AST Assay
AST Assay
Reagent | Aspartate Aminotransferase (AST)
A Marker of Hepatocellular Injury
Powered by BiozBenefits of the Randox Aspartate Aminotransferase (AST) assay
Excellent precision
The Randox AST assay displayed a within run precision of < 4.96%.
Excellent stability
The Randox AST assay is stable to expiry when stored at +2oC to +8oC.
Liquid ready-to-use
The Randox AST assay is available in a liquid ready-to-use format for convenience and ease-of-use.
Calibrator and controls available
Calibrator and controls available offering a complete testing package.
Applications available
Applications available detailing instrument-specific settings for the convenient use of the Randox AST assay on a variety of clinical chemistry analysers.
Ordering Information
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
| Cat No | Size | ||||
|---|---|---|---|---|---|
| AS3804 | R1 6 x 51ml (L) R2 6 x 14ml | Enquire | Kit Insert Request | MSDS | Buy Online |
| AS101 | R1 1 x 100ml (L) R2 1 x 100ml (Colorimetric, manual only) | Enquire | Kit Insert Request | MSDS | Buy Online |
| AS8005 | R1 6 x 56ml (L) R2 6 x 20ml | Enquire | Kit Insert Request | MSDS | Buy Online |
| AS8306 | R1 4 x 20ml (L) R2 4 x 7ml | Enquire | Kit Insert Request | MSDS | Buy Online |
| (L) Indicates liquid option | |||||
Clinical Significance
Enzymes are organic molecules responsible for the acceleration of biochemical reactions, however, emerge unchanged following the reaction. Aminotransferases are a family of enzymes that catalyse the conversion of amino acids to 2-oxo-acids by the transfer of amino acids 1. AST is present in mitochondrial and cytosolic enzymes (80% and 20% of activity respectively), found in brain, cardiac muscle, kidneys, leucocytes, liver, lungs, red blood cells and skeletal muscle 2.
AST is a marker of hepatocellular injury, predominantly alcohol-related liver injury (chronic hepatitis C) and cirrhosis (chronic hepatitis B). In alcoholic liver disease, P-5-P becomes deficient, which is greater on ALT activity compared to AST activity. Consequently, ALT activity is reduced, whereas AST activity is increased 2. The hallmark finding for alcohol liver disease is the AST to ALT ratio of at least 2:1 3. The marked laboratory findings for ischaemic hepatitis is an elevated bilirubin level, however, AST levels are > 10 times the upper reference range limit 2. Acute viral hepatitis, drug or toxin induced liver disease and ischaemic liver injury are characterised by extremely elevated aminotransferase levels 3.
Muscular dystrophy, including Duchenne muscular dystrophy is characterised by hypertransaminasemia. Elevations in both ALT and AST are most striking in the early stages of muscular disease, prior to the onset or only when subtle symptoms are present. Consequently, during these initial stages, ALT/AST testing can enable the early identification of disease and so the early intervention of treatment plans 4.
The diagnosis of liver disease in COVID-19 patients can be challenging for the clinician. There is often uncertainty as to whether there was a pre-existing undiagnosed liver disease. Also, many medications utilised to treat moderate and severe disease have their own profiles of liver toxicity. Elevations of aminotransferase is the most common abnormality in patients presenting with COVID-19. It was identified that AST is more frequently elevated in comparison to ALT 5. AST showed statistically significant elevations in severe COVID-19 in comparison to mild cases 6.
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Albumin Assay
Reagent | Albumin
A Marker of Hepatic Dysfunction
Benefits of the Randox Albumin Assay
Excellent precision
The Randox albumin assay displayed a within run precision of < 1.97%.
Calibrator and controls available
Calibrator and controls available for a complete testing package.
Working Stability
Working reagent stable up to 3 months when stored at +15oC to +25oC.
Flexibility
Liquid and Lyophilised Reagents available for greater customer choice.
Applications available
Applications available detailing instrument-specific settings for the convenient use of the Randox albumin assay on a variety of clinical chemistry analysers.
Ordering information
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
| Cat No | Size | ||||
|---|---|---|---|---|---|
| AB3800 | 9 x 51ml (L) | Enquire | Kit Insert Request | MSDS | Buy Online |
| AB8301 | 4 x 20ml (L) | Enquire | Kit Insert Request | MSDS | Buy Online |
(L) Indicates liquid reagent |
|||||
Clinical Significance
Albumin is the most abundant circulating protein found in plasma, representing approximately half of the total protein content in health human plasma. Synthesised by liver hepatocytes, it is rapidly excreted into the bloodstream, approximately 10gm – 15gm per day, with little remaining in the liver 1. It is responsible for the maintenance of colloidal osmotic pressure, provision of the majority of plasma antioxidant activity, and the binding of a variety of compounds 2.
A correlation between serum albumin concentrations and ill-health has been identified, with an astonishingly strong inverse correlation between serum albumin and mortality risk 2. The association of it with other confounding variables increase mortality (fig 1). The concentration is related to the rates of synthesis and catabolism, but also influenced by state of hydration, lymphatic return, external losses (burns), and rates of transcapillary escape. In starvation, both the synthesis and catabolism fall, whereas in nephrotic syndrome, synthesis rises and catabolism falls 3.
Fig. 1. Potential associations between serum albumin and mortality 3
A direct, casual relationship between serum albumin and mortality is represented by arrow a or the sequence b, a. A non-casual, confounding relationship is represented by arrows b and c. A co-causal relationship is represented by arrows a and c.
Low circulating albumin is associated with an adverse metabolic profile characterised by increased adipose tissue inflammation, glucose concentrations, and adiposity. It inversely correlates with type 2 diabetes mellitus (T2DM) risk 4. Moreover, serum albumin concentrations are inversely correlated with the risk of ketosis in hospitalised patients with T2DM and may require the early initiation of insulin therapy to prevent complications. It is a promising prognostic marker in hospitalised diabetic patients with acute hyperglycaemia 5.
Low levels of serum albumin is common in cirrhosis and is associated with a reduced survival rate. In this setting, the native isoform can be severely reduced as a result of several post-transcriptional changes that impair the non-oncotic properties of the molecule 6.
Hypoalbuminemia status has been associated with the critically ill and mortality across several clinical settings. Hypoalbuminemia can potentially lead to the early recognition of severe disease associated with COVID-19 and can assist clinicians in making informed decisions for their patients 7.
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References
The Correlation Between Liver Cirrhosis and Lactic Acidosis
Lactic acid is an organic compound which produces the conjugate base lactate through a dissociation reaction. Due to it being a chiral compound, two optical isomers of lactate exist; D-Lactate and L-Lactate. The lactate dehydrogenase (LDH) enzyme can produce and metabolise both isomer forms to pyruvate, however due to the isomer-specific nature of LDH different forms of the enzyme are required. D-Lactate requires a D-LDH form whereas L-Lactate requires L-LDH. As a result of this requirement, combined with the fact that mammalian cells only contain L-LDH, the lactate produced in humans is almost exclusively L-Lactate.
One of the roles of L-Lactate is its involvement in the Cori Cycle, a metabolic pathway involved in the production of glucose. The cycle involves the rotatory transportation of lactate and glucose from the liver and the muscle. Lactate is produced in the muscle through glycolysis which is then transported to the liver through the blood stream. In the liver, the lactate is oxidised to pyruvate and then converted to glucose by gluconeogenesis, which is then transported back to the muscle for the process to start again. 1500 mmol of lactate is produced daily by the body and is cleared at a constant rate via the liver.
Problems can arise if the liver fails to regulate the lactate produced. Hyperlactamia is the name given to elevated levels of lactate in the body, as a result of the rate of production exceeding the rate of disposal. This is due to a lack of oxygen that reduces blood flow to the tissues. If levels continue to rise a patient is at risk of lactic acidosis.
The liver is an important tissue in the regulation of lactate, it is therefore no surprise that liver damage can prevent this process resulting in a further diagnosis of lactic acidosis. A healthy liver is a vital part of lactate regulation as it acts as the main consumer of lactate and contributes to 30-40% of lactate metabolism. Potential victims are patients who suffer with cirrhosis, a complication of liver disease, which is commonly caused by alcohol abuse and viral Hepatitis B and C.
Patients with liver cirrhosis have a higher risk of increased lactate levels. Increased levels of the lactate ions disturbs the acid-base equilibrium, causing a tilt towards lactic acidosis. The mortality rate of patients who develop lactic acidosis is high, prompt recognition and treatment of the underlying cause remain the only realistic hope for improving survival.
The Randox L-Lactate reagent allows for a prompt and accurate diagnosis of lactic acidosis.
Randox L-Lactate Reagent
The Randox L-Lactate key benefits include:
- Excellent working reagent stability of two weeks when stored at + 15 – +25°C
- Exceptional correlation of r = 0.99 when compared against other commercially available methods
- A wide measuring range of 0.100 – 19.7 mmol/l and so is capable of detecting abnormal levels in a sample
Other features:
- Colorimetric method
- Lyophilised reagents for enhanced stability
If you are a clinician or laboratory who are interested in running assays for Lactic Acidosis or Liver Disease, Randox offer a range of high-quality routine and niche assays including:L- Lactate, Ethanol, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Albumin which can be used to diagnose conditions commonly affecting the liver. These assays can be run on most automated biochemistry analysers.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
For more information, visit: https://www.randox.com/lactate/ or email: reagents@randox.com
Liver Cirrhosis is a Global Health Burden
#LoveYourLiver this January. This month, we are taking a closer look at Liver Cirrhosis.
Liver cirrhosis occurs when the healthy tissue of the liver is replaced with scar tissue (fibrosis) due to long-term liver damage. Liver cirrhosis can result in liver failure which can be fatal.
Liver complications such as liver disease and cirrhosis can be detrimental if it is not treated or monitored. Liver disease is the only major cause of death still increasing year-on-year. Globally, deaths due to liver cirrhosis have increased from 676,000 in 1980 to over 1 million in 2010 (NCBI, 2014). Cirrhosis and other chronic liver diseases have increased by 12.4% from 2006-2016 and was the cause of 1,256,900 deaths in 2016 (Global Burden of Disease, 2016).
There are a few factors that increase the risk of liver cirrhosis. The three main factors are heavy alcohol consumption, an undiagnosed hepatitis infection, particularly hepatitis C, and non-alcoholic steatohepatitis (a more severe form of non-alcoholic fatty liver disease) due to obesity.
There are numerous symptoms associated with liver cirrhosis. Some of the more severe symptoms include:
- Jaundice – yellowing of the skin and whites of the eyes
- Personality changes, confusion, difficulty concentrating, memory loss, or hallucinations
- A tendency to bleed or bruise easily
- In women, abnormal periods
- In men, enlarged breasts, a swollen scrotum (the loose sac of skin that contains the testicles) or shrunken testicles
- Vomiting
- Diarrhea
- Stomach pain – swollen or bloated stomach
Liver cirrhosis cannot be cured, but the aim of treatment is to manage the symptoms and complications, and to stop the condition getting worse.
#LoveYourLiver and prevent or reduce the symptoms of liver cirrhosis through: moderating alcohol consumption, not sharing needles to inject drugs, using a condom during sex, taking medications as prescribed, and maintaining a healthy weight.
The early stages of liver cirrhosis usually does not present any symptoms and is often first detected using routine blood tests. Liver cirrhosis can be diagnosed and monitored through the following routine blood tests:
Alanine Aminotransferase (ALT)
ALT is one of the enzymes within the aminotransferases group and are among the most sensitive liver enzymes. The normal concentration levels of ALT in the blood are low, however, when the liver is damaged, such as liver cirrhosis, the levels of ALT increase. During the diagnosis of liver cirrhosis, the root cause of the damage can be established, such as disease, drug or injury. ALT is commonly measured alongside AST as part of the hepatic panel.
Aspartate Aminotransferase (AST)
AST is an enzyme found throughout the body. Elevated concentration levels of AST in the blood is directly correlated to the severity of the tissue damage. AST also allows for the root cause of the damage to be diagnosed. Excessive levels are indicative of damage due to acetaminophen overdose or acute viral hepatitis. Moderately high levels are indicative of alcohol abuse. Slightly high levels are indicative of cirrhosis.
AST is commonly measured alongside ALT as part of the hepatic panel, although ALT levels are higher in most types of liver damage.
Albumin
Albumin is a special protein made in the liver and provides the body with the proteins it requires to grow and repair tissue. The body requires a proper balance of albumin to prevent fluid from seeping out of blood vessels. Decreased concentrations levels of this protein in the blood is an indicator of liver cirrhosis.
Randox supply a range of third party clinical diagnostic hepatic reagents to aid in the diagnosis and managing the complications of liver cirrhosis. All reagents are available for use on a range of third party biochemistry analysers. Randox offer the following hepatic reagents to diagnose liver cirrhosis:
Alanine Aminotransferase (ALT)
Aspartate Aminotransferase (AST)
Randox also offer the following high performance and unique tests to diagnose liver cirrhosis:
Why choose Randox reagents?
- Randox offers the largest range of chemistries
- Liquid ready-to-use reagents available
- Automated applications for a wide range of clinical analysers
- Excellent correlation to reference methods
- Wide measuring ranges
- Flexible pack sizes
- Official accreditation to national and international standards including UKAS, ISO 13485:2003, and FDA.
- Easy fit reagents
- Easy read reagents
To request an application for your specific analyser, contact reagents@randox.com
For more information on liver function or to view our hepatic panel, visit https://www.randox.com/liverfunction/
