Influence of phospholipids on the assessment of factor VIII activity

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia 1998-07, Vol.4 (4), p.646-650
• Main Authors: Lee, C. A., Kessler, C. M., Varon, D., Martinowitz, U., Heim, M., MIKAELSSON, M., OSWALDSSON, U., SANDBERG, H.
• Format: Article
• Language: English
• Subjects: assays; Biological Assay - standards; Blood Coagulation Disorders - drug therapy; chromogenic; Drug Contamination; factor VIII; Factor VIII - analysis; Factor VIII - isolation & purification; Factor VIII - standards; Factor VIII - therapeutic use; Haemophilia A; Humans; one-stage; Phospholipids; Recombinant Proteins - isolation & purification; Recombinant Proteins - standards; Recombinant Proteins - therapeutic use; Sensitivity and Specificity
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1046/j.1365-2516.1998.440646.x

In view of reported discrepancies between different factor VIII assays, the influence of phospholipids on the performance of one‐stage clotting (OS) and chromogenic substrate (CS) assays was evaluated. The B domain deleted recombinant factor VIII, rVIII SQ, two full‐length recombinant products and a plasma derived factor VIII concentrate were each diluted into severe haemophilia A plasma and assayed against a plasma standard. The one‐stage activity was 50, 80, 75 and 106%, respectively, of the chromogenic result. Variations in the phospholipid concentration did not affect the chromogenic assay, except at very low levels where the apparent activity increased. In contrast, dilution of the phospholipid reagent had a substantial influence on the activity measured by OS assays, especially in the case of rVIII SQ. At low levels of phospholipid, the one‐stage activity of rVIII SQ exceeded the chromogenic result. When mixtures of phosphatidylserine (PS) and phosphatidyl‐choline (PC) were used as a source of phospholipid, the OS results for rVIII SQ agreed well with the CS activity as long as the content of PS was below 10%, i.e., closer to the physiological level. At higher levels of PS, as in most commercial APTT reagents, the OS activity decreased. When the APTT reagent was replaced by platelets in the OS assay, the results compared well with those obtained by the CS assay for both t‐VIII SQ and full‐length factor VIII products.