Biphasic transmittance waveform in the APTT coagulation assay is due to the formation of a Ca++-dependent complex of C-reactive protein with very-low–density lipoprotein and is a novel marker of impending disseminated intravascular coagulation

Toh, Cheng Hock; Samis, John A.; Downey, Colin; Walker, John B.; Becker, Lev; Brufatto, Nicole; Tejidor, Liliana; Jones, Greg; Houdijk, Wim P.M.; Giles, Alan R.; Koschinsky, Marlys L.; Ticknor, Larry O.; Paton, Ray; Wenstone, Richard; Nesheim, Michael E.

doi:10.1182/blood.v100.7.2522

Cited by 117 publications

(140 citation statements)

References 34 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…AB serum also contains VLDL, and VLDL has been described to bind CRP. 41 However, the VLDL concentration in this serum was so low (0.016 mmol/L) that we can exclude the possibility that VLDL competes away all CRP from the cells.…”

Section: Discussionmentioning

confidence: 73%

C-Reactive Protein Does Not Directly Induce Tissue Factor in Human Monocytes

Paffen

Vos

Bertina

2004

ATVB

View full text Add to dashboard Cite

Objective-It is generally assumed that C-reactive protein (CRP) induces synthesis of tissue factor (TF) in monocytic cells, thereby potentially initiating intravascular blood coagulation. We aimed to elucidate the mechanism of CRP-induced TF expression in monocytes and monocyte-derived macrophages (MDMs) in vitro. Methods and Results-Monocytes were isolated from the blood of healthy donors and cultured with or without CRP or lipopolysaccharide (LPS) to study the time course of TF antigen and TF mRNA expression. Addition of 100 g/mL CRP did not result in a significant increase in TF antigen (range: 9 to 163 pg/10 6 cells, nϭ11) and TF mRNA (relative number of TF transcripts; N TF ϭ0.01 to 0.33), when compared with nonstimulated cells (TF antigen 7 to 46 pg/10 6 cells, N TF ϭ0.01 to 0.13). Variation of CRP concentration and exposure time did not affect the TF response. Similar results were obtained in monocytes cultured in suspension and in MDMs. In contrast, TF was strongly induced by 10 g/mL LPS (TF antigen 1125 to 6120 pg/10 6 cells, N TF ϭ5.94 to 23.43). Cultured monocytes did express FcR␥II, a putative CRP receptor, and addition of CRP induced a 7-fold increase in the production of monocyte chemoattractant protein-1 (MCP-1). Interestingly, CRP addition to peripheral blood mononuclear cells (PBMCs) did result in TF expression on monocytic cells. Conclusions-The

show abstract

Section: Discussionmentioning

confidence: 73%

C-Reactive Protein Does Not Directly Induce Tissue Factor in Human Monocytes

Paffen

Vos

Bertina

2004

ATVB

View full text Add to dashboard Cite

show abstract

“…VLDL-C-reactive protein complexes [14], antiphospholipid antibodies [15]), ROTEM thromboelastometry provides a global overview of the plasmatic and cellular coagulation process by analyzing whole blood. Moreover, it has been shown that platelets are of great importance for the primary thrombin burst [16].…”

Section: Discussionmentioning

confidence: 99%

Uncovering Hypercoagulability in Sepsis Using ROTEM® Thromboelastometry: A Case Series

Luckner¹,

Mayr²,

Fries³

et al. 2008

TOCCMJ

View full text Add to dashboard Cite

This case series presents three patients with sepsis/septic shock in whom standard coagulation tests (international normalized ratio, activated partial thromboplastin time, fibrinogen, antithrombin, thrombocytes) and ROTEM ® thromboelastometry (InTEM, ExTEM, FibTEM) were simultaneously performed. Although all patients showed significantly prolonged plasmatic coagulation times with a putatively increased risk of bleeding, ROTEM ® thromboelastometry revealed normal clotting times and even signs of hypercoagulability. Therefore, no coagulation active therapy was performed in any patient, not even before invasive procedures or major surgical interventions. No bleeding occurred in any study patient during surgery or the subsequent stay on the intensive care unit. These observations suggest that some critically ill patients with sepsis and abnormal standard coagulation tests may in fact have hypercoagulability. ROTEM ® thromboelastometry can add important information in these patients and enable that blood products are used targeted and only for substitution of relevant deficencies. Future studies are necessary to validate these preliminary findings.

show abstract

“…Other studies demonstrated no significant interference due to lipemic or haemolytic sample on PT and APTT measurements by photo optical method [1,2,6]. Some studies uphold photooptical method especially in dysfibrinogenemia and sepsis [7].…”

Section: Discussionmentioning

confidence: 99%

Discrepancy in Optical & Mechanical Method in Coagulation Tests in a Turbid Sample

Aggarwal

Nayak

Manohar

2014

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

Automated coagulation analyzers have replaced manual methods to meet the ever-increasing test load in many laboratories. Of the different methods, two distinct methods exist based on optical and mechanical clot detection (magnetic steel ball method). In optical method the detection of clot formation is measured by a change in optical density (OD) of a test sample. Mechanical clot detection technology, involves monitoring the movement of a steel ball within the test solution using a magnetic sensor. There are limited studies comparing both these methods and they have conflicting results regarding the effect of plasma turbidity on the final result. We report a case where a plasma factor (lipemia) caused prolongation of both PT and APTT, as measured by the photo optical method.

show abstract

Biphasic transmittance waveform in the APTT coagulation assay is due to the formation of a Ca++-dependent complex of C-reactive protein with very-low–density lipoprotein and is a novel marker of impending disseminated intravascular coagulation

Cited by 117 publications

References 34 publications

C-Reactive Protein Does Not Directly Induce Tissue Factor in Human Monocytes

C-Reactive Protein Does Not Directly Induce Tissue Factor in Human Monocytes

Uncovering Hypercoagulability in Sepsis Using ROTEM® Thromboelastometry: A Case Series

Discrepancy in Optical & Mechanical Method in Coagulation Tests in a Turbid Sample

Contact Info

Product

Resources

About