Development of a Factor VII Activating Protease (FSAP) generation assay and its application in studying FSAP in venous thrombosis

Etscheid, Michael; Hanschmann, Kay-Martin; Sandset, Per Morten; Kanse, Sandip M.

doi:10.1016/j.thromres.2022.09.027

Cited by 1 publication

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References 44 publications

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“…Blood samples collected in the prehospital environment are centrifuged with a delay compared to samples collected at hospital arrival. In an earlier study, we noted that a 3-hour delay in the centrifugation of blood has no effect on FSAP activity [22]. These 3 hours are exceeded for a small number of patients (triaged directly to a comprehensive stroke center or neurosurgical department).…”

Section: Discussionmentioning

confidence: 91%

Circulating Factor Seven Activating Protease (FSAP) in the Hyperacute Phase of Stroke

Jæger,

Larsen,

Foerch

et al. 2023

Acta Neurologica Scandinavica

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Background. Factor VII activating protease (FSAP) is a circulating serine protease that could be involved in the pathophysiology of stroke. We analyzed the temporal changes in FSAP antigen and FSAP activity after acute cerebral ischemia (ACI) and tested if FSAP could be used to differentiate between stroke subtypes in the hyperacute phase (<4.5 hours after symptom onset). Methods. Of the 118 suspected stroke patients enrolled, 76 had ACI; of which 20 suffered from large vessel occlusion (LVO), 19 had intracerebral hemorrhage (ICH), and 23 had stroke mimics. Median time from symptom onset to the two plasma sample collections, <4.5 hours, were 66 and 107 minutes for the entire study population. Additional samples were collected up to 90 days post stroke in a subset of ACI patients ( n = 19 ). FSAP antigen, FSAP activity, FSAP-α2-antiplasmin-complex (FSAP-AP complex), and nucleosomes were measured by activity assays or ELISA. Results. ACI patients treated with tissue plasminogen activator (tPA) had elevated FSAP activity < 4.5 hours ( p = 0.016 ) that subsequently normalized after 6 hours. FSAP-AP complex levels decreased significantly from <4.5 hours ( p = 0.015 ) to 6 hours after symptom onset. tPA did not increase FSAP activity significantly in plasma in vitro. FSAP antigen significantly decreased < 4.5 hours after symptom onset in LVO ( p = 0.008 ) and ICH ( p = 0.017 ) patients. FSAP could not differentiate ACI from ICH or strokes (ACI and ICH) from stroke mimics. FSAP did not correlate with stroke severity. Conclusion. LVO and ICH seem to influence FSAP levels in the hyperacute phase of stroke, but FSAP does not differentiate between stroke subtypes in a hyperacute setting.

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Section: Discussionmentioning

confidence: 91%