Thrombin generation: the functional role of alpha-2-macroglobulin and influence of developmental haemostasis.
Currently available chromogenic and fluorogenic substrates for endogenous thrombin potential (ETP) measurement are cleaved by both free (active) and alpha-2-macroglobulin-bound (inactive) thrombin, leading to an overestimation of ETP. Commercial methods for ETP measurement determine this using a mathematical algorithm, which assumes the contribution of alpha-2-macroglobulin to the ETP. This limits application of such methods to populations where variation in alpha-2-macroglobulin concentrations is observed, primarily children. This study examined the contribution of alpha-2-macroglobulin-bound thrombin to the ETP measurement in neonates, children and adults, to determine whether automated methods are appropriate for use in neonates and children.
Ignjatovic
V
V
Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia. verai@unimelb.edu.au
Greenway
A
A
Summerhayes
R
R
Monagle
P
P
D000328:Adult; D000465:Algorithms; D019540:Area Under Curve; D001777:Blood Coagulation / Q000502:physiology; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D006801:Humans; D007231:Infant, Newborn; D012680:Sensitivity and Specificity; D013917:Thrombin / Q000032:analysis / Q000378:metabolism*; D000511:alpha-Macroglobulins / Q000378:metabolism*
D000511:alpha-Macroglobulins; D013917:Thrombin