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Pikta M, Vasse M, Smock KJ, Moser KA, van DMA, Lejniece S, Szanto T, Bautista H, Nouadje G, Banys V. Establishing reference intervals for von Willebrand factor multimers. J Med Biochem 2022; 41:115-121. [PMID: 35431650 PMCID: PMC8970582 DOI: 10.5937/jomb0-31941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background von Willebrand factor (VWF) multimers (VWF:MM) methodologies are technically difficult, laborious, time consuming, non-standardized and results vary between laboratories. A new semi automated VWF:MM assay is available for routine use (Sebia). Due to lack of reference values for VWF:MM fractions, results interpretation can be challenging in some cases. The aim of this study was to determine reference intervals for low molecular weight (LMWM), intermediate molecular weight (IMWM) and high molecular weight (HMWM) multimers. Methods By the international cooperation initiated between 4 countries (Estonia, Latvia, France, and USA) 131 samples of relatively healthy individuals were analyzed for VWF:MM (in total 51 males and 80 non-pregnant females aged 17-69 years). Reference intervals were calculated according to CLSI C28-A3 standard. Results The proposed reference intervals for VWF:MM were calculated for LMWM 10.4-22.5%, IMWM 22.6-37.6%, HMWM 45.6-66.6%. Age related differences were seen in IMWM and HMWM (p<0.001 and 0.038). There was no gender related difference observed. Geographically LMWM results of France were different from the other regions (p<0.05). Conclusions Quantification of VWF:MM fractions, in addition to qualitative assessment of VWF:MM patterns, has the potential to aid in differential diagnosis of von Willebrand disease (VWD) subtypes. The reference values calculated in this study can be used in future research to establish clinical decision limits.
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Affiliation(s)
- Marika Pikta
- North Estonia Medical Centre, Department of Laboratory Medicine, Tallinn, Estonia
| | - Marc Vasse
- Foch Hospital, Department of Biology & UMR INSERM 1176, Suresnes, France
| | - Kristi J. Smock
- University of Utah, School of Medicine, Department of Pathology, Salt Lake City, UT, USA
| | - Karen A. Moser
- University of Utah, School of Medicine, Department of Pathology, Salt Lake City, UT, USA
| | | | | | - Timea Szanto
- Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Department of Hematology, Coagulation Disorders Unit, Helsinki, Finland
| | - Hector Bautista
- Sebia, Research and Developments Department, Lisses - Evry Cedex, France
| | - George Nouadje
- Sebia, Research and Developments Department, Lisses - Evry Cedex, France
| | - Valdas Banys
- Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Vilnius, Lithuania
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Pikta M, Szanto T, Viigimaa M, Lejniece S, Balode D, Saks K, Banys V. Evaluation of a new semi-automated Hydragel 11 von Willebrand factor multimers assay kit for routine use. J Med Biochem 2021; 40:167-172. [PMID: 33776566 PMCID: PMC7982284 DOI: 10.5937/jomb0-26008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/12/2020] [Indexed: 01/10/2023] Open
Abstract
Background Accurate diagnosis and classification of von Willebrand disease (VWD) are essential for optimal management. The von Willebrand factor multimers analysis (VWF:MM) is an integral part of the diagnostic process in the phenotypic classification, especially in discrepant cases. The aim of this study was to evaluate the performance of a new Hydragel 11VWF multimer assay (H11VW). Methods Analytical performance characteristics such as repeatability (intra-assay variability, in gel between track variation), reproducibility (inter-assay variability, between gel variation), sensitivity, EQA performance and differences between two commercially available VWF:MM kits (H5VW and H11VW) were analysed in healthy volunteers' plasmas using in-house prepared reference plasma. Results Repeatability and reproducibility results of H11VW demonstrated acceptable and equivalent performance with previously verified H5VW. Participation in EQA was successful. No statistically significant difference was detected between H5VW and H11VW kits for different fractions of multimers: LMWM p=0.807; IMWM p=0.183; HMWM p=0.774. Conclusions H11VW demonstrated acceptable analytical performance characteristics. H11VW kit conveniently offers a more significant number of samples on a single gel. H5VW and H11VW kits can be used in daily practice interchangeably.
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Affiliation(s)
- Marika Pikta
- North Estonia Medical Centre, Department of Laboratory Medicine, Tallinn, Estonia
| | - Timea Szanto
- Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Coagulation Disorders Unit, Department of Hematology, Helsinki, Finland
| | - Margus Viigimaa
- Tallinn University of Technology, Department of Health Technologies, Tallinn, Estonia
| | | | | | - Kadri Saks
- Tallinn Children`s Hospital, Hematology Department, Tallinn, Estonia
| | - Valdas Banys
- Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Vilnius, Lithuania
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Pikta M, Zemtsovskaja G, Bautista H, Nouadje G, Szanto T, Viigimaa M, Banys V. Preclinical evaluation of a semi-automated and rapid commercial electrophoresis assay for von Willebrand factor multimers. J Clin Lab Anal 2018; 32:e22416. [PMID: 29453814 DOI: 10.1002/jcla.22416] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 01/31/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The von Willebrand factor (VWF) multimer test is required to correctly subtype qualitative type 2 von Willebrand disease (VWD). The current VWF multimer assays are difficult, nonstandardized, and time-consuming. The purpose of this study was to evaluate the clinical utility of the commercial VWF multimer kit by Sebia (Lisses, France), an electrophoresis technique yielding same-day results. METHODS Ten healthy volunteer plasma samples, in-house reference plasma (IRP) and commercial normal plasma (CNP) samples, 10 plasma samples from patients with a known VWD type, 1 hemophilia A plasma sample, and 7 external quality assurance (EQA) samples were analyzed using the commercial VWF multimer kit. Additional coagulation testing included measurements of VWF antigen (VWF:Ag), VWF activity (VWF:Ac), and FVIII activity (FVIII:C). RESULTS The CNP results revealed a relative loss of the highest molecular weight multimers; therefore, IRP was preferred as the reference sample. The interpretations of 10 patients with a known VWD type could be successfully reproduced and agreed with previous VWF multimer results. In all EQA surveys, the multimer results and final VWD diagnosis agreed with expert opinion. CONCLUSIONS The VWF multimer assay by Sebia is easy to perform and can be successfully implemented in any clinical laboratory for second-stage evaluation of VWD. The resolution power of multimer distribution is adequate to correctly classify VWD types 1, 2A, 2B, and 3.
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Affiliation(s)
- Marika Pikta
- North Estonia Medical Centre Laboratory, Tallinn, Estonia.,Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Galina Zemtsovskaja
- North Estonia Medical Centre Laboratory, Tallinn, Estonia.,Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Hector Bautista
- Sebia, Research and Developments Department, Parc Technologique Léonard de Vinci, Evry Cedex, France
| | - Georges Nouadje
- Sebia, Research and Developments Department, Parc Technologique Léonard de Vinci, Evry Cedex, France
| | - Timea Szanto
- Coagulation Disorders Unit, HUSLAB Laboratory Services, Department of Hematology and Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
| | - Margus Viigimaa
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Valdas Banys
- Faculty of Medicine, Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Vilnius University, Vilnius, Lithuania
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Lippok S, Obser T, Müller JP, Stierle VK, Benoit M, Budde U, Schneppenheim R, Rädler JO. Exponential size distribution of von Willebrand factor. Biophys J 2014; 105:1208-16. [PMID: 24010664 DOI: 10.1016/j.bpj.2013.07.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/03/2013] [Accepted: 07/24/2013] [Indexed: 12/13/2022] Open
Abstract
Von Willebrand Factor (VWF) is a multimeric protein crucial for hemostasis. Under shear flow, it acts as a mechanosensor responding with a size-dependent globule-stretch transition to increasing shear rates. Here, we quantify for the first time, to our knowledge, the size distribution of recombinant VWF and VWF-eGFP using a multilateral approach that involves quantitative gel analysis, fluorescence correlation spectroscopy, and total internal reflection fluorescence microscopy. We find an exponentially decaying size distribution of multimers for recombinant VWF as well as for VWF derived from blood samples in accordance with the notion of a step-growth polymerization process during VWF biosynthesis. The distribution is solely described by the extent of polymerization, which was found to be reduced in the case of the pathologically relevant mutant VWF-IIC. The VWF-specific protease ADAMTS13 systematically shifts the VWF size distribution toward smaller sizes. This dynamic evolution is monitored using fluorescence correlation spectroscopy and compared to a computer simulation of a random cleavage process relating ADAMTS13 concentration to the degree of VWF breakdown. Quantitative assessment of VWF size distribution in terms of an exponential might prove to be useful both as a valuable biophysical characterization and as a possible disease indicator for clinical applications.
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Affiliation(s)
- Svenja Lippok
- Faculty of Physics and Center for NanoScience, Ludwig Maximilian University, Munich, Germany
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Olson E, Torres R, Levene MJ. Integrated fluorescence correlation spectroscopy device for point-of-care clinical applications. BIOMEDICAL OPTICS EXPRESS 2013; 4:1074-82. [PMID: 23847733 PMCID: PMC3704089 DOI: 10.1364/boe.4.001074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/30/2013] [Accepted: 05/30/2013] [Indexed: 06/02/2023]
Abstract
We describe an optical system which reduces the cost and complexity of fluorescence correlation spectroscopy (FCS), intended to increase the suitability of the technique for clinical use. Integration of the focusing optics and sample chamber into a plastic component produces a design which is simple to align and operate. We validate the system by measurements on fluorescent dye, and compare the results to a commercial instrument. In addition, we demonstrate its application to measurements of concentration and multimerization of the clinically relevant protein von Willebrand factor (vWF) in human plasma.
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Affiliation(s)
- Eben Olson
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT 06510,
USA
| | - Richard Torres
- Dept of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06510,
USA
| | - Michael J. Levene
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT 06510,
USA
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