State-of-the-Art and Current Controversies in the Detection and Quantitation of Tissue Factor-Bearing Microparticles

Abstract SCI-11

Microparticles are submicron vesicles that circulate in blood and are derived from a variety of vascular cells. Microparticles expressing tissue factor have been shown in animal thrombosis models to contribute to thrombus formation in vivo, which has led to the evaluation of tissue factor bearing microparticle populations in a variety of thrombotic disorders including malignancy, sepsis, and coronary thrombosis. Central to the evaluation of tissue factor-bearing microparticle populations in health and disease is the establishment of accurate means for qualitative or quantitative assessment of circulating microparticles. Whilst there is considerable interest in evaluating whether pathologic disturbances in tissue factor-bearing microparticles contribute to thrombosis, analytic techniques for microparticle measurement remain in the validation stage. The method most commonly employed for the detection of tissue factor-bearing microparticles is light-scatter flow cytometry, which relies on the sizing of particles based on light-scatter profile. Light scatter, however, is also influenced by variables independent of particle size, including the wavelength of incident light, particle shape, presence of surface absorptive material, and relative refractive indices of particles and suspension medium. A number of potentially more sensitive methodologies are currently under investigation such as impedance-based flow cytometry, quasi-elastic light scattering based on Brownian movement, and atomic force microscopy. Alternatively, assays have been developed that measure tissue factor antigen or activity following isolation of microparticles from plasma or whole blood but without determination of particle size. Absent a gold standard for the measurement of tissue factor-bearing microparticle populations by which these approaches can be validated, the development of accurate methodology will require inter-assay and intra-assay precision as well as validation of clinical relevance in human studies.