TGA: Thrombin Generation Assay
E. Berntorp and J. Astermark will use the TGA to evaluate the potential of different FVIII concentrates to generate thrombin in the patient’s inhibitor plasma in order to investigate whether the TGA may be a tool for individualised ITI therapy.
FVIII / VWF-containing concentrates generate more thrombin in vitro in FVIII deficient inhibitor plasmas compared to rFVIII products.
Inhibitor plasma (PPP) is serially diluted in FVIII / VWF deficient plasma (Biopool). FVIII concentrate is added to each plasma dilution and the mixture is tested for thrombin generation. The titre inhibiting 50% of the maximum thrombin generation for each concentrate is calculated and expressed in Malmö inhibitor units (MIU). 1 MIU corresponds to the inactivation of 1 IU of FVIII by 1ml of the patients' plasma.
- Salvagno GL et al. Impact of different inhibitor reactivities with commercial factor VIII concentrates on thrombin generation. Haemophilia 2007; 13(1): 51-6.
- Berntorp E. VWF / FVIII complex and the management of patient with inhibitors: from laboratory to clinical practice. Haemophilia 2007; 13 (s5): 69-72.