Diagnosis and follow-up of thrombotic thrombocytopenic purpura with an automated chemiluminescent ADAMTS13 activity immunoassay.

ADAMTS13 protein biological monitoring chemiluminescent assay diagnosis thrombotic thrombocytopenic purpura

Journal

Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 05 08 2020
revised: 24 09 2020
accepted: 21 10 2020
entrez: 4 2 2021
pubmed: 5 2 2021
medline: 5 2 2021
Statut: epublish

Résumé

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathy (TMA) caused by a severe functional deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type I repeats-13), the specific von Willebrand factor (VWF) cleaving protease. ADAMTS13 activity is essential to diagnose TTP but remains challenging to assess, as reference ADAMTS13 activity assays are manual and time consuming. Current techniques also lack robustness in low detectable ADAMTS13 activity range, which could prove problematic for therapy-driven monitoring. The HemosIL AcuStar ADAMTS13 activity assay is a fast, automated chemiluminescent assay, the performance of which remains to be evaluated prospectively on very large cohorts of patients with TMA and in real-life conditions. Our study was conducted over two successive sequences: a retrospective evaluation followed by a "real-life" prospective evaluation. Overall, we evaluated the HemosIL AcuStar ADAMTS13 activity assay on 539 citrated plasma samples. We extensively studied linearity, limit of detection, contamination, intra-assay and interassay precisions with a specific focus on levels < 25 IU/dL. Diagnostic performances for the detection of < 10 IU/dL ADAMTS13 activity and overall method comparison were conducted with the fluorescence resonance energy transfer (FRETS)-VWF73 assay as the reference method. Technical performance proved excellent. Robustness in low detectable ADAMTS13 activity range was good, potentially qualifying this assay for therapy-driven monitoring. Comparison with the FRETS-VWF73 assay was satisfactory ( The HemosIL AcuStar ADAMTS13 activity assay is a fast, reliable, automated technique well adapted as a first-line ADAMTS13 activity assay for TTP diagnosis and follow-up.

Sections du résumé

BACKGROUND BACKGROUND
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathy (TMA) caused by a severe functional deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type I repeats-13), the specific von Willebrand factor (VWF) cleaving protease. ADAMTS13 activity is essential to diagnose TTP but remains challenging to assess, as reference ADAMTS13 activity assays are manual and time consuming. Current techniques also lack robustness in low detectable ADAMTS13 activity range, which could prove problematic for therapy-driven monitoring.
OBJECTIVES OBJECTIVE
The HemosIL AcuStar ADAMTS13 activity assay is a fast, automated chemiluminescent assay, the performance of which remains to be evaluated prospectively on very large cohorts of patients with TMA and in real-life conditions.
PATIENTS AND METHODS METHODS
Our study was conducted over two successive sequences: a retrospective evaluation followed by a "real-life" prospective evaluation. Overall, we evaluated the HemosIL AcuStar ADAMTS13 activity assay on 539 citrated plasma samples. We extensively studied linearity, limit of detection, contamination, intra-assay and interassay precisions with a specific focus on levels < 25 IU/dL. Diagnostic performances for the detection of < 10 IU/dL ADAMTS13 activity and overall method comparison were conducted with the fluorescence resonance energy transfer (FRETS)-VWF73 assay as the reference method.
RESULTS RESULTS
Technical performance proved excellent. Robustness in low detectable ADAMTS13 activity range was good, potentially qualifying this assay for therapy-driven monitoring. Comparison with the FRETS-VWF73 assay was satisfactory (
CONCLUSION CONCLUSIONS
The HemosIL AcuStar ADAMTS13 activity assay is a fast, reliable, automated technique well adapted as a first-line ADAMTS13 activity assay for TTP diagnosis and follow-up.

Identifiants

pubmed: 33537532
doi: 10.1002/rth2.12461
pii: S2475-0379(22)01312-7
pmc: PMC7845081
doi:

Types de publication

Journal Article

Langues

eng

Pagination

81-93

Informations de copyright

© 2020 Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.

Références

J Thromb Haemost. 2008 Sep;6(9):1534-41
pubmed: 18662260
Br J Haematol. 2005 Apr;129(1):93-100
pubmed: 15801961
Blood. 2012 Jun 14;119(24):5888-97
pubmed: 22547583
Thromb Haemost. 2013 Oct;110(4):852-3
pubmed: 23846249
Blood. 2017 May 25;129(21):2836-2846
pubmed: 28416507
Thromb Haemost. 1999 Nov;82(5):1386-9
pubmed: 10595623
Thromb Haemost. 2018 May;118(5):942-944
pubmed: 29614523
J Thromb Thrombolysis. 2020 Oct;50(3):628-631
pubmed: 32219720
Medicine (Baltimore). 2004 Jul;83(4):233-244
pubmed: 15232311
Blood. 1998 Apr 15;91(8):2839-46
pubmed: 9531594
J Thromb Haemost. 2015 Jun;13(6):1151-3
pubmed: 25714758
Thromb Res. 2014 Nov;134(5):1074-80
pubmed: 25262108
Haematologica. 2008 Feb;93(2):232-9
pubmed: 18223285
N Engl J Med. 2019 Jan 24;380(4):335-346
pubmed: 30625070
Blood. 2010 Feb 25;115(8):1500-11; quiz 1662
pubmed: 20032506
Lancet Haematol. 2016 Nov;3(11):e537-e546
pubmed: 27720178
Blood. 2014 Jul 10;124(2):211-9
pubmed: 24859360
Br J Haematol. 2012 Aug;158(3):323-35
pubmed: 22624596
N Engl J Med. 1998 Nov 26;339(22):1585-94
pubmed: 9828246
N Engl J Med. 1991 Aug 8;325(6):398-403
pubmed: 2062331
N Engl J Med. 2016 Feb 11;374(6):511-22
pubmed: 26863353
Thromb Haemost. 1999 Nov;82(5):1382-5
pubmed: 10595622
Transfusion. 2014 Feb;54(2):389-97
pubmed: 23711330
Res Pract Thromb Haemost. 2020 Dec 15;5(1):81-93
pubmed: 33537532
Blood. 2002 Aug 1;100(3):778-85
pubmed: 12130486
Ann Hematol. 2002 Aug;81(8):430-5
pubmed: 12223999
J Thromb Haemost. 2006 Feb;4(2):333-8
pubmed: 16420561
Haematologica. 2012 Aug;97(8):1181-6
pubmed: 22580997
Blood. 2005 Feb 1;105(3):1085-93
pubmed: 15388580
J Thromb Haemost. 2003 Sep;1(9):1882-7
pubmed: 12941027
Blood. 2017 Sep 7;130(10):1181-1188
pubmed: 28768626
J Thromb Haemost. 2015 Jun;13(6):1064-72
pubmed: 25782102
Nature. 2001 Oct 4;413(6855):488-94
pubmed: 11586351
J Thromb Haemost. 2010 Apr;8(4):631-40
pubmed: 20088924
Thromb Haemost. 2013 Mar;109(3):488-96
pubmed: 23306535
Ann Hematol. 2010 Jun;89(6):591-6
pubmed: 20033409
N Engl J Med. 1998 Nov 26;339(22):1578-84
pubmed: 9828245
Transfusion. 2016 Feb;56(2):354-9
pubmed: 26456149
Lancet Haematol. 2016 May;3(5):e237-45
pubmed: 27132698
Blood. 2001 Sep 15;98(6):1765-72
pubmed: 11535510
Br J Haematol. 2008 May;141(5):651-8
pubmed: 18397340
Transfusion. 2006 Aug;46(8):1444-52
pubmed: 16934083
Thromb Haemost. 2019 Nov;119(11):1767-1772
pubmed: 31587247
Blood. 2016 Oct 27;128(17):2175-2178
pubmed: 27625362
Blood. 2011 Aug 18;118(7):1746-53
pubmed: 21636861
Crit Care Med. 2012 Jan;40(1):104-11
pubmed: 21926591

Auteurs

Nicolas Beranger (N)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Sandrine Benghezal (S)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Bérangère S Joly (BS)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Sophie Capdenat (S)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Adeline Delton (A)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Alain Stepanian (A)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Paul Coppo (P)

French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.
Département d'hématologie clinique Hôpital Saint Antoine Université Pierre et Marie Curie Paris France.

Agnès Veyradier (A)

Service d'hématologie Biologique Hôpital Lariboisière, AP-HP.Nord and EA3518 Institut de Recherche Saint-Louis Université de Paris Paris France.
French National Reference Centre for Thrombotic Microangiopathies Assistance Publique - Hôpitaux de Paris France.

Classifications MeSH