A modified rapid monoclonal antibody-specific immobilization of platelet antigen assay for the detection of human platelet antigen (HPA) antibodies: a multicentre evaluation. 2007

K Campbell, and K Rishi, and G Howkins, and D Gilby, and R Mushens, and C Ghevaert, and P Metcalfe, and W H Ouwehand, and G Lucas
National Health Service Blood and Transplant, Cambridge Centre, Long Road, Cambridge CB2 2PT, UK.

BACKGROUND The monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay is the cornerstone technique for the detection and identification of human platelet antigen (HPA) antibodies. However, the original technique described by Kiefel and colleagues requires approximately 8 h adding to diagnostic delay. Moreover, proficiency exercises indicate that there are substantial variations in the MAIPA protocol, and that these may account for interlaboratory differences in sensitivity and specificity. METHODS A review of current MAIPA assay protocols from six laboratories together with performance in quality-assessment schemes identified several key variables potentially affecting the assay results. An optimized protocol was derived and assay time reduced to 5 h. The modified rapid MAIPA (MR-MAIPA) assay was evaluated using 61 samples with a range of HPA antibodies typically encountered in cases of fetomaternal alloimmune thrombocytopenia (n = 22), post-transfusion purpura (n = 8), platelet refractoriness (n = 7) and other platelet immune conditions (n = 24). The sensitivity of the assay was assessed using three international standards and the recombinant HPA-1a antibody CamTran007. The results obtained were compared with the original findings obtained with the local MAIPA assays. In addition, four different glycoprotein IIb/IIIa capture monoclonal antibodies were evaluated for their effect on assay sensitivity. RESULTS Complete concordance was found between the original MAIPA results and those obtained with the new assay when testing a selected panel of clinical samples. The modified assay had nanogram level sensitivity for the detection of HPA-1a antibodies and titration of HPA-1a and HPA-5b antibody sensitivity standards yielded end-points equal to or greater than the mean recorded in international workshops. CONCLUSIONS The MR-MAIPA assay offers improved turnaround for the detection of HPA antibodies without loss of sensitivity.

UI MeSH Term Description Entries
D007118 Immunoassay A technique using antibodies for identifying or quantifying a substance. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. Immunochromatographic Assay,Assay, Immunochromatographic,Assays, Immunochromatographic,Immunoassays,Immunochromatographic Assays
D007518 Isoantibodies Antibodies from an individual that react with ISOANTIGENS of another individual of the same species. Alloantibodies
D006403 Hematologic Tests Tests used in the analysis of the hemic system. Blood Tests,Hematologic Test,Hematological Tests,Test, Hematologic,Tests, Hematologic,Blood Test,Hematological Test,Test, Blood,Test, Hematological,Tests, Blood,Tests, Hematological
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000094902 Blood Banking The administrative procedures and methods required for collecting, characterizing and storing blood or plasma in BLOOD BANKS. Banking, Blood
D000911 Antibodies, Monoclonal Antibodies produced by a single clone of cells. Monoclonal Antibodies,Monoclonal Antibody,Antibody, Monoclonal
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D016824 Antigens, Human Platelet Human alloantigens expressed only on platelets, specifically on platelet membrane glycoproteins. These platelet-specific antigens are immunogenic and can result in pathological reactions to transfusion therapy. Antigens, Platelet-Specific,Human Platelet Antigen,Human Platelet Antigens,Platelet Alloantigen,Platelet Alloantigens,Platelet-Specific Antigen,Platelet-Specific Antigens,Alloantigen, Platelet,Alloantigens, Platelet,Antigen, Human Platelet,Antigen, Platelet-Specific,Antigens, Platelet Specific,Platelet Antigen, Human,Platelet Antigens, Human,Platelet Specific Antigen,Platelet Specific Antigens

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