Ned Tijdschr Klin Chem Labgeneesk 2004; 29: 295-296
Direct measurement of lithium in whole blood using a capillary electrophoresis microchip
E.X. VROUWE1, P. KÖLLING2, R. LUTTGE1 and A. van den BERG1
Introduction
Receiving clinically relevant blood parameters even
Blood was obtained performing the finger stick
for off-chip cleaned up sample is a nontrivial analy-
method on a volunteer using Haemolance (HaeMedic
tical problem. Few devices have been developed that
AB, Sweden) disposable lancets. Approximately 30
fully exploit combining multiple functions in so-
µl of blood was collected with a pipette and trans-
called micro total analysis systems (1, 2). Instead of
ferred to a plastic tube. For experiments requiring
advanced component integration on chip, here we
whole blood 10 µl of 0.0806 mol/l sodium citrate
demonstrate that the measurement of alkali metals
(Sigma) was added to stop coagulation whereas when
can be performed in a drop of whole blood using an
serum was required the sample was allowed to clot
established type of capillary electrophoresis mi-
for 10 minutes. Serum was collected after centrifug-
crochip (3-7) by applying the principles of moving
ing the sample for 10 minutes at 11,500 g. From each
boundary electrophoresis. The emphasis will be on
sample an aliquot of 18 µl was spiked with 2 µl of 20
the determination of lithium, which is used in the
mmol/l lithium just before the start of an experiment
treatment of manic-depressive mood disorders. The
in order to obtain a concentration of 2 mmol/l.
low therapeutic index of lithium in blood is criticalthroughout the treatment and is therefore an ideal
candidate for the demonstration of a microchip for
Performing capillary electrophoresis on the microchip
the sample was diluted on-chip in the BGE during thesample loading step. Due to electrophoretic mobility
Materials and methods
difference between the cells and the analytes of interesta cell-free sample plug was formed in the double-T.
Because of the EOF suppression, electromigration
The inset of Figure 1 shows the CE chip made of
dominates and therefore the blood cells, which carry
glass. Electrodes were integrated in the device for
a negative charge, migrate in the opposite direction of
conductivity detection. To reduce both the electro-
the cations. We observed that the formed sample plug
osmotic flow (EOF) and the adsorption of proteins to
matches the conductivity of the BGE, which can be
the chip surface the channels were coated with poly-
explained by moving boundary electrophoresis dur-
acrylamide according to the procedure of Hjertén for
ing sample loading. In figure 1, the control run using
fused silica capillaries (8). During the experiments
(a) whole blood without lithium is compared with (b)
the chip was placed in a custom-made holder, which
the same blood sample spiked with lithium. Separa-
was placed on an inverted microscope to follow the
tion of the blood sample plug resulted in three peaks
filling of the channels with the buffer as well as for
originating from potassium, sodium and lithium. For
tracking the cells. For the CE experiments a back-
determining the lithium concentration, the sodium
ground electrolyte (BGE) consisting of 50 mmol/l 2-
peak was used as internal standard assuming a fixed
(N-morpholino)-ethanesulfonic acid (Sigma, Ger-
concentration of 140 mmol/l. By doing so an error of
many) and 50 mmol/l histidine (Fluka, Switzerland)
less than 4% will be introduced in the calculated
with a pH of 6.1 was used. When whole blood was
lithium concentration due to variations within the
used as sample 200 mmol/l glucose (Sigma) was
normal limits for sodium. For quantitation of whole
added to the BGE to adjust the osmotic strength. For
blood samples prepared by manual spiking with
the separations a computer controlled high voltage
lithium there is an uncertainty in the exact concentra-
power supply with four independently controllable
tion of lithium in the plasma since it is not known
positive voltage outputs was used together with a
how fast the cells take up the lithium. The actual con-
custom-made conductivity detector. An optimized
centration of the spiked sample can therefore be in
voltage scheme was applied to form a sample plug in
the range of 3.4 mmol/l (no lithium uptake) to 2.0
the double-T (9). The separation was performed using
mmol/l (equal distribution between plasma and cells).
Based on calibration runs a concentration of 2.7mmol/l (2.1% RSD, n=3) was calculated from theelectropherograms. This was compared to experi-ments performed on serum in which the lithium con-
MESA+ Research institute1, University of Twente, En-schede; Hospital Group, Medisch Spectrum Twente2,
centration was exactly 2.0 mmol/l (Fig. 1c). In that
case the concentration was determined at 1.8 mmol/l
Ned Tijdschr Klin Chem Labgeneesk 2004, vol. 29, no. 5
with a detection limit of 0.4 mmol/l. The measure-ment error in the size of the peak area does not suffi-ciently explain the error of approximately 10% on therecovery for the serum sample. Depending on thechoice of buffer system the concentration profile ofions in the sample plug may be influenced by the ma-trix composition of sample and does not necessarilyrepresent the original concentration. To investigatethe sources of error in detail more experiments are
Conclusion The experiments demonstrated that lithium was sepa- rated from a drop of whole blood with capillary elec- Figure 1. Results of a separation of a) whole blood without
trophoresis on a microchip within two minutes. Cur-
lithium, b) whole blood spiked with 2 mmol/l lithium and c)
rently further investigations are conducted studying
blood serum spiked with 2 mmol/l lithium. The inset shows a
the process of concentration adjustment during the
photograph of the CE chip with a capillary length of 2 cm(Micronit Microfluidics, The Netherlands) with a blow-up
sample loading in order to improve on the accuracy
of the end-column conductivity detection electrodes and the
for quantitation. In addition, potassium was detected
double-T injection region defining the size of the sample plug
by this method and more study is currently dedicated
dispensed into the separation channel.
to separate calcium and magnesium in order to utilizethe full potential of these microchips for ‘point ofcare’-testing.
5. Lichtenberg J, Rooij NF de, Verpoorte E. Electrophoresis
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Ned Tijdschr Klin Chem Labgeneesk 2004; 29: 296-297
Apoptosis induced kinetic changes in autofluorescence of HL60 cells – application for single cell analysis on chip
F. WOLBERS1,2, A. VALERO2, H. ANDERSSON2, R. LUTTGE2, A. van den BERG2 and I. VERMES1
Introduction
household of the cell. This paper presents a new
Natural cellular autofluorescence (AF) can be a use-
method using AF to study apoptosis. Apoptosis or
ful tool to unravel intracellular pathophysiological
programmed cell death plays an important role in
processes and distinguish normal from diseased tis-
maintaining a homeostatic equilibrium between cell
sue. Many cellular metabolites exhibit autofluores-
proliferation and cell death. Induction of apoptosis
cence, e.g. NAD(P)H and flavins, which colocalizes
results in shrinkage of the cell and fragmentation into
strongly within the mitochondria and in some extent
apoptotic bodies (7). AF intensity is first measured
to the lysosomes (1-6). Both components are actively
conventionally at the flow cytometer (FCM) and fi-
involved in a number of metabolic processes within
nally the results will be translated on to a micro-
the cell and play an important role in the energy
fluidic chip to perform single-cell analysis. Autofluorescence measurements Department of Clinical Chemistry1, Medisch Spectrum
Human promyelocytic leukemic HL60 cells were in-
Twente, Hospital Group and Department of Sensorsys-
cubated with camptothecin (CPT), tumour necrosis
tems for Biomedical and Environmental Applications2,MESA+ Institute, University of Twente, Enschede, The
factor (TNF)-a in combination with cycloheximide
(CHX), or irradiated with 6 or 10 Gy, during varying
Ned Tijdschr Klin Chem Labgeneesk 2004, vol. 29, no. 5
Bayer Award Fructose 1,6-bisphosphatase as a marker of gene, have been described. Affected individuals suffer hepatocellular damage in liver transplantation from prolonged apnoea when given an otherwise safeJ Greenwood, S Reddy, P J Friend, R P Taylor dose of a muscle relaxant. The phenotypic assay is lim-Department of Clinical Biochemistry, John Radcliffe Hospital, Oxfordited in th
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