title: The intrinsic coagulation activity assay.
abstract: A new assay for the contact-phase-mediated generation of thrombin activity has been developed - the intrinsic coagulation activity assay (INCA). Citrated plasma (50 microl) is incubated with 5 microl SiO2, 250 mmol/l CaCl2 in polystyrole flat-bottom wells. After exactly 4 and 5 min (37 degrees C) coagulation reaction times (INCA-4 and INCA-5), 100 microl of 2.5 mol/l arginine, pH 8.6, is added to inhibit hemostasis activation in the important ascending part of the thrombin generation curve and to depolymerize fibrin. After 20 min, 50 microl of 1 mmol/l (final concentration 0.24 mmol/l) chromogenic thrombin substrate CHG-Ala-Arg-pNA in 1.25 mol/l arginine, pH 8.7, is added. The increase in absorbance is determined at 405 nm using a microtiterplate photometer. The assay is calibrated against 1 IU/ml thrombin. The normal thrombin activity range of INCA-4 (main value) or INCA-5 (control value) is 100 +/- 30% of normal (mean value +/- 1 SD; 100% = 0.5 IU/ml for INCA-4 and 1.9 IU/ml for INCA-5). With the INCA the normal range of intrinsic hemostasis is reflected, low-molecular-weight heparins can be monitored, the plasma matrix is not changed significantly, and the assay results are a percentage of normal generated thrombin activity and not coagulation seconds.
authors.affiliation: Department of Clinical Chemistry - Central Laboratory, University Hospital Giessen & Marburg, Germany. thstief@med.uni-marburg.de
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Stief
authors.forename: Stefanie
authors.initials: S
authors.lastname: Otto
authors.forename: Harald
authors.initials: H
authors.lastname: Renz
mesh_terms: D001780:Blood Coagulation Tests; D002863:Chromogenic Compounds; D003080:Cold Temperature; D006801:Humans; D009391:Nephelometry and Turbidimetry; D010949:Plasma / Q000737:chemistry; D012016:Reference Values; D013917:Thrombin / Q000378:metabolism*
chemical_list: D002863:Chromogenic Compounds; D013917:Thrombin