Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, Red-Cross Blood Service of Baden-Württemberg-Hessen, Germany.
Transfusion. 2010 Jul;50(7):1429-34. doi: 10.1111/j.1537-2995.2010.02610.x. Epub 2010 Apr 23.
Glycoprotein (GP)-specific platelet (PLT) antibodies can cause allo- or autoimmune thrombocytopenia. Their detection is of high diagnostic value. The simultaneous analysis of specific PLT antibodies (SASPA) assay is based on simultaneous detection of various PLT-specific antibodies by flow cytometry and has entered routine use in our Mannheim institution. In this study, we performed an interlaboratory comparison investigation of PLT-specific antibodies using SASPA versus the "gold standard," the monoclonal antibody-specific immobilization of PLT antigen (MAIPA) assay.
Sera from 194 patients with suspected PLT allo- or autoantibodies were tested against GPIIb/IIIa, IX, Ia/IIa, IV, and HLA Class I by SASPA (in Mannheim) and MAIPA (in Vienna). All data were reported blinded to those from the respective other method. Sensitivity studies included dilution studies with known antibodies against HPA-1a, -1b, -3b, -5b, and -15b and HLA Class I.
Overall, results were concordant in 78.9%. The specificity and sensitivity of SASPA, based on the MAIPA results, were 97.3 and 86.3%, respectively, for the detection of alloantibodies. The respective results for the detection of autoantibodies were 95.3 and 44.9%. Serial dilution experiments with sera containing anti-HPA1a, -1b, -3b, -5b, and -15b and anti-HLA Class I revealed a higher sensitivity of the SASPA assay with all alloantibodies.
In this first blind interlaboratory comparison, SASPA yielded similar results to those of MAIPA. The SASPA assay may be superior to the MAIPA assay for the detection of weak alloantibodies while simultaneous detection of a variety of antibody specificities or immunoglobulin classes and the need of fewer PLTs are obvious advantages.
糖蛋白 (GP)-特异性血小板 (PLT) 抗体可导致同种或自身免疫性血小板减少症。它们的检测具有很高的诊断价值。同时分析特异性 PLT 抗体（SASPA）检测基于流式细胞术同时检测各种 PLT 特异性抗体，已在我们曼海姆机构常规使用。在这项研究中，我们通过 SASPA 与“金标准”——血小板抗原的单克隆抗体特异性固定化 (MAIPA) 检测，对 PLT 特异性抗体进行了实验室间比较研究。
194 例疑似 PLT 同种异体或自身抗体的患者血清用 SASPA（在曼海姆）和 MAIPA（在维也纳）检测针对 GPIIb/IIIa、IX、Ia/IIa、IV 和 HLA Class I 的抗体。所有数据均以盲法报告，与各自的其他方法无关。敏感性研究包括对已知针对 HPA-1a、-1b、-3b、-5b 和 -15b 以及 HLA Class I 的抗体进行稀释研究。
总体而言，78.9%的结果是一致的。基于 MAIPA 结果，SASPA 检测同种异体抗体的特异性和敏感性分别为 97.3%和 86.3%，检测自身抗体的特异性和敏感性分别为 95.3%和 44.9%。含有抗-HPA1a、-1b、-3b、-5b 和 -15b 以及抗-HLA Class I 的血清的系列稀释实验表明，所有同种异体抗体的 SASPA 检测的敏感性更高。
在这项首次盲法实验室间比较中，SASPA 与 MAIPA 产生的结果相似。与 MAIPA 检测相比，SASPA 检测可能更适合检测弱同种异体抗体，同时还具有同时检测多种抗体特异性或免疫球蛋白类别的优势，以及对 PLT 需求较少的优势。
