Beneficial effect of exogenous platelet factor 4 for detecting pathogenic heparin-induced thrombocytopenia antibodies
| Autor: | Caroline Vayne, Anne Bauters, Claire Kizlik-Masson, Eve-Anne Guéry, Yves Gruel, Claire Pouplard, Jérôme Rollin |
|---|---|
| Přispěvatelé: | Génétique, immunothérapie, chimie et cancer (GICC), UMR 7292 CNRS [2012-2017] (GICC UMR 7292 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Serotonin medicine.drug_class [SDV]Life Sciences [q-bio] 030204 cardiovascular system & hematology Biology Monoclonal antibody Platelet Factor 4 Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Heparin-induced thrombocytopenia medicine Humans ComputingMilieux_MISCELLANEOUS Aged Autoantibodies chemistry.chemical_classification medicine.diagnostic_test Heparin Platelet Count Antibodies Monoclonal Anticoagulants Hematology Gold standard (test) medicine.disease Platelet Activation Thrombocytopenia 3. Good health 030104 developmental biology Enzyme chemistry Immunoassay Immunoglobulin G Immunology biology.protein Antibody Platelet factor 4 Biomarkers medicine.drug |
| Zdroj: | British Journal of Haematology British Journal of Haematology, Wiley, 2017, 179 (5), pp.811-819. ⟨10.1111/bjh.14955⟩ |
| ISSN: | 0007-1048 1365-2141 |
| DOI: | 10.1111/bjh.14955⟩ |
| Popis: | Summary The laboratory diagnosis of heparin-induced thrombocytopenia (HIT) is based on an enzyme immunoassay combined with a functional test, and serotonin release assay (SRA) is the gold standard for detecting activating HIT antibodies. However, a recent atypical history of HIT prompted us to evaluate whether addition of platelet factor 4 (PF4) during SRA could improve its ability to detect pathogenic HIT antibodies. Using 5B9, a monoclonal antibody to PF4/H with a human Fc fragment, we first defined the optimal PF4 concentration for detecting low amounts of platelet-activating IgG with SRA. Plasma samples from 50 patients with suspected HIT were then studied, and SRA was positive in 17 cases (Group SRApos), with relatively high levels of PF4-specific IgG (median optical density = 2·66). SRA was also systematically performed after adding 10 μg/ml of PF4 in the reaction mixture, and significant serotonin release was measured with samples from 9 additional patients (Group PF4-SRApos). Importantly, levels of PF4-specific IgG were similar in these samples and those from the 24 persistently SRA negative patients. Moreover, the pre-test probability of HIT was intermediate/high in all ‘SRApos’ or ‘SRA-PF4pos’ patients. In conclusion, addition of exogenous PF4 might improve the detection of pathogenic HIT antibodies by SRA. |
| Databáze: | OpenAIRE |
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