PMID- 38193053
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240110
IS  - 2475-0379 (Electronic)
IS  - 2475-0379 (Linking)
VI  - 7
IP  - 8
DP  - 2023 Nov
TI  - Reassessment of dextran sulfate in anti-Xa assay for unfractionated heparin 
      laboratory monitoring.
PG  - 102257
LID - 10.1016/j.rpth.2023.102257 [doi]
LID - 102257
AB  - BACKGROUND: Anti-Xa assays are used for unfractionated heparin (UFH) monitoring. 
      Dextran sulfate (DS) is used in some assays to overcome the artifactual 
      preanalytical release of platelet factor 4. However, the practical implications 
      of this test modification have not been studied extensively. OBJECTIVES: To 
      investigate the impact of the presence of DS in the anti-Xa assay for UFH 
      laboratory monitoring. METHODS: We studied factor Xa inhibition, using an assay 
      without DS (Stago Liquid Anti-Xa), in normal pool plasma spiked with various 
      concentrations of UFH (up to 1 IU/mL) in the presence of increasing 
      concentrations of DS (up to 2560 mug/mL). We also investigated the effect of DS on 
      FXa inhibition measured after the addition of UFH and heparin antagonists 
      (protamine and Polybrene; Sigma Aldrich). Eventually, we compared the anti-Xa 
      levels measured using the assay without DS to those measured with an assay 
      containing DS (BIOPHEN Heparin LRT, Hyphen BioMed). RESULTS: DS per se had a 
      detectable anti-Xa effect. FXa inhibition in UFH-spiked plasma linearly increased 
      with increasing concentrations of added DS, with a plateau at approximately 160 
      mug/mL DS, at which the apparent anti-Xa level had almost doubled. In the presence 
      of heparin antagonists, the addition of DS increased anti-Xa levels, 
      corresponding to the dissociation of the UFH-antagonists complexes in vitro. With 
      the anti-Xa assay containing DS, UFH inhibition was not detected. CONCLUSION: In 
      the presence of high concentrations of DS, FXa inhibition was much higher than 
      that predicted from added UFH amounts, presumably related to the greater 
      availability of UFH for interaction with antithrombin. While the relevance of 
      measuring this "masked" heparin has not been demonstrated, the presence of DS 
      renders the result inaccurate in the presence of protamine or Polybrene.
CI  - (c) 2023 The Author(s).
FAU - Hardy, Michael
AU  - Hardy M
AD  - CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Namur Research Institute 
      for Life Sciences, Hematology Laboratory, Yvoir, Belgium.
AD  - CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Namur Research Institute 
      for Life Sciences, Department of Anesthesiology, Yvoir, Belgium.
AD  - Universite catholique de Louvain, Institut de Recherche Experimentale et 
      Clinique, Pole Mont, Yvoir, Belgium.
FAU - Cabo, Julien
AU  - Cabo J
AD  - CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Namur Research Institute 
      for Life Sciences, Hematology Laboratory, Yvoir, Belgium.
FAU - Deliege, Antoine
AU  - Deliege A
AD  - CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Namur Research Institute 
      for Life Sciences, Hematology Laboratory, Yvoir, Belgium.
FAU - Douxfils, Jonathan
AU  - Douxfils J
AD  - University of Namur, Department of Pharmacy, Namur Thrombosis and Hemostasis 
      Center, Namur Research Institute for Life Sciences, Namur, Belgium.
AD  - QUALIblood s.a., Namur, Belgium.
FAU - Gouin-Thibault, Isabelle
AU  - Gouin-Thibault I
AD  - CHU of Rennes, Department of Laboratory Hematology, IRSET-INSERM-1085, Rennes, 
      France.
FAU - Lecompte, Thomas
AU  - Lecompte T
AD  - University of Namur, Department of Pharmacy, Namur Thrombosis and Hemostasis 
      Center, Namur Research Institute for Life Sciences, Namur, Belgium.
AD  - CHU of Rennes, Department of Laboratory Hematology, IRSET-INSERM-1085, Rennes, 
      France.
AD  - University of Lorraine, CHRU of Nancy, Nancy, France.
FAU - Mullier, Francois
AU  - Mullier F
AD  - CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Namur Research Institute 
      for Life Sciences, Hematology Laboratory, Yvoir, Belgium.
AD  - Universite catholique de Louvain, Institut de Recherche Experimentale et 
      Clinique, Pole Mont, Yvoir, Belgium.
AD  - University of Namur, Department of Pharmacy, Namur Thrombosis and Hemostasis 
      Center, Namur Research Institute for Life Sciences, Namur, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20231109
PL  - United States
TA  - Res Pract Thromb Haemost
JT  - Research and practice in thrombosis and haemostasis
JID - 101703775
PMC - PMC10772882
OTO - NOTNLM
OT  - anti-Xa
OT  - dextran
OT  - heparin
OT  - polybrene
OT  - protamine
OT  - unfractionated heparin
EDAT- 2024/01/09 06:42
MHDA- 2024/01/09 06:43
PMCR- 2023/11/09
CRDT- 2024/01/09 04:00
PHST- 2023/07/20 00:00 [received]
PHST- 2023/09/20 00:00 [revised]
PHST- 2023/10/18 00:00 [accepted]
PHST- 2024/01/09 06:43 [medline]
PHST- 2024/01/09 06:42 [pubmed]
PHST- 2024/01/09 04:00 [entrez]
PHST- 2023/11/09 00:00 [pmc-release]
AID - S2475-0379(23)05684-4 [pii]
AID - 102257 [pii]
AID - 10.1016/j.rpth.2023.102257 [doi]
PST - epublish
SO  - Res Pract Thromb Haemost. 2023 Nov 9;7(8):102257. doi: 
      10.1016/j.rpth.2023.102257. eCollection 2023 Nov.