{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:37:41Z","timestamp":1760060261412,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ningbo Top Medical and Health Research Program","award":["2022020405","2023Z178","2024Z221"],"award-info":[{"award-number":["2022020405","2023Z178","2024Z221"]}]},{"name":"Ningbo Science and Technology Project","award":["2022020405","2023Z178","2024Z221"],"award-info":[{"award-number":["2022020405","2023Z178","2024Z221"]}]},{"name":"Key Technology Breakthrough Program of \u2018Ningbo Sci-Tech Innovation YONGJIANG 2035\u2019","award":["2022020405","2023Z178","2024Z221"],"award-info":[{"award-number":["2022020405","2023Z178","2024Z221"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJNS"],"abstract":"<jats:p>Seasonal and environmental factors, including temperature, humidity, and storage conditions, significantly impact the stability of biochemical markers in dried blood spot (DBS) samples. This study investigates these influences specifically for adenosine (ADO) levels, a critical biomarker for neonatal screening of adenosine deaminase (ADA) deficiency. This study analyzed seasonal fluctuations in ADO concentrations across three regions in China (Ningbo, Nanjing, and Changsha) over 11 months, and evaluated ADO stability under different storage conditions (4 \u00b0C, 20 \u00b0C, and 40 \u00b0C). ADO levels demonstrated significant seasonal variability, peaking in July\u2013August. Median concentrations increased by 111\u2013189% in warmer months compared to winter across all sites. Storage experiments showed that ADO was most stable at 4 \u00b0C (fluctuations &lt; 5% over 7 days), while levels at 40 \u00b0C increased by 18%. Re-adjusting the ADO reference range based on seasonal data reduced false positive rates from 2.48% to 0.15%, a 94% reduction. This study underscores the necessity of implementing seasonally dynamic reference ranges and strict cold-chain storage (4 \u00b0C) to enhance screening accuracy for ADA deficiency. The findings provide a robust foundation for optimizing neonatal screening protocols globally, especially in regions with distinct seasonal climates.<\/jats:p>","DOI":"10.3390\/ijns11030063","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:30:38Z","timestamp":1755091838000},"page":"63","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seasonal Fluctuations and Stability of Adenosine in Dried Blood Spots for Neonatal Screening"],"prefix":"10.3390","volume":"11","author":[{"given":"Xiangchun","family":"Yang","sequence":"first","affiliation":[{"name":"The Central Laboratory for Birth Defects Prevention and Control, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"},{"name":"Ningbo Key Laboratory for the Prevention and Treatment of Embryogenic Diseases, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"},{"name":"Ningbo Key Laboratory of Genomic Medicine and Birth Defects Prevention, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3592-3438","authenticated-orcid":false,"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha 410000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha 410000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyang","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Genetic Medicine Center, Women\u2019s Hospital of Nanjing Medical University (Nanjing Women and Children\u2019s Healthcare Hospital), Nanjing 210000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanshan","family":"Wu","sequence":"additional","affiliation":[{"name":"Paediatric Surgery Centre, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changshui","family":"Chen","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory for the Prevention and Treatment of Embryogenic Diseases, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9309-6632","authenticated-orcid":false,"given":"Haibo","family":"Li","sequence":"additional","affiliation":[{"name":"The Central Laboratory for Birth Defects Prevention and Control, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"},{"name":"Ningbo Key Laboratory for the Prevention and Treatment of Embryogenic Diseases, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"},{"name":"Ningbo Key Laboratory of Genomic Medicine and Birth Defects Prevention, The Affiliated Women and Children\u2019s Hospital of Ningbo University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","first-page":"463","article-title":"Screening for neonatal inherited metabolic disorders by tandem mass spectrometry in Guangzhou","volume":"50","author":"Tang","year":"2021","journal-title":"Zhejiang Da Xue Xue Bao Yi Xue Ban"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ruoppolo, M., Malvagia, S., Boenzi, S., Carducci, C., Dionisi-Vici, C., Teofoli, F., Burlina, A., Angeloni, A., Aronica, T., and Bordugo, A. 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