Platelet factor 4/heparin antibodies in blood bank donors.
Platelet factor 4/heparin antibodies in blood bank donors.
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DOI：
10.1309/ajcpg0mnr5ngknfx
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发表时间：
2010-11
影响因子：
3.5
通讯作者：
Arepally GM
中科院分区：
文献类型：
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作者：
Hursting MJ;Pai PJ;McCracken JE;Hwang F;Suvarna S;Lokhnygina Y;Bandarenko N;Arepally GM
血小板因子4（PF 4）/肝素抗体，通常与肝素治疗相关，在一些肝素初治人群中有报道。然而，一般人群中的血清阳性率仍不清楚。我们使用商业酶联免疫吸附试验对约4，000名血库供体的PF 4/肝素抗体进行了前瞻性评估，以进行初始检测，然后进行重复（确证）检测。在3，795名供体中的249名（6.6%; 95%置信区间[CI]，5.8%-7.4%）中首次检出抗体，在3，789名可评价供体中的163名（4.3%; 95% CI，3.7%-5.0%）中重复检出抗体。“未确认”阳性大多数（93%）为低阳性（光密度[OD] = 0.40-0.59）。在163份重复阳性样本中，116份（71.2%）为低阳性，124份（76.1%）显示肝素依赖性结合。中度至高度血清阳性样本（OD >0.6）的主要同种型为IgG（20/39 [51%]）、IgM（9/39 [23%]）和不确定（10/39 [26%]）。PF 4/肝素抗体的显著背景血清阳性率（4.3%-6.6%），在献血者中以低水平（且通常不可重现）阳性为主，表明需要进一步测定校准、抗体水平分类以及评价“天然存在”PF 4/肝素抗体临床相关性的研究。
Platelet factor 4 (PF4)/heparin antibody, typically associated with heparin therapy, is reported in some heparin-naive people. Seroprevalence in the general population, however, remains unclear. We prospectively evaluated PF4/heparin antibody in approximately 4,000 blood bank donors using a commercial enzyme-linked immunosorbent assay for initial and then repeated (confirmatory) testing. Antibody was detected initially in 249 (6.6%; 95% confidence interval [CI], 5.8%-7.4%) of 3,795 donors and repeatedly in 163 (4.3%; 95% CI, 3.7%-5.0%) of 3,789 evaluable donors. “Unconfirmed” positives were mostly (93%) low positives (optical density [OD] = 0.40-0.59). Of 163 repeatedly positive samples, 116 (71.2%) were low positives, and 124 (76.1%) exhibited heparin-dependent binding. Predominant isotypes of intermediate to high seropositive samples (OD >0.6) were IgG (20/39 [51%]), IgM (9/39 [23%]), and indeterminate (10/39 [26%]). The marked background seroprevalence of PF4/heparin antibody (4.3%-6.6%) with the preponderance of low (and frequently nonreproducible) positives in blood donors suggests the need for further assay calibration, categorization of antibody level, and studies evaluating clinical relevance of “naturally occurring” PF4/heparin antibodies.