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Clinical diagnostic laboratory

Exacte Labs Laboratory Center specializes in rare, non-routine complicated laboratory tests. We are always open for cooperation, ready to promptly introduce a new test at the request of the customer.

Services

Classic routine tests

General blood analysis
Human blood, quantitative
1 working day
Blood chemistry
Details
Details:

Indicators:
Common bilirubin
Conjugated bilirubin
Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
Common protein
Albumen
Glucose
Cholesterol
HDL cholesterol
LDL cholesterol
Triglycerides
Creatinine
Urea
Uric acid
Alkaline phosphatase
Gamma glutamyl transferase (GGT)
Creatine Kinase (QC)
Electrolytes: Na +, K +, Cl-
C-reactive protein

Human serum, quantitative
1 working day
Details

Rare diagnostic tests

Antibodies to poliomyelitis virus types 1,3 IgG (anti-Poliomyelitis-Virus 1,3 IgG)
Details

Poliomyelitis is a highly contagious enterovirus-caused infectious disease that is spread worldwide.
There are three types of polio virus, which are pathogenic for humans:
Type 1 (Brunhilde): often with severe symptoms;
Type 2 (Lansing): with mild symptoms;
Type 3 (Leon): rare, but with severe symptoms.
Once getting in the oral cavity and gastrointestinal tract, the virus multiplies in epithelial cells, regional lymph nodes of the intestine, and gets to the bloodstream, which leads to its spread to many organs and tissues. In more than 90% of cases, the patient does not have any subjective symptoms. In other cases, nonspecific soreness with moderate fever, headache and dry throat, diarrhea, nausea and vomiting are noted. In a part of patients, the virus enters the central nervous system, multiplies in motor neurons, causing their death and paresis or paralysis of the muscles they innervate.
The convalescence phase can continue up to two years, delayed complications often develop. The source of infection is a patient or a virus carrier that releases a virus with secrets of the upper respiratory tract (throughout the incubation period and in the first week of the disease, less often up to 1.5 months) or with feces (1-6 months). Transmission of the infection is possible by the fecal-oral route, through the patient’s saliva, less often by water. Polio remains endemic, especially in countries in the Asian region. In Europe, cases of transmission of the disease by tourists, sometimes fatal, have been reported.

Indications for use:

Assessment of tension of immunity (including post-vaccination) to polio virus types 1 and 3.

Preanalytical requirements:

Blood serum. An aliquot of serum is stored at a temperature of + 2 ... + 8° C for up to 7 days.
For longer storage should be stored at -20 ° C.

Interpretation of results:

Unit: Unit / ml
<8.0 - negative. No IgG antibodies to poliomyelitis virus type 1.3 were detected;
8.0 - 12.0 - doubtful;
> 12.0 - positive. IgG antibodies to poliomyelitis virus type 1.3 detected.

Literature:

Materials are provided by reagents manufacturer.

Human serum, quantitative, ELISA
10 working days
Details
Antibodies to polyribosylribitolphosphate (PRP) Haemophilus influenzae type B IgG (anti-PRP Haemophilus influenzae type B IgG). Antibodies to Haemophilus influenzae type B, IgG
Details

Haemophilus influenzae type B (HiB) (Haemophilus influenzae) is a gram-negative coccobacillus that is a common cause of acute infectious diseases in children under the age of six.

Following infection, the following clinical manifestations are possible: pericarditis, osteomyelitis, meningitis, encephalitis, pneumonia, sinusitis and otitis media.

One of the causes of the disease is often latent immunodeficiency, leading to a decrease in the humoral immune response to polyribosylribitolphosphate (PRP) present on the polysaccharide membrane of the bacterium. Another cause in children is the immaturity of the immune system.

Children aged three months and older are recommended to be vaccinated with various PRP-containing vaccines. Haemophilus influenzae type B infection vaccines contain its polysaccharide capsule antigen polyribosylribitolphosphate (PRP). Vaccination against hemophilic type b infection in Russia is carried out in accordance with the Order of the Ministry of Health of the Russian Federation dated March 21, 2014 No. 125n “On the approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations according to epidemic indications” for children belonging to risk groups. Monovalent vaccines for the prevention of hemophilic infection of type b are available, as well as combination vaccines containing a component for the prevention of this infection (including Pentaxim, Infanrix Hexa).

Indications for use:

Monitoring the humoral immune response after vaccination (4-6 weeks after vaccination);
Confirmation of the diagnosis of Haemophilus influenzae type B infection by repeated testing with monitoring of antibody concentration;
Risk assessment in patients with immune deficiency leading to failure of vaccination with PRP-containing vaccines (children with chronic, recurrent bacterial infections of the respiratory tract; children with chronic otitis media; patients with confirmed humoral immunodeficiencies (IgG2 deficiency, IgA deficiency); patients with confirmed granulocyte deficiency ; patients undergoing chemo- or cytostatic therapy; children after splenectomy; patients with sickle cell anemia; patients with trisomy 21 (Down syndrome).

Preanalytical requirements:

Venous blood serum. An aliquot of serum is stored at a temperature of + 2 ... + 8 ° C for up to 6 weeks. At a temperature of -17 ... -23˚С up to 6 months.

Interpretation of results:

Unit: μg / ml.
<0.15 - low level;
0.15 - 1.0 - borderline level (HiB infection or history of immunization);
> 1.0 - protective level (post-vaccination or natural).

Literature:

Materials company - manufacturer of reagent kits.

Human serum, quantitative, ELISA
10 working days
Details
QuantiFERON-TB Gold (QFT®) Test for the determination of the immune response to ESAT-6, CFP-10 and TB7.7 (p4) antigens for the diagnosis of tuberculosis infection
Details

Tuberculosis is an infectious disease caused by a complex of microorganisms M. tuberculosis (M. tuberculosis, M. bovis, M. africanum). Infection, as a rule, occurs by airborne droplets from a patient suffering from tuberculosis of the respiratory tract. Active tuberculosis develops in approximately 10% of people infected with M. tuberculosis. In other cases, due to the immune system, the pathogen is eliminated from the body or latent tuberculosis infection (LTI) develops. LTI is a state of persistent immune response of infected individuals in the absence of clinical manifestations of tuberculosis, in which the development of an active form is possible.

Currently, there are two methods for detecting latent tuberculosis infection:

in vivo: intradermal tests with purified or recombinant tuberculosis allergen (Mantoux test, Diaskintest);

in vitro: a study of blood samples to determine the sensitization of immune cells of a patient being examined for tuberculosis mycobacterial antigens (IGRA tests).

In accordance with the clinical recommendations of the Ministry of Health of the Russian Federation and the Russian Society of TB Specialists in the detection and diagnosis of tuberculosis in children entering and studying in educational institutions (2017), the quantiferon test is an alternative intradermal test method for screening for tuberculosis infection.

The quantiferon test is able to detect the immune response of the subject by determining gamma-interferon specifically secreted by T-lymphocytes in response to the recombinant mycobacterial antigens (ESAT-6, CFP-10 and TB7.7 (p4) presented by him, which are absent in all BCG strains and in most non-tuberculous mycobacteria.

Quantiferon test benefits:

Lack of contraindications;
High specificity and sensitivity;
Only one patient visit to the doctor is needed;
No need for fasting the patient before blood donation;
The result does not depend on previous BCG vaccination.

Indications for use:

Diagnosis of tuberculosis infection (including LTI) in children, in people with contraindications for intradermal tests;
With uncertain results of intradermal tests.

Preanalytical requirements:

There are two options for taking biomaterial:

3-4 ml of venous blood in a test tube with lithium heparin (LH, Lithium Heparin). The maximum shelf life of such a tube before delivery to the laboratory is 16 hours at room temperature;

Taking venous blood in three special tubes for the quantiferon test (1 ml per tube). Immediately after filling the tubes, it is necessary to turn over ten (10) times so that you can make sure that their entire inner surface is covered with blood to dissolve the antigens on their walls. After filling, flipping and labeling repeatedly, the tubes should be delivered to the laboratory within 16 hours or, if possible, placed in the incubator (37°C ± 1°C) as soon as possible (no later than 16 hours from the time of blood collection). Before incubation, the tubes should be at room temperature (22°C ± 5°C). Incubation should take place in an upright position for 16-24 hours at 37°C. No CO2 or humidification is required. After incubation at 37 ° C, vacuum collection tubes can be stored at 4°C to 27°C for 3 days immediately before centrifugation. After centrifugation, plasma samples can be stored for up to 28 days at a temperature of 2°C to 8°C; after plasma sampling, a longer shelf life is possible at a temperature of –20°C (preferably at –70°C).

 Interpretation of the result:

“Positive” - the result of the QuantiFERON-TB Gold (QFT®) study, interpreted as “positive”, indicates that the patient’s blood sample has significant T-cell secretion of specifically induced gamma interferon. An immune response to ESAT-6, CFP-10 and TB7.7 (p4) antigens was detected. Probably tuberculosis infection.

“Negative” - the result of the QuantiFERON-TB Gold (QFT®) study, interpreted as “negative”, indicates that the patient’s blood sample lacks significant T-cell secretion of specifically induced gamma-interferon. There is no immune response to ESAT-6, CFP-10 and TB7.7 (p4) antigens. Infection with a complex of microorganisms M. tuberculosis (M. tuberculosis, M. bovis, M. africanum) was not detected.

“Uncertain” - due to the individual characteristics of the patient’s immune status, it is not possible to reliably determine the presence of specific secretion of gamma-interferon by T-cells and to provide an unambiguous result of the study.

Literature:

Materials company - manufacturer of reagent kits.

Human blood, qualitative, ELISA
3 working days
Details

Oncodiagnostics

ESR-test for early diagnosis and monitoring of therapy for malignant proliferation
Details

A study of the structure and functional properties of serum albumin, which allows to detect characteristic changes in the conformation of albumin and disorders of the blood transport system for the initial diagnosis and monitoring of cancer.

More information about the ESR-test: http://epr-test.exactelabs.com/

Preanalytical requirements:

Venous blood plasma (EDTA). An aliquot of plasma is stored at a temperature of + 2 ... + 8˚С for up to 4 days. At a temperature of -17 ... -23˚С up to 3 months.

Literature:

Materials company - manufacturer of reagent kits.

Human serum/plasma, quantitative, ESR
7 working days.
Details

Serological diagnosis of helminthiasis

Antibodies to antigens of the Chinese fluke IgG (anti - Clonorchis sinensis IgG)
Details

Clonorchosis (lat. Clonorchis sinensis - Chinese fluke) - helminthiasis from the group of trematodoses caused by Chinese fluke, refers to the type of flatworms.

Infection of people occurs when eating raw or insufficiently thermally processed fish. In 2-4 weeks after infection, a fever occurs, pain in the muscles, joints, sometimes jaundice. The liver, sometimes the spleen, increases in the blood - eosinophilic leukocytosis. After a few weeks, the disease goes into a chronic stage, accompanied by chronic cholangitis, hepatitis, pancreatitis.

Indications for use:

Suspicion of clonorchiasis.

Preanalytical requirements:

Venous blood serum. An aliquot of serum is stored at a temperature of + 2 ... + 8˚С for up to 5 days, 3 months at -20 ˚С.

Interpretation of results:

"Positive" - the presence of a current infection or a history of infection;
"Negative" - the absence of antibodies to Clonorchis sinensis.

Literature:

Materials company - manufacturer of reagent kits.

Human serum, semi-quantitative, ELISA
10 working days
Details
Antibodies to antigens of nematodes of the genus Anisakis IgG (anti - Anisakis IgG)
Details

Anisacidosis (Anisacidosis) is a zoonotic helminthiasis from the group of nematodes, characterized by damage to the gastrointestinal tract, caused by parasitization of the larval stages of nematodes of the Anisakidae family in the human body. The causative agents of human anisacidosis are the larvae of the nematodes of the family Anisakidae of the genera Anisakis, Contracaecum Pseudoterranova, Porrocaecum. The final owners of these helminths are many marine mammals (cetaceans, pinnipeds), predatory sea fish and fish-eating birds.

Depending on the involved part of the gastrointestinal tract, the gastric and intestinal forms of anisacidosis are distinguished. The gastric form is acute, accompanied by intense pain in the abdomen, fever, nausea and vomiting. Symptoms of the intestinal form occur in waves with periods of worsening in the form of pain in the abdomen, possible complications: acute intestinal obstruction, perforation of the intestine, ascites and pneumoperitoneum.

Indications for appointment:

Suspicion of anisacidosis.

Preanalytical requirements:

Venous blood serum. An aliquot of serum is stored at a temperature of + 2 ... + 8˚С for up to 5 days, 3 months at -20 ˚С.

Interpretation of results:

"Positive" - the presence of a current infection or infection in past;
"Negative" - lack of antibodies to Anisakis.

Literature:

Materials company - manufacturer of reagent kits.

Human serum, semi-quantitative, ELISA
10 working days
Details

Endocrinology

Cortisol in saliva
Details

Cortisol (also known as hydrocortisone, compound F) is the main glucocorticoid in the human body and is produced in the fasciculus of the adrenal cortex. 90% of circulating cortisol is associated with a corticoid-binding globulin (CBG, transcortin), about 7% is associated with albumin and only 1-3% is not (free form). Only the unbound fraction is the active form of cortisol. The level of free cortisol in the blood is mainly regulated by its secretion in the adrenal cortex according to the principle of negative feedback CRH (corticotropin-releasing hormone) in the hypothalamic region and ACTH (adrenocorticotropic hormone) in the pituitary gland, but this is also influenced by various conditions, primarily stress.

A person has a physiological fluctuation in the concentration of cortisol, it reaches the highest level in the morning, and the lowest - after midnight. This fluctuation in plasma cortisol levels is usually reflected in saliva with a peak in the first 90 minutes after waking up. Cortisol measurement is indicated for adrenal disease. Due to diurnal fluctuations in the level of cortisol, collecting saliva samples is a simple method without the stress of repeated venipuncture.

 Indications for use:

• young people with manifestations unusual for their age (osteoporosis, diabetes mellitus, obesity, arterial hypertension, amenorrhea in women, decreased sex drive in men, rapid weight gain in combination with severe general and muscle weakness);
• patients with characteristic changes in appearance and a variety of clinical manifestations of hypercorticism;
• children who have stunted growth in combination with weight gain;
• patients with accidentally detected adrenal gland neoplasms;
• patients of any age with poorly controlled diabetes mellitus and / or hypertension in combination with obesity or rapid weight gain;
• patients with vertebral fractures, especially multiple fractures, under the age of 65 years.

Preanalytical requirements:

Biomaterial is collected in an amount of at least 1.0 ml in special containers for collecting saliva.
30 minutes before collecting samples, you should refuse to eat, drink, chew chewing gum or brush your teeth. Otherwise, it is recommended to rinse your mouth with cold water 5 minutes before collecting the sample. Biomaterial can be sent at +2 - + 8 ° С (on the day of capture). Storage at -20 ° C for up to 6 months.

Interpretation of results:

In a randomized study of samples of the saliva of women and men taken early in the morning, the following results were obtained in the range of absolute values: 5.0 - 21.6 ng / ml.

Literature:

Materials company - manufacturer of reagent kits.

Saliva, quantitative, ELISA
3 working days
Details
Testosterone in saliva
Saliva, quantitative, LC-MS/MS
4 working days
Estradiol in saliva
Saliva, quantitative, LC-MS/MS
4 working days
Progesteron in saliva
Saliva, quantitative, LC-MS/MS
4 working days
Melatonine in saliva
Saliva, quantitative, LC-MS/MS
4 working days
Hepcidin-25
Details

Hepsidin is a peptide hormone, a universal humoral regulator of the concentration of iron in plasma and its distribution in tissues. It is produced by hepatocytes, belongs to the proteins of the acute phase, participates in infectious and inflammatory processes. Secreted in response to increased iron levels and inflammation. With an excess of iron, hepcidin secretion increases, which leads to a decrease in iron absorption by enterocytes. An increase in hepcidin synthesis in inflammatory diseases or infections also leads to blocking the release of iron from macrophages, hepatocytes and enterocytes and its accumulation in cells. A lack of iron in the blood leads to a decrease in erythropoiesis and the development of anemia of chronic diseases (ACP). With iron depletion, hepcidin production decreases. A decrease in hepcidin leads to the release of accumulated iron and an increase in the absorption of iron from food.

The study of hepcidin level in blood serum can be used in the algorithm for differential diagnosis of iron deficiency anemia and functional iron deficiency in ACh

 Preanalytical requirements:

Venous blood serum. An aliquot of serum is stored at a temperature of + 2 ... + 8С for up to 4 days. At a temperature of -17 ... -23˚С up to 12 months.

 Indications for use:

Differential diagnosis of iron deficiency anemia and functional iron deficiency in AChP;
To identify pathological conditions caused by iron overload.

Interpretation of results:

Reference values of Hepcidin-25: 1.49 - 41.46 ng / ml.

 Literature:

Materials company - manufacturer of reagent kits.

Human serum, qualitative, ELISA
10 working days
Details

Neurology

Antibodies to the NR2 subunit of the NMDA glutamate receptor in serum, anti-NR2
Details

Stenotic or thrombotic processes in the vessels of the brain lead to a disruption in the supply of glucose and oxygen to neurons, which is the cause of cerebral ischemia. Excessive release of glutamate due to ischemic brain tissue causes hyperactivation, including glutamate NMDA receptors. NMDA receptors are the main excitatory neuroreceptors that regulate the transmission of electrical signals between neurons and support the functioning of the microvasculature of the brain.

As a result of hyperactivation and hyperproduction, NMDA receptors are cleaved by a serine protease, forming NR2 subunits - peptides that penetrate the blood-brain barrier compromised by ischemia and enter the bloodstream. Due to the immune isolation of the brain, the general immune system activates and begins to produce antibodies to the peptide NR2. These antibodies can persist in the bloodstream for up to 3-6 months after one or more ischemic episodes, and their increased titer directly correlates with the risk of repeated transient ischemic attacks or ischemic stroke. The relationship between neurotoxicity and cerebral ischemia has been described in studies of glutamatergic regulation in the brain. The concentration of antibodies to NR2 in the blood in healthy adults is normally <2.0 ng / ml. A high blood concentration of antibodies to NR2 (above the threshold of 2.0 ng / ml) correlates with an increased risk of ischemic stroke. The results of several studies have shown that an increase in the level of antibodies to NR2 above threshold values is a predictor of the development of transient ischemic attacks or ischemic stroke.

Indications for use:

To assess the risk of acute ischemic stroke in patients with risk factors:
arterial hypertension (> 140/90 mmHg);
atrial fibrillation;
dyslipidemia (cholesterol> 5.2 mmol / L, LDL> 2.5 mmol / L);
smoking;
diabetes;
hyperhomocysteinemia;
the use of estrogen;
patients who have previously suffered an ischemic stroke.
In vascular surgery to assess the risk of developing early postoperative neurological complications.

Preanalytical requirements:

Venous blood serum. Centrifugation is recommended for 3 hours after collection. An aliquot of serum is stored at a temperature of + 2 ° C - + 8 ° C for up to 5 days, at −20 ° C for up to 3 months.

Interpretation of results:

Units: ng / ml.
≤ 2 - absence of chronic cerebral ischemia;
> 2.0 - the presence of chronic cerebral ischemia.

Literature:

Materials company - manufacturer of reagent kits.

Serum, quantitative, ELISA
10 working days
Details

Interferon status

Interferon status
Details

Determination of circulating alpha-interferon level , spontaneous production of alpha-interferon in vitro, spontaneous production of gamma-interferon in vitro, induced synthesis of alpha-interferon in vitro, induced synthesis of gamma-interferon in vitro

Determination of drug sensitivity:
Ingaron
Reaferon
Roferon
Amiksin
Kagocel
Neovir
Cycloferon
Galavit
Immunal
Immunomax
Immunofan
IMUNORIX
Likopid
Polyoxidonium
Taktivin
Timogen
PANAVIR
Isoprinosine
                                             
Human blood, quantitative, ELISA
10 working days
Details