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Molecular diagnostics, automation, and point-of-care testing were the themes of the American Association for Clinical Chemistry's annual meeting July 16-20 in Anaheim, Calif. In a fitting tribute to the theme of molecular diagnostics, NCHGR Director Francis Collins received the AACC's National Lectureship Award and delivered a superb talk entitled "The Human Genome Project and the Future of Medicine."
On the clinical front, James Cook of the University of Kansas Medical Center in Kansas City discussed the application of the transferrin-receptor assay for assessing a patient's iron status. Traditionally, the serum-transferrin-receptor assay has been used to gauge erythropoiesis. But Cook reported that this test may also be used to distinguish iron-deficiency anemia from the anemia produced by chronic disease. The assay found that iron-deficiency-anemia patients had serum transferrin- receptor levels that were three times higher than normal, while patients with chronic-disease anemia had normal levels of transferrin receptors. These results indicate that the serum transferrin-receptor assay may be a valuable substitute for bone-marrow examination, which has been the standard method of distinguishing between these two types of anemia.
The role of homocysteine in coronary artery disease was the focus of a presentation by Robert Jacob of USDA's Western Human Nutrition Research Center in San Francisco. Jacob provided an update on recent studies linking high concentrations of the amino acid homocysteine in the blood to an elevated risk of coronary artery disease by increasing thrombogenic tendencies. He noted that the prevalence of artery narrowing among patients in the Framingham Heart Study was found to correlate directly with serum homocysteine levels, with patients who had the highest homocysteine levels being twice as likely to have advanced arteriosclerosis as those with average levels. Other studies indicate that excessive levels of homocysteine may disrupt the anti-coagulation process, thereby predisposing individuals to thrombotic heart disease. In addition, Jacob says there's experimental evidence that B vitamins, particularly folic acid, may help to lower homocysteine levels. In addition to their implications for the treatment and prevention of thrombotic heart disease, the homocysteine findings help to underscore the often overlooked fact that coronary artery disease is a multifactorial disorder and is not solely determined by cholesterol concentrations.
-Ronald Elin, CC