Sagheer S, Rodgers S, Yacoub O, Dauer R, Mcrae S, Duncan E
Haematology Division, SA Pathology, Adelaide, Australia.
Haematology Department, The Alfred, Prahan, Australia.
Haemophilia. 2016 May;22(3):e200-7. doi: 10.1111/hae.12937. Epub 2016 Apr 14.
Diagnosis of von Willebrand disease (VWD) requires quantitative as well as qualitative determination of von Willebrand factor (VWF) levels. For functional assessment of VWF, ristocetin cofactor assay by aggregometry is considered to be the gold standard. However, need for technical expertise, labour intensiveness, difficult standardization and high intra- and inter- assay variabilities are some of the limitations of this methodology. Various assays for determination of VWF adhesive function using different methodologies have been developed in recent years.
To evaluate the HemosIL AcuStar chemiluminescence assay (VWF:RCo[Acu]) and the HemosIL latex immunoassay (VWF:act) as diagnostic tests for VWD and identification of type 2 VWD in comparison with the ristocetin cofactor assay performed by aggregometry (VWF:RCo[Agg]).
Results from 96 samples analysed by VWF:RCo[Acu] and 128 samples by VWF:act were compared with VWF:RCo[Agg]. Sixty of these samples (25 normal, 17 type 1 and 18 type 2) were analysed by all three assays.
VWF:RCo[Acu] showed excellent agreement with VWF:RCo[Agg], and readily identified all type 2 VWD samples tested. VWF:act showed reasonable agreement with VWF:RCo[Agg] for most patients, but had a slightly lower sensitivity for detection of type 2 VWD.
VWF:RCo[Acu] assay has the potential to replace VWF:RCo[Agg] for the diagnosis of VWD.
血管性血友病(VWD)的诊断需要对血管性血友病因子(VWF)水平进行定量和定性测定。对于VWF的功能评估,通过凝集法进行的瑞斯托霉素辅因子测定被认为是金标准。然而,该方法存在需要技术专长、劳动强度大、标准化困难以及分析内和分析间变异性高等局限性。近年来,已经开发了各种使用不同方法测定VWF黏附功能的检测方法。
与通过凝集法进行的瑞斯托霉素辅因子测定(VWF:RCo[Agg])相比,评估HemosIL AcuStar化学发光检测法(VWF:RCo[Acu])和HemosIL乳胶免疫检测法(VWF:act)作为VWD诊断试验以及2型VWD鉴定的效果。
将通过VWF:RCo[Acu]分析的96个样本和通过VWF:act分析的128个样本的结果与VWF:RCo[Agg]进行比较。其中60个样本(25个正常样本、17个1型样本和18个2型样本)通过所有三种检测方法进行了分析。
VWF:RCo[Acu]与VWF:RCo[Agg]显示出极好的一致性,并且能够轻松识别所有测试的2型VWD样本。对于大多数患者,VWF:act与VWF:RCo[Agg]显示出合理的一致性,但在检测2型VWD方面敏感性略低。
VWF:RCo[Acu]检测法有潜力替代VWF:RCo[Agg]用于VWD的诊断。