A novel hemostasis assay for the simultaneous measurement of coagulation and fibrinolysis

Hematology. 2011 Nov;16(6):327-36. doi: 10.1179/102453311X13085644680348.

Abstract

Thrombin and plasmin are the key enzymes involved in coagulation and fibrinolysis. A novel hemostasis assay (NHA) was developed to measure thrombin and plasmin generation in a single well by a fluorimeter. The NHA uses two fluorescent substrates with non-interfering fluorescent excitation and emission spectra. The assay was tested in vitro using modulators like heparin, hirudin, epsilon-aminocaproic acid, gly-pro-arg-pro peptide and reptilase and validated by measurement of prothrombin fragment 1+2 and plasmin-alpha2-antiplasmin levels. Intra- and inter-assay coefficients of variation were < 9% and 6-25%, respectively. Interplay between coagulation and fibrinolysis was demonstrated by the effect of tissue-type plasminogen activator on thrombin generation and by the different responses of activated protein C and thrombomodulin on fibrinolysis. The last responses showed the linkage between coagulation and fibrinolysis by thrombin activatable fibrinolysis inhibitor. In conclusion, this strategy allows detection of coagulation, fibrinolysis and their interplay in a single assay.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Coagulation / drug effects
  • Blood Coagulation / physiology*
  • Blood Coagulation Tests / methods*
  • Female
  • Fibrinolysin / metabolism
  • Fibrinolysis / drug effects
  • Fibrinolysis / physiology*
  • Hemostasis / physiology*
  • Heparin / pharmacology
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Phosphatidylethanolamines / pharmacology
  • Reproducibility of Results
  • Spectrometry, Fluorescence
  • Substrate Specificity
  • Thrombin / metabolism
  • Tissue Plasminogen Activator / pharmacology
  • Young Adult

Substances

  • Phosphatidylethanolamines
  • Heparin
  • Thrombin
  • Tissue Plasminogen Activator
  • Fibrinolysin