Rock G, Yousef H, Neurath D, Lu M
Department of Pathology and Laboratory Medicine, Division of Hematology and Transfusion Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ont., Canada.
Transfus Apher Sci. 2006 Dec;35(3):235-8. doi: 10.1016/j.transci.2006.08.006. Epub 2006 Nov 16.
ADAMTS-13 is implicated in the pathophysiology of thrombotic thrombocytopenic purpura (TTP). Plasma exchange is thought to be effective through removal of a harmful substance or provision of a required material such as ADAMTS-13. As various methods are used to prepare plasma we determined the effects of storage and solvent detergent treatment on the ADAMTS-13 levels in plasma.
Samples from fresh plasma and fresh frozen plasma (FFP) were stored at 22 degrees C and ADAMTS-13 levels were measured at 0, 12, 24, 48 and 72 h. Samples were also taken from solvent detergent treated plasma (SDP) and cryosupernatant plasma (CSP). Total protein, albumin, fibrinogen and immunoglobulins were also measured.
In fresh plasma, the levels of both the 175 and 140 Kd subunits of von Willebrand factor were consistent at 1.38 and 1.35 OD units from 0 to 48 h indicating normal ADAMTS-13 activity. The Vitex SDP produced slightly more of the 140 Kd subunit than did Octapharma SDP which gave equivalent fragments. Cryosupernatant plasma was the same as normal plasma. None of these values changed over 48 h. There was a 28% decrease in FVIII in fresh plasma over 24 h. Fibrinogen and albumin were unchanged.
ADAMTS-13 levels are not significantly decreased by storage of plasma at room temperature for up to 48 h. Both CSP and SDP also contained essentially normal levels of ADAMTS-13 and therefore could be used for treatment of patients with TTP.
ADAMTS - 13与血栓性血小板减少性紫癜（TTP）的病理生理学有关。血浆置换被认为通过去除有害物质或提供所需物质（如ADAMTS - 13）而有效。由于使用了各种方法来制备血浆，我们确定了储存和溶剂去污剂处理对血浆中ADAMTS - 13水平的影响。
采集新鲜血浆和新鲜冰冻血浆（FFP）样本，在22℃下储存，并在0、12、24、48和72小时测量ADAMTS - 13水平。还从溶剂去污剂处理血浆（SDP）和冷上清血浆（CSP）中取样。同时测量总蛋白、白蛋白、纤维蛋白原和免疫球蛋白。
在新鲜血浆中，血管性血友病因子175和140 Kd亚基的水平在0至48小时内保持一致，分别为1.38和1.35 OD单位，表明ADAMTS - 13活性正常。Vitex SDP产生的140 Kd亚基比Octapharma SDP略多，后者产生的片段相当。冷上清血浆与正常血浆相同。这些值在48小时内均未改变。新鲜血浆中的FVIII在24小时内下降了28%。纤维蛋白原和白蛋白未发生变化。
在室温下储存血浆长达48小时，ADAMTS - 13水平不会显著降低。CSP和SDP中的ADAMTS - 13水平也基本正常，因此可用于治疗TTP患者。
