Detection of soluble intermediates of the fibrinogen-fibrin conversion using erythrocytes coated with fibrin monomers

Largo, R. H.; Heller, V. G.; Straub, P W

doi:10.1182/blood.v47.6.991.991

Cited by 65 publications

(10 citation statements)

References 16 publications

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“…acute fibrin formation than D-dimer assays, which may detect acutely formed crosslinked fibrin as well as proteolytic fragments of intra-and extravascular fibrin clots. Early test systems for soluble fibrin included the ethanol gelation test (12), protamine paracoagulation assays (13), and the erythrocyte agglutination assay (14,15). Later assays were based on the cofactor role of soluble fibrin in t-PA-induced plasminogen activation (16), and on specific epitopes generated by release of fibrinopeptides A from fibrinogen (17)(18)(19), and fibrin polymerization (8,(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Use of soluble fibrin antigen instead of D-dimer as fibrin-related marker may enhance the prognostic power of the ISTH overt DIC score

Dempfle¹,

Wurst²,

Smolinski³

et al. 2004

Thromb Haemost

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The overt DIC score of the DIC subcommittee of the ISTH includes a fibrin-related marker (FRM) as indicator of intravascular fibrin formation. The type of marker to be used has not been specified, but D-dimer antigen, or fibrin degradation products are used by most investigators. Soluble fibrin complexes have been suggested as more specific indicators of acute intravascular fibrin formation. The aim of the present study was to compare the predictive value of the overt DIC score concerning clinical outcome in a surgical intensive care cohort, using either D-dimer antigen, or soluble fibrin antigen as FRM. The cutoff values for 2 and 3 score points for the FRM were assigned on the basis of the 25% and 75% quartiles of 1870 plasma samples obtained from 359 ICU patients during a period of 6 months. For 331 patients with complete diagnostic workup and day 1 blood samples, the Iatro SF as FRM component of the overt DIC score displayed the highest prognostic power concerning clinical outcome. The 28-day mortality of patients with overt DIC at day 1, using Iatro SF as FRM assay was 50.0%, whereas 28-day mortality of patients without overt DIC was 14.0% (p <0.0001). Using MDA D-dimer, and TINAquant D-dimer, 28-day mortality was between 35.5% and 39.3% in patients with overt DIC, and 15.5% to 15.6% in patients without overt DIC. Selection of the FRM as component of the DIC score has a small, but relevant impact on the prognostic performance of the overt DIC score. The present data on the distribution of values may provide a basis for the selection of appropriate cutoff points for assigning 2, and 3 points in the score.

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Section: Discussionmentioning

confidence: 99%

Use of soluble fibrin antigen instead of D-dimer as fibrin-related marker may enhance the prognostic power of the ISTH overt DIC score

Dempfle¹,

Wurst²,

Smolinski³

et al. 2004

Thromb Haemost

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“…For a variety of clinical research applications, measurement of plasma fibrinopeptide A has been useful (5), but problems related to artefactual elevation after phlebotomy and during in vitro processing as well as its short half-life have limited wide clinical application. Fibrin monomer circulates as "soluble fibrin" in complex with fibrinogen, and detection methods include physical and chemical precipitation with ethanol (6) or protamine (7), gel filtration (8) or agglutination of fibrincoated red cells (9). These assays are semi-quantitative, may be time consuming or have low specificity, and these problems limit diagnostic use.…”

mentioning

confidence: 99%

Reactivity of Soluble Fibrin Assays with Plasmic Degradation Products of Fibrin and in Patients Receiving Fibrinolytic Therapy

McCarron

Marder²,

Francis³

1999

Thromb Haemost

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SummaryThe ability to identify the products of thrombin and plasmin action on fibrinogen is important in patients with thrombotic and fibrinolytic disorders. New assays have been developed for “soluble fibrin” which represents soluble derivatives other than fibrinopeptides formed from fibrinogen by thrombin. These assays are either immunological, using antibodies for fibrin-specific neoepitopes, or functional and based on the cofactor activity of soluble fibrin in the tissue plasminogen activator (t-PA)-mediated conversion of plasminogen to plasmin. As plasmic derivations of fibrin share structural features with soluble fibrin, they may be reactive with assays for soluble fibrin. Therefore, we prepared plasmic digests of fibrin and determined the degree of reactivity with four soluble fibrin assays. Three assays used Mabs directed toward the fibrin-specific neoepitopes at α17-23 (A), γ312-324 (B) and α17-78 (D). A fourth (C) was based on t-PA co-factor activity. Tests A and C demonstrated marked crossreactivity with fibrin degradation products, and digests containing the largest derivatives showed greatest reactivity. Plasmic derivatives of crosslinked fibrin had greater reactivity than those of non-crosslinked fibrin. Tests B and D demonstrated minimal reactivity with plasmic derivatives of crosslinked or of non-crosslinked fibrin. Samples from patients with lower limb peripheral arterial occlusion were assayed for soluble fibrin, D-dimer and fibrinogen at presentation and eight hours after thrombolytic therapy. Variable results were seen at presentation with elevations in 13, 1, 0 and 4 of 19 patients using Tests A, B, C and D, respectively. After fibrinolytic therapy, marked increases in soluble fibrin levels were observed up to 600-fold above normal. A strong correlation between baseline levels was observed with Test B and Test D, which showed the least cross-reactivity with plasmic derivations. After thrombolytic therapy there were either weak or no correlations among the different assays. The results demonstrate that assays for soluble fibrin may react with plasmic derivatives of fibrin and this must be considered in interpreting clinical results.

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“…Antithrombin III was measured by immuno-diffusion (12) and by the chromogenic assay (13). FDP was measured in serum according to Merskey et al (14) and the detection of fibrin monomer complexes was carried out as described by Largo et al (15). Plasma devoid of vitamin K-dependent factors was obtained by 2 subsequent adsorptions of normal citrated plasma on aluminium hydroxyde as described by Caen et al (11).…”

Section: Methodsmentioning

confidence: 99%

Severe Protein C Deficiency in Congenital Thrombotic Disease – Description of an Immunoenzymological Assay for Protein C Determination

et al. 1985

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SummaryAn immunoenzymatic assay (ELISA) is described for the quantitative assay of protein C in plasma. This technique allows a safe, reliable, and sensitive assay of protein C, and is easily used for routine investigation. Using this technique, a protein C deficiency (0.16 U/ml) was discovered in a 16 year old patient with a history of very severe thrombotic disease. Protein C deficiency was also discovered in his mother (0.62 U/ml) and father (0.50 U/ml). We therefore suggest that this case could represent a homozygous deficiency of protein C.

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Detection of soluble intermediates of the fibrinogen-fibrin conversion using erythrocytes coated with fibrin monomers

Cited by 65 publications

References 16 publications

Use of soluble fibrin antigen instead of D-dimer as fibrin-related marker may enhance the prognostic power of the ISTH overt DIC score

Use of soluble fibrin antigen instead of D-dimer as fibrin-related marker may enhance the prognostic power of the ISTH overt DIC score

Reactivity of Soluble Fibrin Assays with Plasmic Degradation Products of Fibrin and in Patients Receiving Fibrinolytic Therapy

Severe Protein C Deficiency in Congenital Thrombotic Disease – Description of an Immunoenzymological Assay for Protein C Determination

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