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6 protocols using asserachrom free tfpi

1

Coagulation and Inflammatory Biomarkers Measurement

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Fibrinogen (Dade® Thrombin reagent, Siemens, Marburg, Germany) and coagulation factor VIII (TriniCLOT automated aPTT, Diagnostica Stago, Asnières, France) were determined by chronometric coagulation assays on BCS (Dade Behring, Deerfield, IL, USA). D-dimer levels were measured by quantitative latex assay (STA-Liatest D-Di®, Diagnostica Stago) on a STA-R analyzer (Diagnostica Stago). Soluble P-selectin (R&D Systems, Minneapolis, MN, USA), interleukin-6 (R&D Systems), von Willebrand factor antigen (Asserachrom® VWF:Ag, Diagnostica Stago) and free TFPI (Asserachrom® Free TFPI, Diagnostica Stago) were measured by immunoassay following the manufacturer’s instructions. Circulating extracellular DNA was extracted from plasma samples using QIAamp® UltraSens Virus Kit (Qiagen) and measured using the PicoGreen Quant-iT dsDNA Assay Kit (Life Technologies). The measurement of MV-TF activity was performed according to standardized protocol for a chromogenic endpoint assay measuring TF-dependent Xa generation as reported previously [36 (link)]. Plasma thrombin generation was measured in PFP using the Calibrated Automated Thrombogram (CAT®, Diagnostica Stago) at a final concentration of 1 pM TF and 4 mM phospholipids (PPP-Reagent LOW®, Diagnostica Stago).
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2

Coagulation and Fibrinolysis Measurements

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Thrombin formation in cryopreserved citrate plasma was assayed using the CAT assay [36 (link)] according to the user manual provided by Thrombinoscope B.V (Maastricht, The Netherlands). From the CAT assay we analyzed the parameters ETP, ie. the area under the thrombin generation curve and Peak, the maximum concentration of thrombin. Coagulation was triggered by recalcification of plasma in the presence of 5 pM recombinant, relipidated human tissue factor (PPP-reagent, Thrombinoscope B.V), and 417 μM fluorogenic substrate (FluCa, Thrombinoscope B.V). Fluorescence was monitored using the Fluoroscan Ascent fluorometer (ThermoLabsystems, Helsinki, Finland), and the thrombin generation parameters were calculated using the Thrombinoscope® software (Thrombino-scope B.V). In order to increase reproducibility all CAT-derived parameters were normalized by dividing the measured test value with that of reference plasma pooled from 34 healthy adults run in the same assay.
Free protein S, free Tissue Factor Plasminogen Inhibitor (TFPI) and D-dimer were analyzed in cryopreserved citrate plasma using commercial ELISA kits (Zymutest free protein S from Hyphen Biomed, Neuville Sur Oise, France; Asserachrom® Free TFPI and Asserachrom® D-Dimer from Diagnostica Stago, Asnières, France).
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3

Plasma TFPI Levels in CLL Patients

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Citrated venous blood samples were collected from 36 CLL patients (25 males and 11 females, mean age 65 years, range 38–80 years). Patients were also clinically staged according to the Binet staging system26 (link),27 (link) with the following distribution: stage A, 21 (58.3%), stage B, 7 (19.4%) and stage C, 8 (22.2%). Citrated venous blood samples from 34 healthy subjects (17 males and 17 females, mean age 42 years, range 24–68 years) were used as controls. Plasma samples were collected by centrifugation at 2500×g for 15 min at 20 °C. Plasma aliquots were frozen and stored at − 80 °C until being assayed. The commercial enzyme-linked immunosorbent assay (ELISA) Asserachrom Free TFPI (Diagnostica Stago, Asnières, France) was used to measure the concentration of full-length TFPI in the plasma according to the manufacturer’s protocol28 (link).
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4

Endogenous Thrombin Potential Measurement

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The endogenous thrombin potential (ETP) was measured using the Calibrated Automated Thrombogram (CAT) assay
[26 (link)], according to the manufacturer’s instructions (Thrombinoscope B.V, Maastricht, the Netherlands). Four thrombin generation parameters were recorded; ETP (time integral of the thrombin formation), lag time, peak thrombin (Peak), and time to peak thrombin (ttPeak). APC resistance was determined after the addition of APC (American Diagnostica Inc., Stamford, CT, USA), and the results were reported as APC-sensitivity ratio (APC-sr); which is the ratio of ETP in presence of APC divided by ETP in absence of APC normalized against the similar ratio obtained with PNP measured in the same run
[25 (link)]. The coagulation inhibitors antithrombin and protein C activities, and free protein S antigen, were analyzed using the Chromogenix Coamatic® Antithrombin, the Chromogenix Coamatic® Protein C, and the Chromogenix Coamatic® Protein S-Free kits from Instrumentation Laboratory (Lexington, MA, USA). Free TFPI antigen and D-dimer were analyzed by the commercial enzyme-linked immunosorbent assay kits Asserachrom® Free TFPI and Asserachrom® D-DI from Diagnostica Stago, Asnières, France. The hemostatic parameters are shown in Additional file
1: Figure S1.
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5

Coagulation and Fibrinolysis Assays

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PT, APTT, and CFIB were measured using STA Neoplastine C1 plus, STA Cephascreen, and STA fibrinogen in clot-based assays, respectively. Antithrombin (AT), protein C (PC), free protein S (FPS), and DD were assayed using STA-Stachrom ATIII, STA-Stachrom protein C, Liatest Free Protein S, and STA Liatest D-Di. Colorimetric technique was employed for AT and PC, while latex immunoassay technology was employed for DD and FPS. FVII and FVIII were assayed using STA deficient VII/VIII immunodepleted plasma in coagulation-based assays. All reagents were purchased from Diagnostica Stago (Asniers, France) with assays performed on STA-R Evolution analyzer (Diagnostica Stago) according to manufacturer protocols and as previously described.
21 (link)
Free tissue factor pathway inhibitor (TFPI) was measured using an ELISA (Asserachrom Free TFPI, Diagnostica Stago). PAI was also measured with ELISA (Human Serpin E1/PAI-1 Quantikine ELISA kit (DSE100), R&D Systems).
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6

Quantifying Free TFPI Antigen

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Free tissue factor pathway inhibitor antigen (TFPI) was assayed with Asserachrom Free TFPI (Diagnostica Stago). Most of the TFPI is bound to endothelial cells, but it is also found in platelets and is released on activation. TFPI in plasma is found in the following 2 forms: lipoprotein-associated (approximately 80%) and free TFPI. Only the free form of TFPI is associated with the anticoagulant activity. The normal level of TFPI is 10 ng/mL.
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