title: Thrombin generation assays: accruing clinical relevance.
abstract: OBJECTIVE
  After decades of near oblivion, thrombin generation is being revived as an overall function test of the plasmatic coagulation system in platelet-poor plasma (PPP). In platelet-rich plasma (PRP) it assesses platelet procoagulant functions as well.
  
  
  RESULTS
  The recently developed use of special fluorogenic thrombin substrates allows monitoring of thrombin concentration in clotting PPP and PRP on line in up to 24 parallel samples. Studies in model systems stress the importance of cell-bound thrombin generation such as measured in PRP.
  
  
  CONCLUSIONS
  The method can be profitably applied to various hitherto unyielding problems such as the control of (low-molecular-weight) heparin therapy, the detection of lupus anticoagulant, and various forms of thrombomodulin and activated protein C resistance (including the use of oral contraceptives) as well as monitoring the treatment of hemophiliacs by factor VIII bypassing therapy. In PRP it reflects the abnormalities encountered in von Willebrand disease and Glanzmann and Bernard-Soulier thrombopathy as well as the action of antiplatelet drugs.
authors.affiliation: Synapse BV, Cardiovascular Research Institute, 6200 MD Maastricht, The Netherlands. H.C.Hemker@Thrombin.com
authors.forename: H Coenraad
authors.initials: HC
authors.lastname: Hemker
authors.forename: Raed
authors.initials: R
authors.lastname: Al Dieri
authors.forename: Suzette
authors.initials: S
authors.lastname: Béguin
mesh_terms: D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis*; D001780:Blood Coagulation Tests / Q000379:methods*; D001792:Blood Platelets / Q000502:physiology; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D013917:Thrombin / Q000032:analysis* / Q000096:biosynthesis* / Q000276:immunology; D013997:Time Factors
chemical_list: D013917:Thrombin