Singh, D;
Subhan, MO;
De Groot, R;
Vanhoorelbeke, K;
Zadvydaite, A;
Dragūnaitė, B;
Scully, M;
(2023)
ADAMTS13 activity testing: evaluation of commercial platforms for diagnosis and monitoring of thrombotic thrombocytopenic purpura.
Research and Practice in Thrombosis and Haemostasis
, 7
(2)
, Article 100108. 10.1016/j.rpth.2023.100108.
Preview |
Text
De Groot_1-s2.0-S2475037923000778-main.pdf Download (894kB) | Preview |
Abstract
Background: ADAMTS13 activity is one of the key investigations needed to diagnose thrombotic thrombocytopenic purpura, and there are a number of different assays available to measure it. HemosIL AcuStar, a chemiluminescent immunoassay, was developed and used as a quicker, automated test. In clinical practice, discrepancies between AcuStar and the gold standard FRETS-VWF73 have been documented in a manner that would affect diagnosis and treatment. / Objectives: We aimed to identify and highlight clinical situations where this discrepancy occurs and to attempt to determine the cause. / Method: Therefore, we undertook a study to compare the FRETS-VWF73 assay with AcuStar, the Technozym Activity ELISA, and Ceveron FRET assays using a mixture of 94 retrospective and prospective patient samples. / Results: We found that although the concordance between FRETS-VWF73 and the other methods was generally very good, discrepancies were found in a small number tested on AcuStar affecting diagnosis (5 of 32) and follow-up (7 of 51). A Wilcoxon test comparing FRETS-VWF73 to the AcuStar results suggested that the AcuStar results were significantly lower in 42 samples tested on all 4 platforms. We investigated potential causes for this difference by testing the impact of high vWF levels and addition of a monoclonal ADAMTS13 autoantibody (3H9) to samples. We found no impact of high vWF levels on interassay variability but found that 3H9 reduced ADAMTS13 activity levels much more in AcuStar and ELISA assays than in FRETS assays. / Conclusion: Based on our findings, we would suggest that when AcuStar is used upfront to guide management, a second testing method should be used in patients with an atypical thrombotic thrombocytopenic purpura presentation or unexpectedly slow ADAMTS13 recovery.
| Type: | Article |
|---|---|
| Title: | ADAMTS13 activity testing: evaluation of commercial platforms for diagnosis and monitoring of thrombotic thrombocytopenic purpura |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.rpth.2023.100108 |
| Publisher version: | https://doi.org/10.1016/j.rpth.2023.100108 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | AcuStar, ADAMTS13, ADAMTS13 monitoring, chemiluminescent assay, FRETS assay, thrombotic thrombocytopenic purpura |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10168683 |
Archive Staff Only
 |
View Item |
