NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
The assessment of in vivo lipid peroxidation and considered to be an index of systemic oxidative stress over time
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
|Test ID||Reporting Name||Available Separately||Always Performed|
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When F2-Isoprostanes testing is performed, urine creatinine will always be performed at no additional charge.
F2ISO: Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
AACT: Enzymatic Colorimetric Assay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
8-epi Prostaglandin F2 alpha
8-iso Prostaglandin F2 alpha
8-epi Prostaglandin F2 alpha
8-iso Prostaglandin F2 alpha
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Plastic, 10-mL urine tube (Supply T068)
Specimen Volume: 10 mL
1. Collect a random urine specimen.
2. No preservative.
Additional Information: Patient should not have taken nonsteroidal anti-inflammatory drugs within 72 hours or aspirin within 2 weeks prior to collection of a specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
|Urine||Refrigerated (preferred)||7 days|
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Oxidative stress results from the generation and overaccumulation of reactive oxygen and nitrogen species and has been shown to damage lipoproteins, lipids, DNA, and proteins. Furthermore, oxidative stress may modulate modifications to these lipoproteins and DNA such that endothelial function and inflammatory processes are altered, ultimately resulting in the initiation and progression of atherosclerosis and cardiovascular disease (CVD). Isoprostanes are a series of prostaglandin-like compounds produced via the free-radical catalyzed peroxidation of arachidonic acid, independent of the cyclooxygenase-derived prostaglandins. F2-isoprostanes are considered the "gold standard" test for quantifying lipid peroxidation/oxidative stress in vivo. 15-F2t-isoprostane (15-F2t-IsoP), also referred to as 8-iso-PGF2 alpha or 8-isoprostane F2 alpha, is 1 of the F2-isoprostanes produced in abundance in vivo and has demonstrated potency as a vasoconstrictor within the vasculature of the heart, brain, lung, and kidneys. Generation of 15-F2t-IsoP induces downstream effects including proliferation of vascular smooth muscle cells and release of endothelin. Additional evidence suggests that F2-isoprostanes may increase aspirin resistance to platelet aggregation within platelets and whole blood.
F2-isoprostanes are advantageous over other markers of lipid peroxidation due to their in vivo and in vitro stability and are detectable in a variety of human tissues and biological fluids including plasma, urine, lavage fluid, RBCs, and cerebrospinal fluid. Quantitation of F2-isoprostanes in a random urine specimen is considered to be the most accurate and robust measurement of circulating isoprostanes and is a noninvasive method of assessment.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
> or =18 years: < or =1.0 ng/mg creatinine
<18 years: not established
Elevated urinary F2-isoprostanes reflect widespread oxidative stress and systemic burden of lipid peroxidation end products. Quantitation of F2-isoprostanes in urine is highly dependent upon the methodology utilized; however, mass spectrometry methods (gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry) assays yield superior sensitivity and analytical specificity compared with immunoassays.
F2-isoprostanes demonstrate superior clinical sensitivity compared to other oxidative stress biomarkers but lack clinical specificity for any particular disease. Pharmacological treatment with antioxidant supplementation, hypoglycemic agents in diabetes, smoking cessation, and weight reduction have all been shown to decrease production of F2-isoprostanes.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
For the most accurate assessment of lipid oxidation status, individuals should not be on aspirin or other nonsteroidal anti-inflammatory drugs, have smoked, or have had acute changes in statin mono- or combination therapies.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Strobel NA, Fassett RG, Marsh SA, Coombes JS: Oxidative stress biomarkers as predictors of cardiovascular disease. Int J Cardiol 2011;147:191-201
2. Davies SS, Roberts, LJ: F2-isoprostanes as an indicator and risk factor for coronary heart disease. Free Radic Biol Med 2011 Mar 1;50(5):559-566
3. Kontush A, de Faria EC, Chantepie S, Chapman MJ: A normotriglyceridemic, low HDL-cholesterol phenotype is characterized by an elevated oxidative stress and HDL particles with attenuated antioxidative activity. Atherosclerosis 2005;182:277-285
4. Vassale C, Botto N, Andreassi MG, et al: Evidence for enhanced 8-isoprostane plasma levels, as an index of oxidative stress in vivo, for patients with coronary artery disease. Coron Artery Dis 2003 May;14(3):213-218
Method Description Describes how the test is performed and provides a method-specific reference
F2-isoprostane (15-F2t-IsoP) and prostaglandin F2 alpha (PGF2 alpha) are separated and quantified in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Deuterium-labeled 15-F2t-IsoP and PGF2 alpha internal standards are added to the samples which are then positive-pressure filtered to remove particulates and sediment from the urine. A Cyclone MAX mixed mode anion exchange turboflow column is used for sample clean-up, while a Waters Xbridge C8 analytical column is used for separation of 15-F2t-IsoP and PGF2 alpha. From this column, the sample is transferred to an API 5000 MS/MS for instrumental analysis. The ratios of the extracted peak areas of 15-F2t-IsoP and PGF2 alpha to their respective deuterium labeled internal standards are used to calculate the concentration of the respective analyte present. PGF2 alpha is not clinically reported, as its analysis is conducted only to ensure complete separation from 15-F2t-IsoP.(Milne GL, Sanchez SC, Musiek, ES, Morrow JD: Quantification of F2-isoprostanes as a biomarker of oxidative stress. Nature Prot 2007;2:221-226)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Thursday; 8 am
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
|Result ID||Reporting Name||LOINC Code|
|88677||15-F2t-Isoprostane, U||In Process|