Lupus anticoagulant testing: Taipan snake venom time with ecarin time as confirmatory test

Book chapter

Moore, G. 2023. Lupus anticoagulant testing: Taipan snake venom time with ecarin time as confirmatory test. in: Favaloro, E. and Gosselin, R. (ed.) Hemostasis and Thrombosis: Methods and Protocols New York, NY Humana.
Chapter titleLupus anticoagulant testing: Taipan snake venom time with ecarin time as confirmatory test
AuthorsMoore, G.

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 -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.

KeywordsAnticoagulants - pharmacology, Thrombosis, Blood Coagulation Tests - methods, Prothrombin, Humans, Antiphospholipid Syndrome, Antiphospholipid antibodies, Elapid Venoms, Taipan snake venom time, Lupus Coagulation Inhibitor, Snake Venoms, Phospholipids, Ecarin time, Antiphospholipid syndrome, Phospholipid, Prothrombin Time, Cofactors, Partial Thromboplastin Time, Lupus anticoagulant
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
Book titleHemostasis and Thrombosis: Methods and Protocols
EditorsFavaloro, E. and Gosselin, R.
Place of publicationNew York, NY
SeriesMethods in Molecular Biology (Clifton, N.J.)
Publication dates
Online20 May 2023
Print20 May 2023
Publication process dates
Deposited01 Jun 2023
Output statusPublished
Digital Object Identifier (DOI)
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