Fibrinolysis standards: A review of the current status

Thelwell, Craig

doi:10.1016/j.biologicals.2010.02.006

Cited by 4 publications

(3 citation statements)

References 69 publications

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“…SI units are derived through absolute measurement using a strictly defined reference method; this is in contrast to IU which are derived by comparative assay. A similar approach could be used to dual‐label existing and/or future new and replacement protease and inhibitor IS, and this possibility is discussed in a recent review of the current status of fibrinolysis standards [14]. The decision to calibrate the 1st IS for AAT in terms of moles (and mg) was primarily for consistency with the potency units assigned to established licensed therapeutic AAT products.…”

Section: Discussionmentioning

confidence: 99%

An international collaborative study to establish the WHO 1st international standard for alpha‐1‐antitrypsin

Thelwell

Marszal²,

Rigsby

et al. 2010

Vox Sanguinis

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Section: Discussionmentioning

confidence: 99%

An international collaborative study to establish the WHO 1st international standard for alpha‐1‐antitrypsin

Thelwell

Marszal²,

Rigsby

et al. 2010

Vox Sanguinis

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“…Activities of fibrinolytic proteins are often determined relative to the WHO International Standard as a primary calibrator. 3 Examples are available in publications of the development of fibrinolysis as per WHO International Standards (e.g., Locke et al 7 ).…”

Section: Assays For Thrombolytic Proteinsmentioning

confidence: 99%

“…The National Institute for Biological Standards and Control (NIBSC) is a World Health Organization (WHO) collaborating center with the responsibility to generate, store and distribute biological standards. A major part of our portfolio covers diagnostic and drug-related standards in hemostasis, including fibrinolysis 3 and reviews on the ways in which our biological standards can be used have been published elsewhere. 4,5 Keywords ► fibrinolysis ► biomarkers ► standardization ► thrombolytics ► antifibrinolytics…”

Section: Introductionmentioning

confidence: 99%

Measuring Fibrinolysis

Longstaff

2021

Hamostaseologie

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Physiological fibrinolysis under normal conditions progresses slowly, in contrast to coagulation which is triggered rapidly to stop bleeding and defend against microbial invasion. Methods to detect fibrinolysis abnormalities are less simple and poorly standardized compared with common coagulation tests. Fibrinolysis can be accelerated by preparing euglobulin from plasma to reduce endogenous inhibitors, or by adding plasminogen activators to normal plasma. However, these manipulations complicate interpretation of results and diagnosis of a “fibrinolysis deficit.” Many observational studies on antigen levels of fibrinolysis inhibitors, plasminogen activator inhibitor 1 or thrombin-activatable fibrinolysis inhibitor, zymogen or active enzyme have been published. However, conclusions are mixed and there are clear problems with harmonization of results. Viscoelastic methods have the advantage of being rapid and are used as point-of-care tests. They also work with whole blood, allowing the contribution of platelets to be explored. However, there are no agreed protocols for applying viscoelastic methods in acute care for the diagnosis of hyperfibrinolysis or to direct therapy. The emergence of SARS-CoV-2 and the dangers of associated coagulopathy provide new challenges. A common finding in hospitalized patients is high levels of D-dimer fibrin breakdown products, indicative of ongoing fibrinolysis. Well-established problems with D-dimer testing standardization signal that we should be cautious in using results from such tests as prognostic indicators or to target therapies.

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