Methods, precision, and analytical sensitivity of a novel low-plasma-volume assay of fibrinolytic capacity utilizing the euglobulin fraction

IF 2.2 4区 医学 Q3 HEMATOLOGY International Journal of Laboratory Hematology Pub Date : 2024-07-09 DOI:10.1111/ijlh.14340
Steven Bruzek, Marisol Betensky, Anthony A. Sochet, Neil A. Goldenberg, Vera Ignjatovic
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Abstract

Introduction

Fibrinolysis is a critical aspect of the hemostatic system, with assessment of fibrinolytic potential being critical to predict bleeding and clotting risk. We describe the method for a novel low-plasma-volume assay of fibrinolytic capacity utilizing the euglobulin fraction (the “modified mini-euglobulin clot lysis assay [ECLA]”), its analytic sensitivity to alterations in key fibrinolytic substrates/regulators, and its initial applications in acute and convalescent disease cohorts.

Methods

The modified mini-ECLA requires 50 μL of plasma, a maximal read time of 3 h (with most results available within 60 min), and is entirely performed in a 96-well microplate. Assay measurements were obtained in a variety of commercial control and deficient plasmas representing clinically relevant hypo- and hyperfibrinolytic states, and in three distinct adolescent cohorts with acute or convalescent illness: critically ill, following endotracheal intubation; acute COVID-19-related illness; and ambulatory, 3 months following a venous thromboembolic event.

Results

In 100% and 75% deficient plasmas, hypofibrinolysis for plasminogen-deficient, fibrinolysis for alpha-2-antiplasmin-deficient, and hyperfibrinolysis for plasminogen activator inhibitor-1-deficient plasmas were observed.

Conclusion

The modified mini-ECLA Clot Lysis Time Ratio (“CLTR”) demonstrated moderate-strength correlations with the Clot Formation and Lysis (CloFAL) assay, is analytically sensitive to altered fibrinolytic states in vitro, and correlates with clinical outcomes in preliminarily-studied patient populations.

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利用优球蛋白部分进行纤维蛋白溶解能力的新型低血浆容量测定的方法、精确度和分析灵敏度。
简介:纤溶是止血系统的一个重要方面,评估纤溶潜能对于预测出血和凝血风险至关重要。我们介绍了利用优球蛋白部分("改良型迷你优球蛋白凝块溶解试验[ECLA]")对纤溶能力进行新型低血浆容量测定的方法、其对关键纤溶底物/调节因子变化的分析灵敏度以及在急性和康复性疾病队列中的初步应用:方法:改良型迷你 ECLA 需要 50 μL 血浆,最长读取时间为 3 小时(大多数结果可在 60 分钟内获得),并且完全在 96 孔微孔板中进行。在代表临床相关的纤溶不足和纤溶亢进状态的各种商用对照血浆和缺陷血浆中,以及在患有急性或康复性疾病的三个不同青少年组群中进行了测定:危重病人,气管插管后;与 COVID-19 相关的急性疾病;以及非住院病人,静脉血栓栓塞事件后 3 个月:结果:在100%和75%缺乏血浆中,观察到纤溶酶原缺乏的纤溶不足、α-2-抗蛋白酶缺乏的纤溶不足和纤溶酶原激活物抑制剂-1缺乏的纤溶亢进:结论:改良的微型ECLA凝块溶解时间比("CLTR")与凝块形成和溶解(CloFAL)测定具有中等强度的相关性,对体外纤溶状态的改变具有分析敏感性,并与初步研究的患者群体的临床结果相关。
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来源期刊
CiteScore
4.50
自引率
6.70%
发文量
211
审稿时长
6-12 weeks
期刊介绍: The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.
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