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Cited by 5Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVenomous Animal Envenomation and Studies

Lupus Anticoagulant Testing: Taipan Snake Venom Time with Ecarin Time as Confirmatory Test

Moore, Gary W.·2023·Methods in Molecular Biology
DOI 10.1007/978-1-0716-3175-1_16
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Abstract

Testing for lupus anticoagulants (LA) in the presence of therapeutic anticoagulation is largely discouraged because of the risk of false-positive and false-negative results, although the ability to detect LA in this setting can be clinically valuable. Strategies such as mixing tests and anticoagulant neutralization can be effective, but have their own limitations. The prothrombin activators in venoms from Coastal Taipan and Indian saw-scaled viper snakes provide an additional analytical avenue in that they are insensitive to the effects of vitamin K antagonists and inevitably bypass the effects of direct factor Xa inhibitors. Oscutarin C in Coastal Taipan venom is phospholipid- and Ca 2+-dependent, so the venom is used in a dilute phospholipid design as an LA screening test called the Taipan snake venom time (TSVT). The ecarin fraction of Indian saw-scaled viper venom is cofactor-independent and operates as a prothrombin-activated confirmatory test, the ecarin time, because the absent phospholipid precludes inhibition by LAs. Bypassing all coagulation factors except prothrombin and fibrinogen renders the assays innately more specific than other LA assays, while TSVT as a screening test has good sensitivity to LAs detected in other assays, as well as occasional antibodies unreactive in other assays.

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Crossref · 10.1007/978-1-0716-3175-1_16

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Research works printed but not linked: 2

  1. CLSI (2014) Laboratory testing for the lupus anticoagulant; approved guideline. CLSI document H60-A. Clinical and Laboratory Standards Institute, Wayne, PA
  2. CLSI (2008) Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline, CLSI document C28-A3, 3rd edn. Clinical and Laboratory Standards Institute, Wayne, PA

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Authors
Moore, G. W.
Affiliations
Cambridge University Hospitals NHS Foundation Trust (GB)
Corresponding author
Moore, Gary W.
ORCID
Moore, Gary W.
Venue
Methods in Molecular Biology
Publisher
Springer US
Published
2023
Volume
2663
Pages
263-274
ISSN
  • 1064-3745 (ISSN-L)
  • 1940-6029
DOI
10.1007/978-1-0716-3175-1_16
OpenAlex
W4377093087
Semantic Scholar
cbac4f29e9ce9818389ab2ffacdad53141ad70be
Cited by
5
References
33
Citations by year
2025: 1 · 2024: 2 · 2023: 2
FWCI
9.45
Type
book chapter
Language
en
Open access
closed
Licence
Locations
  • Methods in molecular biology (publishedVersion)
  • PubMed (publishedVersion)
  • Middlesex University Research Repository (Middlesex University Of London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Venomous Animal Envenomation and Studies
Keywords
lupus anticoagulant, prothrombin activator, vitamin K antagonists, factor Xa inhibitors, therapeutic anticoagulation, false positives
MeSH terms
Anticoagulants, Blood Coagulation Tests, Elapid Venoms, Humans, Partial Thromboplastin Time, Endopeptidases, Phospholipids, Prothrombin, Prothrombin Time, Snake Venoms, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome

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