The importance of CDT-IFCC, marker of chronic alcohol excessive consumption

Abstract

The presentation comprises of a brief introduction regarding the effects of excessive alcohol consumption, its impact globally and the timely apparition of serum CDT.

Serum total CDT was an improvement over traditional markers but had its pitfalls and limitations, until its path towards standardisation through the IFCC CDT Working group manifested and its evolution to CDT-IFCC.

Upon its recognition to being a very specific marker for chronic excessive alcohol consumption, CDT-IFCC is a valuable marker in both clinical (for example, primary care, psychiatry, lifestyle drinking, antenatal first trimester and emergency departments) and forensic settings (for example, driver licensing, aviation, locomotion, and maritime).

Capillary electrophoresis is the commercial alternative separation technique, which aims to mirror the IFCC approved standard reference HPLC procedure.

There is a great need to raise awareness and educate the importance of CDT-IFCC which is currently the only IFCC approved alcohol marker compared to other upcoming markers and they tend to be associated with short term drinking. CDT-IFCC has a half life of approximately two weeks and makes it an excellent retrospective marker.

The high specificity of CDT-IFCC in the assessment of chronic excessive consumption over traditional markers, its successful standardisation, its uses in both clinical and forensic settings can only indicate that it is ‘time for change’, with inclusive use of the marker by diagnostic service centres and increasing requests by their clients. Collaboration by diagnostic laboratories, local authorities, psychiatrists, primary cares, and CDT manufacturers would be a good approach to promote demand and uptake for CDT-IFCC.

Speakers's biography

An experience currently spanning thirty years in Biochemistry diagnostics in the roles of Clinical and Biomedical Scientist during this period.

A curiosity into an idle Sebia HYDRASYS unit on a laboratory bench in December 2001 initiated a journey into the field of protein electrophoresis from gel to capillary systems, resulted in successful service income generation, application of reflex testing for the identification of monoclonal proteins in local populations under sixty years old, development of a clarification and concentration procedure for urine proteins <0.2 g/L in the successful screening and characterisation of Bence Jones, protein routine use of serum alkaline phosphatase isoenzymes, ISOPAL, with interesting findings, by 2004.

A personal interest and passion into this field of protein separation resulted in presentations of experiences and interesting findings at national and international scientific meetings, workshops and conferences.

Testing a demonstration CDT kit in 2008 created another unexpected path and following a presentation of local findings and experiences with the assay, resulted in an invitation to join the IFCC CDT Working Group in 2013. Membership within the group was achieved by 2015 and elected Chair of the IFCC CDT Working Group from January 2018. The membership period included successful standardisation and IFCC approval of the HPLC procedure as reference method.

The UK diagnostic CDT laboratory is currently one of only five successful laboratories globally to bear recognition for running the IFCC approved reference HPLC method and is also the only site in the world to provide a routine CDT-IFCC service with three different analytical platforms readily available.

The personal journey with Sebia, its equipment and selected assays is presently reaching its twentieth year.