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Antiphospholipid antibodies impact the protein C (PC) pathway behavior
Laura C Gennari1, Alicia N Blanco, María Fabiana Alberto
1Departamento de Hemostasia y Trombosis, Instituto de Investigaciones Hematológicas Mariano R. Castex, Academia Nacional de Medicina, Buenos Aires, Argentina. laugennari@hematologia.anm.edu.ar
American Journal of Hematology
|September 28, 2002
Summary
Antiphospholipid antibodies can resist activated protein C (PC). Lupus anticoagulant samples showed higher detection rates for resistance using the APCR test compared to the ProCG system.
Area of Science:
- Hematology
- Immunology
- Thrombosis
Background:
- Antiphospholipid antibodies (aPL) are associated with an increased risk of thrombosis.
- These antibodies can interfere with the protein C (PC) pathway, leading to a resistant phenotype.
- Evaluating this resistance is crucial for understanding thrombotic risk in patients with antiphospholipid syndrome.
Purpose of the Study:
- To compare the diagnostic performance of the activated protein C resistance (APCR) assay and the ProCG system in detecting antiphospholipid antibody-mediated PC pathway resistance.
- To investigate the correlation between results from different assay systems and identify potential reasons for discrepancies.
Main Methods:
- The study analyzed 36 lupus anticoagulant samples.
- Two systems were used: the original activated protein C resistance (APCR) assay and the ProCG system.
- Results were compared, and correlations between the systems were assessed.
Main Results:
- Abnormal results were observed in 47% of APCR(original) tests, 17% of APCR(modified) tests, and 22% of ProCG tests.
- ProCG values showed correlation with APCR(original) but not with APCR(modified).
- The majority of lupus anticoagulants impacting the PC pathway yielded abnormal APCR(original) results but normal ProCG values.
Conclusions:
- The APCR(original) assay appears more sensitive than the ProCG system for detecting antiphospholipid antibody-related PC pathway resistance.
- Discrepancies may stem from antibody heterogeneity or differences in assay methodology (e.g., addition of PC activator in ProCG vs. exogenous activated PC in APCR).
- Further research is needed to elucidate the mechanisms behind these observed differences and optimize diagnostic strategies.