfold during lactation. In contrast, the concentration of 3-sialyl lactose (3-SL) containing sialic acid a2-3 linked to galactose remained constant during nine months of lactation. Disialyl lacto-Ntetraose (DSLNT) which contain sialic acid linked α2-3 to Gal and α2-6 to GlcNAc decreased approximately threefold during lactation. Lectin ELISA was used to analyze sialic acid on the secreted milk glycoprotein bile-salt-stimulated lipase (BSSL ). There was a gradual decrease in the binding of Sambucus Nigra lectin to BSSL, indicating decreased amount of α2-6 linked sialic acid during lactation. In contrast, binding of Maackia Amurensis lectin remained constant, indicating a constant expression of α2-3 linked sialic acid on BSSL during lactation. This suggests a shift from preferentially 6-linked to 3-linked sialic acid on free and protein-bound oligosaccharides during lactation. The shift may reflect changes in sialyltransferase activities and, on a higher level, changes in the population of mammary epithelial cells. This finding may be of importance for the development of a correct immune response to environmental challenges.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80000 (URN)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2012-08-17Bibliographically approved
  • 5.
    Landberg, Eva
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Chemistry.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Alehagen, Urban
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Serum prolactin and macroprolactin in heart failure: no relation to established laboratory or clinical parameters2011In: ANNALS OF CLINICAL BIOCHEMISTRY, ISSN 0004-5632, Vol. 48, p. 51-56Article in journal (Refereed)
    Abstract [en]

    Background: A few smaller studies have reported that the prolactin concentration is elevated in connection with heart failure. As heart failure is combined with disturbances of several biological systems any or all of which may also influence prolactin concentrations, we wanted to evaluate the relation of prolactin to prognosis in elderly patients. Methods: A total of 462 elderly patients from a primary health-care centre, all with symptoms of heart failure, were included. In addition to clinical examination including echocardiography, concentrations of prolactin, macroprolactin, C-reactive protein, thyroid-stimulating hormone and N-terminal pro B-type natriuretric peptide (NT-proBNP) were measured. Patients were then followed for 10 y, and all incidents of cardiovascular mortality were registered. Results: After excluding patients with macroprolactin, hyperprolactinaemia was found in 3.7% of the patients. There were no differences in prolactin concentrations or in the frequency of macroprolactin between patients with heart failure and those with normal cardiac function, defined as left ventricular ejection fraction of at least 50%. No significant correlation could be found between NT-proBNP and prolactin. Neither could any association be found between cardiovascular mortality and prolactin concentration during 10 y of follow-up. Conclusions: Prolactin concentrations were not associated with cardiovascular mortality or any clinical or biochemical marker of heart failure. Macroprolactin was found in similar frequency among patients with and without heart failure, and showed no correlation with mortality risk.

  • 6.
    Landberg, Eva
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Huang, Yunping
    Department of Chemistry, Indiana University, Bloomington, Indiana, USA.
    Strömqvist, Mats
    AstraZeneca R&D, Umeå, Sweden.
    Mechref, Yehia
    Department of Chemistry, Indiana University, Bloomington, Indiana, USA.
    Hansson, Lennart
    AstraZeneca R&D, Umeå, Sweden.
    Lundblad, Arne
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Novotny, Milos
    Department of Chemistry, Indiana University, Bloomington, Indiana, USA.
    Påhlsson, Peter
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Changes in Glycosylation of Human Bile-Salt-Stimulated Lipase during Lactation2000In: Archives of Biochemistry and Biophysics, ISSN 0003-9861, E-ISSN 1096-0384, Vol. 377, no 2, p. 246-254Article in journal (Refereed)
    Abstract [en]

    Bile-salt-stimulated lipase (BSSL) is an enzyme in human milk, which is important for the fat digestion in the newborn infant. BSSL is highly glycosylated and includes one site for N-glycosylation and several sites for O-glycosylation. BSSL has previously been found to express Lewis a, Lewis b, and Lewis x carbohydrate antigens. In this study, glycosylation of BSSL was studied at different times during lactation. BSSL was purified from milk collected individually from four donors at several different times during the first 6 months of lactation. The BSSL glycans were characterized through monosaccharide analysis, high-pH anion-exchange chromatography, matrix-assisted laser desorption–ionization mass spectrometry, and ELISA. Both total carbohydrate content and relative amount of sialic acid were higher in BSSL from the first lactation month as compared to BSSL from milk collected later in lactation. BSSL from the first lactation month also showed a different composition of sialylated O-linked glycans and the N-linked oligosaccharides consisted of lower amounts of fucosylated structures compared to later in lactation. We also found a gradual increase in the expression of the carbohydrate epitope Lewis x on BSSL throughout the lactation period. This study shows that glycosylation of BSSL is dependent on blood group phenotype of the donor and changes substantially during the lactation period.

  • 7.
    Landberg, Eva
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Lundblad, Arne
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Påhlsson, Peter
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Changes in the relative amounts of α2-3 and α2-6 linked sialic acid on free and protein-bound milk oligosaccharides during lactationManuscript (preprint) (Other academic)
    Abstract [en]

    Human milk contains large amounts of oligosaccharides, both in free and protein-bound forms. Sialic acid is a common constituent of milk oligosaccharides and is present α2-3 or α2-6 linked to galactose, α2-6 to N-acetyl glucosamine or α2-6 to N-acetyl galactosamine. High-performance anionexchange chromatography with pulsed amperometric detection (HPAEC-PAD) was used to quantify four major sialylated milk oligosaccharides. The concentrations of the individual oligosaccharides were analyzed in milk from five donors, followed separately during six to nine months of lactation. The oligosaccharides containing sialic acid a2-6 linked to galactose ( 6-sialyl lactose and LSTc) decreased more than tenfold during lactation. In contrast, the concentration of 3-sialyl lactose (3-SL) containing sialic acid a2-3 linked to galactose remained constant during nine months of lactation. Disialyl lacto-Ntetraose (DSLNT) which contain sialic acid linked α2-3 to Gal and α2-6 to GlcNAc decreased approximately threefold during lactation. Lectin ELISA was used to analyze sialic acid on the secreted milk glycoprotein bile-salt-stimulated lipase (BSSL ). There was a gradual decrease in the binding of Sambucus Nigra lectin to BSSL, indicating decreased amount of α2-6 linked sialic acid during lactation. In contrast, binding of Maackia Amurensis lectin remained constant, indicating a constant expression of α2-3 linked sialic acid on BSSL during lactation. This suggests a shift from preferentially 6-linked to 3-linked sialic acid on free and protein-bound oligosaccharides during lactation. The shift may reflect changes in sialyltransferase activities and, on a higher level, changes in the population of mammary epithelial cells. This finding may be of importance for the development of a correct immune response to environmental challenges.

  • 8.
    Landberg, Eva
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Lundblad, Arne
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Påhlsson, Peter
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Quantitative changes of fucosylated human milk oligosaccharides during lactation in comparison to milk fucosyltransferase activityManuscript (preprint) (Other academic)
    Abstract [en]

    Human milk contains 7-20 g/L of free oligosaccharides. The oligosaccharides show large variations in size and structure. It has been suggested that milk oligosaccharides can prevent pathogenic microorganisms from attaching to the gastrointestinal epithelium by blocking bacterial adhesins. However, the biological role of milk oligosaccharides is far from understood. In this study, the major fucosylated oligosaccharides in milk were followed during six to nine months of lactation. Individual oligosaccharides were separated and quantified by high-performance anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD). The fucosylated oligosaccharides 2-fucosyl lactose, lacto-N-fucopentaose I and lacto-N-di-fucohexaose I showed decreasing concentrations in milk during lactation. The concentrations of lacto-difucotetraose, lacto-N-fucopentaose II and Ill remained constant, while 3-fucosyl lactose (3-FL) showed increasing concentrations during lactation. The increase of 3-FL was found for all individuals independent of secretor status, but did not correlate to milk fucosyltransferase activity when the product 3-FL was measured separately. Instead all individuals showed a decrease in fucosyltransferase activity during lactation, indicating that fucosyltransferase activity in milk does not reflect the biosynthetic activity in the mammary gland. This study shows that the composition of fucosylated oligosaccharides vary considerably during the first six months of lactation. This may reflect unique biological roles of certain oligosaccharides in the infant's adaptation to the environment.

  • 9.
    Landberg, Eva
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Lundblad, Arne
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Påhlsson, Peter
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Temperature effects in high-performance anion-exchange chromatography of oligosaccharides1998In: Journal of Chromatography A, ISSN 0021-9673, E-ISSN 1873-3778, Vol. 814, no 1-2, p. 97-104Article in journal (Refereed)
    Abstract [en]

    High-performance anion-exchange chromatography (HPAEC) with pulsed amperometric detection has been widely used for analysis of mono-, oligo- and polysaccharides. Many factors that affect separation of carbohydrates by HPAEC have been evaluated, however effect of temperature has not been carefully studied. In the present study, neutral and sialylated oligosaccharides from human milk and different types of N-linked oligosaccharides were analysed by HPAEC at temperatures ranging from 13 to 30°C. N-Acetyl neuraminic acid, galacturonic acid and stachyose were also analysed since they have been used as internal standards when analysing various oligosaccharides by HPAEC. All oligosaccharides showed decreased retention times with increased temperature. Even small differences in temperature (i.e. ±5°) resulted in considerable changes in retention times. In addition, individual oligosaccharides showed different relative changes in retention time with increased temperature. By changing the temperature, a switch in elution order of individual oligosaccharides were sometimes found. These results show that retention times relative to an internal standard cannot be used for oligosaccharide identification unless temperature is carefully controlled. Regulation of temperature is also a valuable tool in achieving optimal separation of oligosaccharides by HPAEC.

  • 10.
    Landberg, Eva
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Påhlsson, Peter
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Krotkiewski, Hubert
    Institute of Immunology & Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland.
    Strömqvist, Mats
    Astra Hässle, Preclinical Research and Development, Umeå, Sweden.
    Hansson, Lennart
    Astra Hässle, Preclinical Research and Development, Umeå, Sweden.
    Lundblad, Arne
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Glycosylation of Bile-Salt-Stimulated Lipase from Human Milk: Comparison of Native and Recombinant Forms1997In: Archives of Biochemistry and Biophysics, ISSN 0003-9861, E-ISSN 1096-0384, Vol. 344, no 1, p. 94-102Article in journal (Refereed)
    Abstract [en]

    Bile-salt-stimulated lipase (BSSL) is an enzyme present in human milk. BSSL is important for fat digestion in infants. It contains one site for N-glycosylation and a serine/threonine-rich domain which is highly O-glycosylated. Both N- and O-linked sugar chains were studied on native BSSL from three donors and compared to the glycosylation of recombinant BSSL produced in Chinese hamster ovary or mouse fibroblast (C-127) cell lines. The carbohydrate composition of oligosaccharides was mapped using sugar and methylation analyses, enzyme-linked immunosorbant assay, and different separation techniques. Native BSSL was found to be highly glycosylated (19–26%). It contained a high amount of fucosylated oligosaccharides and expressed both Lewis a and Lewis b blood group antigens. None of the recombinant BSSL forms contained fucose. N-linked structures on native BSSL were identified as mainly mono- and disialylated biantennary complex type structures with or without fucose substitution. High-pH anion-exchange chromatography analysis indicated that the recombinant forms of BSSL contained similar types ofN-glycan structures differing mainly in their content of sialic acid and by the absence of fucose residues. Native BSSL contained predominantly large O-linked oligosaccharides. This was in contrast to the recombinant forms of BSSL which contained mainly short typeO-glycans with a high content of sialic acid. Interestingly, the estimated number of O-glycans attached to native BSSL was lower than that for the recombinant forms.

  • 11.
    Landberg, Eva
    et al.
    Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Wahlberg Topp, Jeanette
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Rydén, Ingvar
    Division of Clinical Chemistry, Kalmar County Hospital, Kalmar, Sweden.
    Arvidsson, Britt-Marie
    Division of Clinical Chemistry, Kalmar County Hospital, Kalmar, Sweden.
    Ekman, Bertil
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Detection of molecular variants of prolactin in human serum, evaluation of a method based on ultrafiltration2007In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 376, no 1-2, p. 220-225Article in journal (Refereed)
    Abstract [en]

    Background

    In human blood, there are several molecular variants of prolactin with different biological effects. There is a need for new methods to detect and quantify these variants in order to fully understand the pathophysiological role of prolactin.

    Methods

    A method based on ultrafiltration was optimized, validated and compared to PEG precipitation. Serum samples from 84 patients were analyzed before and after pre treatment on two immunoassays, Elecsys (Roche) and Access (Beckman). Protein G precipitation was used to confirm presence of macroprolactin.

    Results

    The recovery of prolactin after ultrafiltration was lower than after PEG precipitation. A limit of 40% recovery after PEG precipitation corresponded to 27% recovery after ultrafiltration. Using these limits there were total agreement regarding detection of macroprolactin (rs = 0.96). In contrast, recovery of prolactin in samples without macroprolactin showed a considerable disagreement between ultrafiltration and PEG precipitation (rs = 0.48). Within-run CV was 4% for the ultrafiltration method. The correlation coefficient (r) between the immunoassays was 0.96 after ultrafiltration.

    Conclusions

    Ultrafiltration can be used to compare different prolactin immunoassays and to detect macroprolactin in assays with interference from PEG. For samples without macroprolactin ultrafiltration may give additional information reflecting individual variations of other molecular variants of prolactin.

  • 12.
    Landberg, Eva
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Chemistry.
    Åström, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Kågedal, Bertil
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Chemistry.
    Påhlsson, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Disialo–trisialo bridging of transferrin is due to increased branching and fucosylation of the carbohydrate moiety2012In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 414, p. 58-64Article in journal (Refereed)
    Abstract [en]

    Background

    Carbohydrate deficient transferrin (CDT) is used for detection of alcohol abuse and follow-up. High performance liquid chromatography (HPLC) of transferrin glycoforms is highly specific for identification of alcohol abuse, but unresolved disialo- and trisialotransferrin glycoforms sometimes makes interpretation difficult. The cause of this phenomenon is unknown, cannot be explained by genetic variants of transferrin, but seems to be associated with liver disease.

    Methods

    Nineteen serum samples showing di–tri bridging when analyzed by HPLC were collected. Transferrin was purified by affinity chromatography, and N-linked oligosaccharides were released enzymatically. The N-glycans were further analyzed by high performance anion-exchange chromatography with pulsed amperometric detection and MALDI-TOF mass spectrometry.

    Results

    The HPLC-analysis showed three different types of glycoform patterns. The N-glycans from fifteen samples showed patterns with increased number of triantennary structures containing one or two fucose residues. One sample contained an increased amount of triantennary glycans without fucose. Three samples showed a glycosylation pattern similar to normal transferrin.

    Conclusions

    The di–tri bridging phenomenon was associated with alterations in transferrin glycosylation in the majority of cases. Transferrin contained a higher extent of triantennary and often fucosylated N-linked oligosaccharides. These results may be important in future diagnostic approaches to liver diseases.

  • 13.
    Nilsson, Staffan
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Primary Health Care in Norrköping.
    Andersson, Per O.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.
    Borgquist, Lars
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Grodzinsky, Ewa
    Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Kvick, Magnus
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Primary Health Care in Norrköping.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Nilsson, Håkan
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.
    Karlsson, Jan-Erik
    Department of Internal Medicine, County Hospital Ryhov, Jönköping.
    Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care2013In: International Journal of Family Medicine, ISSN 2090-2042, E-ISSN 2090-2050, Vol. 2013Article in journal (Refereed)
  • 14.
    Parenmark, Anna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    To mix or not to mix venous blood samples collected in vacuum tubes?2011In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 49, no 12, p. 2061-2063Article in journal (Refereed)
    Abstract [en]

    Background: There are recommendations to mix venous blood samples by inverting the tubes immediately after venipuncture. Though mixing allows efficient anticoagulation in plasma tubes and fast initiation of coagulation in serum tubes, the effect on laboratory analyses and risk of haemolysis has not been thoroughly evaluated. less thanbrgreater than less thanbrgreater thanMethods: Venous blood samples were collected by venipuncture in vacuum tubes from 50 patients (10 or 20 patients in each group). Four types of tubes and 18 parameters used in routine clinical chemistry were evaluated. For each patient and tube, three types of mixing strategies were used: instant mixing, no mixing and 5 min of rest followed by mixing. less thanbrgreater than less thanbrgreater thanResults: Most analyses did not differ significantly in samples admitted to different mixing strategies. Plasma lactate dehydrogenase and haemolysis index showed a small but significant increase in samples omitted to instant mixing compared to samples without mixing. However, in one out of twenty non-mixed samples, activated partial thromboplastin time was seriously affected. less thanbrgreater than less thanbrgreater thanConclusions: These results indicate that mixing blood samples after venipuncture is not mandatory for all types of tubes. Instant mixing may introduce interference for those analyses susceptible to haemolysis. However, tubes with liquid-based citrate buffer for coagulation testing should be mixed to avoid clotting.

  • 15.
    Wahlberg Topp, Jeanette
    et al.
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Tillmar, Linda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Ekman, Bertil
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
    Lindahl, Tomas
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Effects of prolactin on platelet activation and blood clotting2013In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 73, no 3, p. 221-228Article in journal (Refereed)
    Abstract [en]

    Increased levels of prolactin often coincide with an increased risk for thromboembolic events, but it is unclear whether a direct causal relation exists. Our aim was to examine the effect of prolactin on platelet function. In addition to using recombinant prolactin for experiments in vitro, we analyzed platelet function by flow cytometry in a group of 13 females with hyperprolactinaemia and 18 healthy female controls. Platelet activation was measured by P-selectin expression and by the amount of platelet-bound fibrinogen after stimulation with adenosine diphosphate (ADP), collagen-related peptide and the protease activated receptor (thrombin receptor) (PAR)-activating peptides PAR4-AP and PAR1-AP. Free oscillation rheometry was used to measure clotting time in whole blood. No significant effect on platelet activation or clotting time could be seen in in vitro experiments by adding recombinant prolactin. However, significantly lower P-selectin expression was found in the hyperprolactinemic group when platelets were activated by ADP (5 and 10 mu M) or PAR4-AP. The expression of fibrinogen did not differ between the two groups for any of the activators used. For all samples, inverse significant correlations between P-selectin expression and prolactin concentration were found for both 5 mu M ADP (r = 0.61, p andlt; 0.01), 10 mu M ADP (r = -0.62, p andlt; 0.001) and PAR4-AP (r = -0.69, p andlt; 0.001). Thrombin cleavage of recombinant prolactin resulting in a 16 kDa C-terminal fragment did not alter the P-selectin expression upon activation. We found an indirect inhibitory effect of prolactin on platelets in hyperprolactinemic patients, suggesting that prolactin might have a protective role in thromboembolic disease.

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