Elms M J, Bunce I H, Bundesen P G, Rylatt D B, Webber A J, Masci P P, Whitaker A N
Am J Clin Pathol. 1986 Mar;85(3):360-4. doi: 10.1093/ajcp/85.3.360.
Conformational and structural changes on conversion of fibrinogen to fibrin and its cross-linking by Factor XIIIa lead to the development of new antigenic determinants that permit differentiation between their plasminolytic cleavage products. A monoclonal antibody (DD-3B6/22) that is specific for cross-linked fibrin derivatives containing the D dimer configuration has been used in developing a latex agglutination procedure that can detect fibrin degradation products in either plasma or serum. Fibrinogen or its degradation products do not cross-react with this antibody. Results were calibrated with an enzyme immunoassay, which used a purified D dimer standard. Plasmas from 40 normal subjects, all having D dimer levels below 250 ng/mL measured by enzyme immunoassay, were all negative by latex assay. In contrast, positive latex agglutination titers were obtained with 87 of 88 patients with demonstrated deep venous thrombosis, pulmonary embolism, or disseminated intravascular coagulation. Compared to enzyme immunoassay, latex agglutination assay is less sensitive, but this latex procedure provides a rapid and less elaborate test for elevated levels of cross-linked fibrin degradation products in patients with thrombosis. Plasma assays for fibrin degradation products are preferable to those using serum.
纤维蛋白原转化为纤维蛋白及其经因子ⅩⅢa交联过程中的构象和结构变化导致新抗原决定簇的形成，这些决定簇使得能够区分它们的纤溶酶裂解产物。一种对含有D二聚体结构的交联纤维蛋白衍生物具有特异性的单克隆抗体（DD-3B6/22）已被用于开发一种乳胶凝集试验，该试验能够检测血浆或血清中的纤维蛋白降解产物。纤维蛋白原或其降解产物与该抗体不发生交叉反应。结果通过酶免疫测定法进行校准，该方法使用纯化的D二聚体标准品。40名正常受试者的血浆，通过酶免疫测定法测得其D二聚体水平均低于250 ng/mL，乳胶试验均为阴性。相比之下，88例已证实患有深静脉血栓形成、肺栓塞或弥散性血管内凝血的患者中，有87例乳胶凝集试验滴度呈阳性。与酶免疫测定法相比，乳胶凝集试验灵敏度较低，但该乳胶方法为检测血栓形成患者中交联纤维蛋白降解产物水平升高提供了一种快速且操作不太复杂的检测方法。检测纤维蛋白降解产物时，血浆检测优于血清检测。
