Diazyme Laboratories 12889 Gregg Court Poway, CA 92064, USA Tel: 858-455-4768 / Fax: 858-455-3701 Email: support@diazyme.com Website: www.diazyme.com Assay Principle 25-Hydroxy Vitamin D Assay Kit Configuration Diazyme’s 25-Hydroxy Vitamin D Assay Kit is provided in the following microplate (colorimetric) configuration (96 tests): Instrument Microplate reader Catalog # Kit size EX: Extraction solution (1x 30 mL) R1a: Lyophilized Reagent (1 vial) R1: Reconstitution Buffer (1x 8 mL) R2a: Lyophilized Reagent (1 vial) R2: Reconstitution Buffer (1x 6 mL) R3a: Lyophilized Reagent (1 vial) DZ688A-K R3: Reconstitution Buffer (1x 12.5 mL) STOP: STOP Reagent (1x 8 mL) 8-well Microtube Strips (12) Microtube Rack (1) 96-well Microplate (1) Microplate Sealing Film (3) *Cal: DZ688A-CAL (6x 1mL) *Note: Diazyme 25-Hydroxy Vitamin D Assay Calibrator Set is sold separately. Intended Use The Diazyme 25-hydroxy Vitamin D Assay is designed for the quantification of total 25-hydroxy Vitamin D in human serum and plasma. The assay results are to be used in parallel with other clinical data to assess the Vitamin D status of a patient. For investigational use only in the USA. Clinical Significance The assay is based on the principle of α-complementation of the enzyme β-galactosidase and the competition between an enzyme donor-25-hydroxy Vitamin D conjugate, Vitamin D binding protein and the 25-hydroxy Vitamin D content of a serum sample. Samples with higher 25-hydroxy Vitamin D concentrations produce higher β-galactosidase activities and vice versa. Chlorophenol red-β-D- galactopyranoside (CPRG) is used as the enzyme substrate and the accumulation of the reaction's product (chlorophenol red) is monitored at 560 nm. The 25-hydroxy Vitamin D concentration of a patient sample is proportional to the measured β-galactosidase activity. The assay consists of a sample extraction step during which Vitamin D is irreversibly dissociated from its serum transporter. Extracted samples are then analyzed on a microplate reader after the sequential addition of three reagents. Unlike most microplate-based assays, the Diazyme assay does not require tedious washing steps between reagents. The whole assay procedure takes about 2 hours. Materials Required but not Provided 1. Six level calibrators (DZ688A-CAL): Human serum containing specific amounts of 25-hydroxy Vitamin D. Calibrators are supplied in aliquots of 1.0 mL. The exact concentration (ng/mL) of each calibrator is indicated on the included certificate of analysis. 6 x 1 mL vials are provided per kit. 2. Two Level controls (DZ688A-CON): Human serum containing specific amounts of 25-hydroxy Vitamin D. Controls are supplied in aliquots of 1.0 mL. Control level 1 has a concentration of 25-OH Vitamin D that corresponds to a deficient patient. Control level 2 has a concentration of Vitamin D that corresponds to a normal patient. 2 x 1 mL vials are provided per kit. 3. Flat-head Vortex mixer, micro pipettes. Vitamin D is a steroid hormone involved in the active intestinal absorption of calcium and in the regulation of its homeostasis. Vitamin D has two isomers: Vitamin D2 and Vitamin D3. Vitamin D2 is obtained from dairy products whereas Vitamin D3 is produced in the skin after exposure to ultraviolet light. In the liver, Vitamin D is hydroxylated at its carbon 25 to form 25-hydroxy Vitamin D. This metabolite is the predominant circulating form of Vitamin D and is considered to be an accurate indicator of the general Vitamin D status of an individual. Vitamin D deficiency has been linked to many diseases including osteoporosis, rickets, osteomalacia, cancers, and cardiovascular diseases. Both dietary supplements of Vitamin D that are currently available in the market (Vitamin D2 and Vitamin D3) are converted to 25-hydroxy Vitamin D in the liver. The sum of the concentrations of 25hydroxy Vitamin D2 and 25-hydroxy Vitamin D3, in serum or plasma, is referred to as “Total 25-hydroxy Vitamin D”. Accurate monitoring of total 25-hydroxy Vitamin D (25-OH) level is critical in clinical settings. Vitamin D deficient patients who are prescribed a daily Vitamin D supplement should regularly monitor their serum or plasma Vitamin D levels in order to reach an optimal level and prevent their 25-hydroxy Vitamin D concentrations from reaching excessive levels that are considered toxic1-5. Reagent Composition Extraction solution EX: Acetonitrile-based extraction solution. Reagent R1: (R1a): Lyophilized enzyme acceptor, Vitamin D binding protein and phosphate salts. (R1): Reconstitution buffer containing phosphate salts and preservatives. Reagent R2: (R2a): Lyophilized enzyme donor. (R2): Reconstitution buffer containing phosphate salts and preservatives. Reagent R3: (R3a): Lyophilized substrate (CPRG). (R3): Reconstitution buffer containing phosphate salts and preservatives. STOP reagent: Sodium carbonate solution. Diazyme Laboratories 70327 Rev. D Page 1 of 3 Effective: 10/04/10 Preparation and Storage Calibrators and Controls Calibrators and controls are serum-based solutions and stable when stored at -20°C until the expiration date on the label. If calibrators and controls are stored at 2-8°C, the material should be used within 11 days. Equilibrate the needed volume of calibrators and controls to room temperature for 30 minutes before use. Avoid repeated freeze-thaw cycles. absence of infectious agents, this material and all patient samples should be handled as though capable of transmitting infectious disease and such biohazardous material should be disposed of according to relevant local, state or federal regulations. 6. Additional safety information concerning storage and handling of this product is provided within the Material Safety Data Sheet for this product. To obtain an MSDS, please contact our customer service department at 858-455-4768 or email support@diazyme.com. Extraction solution (EX) This reagent is ready to use. It is stable when stored at room temperature until the expiration date on the label. EX buffer contains an organic solvent, Acetonitrile, and should be handled per MSDS instructions. Keep bottle tightly closed after use. Reagents 1, 2, and 3 Reagents are supplied as lyophilized powders, and need to be reconstituted with the provided reconstitution buffers before use. The lyophilized reagents and their reconstitution buffers are stable when stored at 2-8°C until the expiration date on the label. The reconstituted reagents are stable for 11 days at 2-8°C. Reconstitute R1a, R2a and R3a with the entire contents of the provided R1, R2 and R3 buffer, respectively. Invert 4-5 times and incubate at room temperature for 30 minutes. Use immediately or store in a tightly closed bottle at 2-8°C. Allow cold reagents (28°C) to equilibrate to room temperature before use. Assay Procedure Reconstitute and prepare reagents as described in the “Preparation and Storage” section. 1. Pipette 90 µL of samples, calibrators and controls into the wells of the provided microtube strips (use the provided microtube rack). 2. Using a multi-channel pipette, carefully add 180 µL of Extraction solution (EX) to each well containing samples. Make sure that reagent EX is fully equilibrated to room temperature before use. STOP reagent This reagent is ready to use and should be stored at room temperature upon receipt of the kit. It is stable until the expiration date. Specimen Collection and Handling Serum, heparinized plasma or EDTA plasma samples can be used for the assay. For serum, collect whole blood by venipuncture and allow clotting. For plasma, mix the sample by gentle inversion prior to centrifugation. Centrifuge and separate serum or plasma as soon as possible after collection. The specimens may be refrigerated at 2-8°C for two weeks. For long term storage, they can be stored at -20°C. Avoid repeated freeze-thaw cycles. Allow the refrigerated or frozen-thawed samples to equilibrate to room temperature for 30 minutes before use; samples must be mixed well before analysis. Precautions 1. DO NOT INGEST. Avoid contact with skin and eyes. 3. Cap each microtube tightly and vortex each strip for 30 seconds. Hold the strip with both hands to make sure that all 8 microtube of the strip are uniformly mixed. Let stand for 10 minutes at room temperature to ensure clear top phase separation. 2. EX buffer contains an organic solvent, Acetonitrile, and should be handled per MSDS instructions. 3. Reagents contain sodium azide, which may react with lead or copper plumbing to form explosive compounds. Flush drains with copious amounts of water when disposing of reagents. 4. Specimens containing human sourced materials should be handled as if potentially infectious, using safe laboratory procedures such as those outlined in Biosafety in Microbiological and Biomedical Laboratories, 5th Ed (HHS Publication Number [CDC] 211112). 5. Calibrators and controls contain human source material. Each donor unit of serum in the preparation of these materials were tested by FDA-approved methods and found negative for the Human Immunodeficiency Virus Antibody (HIV I/II Ab), Hepatitis B Surface Antigen (HBsAg), and Hepatitis C Virus Antibody (HCV). Because no method can offer complete assurance as to the 4. Pipette 20 µL of the top phase into the provided 96-well microplate. Make sure that the precipitated proteins are not carried over. Diazyme Laboratories 70327 Rev. D Page 2 of 3 Effective: 10/04/10 deficient: 15.0 to 31.9 ng/mL; optimal: 32.0 to 100.0 ng/mL and possible toxicity over 100.0 ng/mL1. It is recommended, however, that each laboratory establishes the range of normal values that corresponds to the population of their region. Limitations 1. 2. For investigational use only in the USA. The assay is designed for use with human serum and plasma samples only. 3. 5. Incubate the 96-well microplate on a lab bench, uncovered, for 45 minutes to evaporate the organic solvent (see MSDS). Samples suspected of containing analyte values greater than 120 ng/mL should be reported as >120 ng/mL. 4. 6. Add 50 µL of Reagent R1 into each well. Pipette-mix 3-4 times. Seal the microplate with the provided film and incubate for 30 minutes at room temperature. As with any diagnostic test procedure, results should be interpreted considering all other test results and the clinical status of the patient. 5. As with any diagnostic test it is possible that technical, procedural errors as well as substances and factors not listed may interfere with the proper functioning of the test kit. 7. Add 50 µL of Reagent R2 into each well. Pipette-mix 3-4 times. Seal the microplate with the provided film and incubate for 30 minutes at room temperature. 8. Add 100 µL of Reagent R3 into each well. Pipette-mix 3-4 times. Seal the microplate with the provided film and incubate for 20 minutes at room temperature. 9. Add 50 µL of STOP reagent into each well. Pipette-mix 3-4 times and read at 560 nm using a microplate reader. The developed color is stable for 90 minutes. Calibration Six calibration levels are needed for each run. Calibrators and controls should be treated exactly the same as patient samples. We recommend fitting the calibration data to the 4-parameter model. A typical calibration curve is shown below. Performance Characteristics Sensitivity The analytical sensitivity of the assay was found to be 4.2 ng/mL. Accuracy The performance of this assay was compared to the performance of a legally marketed 25-OH Vitamin D enzyme immunoassay. Using 76 serum samples (with 25-OH Vitamin D concentrations ranging from 7.4 ng/mL to 90.3 ng/mL), the correlation coefficient between the two methods was 0.92, the slope was 1.097 and the y intercept was - 3.89 ng/mL. Precision Using seven precision levels covering the dynamic range of the assay, intra-assay precisions were under 6.5% and total precisions were under 9.7%. (OD) Linearity The assay was found to be linear between 4.2 and 120.2 ng/mL. Interference The assay’s results were not significantly affected by the presence of bilirubin (up to 40 mg/dL), hemoglobin (up to 250 mg/dL), ascorbic acid (up to 10 mM) and triglycerides (up to 500 mg/dL). (ng/mL) References Quality control We recommend that each laboratory uses 25-OH Vitamin D controls to validate the performance of reagents. A bi-level set of controls is available from Diazyme Laboratories (Catalog # DZ688ACON). Results Results are expressed in ng/mL. Note: Samples with values greater than 120 ng/mL should be reported as >120 ng/mL. 1. Baudeoin D. 25-OH Vitamin D and Calcium Reference Ranges Update. January 2008. The Legacy Health System. 2. Morris H. A. Vitamin D: A Hormone for All Seasons-How Much is enough? Clin. Biochem. Rev., 2005, 26, 21-32. 3. Bikle D. D. Vitamin D and the skin. J. Bone Miner. Metab., 2010, 28, 117-30. 4. Zerwekh J. E. Blood biomarkers of vitamin D status. Am. J. Clin. Nutr., 2008, 87, 1087S-91S. 5. Moyad M. A. Vitamin D: a rapid review. Dermatol Nurs., 2009, 21, 25-30. Reference Range Although the normal range of 25-hydroxy vitamin D is populationdependent, it has been established through a large scale analysis (3200 patients) that the following reference ranges should be considered by physicians: severely deficient: 0 to 14.9 ng/mL; mildly Diazyme Laboratories 70327 Rev. D Page 3 of 3 Effective: 10/04/10
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