Discrepancy between latex and ELISA D-dimer values in sepsis may be caused by human neutrophil elastase.
Thromb Res
; 86(2): 141-52, 1997 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-9175235
ABSTRACT
We have recently shown that D-dimers are degraded by human neutrophil elastase (HNE) in vitro, causing rapid decrease in the D-dimer levels measured by a Latex test, but not with an ELISA test employing the same monoclonal antibody against D-dimer. To see if such discrepant D-dimer concentrations occurred in patients with high HNE concentration, we examined 80 plasma samples from 8 patients with sepsis with a Latex and an ELISA test and calculated the ratio between the D-dimer values obtained with the two tests. Twenty healthy pregnant and twenty pre-eclamptic patients, who are known to have raised D-dimer but low HNE concentrations, were chosen as controls. HNE levels were estimated by determining the HNE-alpha 1-proteinase inhibitor complex (HNE-A1PI) concentration. HNE-A1PI concentration was increased in sepsis patients compared with pre-eclamptic patients (p < 0.0005) and healthy pregnant women (p < 0.0005). In sepsis patients, the D-dimer results were skewed towards lower ratios between Latex and ELISA values compared to pre-eclamptic patients (p = 0.008) and healthy pregnant women (p = 0.0001). In plasma samples from patients with the largest discrepancy between Latex and ELISA D-dimer values, Western blotting with immunostaining indicated degradation of D-dimers to D-like fragments similar to those observed following degradation of cross-linked fibrin by HNE in vitro. We conclude that in sepsis patients there is a marked discrepancy between Latex and ELISA D-dimer values that may be caused by HNE. In such patients Latex D-dimer assays may cause severe underestimation of fibrinolysis.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Productos de Degradación de Fibrina-Fibrinógeno
/
Ensayo de Inmunoadsorción Enzimática
/
Pruebas de Fijación de Látex
/
Sepsis
/
Elastasa de Leucocito
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
/
Pregnancy
Idioma:
En
Revista:
Thromb Res
Año:
1997
Tipo del documento:
Article
País de afiliación:
Noruega