Measuring calprotectin in plasma and blood with a fully automated turbidimetric assay

Calprotectin in plasma and blood might prove to be a useful biomarker of inflammation and infection; however, automated methods for analysing the concentration of calprotectin in those materials are lacking. We have validated a fully automated turbidimetric method and present health-related reference limits. Calprotectin was measured by Siemens Advia XPT with the Bühlmann fCAL® turbo test (Bühlmann Laboratories AG, Schönenbuch, Switzerland), a particle enhanced turbidimetric immunoassay for quantification of calprotectin in fecal extracts. Plasma and serum samples were analysed directly, while whole blood was first extracted with M-PER® Mammalian Protein Extraction Reagent (ThermoFisher) and diluted with B-CAL-EX (Bühlmann). We studied analytical imprecision, estimated health-related reference limits and examined the correlation between neutrophil-calprotectin (blood-calprotectin adjusted for plasma-calprotectin) and the neutrophil count. The intermediate ('day-to-day') coefficient of variation was 3.5 and 1.0% for heparin-plasma-calprotectin at 0.52 mg/L and 3.53 mg/L, respectively, and 4.9% for heparin-blood-calprotectin at 50.2 mg/L. Health-related reference limits were 0.470-3.02 mg/L for calprotectin in heparin-plasma, 50.8-182 mg/L for calprotectin in heparin-blood, 0.534-2.41% for the ratio between them and 24.7-33.3 pg for the mean amount of calprotectin per neutrophil. Compared to heparin-plasma, calprotectin concentrations were significantly lower in EDTA-plasma and higher in serum (p < .05). Correlation between neutrophil-calprotectin and the neutrophil count was excellent. We have shown that the Bühlmann fCAL® turbo test can be used to measure calprotectin in plasma and blood.