
doi: 10.1111/hae.12872
pmid: 26822998
IntroductionFactor VIII (FVIII) products used in haemophilia A treatment show inter‐and intra‐product and inter‐assay differences in specific activity. The mechanistic basis of these differences remains unclear.AimThe aim of this study was to mechanistically compare the functional properties of an in‐house excipient‐free full‐length FVIII standard and pharmacologic recombinant products containing full‐length (products A and B) or B‐domainless (C and D) FVIII.MethodsFactor VIII protein concentration was quantitated by ELISA. Product potency determinations (APTT, intrinsic tenase assays) and kinetic analyses detailing these products' activations by thrombin and FXa, their spontaneous and activated protein C (APC) catalysed inactivation and their performances in coagulation proteome reconstructions were studied +/− von Willebrand factor (VWF). Computational models were developed to facilitate interpretation of empirical data.ResultsFactor VIII protein content per manufacturer activity unit was highest for product C with the other three products similar to the standard. Potency estimates, done five different ways, varied 20–30% in inter‐ and intra‐assay comparisons, with product B consistently showing lower specific activity. Kinetic analyses showed the five FVIII species to differ somewhat in maximum rate of activation, the maximum level of activity achieved, the rate of spontaneous or APC catalysed inactivation and the magnitude of the effect of VWF on these parameters. When evaluated both computationally and empirically in the context of tissue factor initiated thrombin generation, product C appears the most dissimilar.ConclusionAssessments of FVIII activation/inactivation dynamics report larger differences between FVIII products than standard functional assays. However, all FVIII products promote a ‘normal' thrombin generation response to TF.
Factor VIII, Coagulants, Thrombin, Enzyme-Linked Immunosorbent Assay, Hemophilia A, Catalysis, Recombinant Proteins, Kinetics, Factor Xa, von Willebrand Factor, Humans, Partial Thromboplastin Time, Protein C
Factor VIII, Coagulants, Thrombin, Enzyme-Linked Immunosorbent Assay, Hemophilia A, Catalysis, Recombinant Proteins, Kinetics, Factor Xa, von Willebrand Factor, Humans, Partial Thromboplastin Time, Protein C
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 7 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Top 10% |
