Detection and identification of platelet antibodies using a sensitive multiplex assay system-platelet antibody bead array.

BACKGROUND: Tests for platelet-specific antibodies are important in the diagnosis of immune platelet disorders. Monoclonal antibody glycoprotein capture assays have been the gold standards in platelet antibody detection for almost 30 years. However, such assays are complex and cumbersome to perform, which limits their routine use. We report the performance of a newly developed, easy to perform platelet antibody bead array (PABA) for the detection of platelet-specific antibodies. STUDY DESIGN AND METHODS: PABA is the equivalent of the monoclonal antigen capture enzyme-linked immunosorbent assay (ELISA) (MACE) on a bead and instead with fluorescent detection of immunoglobulin (Ig)G platelet antibodies by Luminex. Antibodies against platelet glycoproteins (GP) GPIIb/IIIa, GPIb/IX, GPIa/IIa, GPIV, and class I human leukocyte antigen (HLA) could be detected in a patient's serum simultaneously in a single well of a microplate. Results from 80 patient samples and 20 normal donor samples were compared using PABA, MACE, and a commercial ELISA kit. RESULTS: PABA detected all antibodies, with specificity for human platelet antigens (HPAs) HPA-1a, HPA-1b, HPA-2a, HPA-2b, HPA-3a, HPA-3b, HPA-4a, HPA-4b, HPA-5a, HPA-5b, HPA-15b, and HLA. Overall, compared with MACE, the sensitivity and specificity of PABA were 99% and 97%, respectively, and both were significantly better than those of the commercial ELISA. PABA had greater analytic sensitivity than MACE for HPA-1a, HPA-3a, and HPA-5b antibodies. In addition, PABA detected HPA-5b and HPA-3b antibodies that were missed by MACE. The overall false-positive rate of PABA compared with MACE was 2.7%. CONCLUSIONS: The PABA is a rapid, highly sensitive and specific, multiplex bead-based assay for detecting human platelet antibodies. Such a simple yet high-throughput platform will facilitate practical, routine testing for the identification of platelet-specific antibodies.

Sensory processing, participation, and recovery in adults with serious mental illnesses.

OBJECTIVE: People with serious mental illnesses (SMI) have different sensory processing patterns compared to the general population. The purpose of the study was to examine the relationship between different sensory processing patterns and community participation and recovery-oriented outcomes to inform the development of innovative rehabilitation interventions, including those resulting in more accommodating environments. METHODS: A quasi-experimental, comparative research design was conducted by using data obtained from 95 adults with SMI who received public mental health services. Participants completed a sensory processing profile and measures of community participation, recovery, and quality of life. Comparisons were made between sensory profile categories for each dependent variable using multivariate analyses of variance. RESULTS: The category with more evidence of self-reported low registration and sensory sensitivity than most reported less participation and lower levels of recovery than did their peers with processing patterns in typical ranges. The category with more self-reported sensory sensitivity than most reported lower quality of life. Finally, the category in the "similar" to "more than most" range on self-reported sensory seeking had higher levels of participation and recovery. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Assessment of sensory processing patterns in adults with SMI can inform sensory-based interventions that might result in greater community participation and other recovery outcomes. Interventions can include those that seek to enhance person-environment fit by altering the environment, as well as interventions that enhance adaptive sensory responses to external stimuli.