I saw the posting by Peter Howell re: D-lactate and Bob Cramb's (Hello,
Bob!) response on the ACB Mailbase. We started to set up this assay at
Danbury back in 1992 to support a research study by one of our
gastroenterologists to measure this species in the ascitic fluid from
patients with spontaneous bacterial peritonitis. The study never got
off the ground, so we never got the assay fully worked up; however, I
pulled my file on it to see if I had any info that would be helpful to
you, Peter.
As Bob says, you can indeed get the reagents and technical information
you need from Sigma Diagnostics. I believe that D-LDH (EC 1.1.1.28) is
also available from Boehringer Mannheim. If you are going to set up the
assay on an automated chemistry analyzer, you may find the paper
published by John Eckfeldt's group from the VA Medical Center in
Minneapolis, MD (Ludvigsen CW et al, Clinical Chemistry 1983;29:1823-25)
to be useful. There was also a more recent publication by a Dutch group
(Bongaerts G et al, Clin Chem 1995;41:107-110) and another by a Spanish
group (Marcos MA et al, Eur J Clin Microbiol Infect Dis
1991;10:966-969). You need to be careful that you check the
stereospecificity of the D-LDH enzyme at high concentrations of
l-lactate - I believe there were some follow-up letters to the editor in
Clin Chem re: mixtures of D- and L-lactate and the associated problems.
In the US, the test is available from some of the larger reference labs,
e.g., Mayo and SmithKline, but it is very expensive!! (My notes show a
1992 price of $100.20 US from Mayo.) Hope this is helpful.
Cheers,
Sal Sena
Salvador F. Sena, Ph.D., DABCC
Associate Director, Clinical Chemistry
Dept. of Pathology and Laboratory Medicine
Danbury Hospital
Danbury, CT 06810 USA
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