Radioimmunoassay Procedure for Parathyroid Hormone
A radioimmunoassay (RIA) procedure for parathyroid hormone (PTH) was first described in 1963 by Berson et al.1 However, this assay could differentiate only half of patients with primary hyperparathyroidism (1 °HPT) from normal subjects, and many clinicians believed that the assay’s value would be in research rather than patient evaluation. This belief persisted during the next 8–10 years for several reasons: First, Berson and Yalow2 published their classic report on the phenomenon of immunoheterogeneity which showed that there were at least two and probably several different immunoreactive forms of PTH that existed. Second, probably related to the question of immunoheterogeneity, there were numerous conflicting published reports of PTH assays with considerable variation in clinical performance. Third, the reagents necessary for a PTH radioimmunoassay (purified PTH and antiserum) were extremely hard to obtain. And fourth, because of the low circulating levels of PTH in normal humans, the radioimmunoassay “art” had to be extended nearly to its practical limits in order to have the sensitivity required for the assay.
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