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Enzyme-multiplied immunoassay technique (EMIT) performed using
Olympus analyzer:EMIT offers an alternative to the traditional
spectroscopic and chromatographic method for quantitating blood
concentrations of drugs. The technique for drugs is based upon
an enzymatic assay for glucose-6-phosphate dehydrogenase,
using spectral properties at 340 nm, in which the reduction of nicotinamide
adenine dinucleotide (NAD) substrate is monitored. The basis of the
drug detection technique is an immunological reaction between the
drug and a specific antibody. The reagent contains the enzyme
(glucose-6-phosphate dehydrogenase) to which the drug is covalently
bound and antibody-specific to the drug. The antibody binds most of the
drug-bound enzyme, rendering the enzyme inactive. This results
in a baseline enzymatic activity. In the presence of free drug, antibody
equilibrates between free drug and enzyme-bound drug leaving
some of the drug-bound enzyme uncomplexed and able to catalyze
the reaction. If more free drug is introduced, either as standard or
sample, then competition for the antibody takes place between the
drug in the sample and the drug attached to the enzyme. This
results in more drug-bound enzyme being left uncomplexed and
able to catalyze the enzyme reaction at a greater rate as
compared to the baseline activity. The observed enzyme activity
increases with the amount of total free drug in the sample. (Moyer TP:
Therapeutic drug monitoring. In Tietz Textbook of Clinical Chemistry.
4th edition. Edited by CA Burtis, ER Ashwood. WB Saunders
Company, Philadelphia, 2005, pp 1237-1285)