Thrombin generation assays: accruing clinical relevance.
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.
Hemker
H Coenraad
HC
Synapse BV, Cardiovascular Research Institute, 6200 MD Maastricht, The Netherlands. H.C.Hemker@Thrombin.com
Al Dieri
Raed
R
Béguin
Suzette
S
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
D013917:Thrombin