A review of platelet secretion assays for the diagnosis of inherited platelet secretion disorders

Andrew D. Mumford; Andrew L. Frelinger III; Christian Gachet; Paolo Gresele; Patrizia Noris; Paul Harrison; Diego Mezzano

doi:10.1160/TH14-11-0999

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2015; 114(01): 14-25
DOI: 10.1160/TH14-11-0999

Review Article

Schattauer GmbH

A review of platelet secretion assays for the diagnosis of inherited platelet secretion disorders

Andrew D. Mumford

¹School of Clinical Sciences, University of Bristol, Bristol, UK

,

Andrew L. Frelinger III

²Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA

,

Christian Gachet

³UMR-S949 INSERM, Université de Strasbourg, Etablissement Français du Sang-Alsace, Strasbourg, France

,

Paolo Gresele

⁴Department of Medicine, University of Perugia, Perugia, Italy

,

Patrizia Noris

⁵Department of Internal Medicine, University of Pavia-IRCCS Policlinico San Matteo Foundation, Pavia, Italy

,

Paul Harrison

⁶School of Immunity and Infection, University of Birmingham Medical School, Birmingham, UK

,

Diego Mezzano

⁷School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; and Conicyt 1130853

› Institutsangaben

Abstract

Summary

Measurement of platelet granule release to detect inherited platelet secretion disorders (IPSDs) is essential for the evaluation of patients with abnormal bleeding and is necessary to distinguish which granule sub-types are affected and whether there is abnormal granule bio-synthesis or secretion. The radioactive serotonin incorporation and release assay, described before 1970, is still considered the “gold standard” test to assess platelet δ-granule release, although is unsuitable for clinical diagnostic laboratories. Luciferin-based assays, such as lumiaggregometry, are the most widely performed alternatives, although these methods do not distinguish defects in δ-granule biosyn-thesis from defects in secretion. Platelet α-granule release is commonly evaluated using flow cytometry by measuring surface exposure of P-selectin after platelet activation. However, this assay has poor sensitivity for some α-granule disorders. Only few studies have been published with more recently developed assays and no critical reviews on these methods are available. In this review, we describe the rationale for developing robust and accurate laboratory tests of platelet granule release and describe the characteristics of the currently available tests. We identify an unmet need for further systematic evaluation of new assays and for standardisation of methodologies for clinical diagnostic laboratories.

Keywords

Platelet pathology - inherited - acquired - secretion - exocytosis - diagnosis management

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Referenzen

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