Interferenza da biotina negli immunodosaggi: raccomandazioni del Gruppo di Studio SIBioC sulla Variabilità Extra-Analitica (SIBioC-VEA)
Giuseppe Lippi1,2, Graziella Bonetti1,3, Annalisa Modenese1,4, Andrea Padoan1,5, Davide Giavarina1,6, per il GdS SIBioC sulla Variabilità Extra-Analitica (SIBioC-VEA) 1Gruppo di Studio sulla Variabilità Extra-Analitica (SIBioC-VEA) 2Sezione di Biochimica Clinica, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italia 3Laboratorio Centrale di Chimica Clinica, ASST – Spedali Civili, Brescia, Italia 4Istituto Clinico Città Studi (ICCS) Milano, Italia 5Dipartimento Strutturale Medicina di Laboratorio, Azienda Ospedale Università di Padova, Italia 6Dipartimento della Diagnostica, Laboratorio Analisi, Ospedale San Bortolo, Vicenza, Italia
Biotin interference in immunoassays: recommendations of the SIBioC Working Group on Extra-Analytical Variability (WG-VEA).
Biotin is a water-soluble vitamin, which participates to a vast array of metabolic pathways involving fatty acids, carbohydrates and amino acids metabolism. This vitamin is also capable to form high-affinity bonds with various molecules, including streptavidin and avidin, which are essential components of many nimmunoassays based on the principle of biotin-streptavidin or biotin-avidin binding. In patients assuming high doses of biotin, therefore, some competitive and non-competitive immunoassays may exhibit falsely increased and falsely decreased test results, respectively, with magnitude of interference depending on biotin concentration in the test sample and on specific vulnerability of the immunoassay. With the aim to provide some expert guidance for identifying, preventing and managing biotin interference in clinical laboratory practice, this document contains a series of consensus recommendations endorsed by the Working Group on Extra-Analytical Variability of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (SIBioC). Briefly, the most important recommendations encompass local evaluation of possible biotin interference, routine history taking on biotin intake for both inpatients and outpatients, informing clinicians on potentially biotin-sensitive immunoassays, sample retesting 24-48 hours after the last biotin administration, along with possible consideration to add a note in the laboratory report highlighting the methods more vulnerable to biotin interference. Routine biotin measurement in all samples is currently discouraged.