Bach-Gansmo E T, Godal H C, Skjønsberg O H
Department of Pulmonary Medicine, Ullevål Hospital, University of Oslo, Norway.
Thromb Res. 1998 Nov 1;92(3):125-34. doi: 10.1016/s0049-3848(98)00121-2.
Recently, we observed that D-dimers are degraded by human neutrophil elastase (HNE) into two D-like fragments, reacting with the monoclonal antibody in an ELISA D-dimer test but not reacting with the corresponding latex D-dimer test. To investigate this in more detail, we studied the degradation of cross-linked fibrin and fibrinogen by plasmin and HNE to see if this resulted in D-fragments or D-like fragments. Degradation of fibrinogen, both by plasmin and HNE, resulted in D- and D-like fragments, respectively, detected by the ELISA D-dimer test. Degradation of cross-linked fibrin by plasmin and HNE also resulted in D- and D-like fragments, which were detected by the ELISA method. Intact D-dimers detected by the latex D-dimer test were only observed after degradation of cross-linked fibrin with plasmin. We conclude that during lysis of cross-linked fibrin as well as fibrinogen by plasmin and HNE, D-fragments, and D-like fragments, detected by the ELISA D-dimer test, are formed. Only during degradation of cross-linked fibrin by plasmin, intact D-dimers, detected by latex D-dimer test, are formed. The ELISA D-dimer test may therefore be used to detect fibrin and fibrinogen degradation products generated by the combined action of plasmin and HNE in sepsis and other conditions with increased HNE activity, while the latex D-dimer test may be used to detect plasmin derived intact D-dimers.
最近，我们观察到D - 二聚体被人中性粒细胞弹性蛋白酶（HNE）降解为两个D样片段，在ELISA D - 二聚体检测中与单克隆抗体发生反应，但在相应的乳胶D - 二聚体检测中不发生反应。为了更详细地研究这一现象，我们研究了纤溶酶和HNE对交联纤维蛋白和纤维蛋白原的降解情况，以确定这是否会产生D片段或D样片段。纤溶酶和HNE对纤维蛋白原的降解分别导致了通过ELISA D - 二聚体检测法检测到的D片段和D样片段。纤溶酶和HNE对交联纤维蛋白的降解也产生了通过ELISA方法检测到的D片段和D样片段。只有在用纤溶酶降解交联纤维蛋白后，才观察到乳胶D - 二聚体检测法检测到的完整D - 二聚体。我们得出结论，在纤溶酶和HNE对交联纤维蛋白以及纤维蛋白原的溶解过程中，会形成通过ELISA D - 二聚体检测法检测到的D片段和D样片段。只有在纤溶酶降解交联纤维蛋白的过程中，才会形成乳胶D - 二聚体检测法检测到的完整D - 二聚体。因此，ELISA D - 二聚体检测法可用于检测脓毒症及其他HNE活性增加情况下，纤溶酶和HNE共同作用产生的纤维蛋白和纤维蛋白原降解产物，而乳胶D - 二聚体检测法可用于检测纤溶酶衍生的完整D - 二聚体。
