New platelet functional method for identification of pathogenic antibodies in HIT patients

• Published in: Platelets (Edinburgh) Vol. 28; no. 7; pp. 728 - 730
• Main Authors: Guarino, M. L., Massimi, I., Mardente, S., Lappa, A., Donfrancesco, S., Visentin, G. P., Pulcinelli, F. M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.10.2017; Taylor & Francis Group
• Subjects: Adenosine Triphosphate - blood; Adult; Aged; Antibodies - blood; Anticoagulants - adverse effects; Anticoagulants - immunology; ATP release; Blood Platelets - immunology; Blood Platelets - pathology; Female; Firefly Luciferin - chemistry; Follow-Up Studies; Gene Expression; Heparin - adverse effects; Heparin - immunology; HIT; Humans; Immunoassay - methods; Luciferases, Firefly - chemistry; Luminescent Measurements - methods; Male; Middle Aged; Platelet Factor 4 - genetics; Platelet Factor 4 - immunology; Serotonin - blood; Thrombocytopenia - blood; Thrombocytopenia - chemically induced; Thrombocytopenia - diagnosis; Thrombocytopenia - immunology; HIT; ATP release
• ISSN: 0953-7104; 1369-1635
• DOI: 10.1080/09537104.2017.1293803

Heparin-induced thrombocytopenia (HIT) is a thrombotic complication of heparin therapy. The most used functional method for HIT diagnosis is serotonin release assay (SRA). A different functional method based on ATP release with luciferin/luciferase long-life and stable luminescent signal is used here, which is shown to be comparable for accuracy with SRA in both negative (patients 4Ts ≤3, and negative for both anti-PF4/heparin immunoassay and SRA) and positive (4Ts >3, and positive for both PF4/heparin antibodies and SRA) patients. Our results show that ATP release is higher in washed platelets activated by sera from positive patients than in platelets activated by sera from negative patients. In conclusion, we demonstrate that ATP release assay is a valid alternative method to SRA for the identification of pathogenic anti-PF4/heparin antibodies.