A rapid agglutination assay to detect anti-streptokinase antibodies.
BACKGROUND
Streptokinase resistance may cause suboptimal thrombolytic therapy.


OBJECTIVE
To develop a rapid latex-bead assay to detect streptokinase antibodies.


METHODS
Sera were obtained from 16 patients presenting with acute myocardial infarction (MI) before treatment with streptokinase and 1 and 6 months post treatment, and from 100 controls. Sera were assayed for anti-streptokinase antibodies using a functional streptokinase-neutralising assay.


RESULTS
Streptokinase-neutralising activity was low in controls (54 +/- 5U/ml) and patients prior to treatment (101 +/- 18), increasing to 2,110 +/- 823 and 1,017 +/- 169 at 1 and 6 months (mean +/- SEM). The latex assay had a sensitivity of 94% and a specificity of 93% for detecting individuals with > 350U/ml of streptokinase resistance, which is sufficient to neutralise the drug clinically.


CONCLUSIONS
Estimation of streptokinase resistance using an enzyme immunoassay and a latex bead assay correlated well with serum neutralising activity. This assay can rapidly identify patients who have a high level of streptokinase-neutralising activity.
McRedmond
J P
JP
Department of Clinical Pharmacology, Royal College of Surgeons, Galway, Ireland. james.mcredmond@ucd.ie
Mulvihill
N T
NT
Kane
M
M
Burke
B
B
Aloul
B
B
Forde
T
T
Walsh
M
M
Fitzgerald
D J
DJ
D000372:Agglutination Tests / Q000379:methods*; D000906:Antibodies / Q000097:blood*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007840:Latex; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy; D018709:Statistics, Nonparametric; D013300:Streptokinase / Q000276:immunology* / Q000627:therapeutic use; D015912:Thrombolytic Therapy
D000906:Antibodies; D007840:Latex; D013300:Streptokinase