Biotechnology applications in thrombotic diagnosis
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Hussain Habibi,1,* Yegane Sadeghi,2 Yegane Bondar,3 Fatemeh Javanbakht,4 Maede Zakeri Zarch,5 Mina Nikbakhtan,6
1. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
2. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
3. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
4. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
5. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
6. Department of medical laboratory sciences, Varastegan institute for medical sciences, Mashhad, Iran
- Introduction: Multiple mechanisms are involved in clot formation and prevention of bleeding in the human body. In contrast, there are regulatory mechanisms including endothelial anticoagulant, antithrombin III, thrombin, and thrombomodulin to remove the clot and prevent its movement and thrombosis. However, pathological processes such as vascular disorders due to aging or cholesterol deposition, dysfunction or several coagulation factors, and platelet disorders affect the physiological balance in the homeostasis process and increase the risk of thrombosis. Diagnosis of thrombosis is very complex due to the variety of factors that upset this balance and is important because of its direct association with life-threatening diseases such as heart attack and stroke. Therefore, in this article, we want to review the diagnostic tests for thrombotic diseases and the application of biotechnological achievements for uses of in of these tests.
- Methods: Search for keywords such as thrombosis, platelets, biotechnology, and the name of thrombosis diagnostic tests have been done in various databases such as PubMed, Science Direct, and Google scholar. According to criteria such as the English language and the novelty (2015_2022) of the articles, the articles are selected and then studied and their abstracts are taken in the direction of the intended purpose.
- Results: In general, diagnostic laboratory tests for thrombosis are divided into two main groups; general and specific:
General tests:
Bleeding time (BT): The time to stop bleeding is measured and monitors platelet function.
Clotting time (CT): Clotting time is the time it takes for clots to form. As a result of this test, coagulation factor dysfunction is effective.
Closing time (CT): Closing time (CT) is also known as "in vitro" bleeding time. CT is evaluated using a platelet function analyzer (PFA-100®) and is now available as an alternative to clinical laboratory bleeding time testing.
Reptilase Time (RT): This test examines plasma clotting activity based on the enzymatic function of batroxobin.
Of course, there are some more general tests such as; PT, PTT, FT, and TT that evaluate quality and quantity of coagulation factors.
Specific tests:
D-dimer: D-dimer is a fibrin biomarker that can be found in whole blood or plasma. D-dimer levels are elevated in diseases linked to thrombosis.
Protein C & Protein S: Protein C and S are natural anticoagulants and their low level is associated with thrombosis
Light Transmission Aggregometry (LTA): This method examines changes in light transmission due to platelet aggregation that occurs by adding an agonist to platelet-rich plasma.
Whole-Blood Impedance Aggregometry: This method measures the change in electrical impedance between two electrodes when platelet aggregation in whole blood occurs in response to an agonist.
Flow cytometry: Flow cytometry is a technique for analyzing single cells in solution quickly and with multiple parameters. Flow cytometers use lasers as light sources to generate scattered and fluorescent light signals, which are detected by photodiodes or photomultiplier tubes.
- Conclusion: All general tests are performed for primary screening but CT (closing time) and RT tests are superior to other general tests. The Closing time test is done with the PFA100 device by removing maximum human error and new methods of biotechnology and genetics are used in the RT test process, but because both are not sensitive enough to detect platelet anomalies, especially thrombosis, they will push us to more specific tests with higher sensitivity.
Early diagnosis of thrombosis in emergency patients at high risk of stroke is an important goal and the D-dimer test by the biotechnology of Latex agglutination and ELISA is considered the first step toward this goal. Since the test cannot show the exact location of the clot and in some cases its surface elevation under non-thrombosis conditions, it needs further tests as supplementary.
Ultimately, we have tests that are most beneficial from biotechnology. The recent technology added to the LTA test that has minimized the need for personnel has increased the accuracy of the result by reducing the error percentage. However, the time-consuming test has been influenced by variables, and the need for high blood volume in it compared with EIA has made EIA preferable.
Finally, the unique accuracy and minimal flow cytometry limitations that have an effective relationship with the biotechnology achievements that are applied in it make it preferable to other tests.
- Keywords: thrombosis, platelets, biotechnology, thrombosis diagnostic tests
