Monoclonal antibodies to crosslinked fibrin degradation products (XL‐FDP) II. EVALUATION IN A VARIETY OF CLINICAL CONDITIONS

Abstract

Plasmas from patients with a wide variety of thrombotic and presumed prethrombotic conditions were examined for high molecular weight crosslinked fibrin degradation products (known as X-oligomers) using a two-site enzyme-linked immunospecific assay (ELISA). This assay employed a catcher-tag principle using two monoclonal antibodies (mabs) directed towards different epitopes on the complex X-oligomer fraction. In general, thrombotic events (pulmonary embolism, PE, myocardial infarction, MI, peripheral vascular disease, PVD, and disseminated intravascular coagulation, DIC) were accompanied by elevated levels of X-oligomers in the plasma. During pregnancy the value of X-oligomer assays was demonstrated to be a clear-cut marker for pre-eclampsia. Patients following a variety of forms of surgery present with heterogeneous plasma levels of X-oligomers and this may merely reflect the formation and lysis of the fibrin formed during and after surgery. The possible value of this ELISA procedure in monitoring thrombolytic therapy is discussed with a critical analysis of the data presented herein. While the assay of X-oligomer was demonstrated to be a valuable marker of fibrinolysis in plasma, more extensive data are required in order to assess whether such an assay is of diagnostic value in thrombosis-related conditions.

Development and clinical application of a new ELISA assay to determine plasmin–α2‐antiplasmin complexes in plasma

“…Among them, those generated from plasmin action on fibrinogen or fibrin (fibrinogen degradation products, D dimer, B 15-42 fragment or X oligomers) are of particular interest (Gaffney et al, 1988). Among them, those generated from plasmin action on fibrinogen or fibrin (fibrinogen degradation products, D dimer, B 15-42 fragment or X oligomers) are of particular interest (Gaffney et al, 1988).…”

Acute Disseminated Intravascular Coagulation Syndrome in Cancer Patients

“…In the majority of patients chronic DIC is found, character ized by few laboratory abnormalities and without hemor rhagic symptoms, while only in a small number of cases DIC may have an acute course with marked laboratory alterations and bleeding [16]. Acute DIC often accompa nies the onset of APL, but is rarely present as the first clincal manifestation of solid tumors.…”

Pulmonary embolism: investigation of the clinically assessed intermediate risk subgroup

“…The role of D-Dimer estimation in patients with suspected acute thromboembolic events is its negative predictive power. An elevated D-Dimer unrelated to thrombus formation may be seen in patients with sepsis or malignancy, in association with markedly elevated C-reactive protein levels, following surgery, in elderly patients per se and those who have undergone prolonged hospitalisation [19][20][21][22]; in such patients reliance upon clinical evaluation and diagnostic imaging studies is more valuable. Conversely, the requesting clinician must be alert to occasions when the D-Dimer value may be falsely suppressed, including those receiving heparin treatment [23] or warfarin therapy [24][25][26], and measurement in patients receiving such anticoagulation should be viewed with caution.…”