CA2400651A1 - Electrochemical sensor for determining blood clotting, corresponding system for measuring blood clotting and method for determining blood clotting - Google Patents
Electrochemical sensor for determining blood clotting, corresponding system for measuring blood clotting and method for determining blood clotting Download PDFInfo
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- G01N2333/914—Hydrolases (3)
- G01N2333/948—Hydrolases (3) acting on peptide bonds (3.4)
- G01N2333/974—Thrombin
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Abstract
The invention relates to a dry chemical based electrochemical sensor for determining blood clotting. The inventive sensor comprises at least 2 electrodes on an inert support, in addition to a dry reagent. The invention is characterized in that the reagent contains a thrombin substitute consisting of a peptide radical which can be cleaved off from thrombin and which is amidically linked to a phenylenediamine radical by the carboxyl end thereof. The invention also relates to a system for measuring blood clotting, comprising one such sensor and a current measurment device. The invention further relates to a method for determining blood clotting with the aid of t he inventive sensor and a reagent for determining blood clotting, comprising a thrombin substitute consisting of a peptide radical which can be cleaved off from thrombin and is which is amidically linked to a phenylenediamine radica l by the carboxyl end thereof. Said reagent is characterized that it also contains a dye oxidoreductase, such as glucose dye oxidoreductase.
Description
Electrochemical sensor for determining blood clotting, corresponding system for measuring blood clotting and method for determining blood clotting The invention concerns a sensor based on dry chemistry for the determination of blood coagulation which has at least 2 electrodes on an inert support and a dry reagent. The invention additionally concerns a blood coagulation measuring system containing an electrochemical sensor and an instrument for measuring electrical current. Finally the invention also concerns a method for determining blood coagulation by means of an electrochemical sensor.
EP-B 0 441 222 describes a method and sensor electrode system for the electrochemical determination of an analyte or an oxidoreductase. The patent document discloses the role of a reducible substance as an electron carrier in a redox reaction of an analyte to be determined on an electrode. A typical analyte is glucose, lactate or a redox enzyme such as glucose dehydrogenase or lactate dehydrogenase.
An electrochemical method for determining proteases and antiproteases is known from EP-B 0 018 002. This uses a protease or antiprotease substrate composed of an oligopeptide to which an aromatic or heterocyclic amine or polyamine is bound.
The enzyme to be determined cleaves the bond between the carboxyterminal amino acid and the amine or polyamine and the amount of released amine or polyamine is determined electrochemically. The determination of freely mobile components of the blood coagulation cascade in solution is described.
An electrochemical sensor for coagulation detection is known from C. Bisson et al., "A microanalytical device for the assessment of coagulation parameters in whole blood", Technical Digest Solid-State Sensor and Actuator Workshop, Hilton Head Island, South Carolina, USA, June 8-11, 1998. This publication describes in general the possibility of using electrochemical coagulation sensors with amperometric detection. Details of the substrates used are for example not disclosed.
Furthermore the described electrodes and test devices are complicated to manufacture and are thus unattractive for a mass market.
In general it can be stated that the prior art does not provide a simple and reliable starting point for electrochemical coagulation sensors and corresponding methods for coagulation detection.
In order to resolve this problem the present invention provides an electrochemical sensor, a measuring system for blood coagulation and a method for determining blood coagulation as described in the independent patent claims. Preferred embodiments are given in the dependent claims.
The sensor according to the invention is an analytical element based on dry chemistry. The sensor contains at least two electrodes of which at least one electrode is a so-called working electrode. In a preferred embodiment it contains no classical reference electrode such as an Ag/AgCI reference electrode, but only at least one working electrode and one counterelectrode. The electrodes can be composed of all conventional electrode materials such as metals, noble metals, alloys or graphite and are preferably composed of noble metals such as gold or palladium, or graphite. The various electrodes of the sensor can be composed of the same or different materials.
In a particularly preferred embodiment the sensor contains a working electrode and a counterelectrode that are both made of palladium.
The dry reagent of the sensor according to the invention contains for example the compound (I) HZN ~ ~ NH-CO-Arg-Pro-Gly-Tos (I) as a thrombin substrate. Arg denotes arginine, Pro denotes proline and Gly denotes glycine; Tos corresponds to the amino protecting group tosyl. In general any residues that can be cleaved by thrombin can be used as peptide residues of the thrombin substrate according to the invention such that phenylenediamine that can be determined electrochemically is released from the substrate.
The enzyme thrombin is the Iast protease of the coagulation cascade and is only formed during blood coagulation from the protein prothrombin. Hence it is possible to monitor the clotting of blood and thus determine clotting time by measuring the enzyme activity of thrombin.
When the thrombin substrate is cleaved, a p-aminoaniline (phenylenediamine) is farmed which is oxidized on the working electrode of the sensor as described in EP-B 0 441 222. The released electrons are detected. Basically all the compounds which are described as electron carriers (or mediators) of type 2 in EP-B 0 can in principle be used as the electrochemically detectable part of the thrombin substrate according to the invention.
In the present invention it has turned out to be particularly advantageous to add the reagent glucose-dye-oxidoreductase (GIucDOR) to the reagent as an amplification system which oxidizes the glucose present in the blood to be examined and in this process uses the type 2 electron carrier released by the thrombin activity as an electron acceptor.
The reaction scheme is as follows:
thrombin ' glucono-peptide-NH: ~ ~ NHZ HEN ~ ~ NHz lactone peptide electrode ~~ 2e~ ~R
m HN ~ NHZ ~ glucose The primary oxidation product of the type 2 electron carrier is a quinone diirnine which can be recycled in the form of p-aminoaniline by means of a dye oxido-reductase such as glucose-dye oxidoreductase (GIucDOR) and can thus again transfer electrons to the working electrode. Hence it is possible to considerably amplify the original signal. In addition to GIucDOR, there are other enzymes (such as alcohol dehydrogenase or oxidases such as glucose oxidase or lactate oxidase) which can convert the quinone diimine into phenylenediamine. Additional special substrates (corresponding to the glucose for GIucDOR) are required for this (such as alcohols for the enzyme alcohol dehydrogenase or lactate for lactate oxidase) which can then be optionally incorporated in suitable amounts into the reagent formulation.
The electrochemical determination ofblood coagulation occurs quasi-potentiostatically, preferably using a 2 electrode system in which one electrode operates simultaneously as a reference and counterelectrode and the other electrode operates as a working electrode. A constant voltage is applied to this 2 electrode system and the current is measured over time. This method is also referred to as an amperometric measurement procedure. In order to determine the blood clotting time, the current time course is measured and it is determined after which time period from the start of the coagulation measurement the measured current exceeds a predetermined threshold value. This time period is a measure for the clotting time.
In addition to the amperometric measuring methods, it is also possible to use voltammetric measuring methods. In this case the voltage between the electrodes is not set to be constant, but rather the voltage is changed linearly from an initial value to a final value and subsequently returned to the initial value. This process can be repeated several times aver the entire measurement period.
In the voltammetric method the current is plotted against the voltage and then when this is repeated one obtains a nested set of current-voltage curves (cyclovoltammograms). If the voltage range is suitable, oxidation peaks and reduction peaks of the electron carrier are formed in these curves. The height of these peaks is directly proportional to the concentration of the electron carrier S
provided that other redox-active substances are not co-oxidized or co-reduced in the covered potential range and thus additionally contribute to the current.
Such an interference may be ignored when measuring a concentration change.
If the current values for the peak maxima or the areas enclosed by the curves (corresponding to the charge turnover) of the individual current voltage loops are plotted against time, one also obtains a picture of the concentration change of the electron carrier over the measurement period in a time raster given by the cycle period. This information can then be used - as in the amperometric methods -to determine the blood clotting time.
Oligopeptide derivatives of the following general formula (II) are used for a coagulation test which is based on the determination of the enzyme activity of a protease e.g. thrombin:
O
H
X1/'X2wX~ N Xa~~X5 (II) NH
H
In this case X,, X2 and X3 represent natural or artificial amino acids including possible protective groups. The sequence X,-Xz-X3 is selected according to the desired application, for example for detection by means of thrombin, and has been described for various purposes in numerous publications (c~ e.g. U. Becker et al., Clin. Chem., 30 (4), 524-S28 (1984); M.-C. Bouton et al., Eur. J. Biochem., 229 (2), 526-532 ( 1995); H.D. Bruhn et al., "Hamostaseologie", 15 ( 1 ), 54-S6 ( 1995); E. De Candia et al., Thromb. Haemostasis, 77 (4), 735-740 (1997) ; P.L. Coleman et al., Clin. Chem., 29 (4), 603-608 (1983); J. DiMaio et al., J. Med. Chem., 35, 3331-( 1992); A. Frigola et al., J. Clin. Pathol., 32 ( 1 ), 21-25 ( I979); P. J.
Gaffney et al., Thromb. Res., 10 (4), 549-556 (I977); J. Hofsteenge et aL, Biochem. J., 237, (1986); R. Lottenberg et al., Thromb. Res., 28, 3I3-332 (1982); M.K. Ramjee, Anal.
Biochem., 277, 11-18 (2000); J.). Slon-Usakiewicz et al., Biochern. 36, 13494-( 199?); S.A. Sonder et al., Clin. Chem. 32 (6), 934-937 ( 1986); C. Soria et al., Thromb. Res., 19 (3), 435-440 (I980); T. Steinmetzer et al., J. Med. Chem., 42, 3109-3115 (1999); A. Tripodi et al., Clin. Chem., 30 (8), 1392-1395 (1984); J.
I.
Wining et al., Thromb. Res., 46 (4), 567-574 (1987); EP-B 0 018 002; US
5,108,890;
US 5,190,862; EP-A 0 280 610; EP-B 0 144 744). Furthermore some of these amino acid sequences are also offered commercially by various companies to detect different coagulation factors for example from Pentapharrn Ltd, Basle, Switzerland or from Chromogenix Germany, Haemochrom Diagnostica GmbH, Essen, Germany.
A moiety X4-X5 is attached as a leaving group to the amino acid sequence XI-XZ-and is cleaved by the proteolytic activity of the coagulation factor i.e.
thrombin for example. Depending on the desired detection principle, the moiety X4-XS that is used to detect the proteolytic activity is coloured (photametric determination), fluorescent (cf. inter alia M.K. Ramjee, Anal. Biochem., 277, 11-18 (2000)) or electroactive (cf. EP-B 0 018 002).
The moiety X4-XS is electroactive within the scope of the present invention i.e. can be converted at an electrode with release or uptake of electrons. XQ-XS
preferably has a maximum oxidation potential of 350mV relative to an AgIAgCI electrode and can be detected by an electrochemical measurement.
In this connection X4 can be an atom or group which forms the link with the oligopeptide sequence N or NH.
The moiety XS can have the following structure (III) __ N R2 (III) Ra in which R, and RZ are independently of one another alkyl, hydroxyalkyl, alkoxy-alkyl, phosphoramide alkyl, polyhydroxyalkyl, sulfone alkyl or hydrogen and R3 and R4 are OH, O-alkyl, alkyl, H, halogen, NR1R2, COZR, CONR1R2, SRS, NRi-CO-Rl, O-CO-R,, H.
Peptide substrates of this type in which X4 = N or NH are for example described in the following patents or patent applications: JP-A 56042597; JP-A 58090535;
WO-A 86/01209; US 5,059, 525; JP-A 61112096; JP-A 03157353.
XS can alternatively have the following structure (IV):
(IV) in which R, to R3 have the meaning given above for formula III.
Peptide substrates of this type in which X4 = NR are known (c~ for example JP-A
03271299; EP-B 0 350 915; P. Kurzhals et al., Acta Pharm. Nord., 1 (5), 269-78 ( 1989); US 4,797,472; EP-B 0 224 254; WO-A 87/05608; EP-B 0 170 797; EP-B 0 980; EP-B 0 152 872; EP-B 0 076 042; JP-A 52148032).
XS can alternatively have the following structure (V):
S
\R, R~
in which R1 to R3 have the meaning given above for formulae III and IV.
Peptide substrates of this type in which X4 = NR, O are known (cf. for example T.
Morimoto et al., Pept. Chem., Vol. date 1989, 27'h., 387-390 ( 1999); N.
Nishino et _ 8 _ al., Pept. Chem., Vol. date 1988, 26'h, 21-24 ( 1989); B.J. Johnson et al., J.
Org.
Chem., 35 ( 1 ), 255-257 ( 1970) ).
In a preferred embodiment the peptide substrate is a thrombin substrate of the general formula VI
R~
N ~ ~ NH-CO-Arg-Pro-Gly-Tos (VI) RZ ~ R3 in which R1 denotes an alkyl residue or hydrogen, Rz denotes a hydroxy alkyl residue or hydrogen and R~ denotes hydrogen, halogen, alkoxy or alkylthio.
Suitable protease substrates are generally compounds which are composed of a peptide residue that can be cleaved off by a protease of the blood coagulation system and are bound via an amide bond at the carboxyl end to substituted anilines and in particular to a phenylenediamine residue.
In addition to so-called global tests in which the clotting time is determined as such and which determine the activity of the protease thrombin for this purpose, appropriate alternative substrates known to a person skilled in the art can be used as a basis for other coagulation tests e.g. an anti-factor Xa test or to determine individual coagulation factors. For this it is necessary to adapt the peptide part of the substrate to the protease to be determined. For the electrochemical determination of coagulation or individual coagulation factors according to the invention it is important that a cleavage product of the peptide substrate that can be determined electrochemically is formed and detected.
The global tests include in particular the following tests: PT (prothrombin time test), aPTT (activated partial prothrombin time test) and ACT (activated clotting time test).
_g_ The invention is elucidated in more detail by the following examples. All examples are described using whole blood as the sample material. The sensors and methods according to the invention are, however, also suitable for citrate plasma if calcium is added to the formulation of the test support or to the sample. Furthermore it is possible according to the invention, in addition to the method mentioned in the examples, of applying the reagent to the electrodes (activators and substrate are both applied to the electrodes and subsequently dried), to not directly apply and dry the reagent to the electrode but in the vicinity of the electrodes for example next to the electrodes on a flat substrate. In this case the reagent is transported to the electrodes with the blood sample during the measurement. Alternatively it is possible to incorporate the reagent in porous materials such as fleeces, papers, membranes and such like, and for example to incorporate the reagent in a detachable form. In this case the blood or plasma sample has to flow through these materials before contact with the electrodes and in this process take up the reagent.
It is also possible to apply individual components of the reagent to different compartments of the test support, for example the thrombin substrate on or directly adjacent to the electrode, but the activator spatially separated therefrom (e.g. further removed from the electrode) or to impregnate both substances in different layers (e.g. membranes or fleeces).
Example 1:
Manufacture of a coagulation sensor for a PT test I. Description of the electrochemical function a) Open two electrode system for "top dosing" sample application. Flat construction with 2 Pd electrodes. An Ag/AgCI paste (type: Acheson Electrodag 6037 SS) is dispensed over the whole area of a Pd electrode such that the entire surface of this Pd electrode is covered by Ag/AgCI.
The electrochemical operation occurs quasi-potentiostatically preferably as a 2 electrode system in which the Ag/AgCI electrode operates simultaneously as a reference and counterelectrode and the Pd electrode operates as a working electrode.
A constant voltage is applied to this two electrode system and the current is measured over time.
b) Replacement of the silver-silver chloride reference electrode by a soluble substance that can be reduced at the counterelectrode (type 2 mediator):
A soluble reducible substance is used which accepts electrons at the counter-electrode and thus ensures current transport through the counterelectrode. At the same time the reduction potential that can be reached at the working electrode is limited by the reduction potential of this substance and by the constant voltage applied to the sensor between the working and the counter-electrode. The p-aminoaniline to be detected at the working electrode by oxidation must be within the achievable oxidation potential. The potential at the working electrode against a hypothetical silver-silver chloride reference electrode must be such that the current through the working electrode (in this case anode) and the current through the counterelectrode (in this case cathode) are identical in terms of magnitude. The reducible substance should not at the same time be oxidizable at the working electrode within the maximum achievable oxidation potential since otherwise it would be superimposed on the signal of the p-aminoaniline cleaved in the previous enzymatic reaction.
II. Manufacture of a dry chemistry format for a PT test a) Formulation of the bulk reagent:
Formulation 1: Ag/AgCI electrode configuration as described in l.La):
Concentration Substance Function of the Supplier (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing proteinRoche %) (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2 ~g/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation Formulation 2: to be used with the type 2 mediator according to l.Lb) Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche %) protein (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2 pg/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 50 mM p-nitroso-bis type 2 mediatorRoche (1-250 mM) hydroxyethylaniline b) Metering and drying ~l of these suspensions were metered on the sensors described under l.La) and b) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Formulation 1 is suitable for the sensor according to l.La); formulation 2 is suitable for the sensor according to l.Lb).
c) When the sensor obtained in this manner is used to determine blood coagulation a function curve (current versus time) is obtained as shown in fig. 1. Fig. 2 shows the function curve of a sensor with a reference electrode.
- 1~ -Example 2 Manufacture of a dry chemistry format for an ACT test:
a) Formulation of the bulk reagent Formulation (alternative 1):
Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche %) protein (bovine serum albumin) 0.5 % Celite activator of Sigma the intrinsic path of plasmatic coagulation Formulation (alternative 2):
Concentration Substance Function of Supplier the substance 30 mg/ml sucrose stabilizer Sigma mg/g gelatin film former American Gelatin 0.1 mg/ml Triton X100 detergent Sigma 40 mg/ml glycine buffer Roche 1 % BSA stabilizing Roche protein (bovine serum albumin) 0.1 pg/ml rhTF activator of Stago the (human recombinantextrinsic path of tissue factor) plasmatic coagulation 3 mg/ml bovine sulfatideactivator of Sigma the intrinsic path of plasmatic coagulation b) Metering and drying 5 ~1 of one of these suspensions was metered on the sensor described under 1.
(variant la, i.e. with Ag/AgCI reference electrode) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Example 3:
Amplification of the measurement signal:
A p-aminoaniline (phenylenediamine) is released from the thrombin substrate by the action of the coagulation cascade. This is oxidized on the working electrode and the electrons released in this process are detected. The primary oxidation product is a quinone diamine. Enzymatic recycling of this oxidation product into the phenylenediamine by a dye-oxidoreductase such as glucose-dye-oxidoreductase (GIucDOR) enables a renewed oxidation on the electrode and thus an amplification of the original signal.
a) Formulation of the bulk reagent:
Concentration Substance Function of Supplier the (in brackets allowed substariCe range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( IO-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche Diagnostics %) protein (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2~g/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 1.2 KU/g glucose-dye- enzyme Roche (0.01-10 KU/g) oxidoreductase (GIucDOR) The glucose required as a substrate for the amplification enzyme GIucDOR is a component of the sample (ca. 10 mM) and was therefore not incorporated into the formulation. However, in principle it is possible to add glucose.
b) Metering and drying ~1 of this suspension was metered on the sensor described under l.La. and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Example 4:
Electochemical ACT test a) Test composition The test composition (sensor) used in this example corresponded to the sensor described in l.Lb) (use of a type 2 mediator).
b) Formulation of the bulk reagent Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( 10-500 mM) 0.1 % BSA stabilizing Roche protein (0.01-1 %) (bovine serum albumin) 0.2 pg/ml rhTF activator of Stago the (0.01-2 ~tg/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 6 mg/ml bovine sulfatideactivator of Life Science the (0.5 - 50 mg/ml) extrinsic path Research of plasmatic coagulation 50 mM p-nitroso-bis- type 2 mediatorRoche ( 1- 250 mM) hydroxyethylaniline c) Metering and drying ~1 of this suspension was metered on the sensor described under a) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
d) Results of the measurement for the ACT test An ACT test was carried out with the sensor described above using whole blood samples to which 1 to 6 U heparin per ml was added (heparin spike). A
potential of 300 mV was applied and the time was read at a threshold value of 0.5 ~A. The results are shown in the following table:
Heparin concentration Clotting time (s]
[U/ml]
EP-B 0 441 222 describes a method and sensor electrode system for the electrochemical determination of an analyte or an oxidoreductase. The patent document discloses the role of a reducible substance as an electron carrier in a redox reaction of an analyte to be determined on an electrode. A typical analyte is glucose, lactate or a redox enzyme such as glucose dehydrogenase or lactate dehydrogenase.
An electrochemical method for determining proteases and antiproteases is known from EP-B 0 018 002. This uses a protease or antiprotease substrate composed of an oligopeptide to which an aromatic or heterocyclic amine or polyamine is bound.
The enzyme to be determined cleaves the bond between the carboxyterminal amino acid and the amine or polyamine and the amount of released amine or polyamine is determined electrochemically. The determination of freely mobile components of the blood coagulation cascade in solution is described.
An electrochemical sensor for coagulation detection is known from C. Bisson et al., "A microanalytical device for the assessment of coagulation parameters in whole blood", Technical Digest Solid-State Sensor and Actuator Workshop, Hilton Head Island, South Carolina, USA, June 8-11, 1998. This publication describes in general the possibility of using electrochemical coagulation sensors with amperometric detection. Details of the substrates used are for example not disclosed.
Furthermore the described electrodes and test devices are complicated to manufacture and are thus unattractive for a mass market.
In general it can be stated that the prior art does not provide a simple and reliable starting point for electrochemical coagulation sensors and corresponding methods for coagulation detection.
In order to resolve this problem the present invention provides an electrochemical sensor, a measuring system for blood coagulation and a method for determining blood coagulation as described in the independent patent claims. Preferred embodiments are given in the dependent claims.
The sensor according to the invention is an analytical element based on dry chemistry. The sensor contains at least two electrodes of which at least one electrode is a so-called working electrode. In a preferred embodiment it contains no classical reference electrode such as an Ag/AgCI reference electrode, but only at least one working electrode and one counterelectrode. The electrodes can be composed of all conventional electrode materials such as metals, noble metals, alloys or graphite and are preferably composed of noble metals such as gold or palladium, or graphite. The various electrodes of the sensor can be composed of the same or different materials.
In a particularly preferred embodiment the sensor contains a working electrode and a counterelectrode that are both made of palladium.
The dry reagent of the sensor according to the invention contains for example the compound (I) HZN ~ ~ NH-CO-Arg-Pro-Gly-Tos (I) as a thrombin substrate. Arg denotes arginine, Pro denotes proline and Gly denotes glycine; Tos corresponds to the amino protecting group tosyl. In general any residues that can be cleaved by thrombin can be used as peptide residues of the thrombin substrate according to the invention such that phenylenediamine that can be determined electrochemically is released from the substrate.
The enzyme thrombin is the Iast protease of the coagulation cascade and is only formed during blood coagulation from the protein prothrombin. Hence it is possible to monitor the clotting of blood and thus determine clotting time by measuring the enzyme activity of thrombin.
When the thrombin substrate is cleaved, a p-aminoaniline (phenylenediamine) is farmed which is oxidized on the working electrode of the sensor as described in EP-B 0 441 222. The released electrons are detected. Basically all the compounds which are described as electron carriers (or mediators) of type 2 in EP-B 0 can in principle be used as the electrochemically detectable part of the thrombin substrate according to the invention.
In the present invention it has turned out to be particularly advantageous to add the reagent glucose-dye-oxidoreductase (GIucDOR) to the reagent as an amplification system which oxidizes the glucose present in the blood to be examined and in this process uses the type 2 electron carrier released by the thrombin activity as an electron acceptor.
The reaction scheme is as follows:
thrombin ' glucono-peptide-NH: ~ ~ NHZ HEN ~ ~ NHz lactone peptide electrode ~~ 2e~ ~R
m HN ~ NHZ ~ glucose The primary oxidation product of the type 2 electron carrier is a quinone diirnine which can be recycled in the form of p-aminoaniline by means of a dye oxido-reductase such as glucose-dye oxidoreductase (GIucDOR) and can thus again transfer electrons to the working electrode. Hence it is possible to considerably amplify the original signal. In addition to GIucDOR, there are other enzymes (such as alcohol dehydrogenase or oxidases such as glucose oxidase or lactate oxidase) which can convert the quinone diimine into phenylenediamine. Additional special substrates (corresponding to the glucose for GIucDOR) are required for this (such as alcohols for the enzyme alcohol dehydrogenase or lactate for lactate oxidase) which can then be optionally incorporated in suitable amounts into the reagent formulation.
The electrochemical determination ofblood coagulation occurs quasi-potentiostatically, preferably using a 2 electrode system in which one electrode operates simultaneously as a reference and counterelectrode and the other electrode operates as a working electrode. A constant voltage is applied to this 2 electrode system and the current is measured over time. This method is also referred to as an amperometric measurement procedure. In order to determine the blood clotting time, the current time course is measured and it is determined after which time period from the start of the coagulation measurement the measured current exceeds a predetermined threshold value. This time period is a measure for the clotting time.
In addition to the amperometric measuring methods, it is also possible to use voltammetric measuring methods. In this case the voltage between the electrodes is not set to be constant, but rather the voltage is changed linearly from an initial value to a final value and subsequently returned to the initial value. This process can be repeated several times aver the entire measurement period.
In the voltammetric method the current is plotted against the voltage and then when this is repeated one obtains a nested set of current-voltage curves (cyclovoltammograms). If the voltage range is suitable, oxidation peaks and reduction peaks of the electron carrier are formed in these curves. The height of these peaks is directly proportional to the concentration of the electron carrier S
provided that other redox-active substances are not co-oxidized or co-reduced in the covered potential range and thus additionally contribute to the current.
Such an interference may be ignored when measuring a concentration change.
If the current values for the peak maxima or the areas enclosed by the curves (corresponding to the charge turnover) of the individual current voltage loops are plotted against time, one also obtains a picture of the concentration change of the electron carrier over the measurement period in a time raster given by the cycle period. This information can then be used - as in the amperometric methods -to determine the blood clotting time.
Oligopeptide derivatives of the following general formula (II) are used for a coagulation test which is based on the determination of the enzyme activity of a protease e.g. thrombin:
O
H
X1/'X2wX~ N Xa~~X5 (II) NH
H
In this case X,, X2 and X3 represent natural or artificial amino acids including possible protective groups. The sequence X,-Xz-X3 is selected according to the desired application, for example for detection by means of thrombin, and has been described for various purposes in numerous publications (c~ e.g. U. Becker et al., Clin. Chem., 30 (4), 524-S28 (1984); M.-C. Bouton et al., Eur. J. Biochem., 229 (2), 526-532 ( 1995); H.D. Bruhn et al., "Hamostaseologie", 15 ( 1 ), 54-S6 ( 1995); E. De Candia et al., Thromb. Haemostasis, 77 (4), 735-740 (1997) ; P.L. Coleman et al., Clin. Chem., 29 (4), 603-608 (1983); J. DiMaio et al., J. Med. Chem., 35, 3331-( 1992); A. Frigola et al., J. Clin. Pathol., 32 ( 1 ), 21-25 ( I979); P. J.
Gaffney et al., Thromb. Res., 10 (4), 549-556 (I977); J. Hofsteenge et aL, Biochem. J., 237, (1986); R. Lottenberg et al., Thromb. Res., 28, 3I3-332 (1982); M.K. Ramjee, Anal.
Biochem., 277, 11-18 (2000); J.). Slon-Usakiewicz et al., Biochern. 36, 13494-( 199?); S.A. Sonder et al., Clin. Chem. 32 (6), 934-937 ( 1986); C. Soria et al., Thromb. Res., 19 (3), 435-440 (I980); T. Steinmetzer et al., J. Med. Chem., 42, 3109-3115 (1999); A. Tripodi et al., Clin. Chem., 30 (8), 1392-1395 (1984); J.
I.
Wining et al., Thromb. Res., 46 (4), 567-574 (1987); EP-B 0 018 002; US
5,108,890;
US 5,190,862; EP-A 0 280 610; EP-B 0 144 744). Furthermore some of these amino acid sequences are also offered commercially by various companies to detect different coagulation factors for example from Pentapharrn Ltd, Basle, Switzerland or from Chromogenix Germany, Haemochrom Diagnostica GmbH, Essen, Germany.
A moiety X4-X5 is attached as a leaving group to the amino acid sequence XI-XZ-and is cleaved by the proteolytic activity of the coagulation factor i.e.
thrombin for example. Depending on the desired detection principle, the moiety X4-XS that is used to detect the proteolytic activity is coloured (photametric determination), fluorescent (cf. inter alia M.K. Ramjee, Anal. Biochem., 277, 11-18 (2000)) or electroactive (cf. EP-B 0 018 002).
The moiety X4-XS is electroactive within the scope of the present invention i.e. can be converted at an electrode with release or uptake of electrons. XQ-XS
preferably has a maximum oxidation potential of 350mV relative to an AgIAgCI electrode and can be detected by an electrochemical measurement.
In this connection X4 can be an atom or group which forms the link with the oligopeptide sequence N or NH.
The moiety XS can have the following structure (III) __ N R2 (III) Ra in which R, and RZ are independently of one another alkyl, hydroxyalkyl, alkoxy-alkyl, phosphoramide alkyl, polyhydroxyalkyl, sulfone alkyl or hydrogen and R3 and R4 are OH, O-alkyl, alkyl, H, halogen, NR1R2, COZR, CONR1R2, SRS, NRi-CO-Rl, O-CO-R,, H.
Peptide substrates of this type in which X4 = N or NH are for example described in the following patents or patent applications: JP-A 56042597; JP-A 58090535;
WO-A 86/01209; US 5,059, 525; JP-A 61112096; JP-A 03157353.
XS can alternatively have the following structure (IV):
(IV) in which R, to R3 have the meaning given above for formula III.
Peptide substrates of this type in which X4 = NR are known (c~ for example JP-A
03271299; EP-B 0 350 915; P. Kurzhals et al., Acta Pharm. Nord., 1 (5), 269-78 ( 1989); US 4,797,472; EP-B 0 224 254; WO-A 87/05608; EP-B 0 170 797; EP-B 0 980; EP-B 0 152 872; EP-B 0 076 042; JP-A 52148032).
XS can alternatively have the following structure (V):
S
\R, R~
in which R1 to R3 have the meaning given above for formulae III and IV.
Peptide substrates of this type in which X4 = NR, O are known (cf. for example T.
Morimoto et al., Pept. Chem., Vol. date 1989, 27'h., 387-390 ( 1999); N.
Nishino et _ 8 _ al., Pept. Chem., Vol. date 1988, 26'h, 21-24 ( 1989); B.J. Johnson et al., J.
Org.
Chem., 35 ( 1 ), 255-257 ( 1970) ).
In a preferred embodiment the peptide substrate is a thrombin substrate of the general formula VI
R~
N ~ ~ NH-CO-Arg-Pro-Gly-Tos (VI) RZ ~ R3 in which R1 denotes an alkyl residue or hydrogen, Rz denotes a hydroxy alkyl residue or hydrogen and R~ denotes hydrogen, halogen, alkoxy or alkylthio.
Suitable protease substrates are generally compounds which are composed of a peptide residue that can be cleaved off by a protease of the blood coagulation system and are bound via an amide bond at the carboxyl end to substituted anilines and in particular to a phenylenediamine residue.
In addition to so-called global tests in which the clotting time is determined as such and which determine the activity of the protease thrombin for this purpose, appropriate alternative substrates known to a person skilled in the art can be used as a basis for other coagulation tests e.g. an anti-factor Xa test or to determine individual coagulation factors. For this it is necessary to adapt the peptide part of the substrate to the protease to be determined. For the electrochemical determination of coagulation or individual coagulation factors according to the invention it is important that a cleavage product of the peptide substrate that can be determined electrochemically is formed and detected.
The global tests include in particular the following tests: PT (prothrombin time test), aPTT (activated partial prothrombin time test) and ACT (activated clotting time test).
_g_ The invention is elucidated in more detail by the following examples. All examples are described using whole blood as the sample material. The sensors and methods according to the invention are, however, also suitable for citrate plasma if calcium is added to the formulation of the test support or to the sample. Furthermore it is possible according to the invention, in addition to the method mentioned in the examples, of applying the reagent to the electrodes (activators and substrate are both applied to the electrodes and subsequently dried), to not directly apply and dry the reagent to the electrode but in the vicinity of the electrodes for example next to the electrodes on a flat substrate. In this case the reagent is transported to the electrodes with the blood sample during the measurement. Alternatively it is possible to incorporate the reagent in porous materials such as fleeces, papers, membranes and such like, and for example to incorporate the reagent in a detachable form. In this case the blood or plasma sample has to flow through these materials before contact with the electrodes and in this process take up the reagent.
It is also possible to apply individual components of the reagent to different compartments of the test support, for example the thrombin substrate on or directly adjacent to the electrode, but the activator spatially separated therefrom (e.g. further removed from the electrode) or to impregnate both substances in different layers (e.g. membranes or fleeces).
Example 1:
Manufacture of a coagulation sensor for a PT test I. Description of the electrochemical function a) Open two electrode system for "top dosing" sample application. Flat construction with 2 Pd electrodes. An Ag/AgCI paste (type: Acheson Electrodag 6037 SS) is dispensed over the whole area of a Pd electrode such that the entire surface of this Pd electrode is covered by Ag/AgCI.
The electrochemical operation occurs quasi-potentiostatically preferably as a 2 electrode system in which the Ag/AgCI electrode operates simultaneously as a reference and counterelectrode and the Pd electrode operates as a working electrode.
A constant voltage is applied to this two electrode system and the current is measured over time.
b) Replacement of the silver-silver chloride reference electrode by a soluble substance that can be reduced at the counterelectrode (type 2 mediator):
A soluble reducible substance is used which accepts electrons at the counter-electrode and thus ensures current transport through the counterelectrode. At the same time the reduction potential that can be reached at the working electrode is limited by the reduction potential of this substance and by the constant voltage applied to the sensor between the working and the counter-electrode. The p-aminoaniline to be detected at the working electrode by oxidation must be within the achievable oxidation potential. The potential at the working electrode against a hypothetical silver-silver chloride reference electrode must be such that the current through the working electrode (in this case anode) and the current through the counterelectrode (in this case cathode) are identical in terms of magnitude. The reducible substance should not at the same time be oxidizable at the working electrode within the maximum achievable oxidation potential since otherwise it would be superimposed on the signal of the p-aminoaniline cleaved in the previous enzymatic reaction.
II. Manufacture of a dry chemistry format for a PT test a) Formulation of the bulk reagent:
Formulation 1: Ag/AgCI electrode configuration as described in l.La):
Concentration Substance Function of the Supplier (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing proteinRoche %) (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2 ~g/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation Formulation 2: to be used with the type 2 mediator according to l.Lb) Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche %) protein (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2 pg/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 50 mM p-nitroso-bis type 2 mediatorRoche (1-250 mM) hydroxyethylaniline b) Metering and drying ~l of these suspensions were metered on the sensors described under l.La) and b) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Formulation 1 is suitable for the sensor according to l.La); formulation 2 is suitable for the sensor according to l.Lb).
c) When the sensor obtained in this manner is used to determine blood coagulation a function curve (current versus time) is obtained as shown in fig. 1. Fig. 2 shows the function curve of a sensor with a reference electrode.
- 1~ -Example 2 Manufacture of a dry chemistry format for an ACT test:
a) Formulation of the bulk reagent Formulation (alternative 1):
Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche (10-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche %) protein (bovine serum albumin) 0.5 % Celite activator of Sigma the intrinsic path of plasmatic coagulation Formulation (alternative 2):
Concentration Substance Function of Supplier the substance 30 mg/ml sucrose stabilizer Sigma mg/g gelatin film former American Gelatin 0.1 mg/ml Triton X100 detergent Sigma 40 mg/ml glycine buffer Roche 1 % BSA stabilizing Roche protein (bovine serum albumin) 0.1 pg/ml rhTF activator of Stago the (human recombinantextrinsic path of tissue factor) plasmatic coagulation 3 mg/ml bovine sulfatideactivator of Sigma the intrinsic path of plasmatic coagulation b) Metering and drying 5 ~1 of one of these suspensions was metered on the sensor described under 1.
(variant la, i.e. with Ag/AgCI reference electrode) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Example 3:
Amplification of the measurement signal:
A p-aminoaniline (phenylenediamine) is released from the thrombin substrate by the action of the coagulation cascade. This is oxidized on the working electrode and the electrons released in this process are detected. The primary oxidation product is a quinone diamine. Enzymatic recycling of this oxidation product into the phenylenediamine by a dye-oxidoreductase such as glucose-dye-oxidoreductase (GIucDOR) enables a renewed oxidation on the electrode and thus an amplification of the original signal.
a) Formulation of the bulk reagent:
Concentration Substance Function of Supplier the (in brackets allowed substariCe range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( IO-500 mM) 0.1 % (0.01-1 BSA stabilizing Roche Diagnostics %) protein (bovine serum albumin) 0.1 ~g/ml rhTF activator of Stago the (0.01-2~g/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 1.2 KU/g glucose-dye- enzyme Roche (0.01-10 KU/g) oxidoreductase (GIucDOR) The glucose required as a substrate for the amplification enzyme GIucDOR is a component of the sample (ca. 10 mM) and was therefore not incorporated into the formulation. However, in principle it is possible to add glucose.
b) Metering and drying ~1 of this suspension was metered on the sensor described under l.La. and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
Example 4:
Electochemical ACT test a) Test composition The test composition (sensor) used in this example corresponded to the sensor described in l.Lb) (use of a type 2 mediator).
b) Formulation of the bulk reagent Concentration Substance Function of Supplier the (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( 10-500 mM) 0.1 % BSA stabilizing Roche protein (0.01-1 %) (bovine serum albumin) 0.2 pg/ml rhTF activator of Stago the (0.01-2 ~tg/ml) (human recombinantextrinsic path of tissue factor) plasmatic coagulation 6 mg/ml bovine sulfatideactivator of Life Science the (0.5 - 50 mg/ml) extrinsic path Research of plasmatic coagulation 50 mM p-nitroso-bis- type 2 mediatorRoche ( 1- 250 mM) hydroxyethylaniline c) Metering and drying ~1 of this suspension was metered on the sensor described under a) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
d) Results of the measurement for the ACT test An ACT test was carried out with the sensor described above using whole blood samples to which 1 to 6 U heparin per ml was added (heparin spike). A
potential of 300 mV was applied and the time was read at a threshold value of 0.5 ~A. The results are shown in the following table:
Heparin concentration Clotting time (s]
[U/ml]
Exam 1p a 5:
Electochemical aPTT test a) Test composition:
The test composition used in this example corresponded to the composition described in l.Lb).
b) Formulation of the bulk reagent:
Concentration Substance Function of the Supplier (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( 10-500 mM) 0.1 % BSA stabilizing proteinRoche Diagnostics (0.01-I %) (bovine serum albumin) 0.6 mg/ml soy bean activator of Sigma the (0.05-10 mg/ml) phosphatides extrinsic path of plasmatic coagulation 1 mg/ml bovine sulfatideactivator of Life Science the (0.1-10 mg/ml) extrinsic path Research of plasmatic coagulation 50 mM p-nitroso-bis- type 2 mediator Roche ( 1- 250 mM) hydroxyethylaniline c) Metering and drying ~l of this suspension was metered on the sensor described under l.Lb) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
d) Results of the measurement for the aPTT test An aPTT test was carried out with the sensor described above using whole blood samples to which 0 to 0.35 U heparin per ml was added (heparin spike). A
potential of 300 mV was applied and the time was read at a threshold value of 0.5 ~A.
The results are shown in the following table:
Heparin concentration Clotting time [U/ml] [s]
0.15 79 0.25 117 0.35 164 Example 6:
Compensation of the haematocrit effect I. Description of the method:
In chronoamperometric or voltammetric measuring methods the current resulting from an oxidation or reduction depends on the haematocrit when using whole blood as the analyte. Hence in evaluation methods which are based on a defined current threshold to determine the clotting time, different clotting times are determined depending on the haematocrit.
The haematocrit can be measured by a special measurement algorithm and used to correct the current measurements. For this purpose a brief measurement of the apparent resistance of the sensor wetted with blood is carried out before the actual chronoamperometric measurement. For this an alternating voltage with a frequency of 2 kHz and an amplitude of about 10 mV is applied between the working electrode and the counterelectrode and the resulting effective value of the alternating current flowing through the sensor is measured. The apparent resistance Z of the sensor filled with the blood sample is obtained by dividing the effective value of the applied voltage with the effective value of the alternating current. This apparent resistance Z is dependent on the temperature and the haematocrit of the blood. Under thermostatted isothermal conditions it is thus possible to measure the haematocrit in the blood independent of the concentration of the actual electron carrier (mediator).
The current values of the actual chronoamperometric detection measurement (imess) can then be corrected using the following formula in order to thus obtain results (i~orl) which are independent of the haematocrit content:
lcorr = lmess X ( (Z - Zmedian) x ~.~~ 1 -t- 1 ) in which Z is the apparent resistance of the actual measurement and Zmeaian is the apparent resistance of the average of many blood samples and is derived as the result of a batch calibration.
II. Experimental procedure IL 1 Preparation of the dry chemistry format for the PT test:
Compensation for the haematocrit effect is demonstrated using a PT test as an example. The test composition used in this example corresponded to the composition described in example 1 under Ib). The formulation used was identical to formulation 2 described in section IIa) of example I.
IL2. Setting the haematocrit values Fresh venous blood was cooled on an ice bath to 0°C. Aliquots were separated in a bench centrifuge into erythrocytes and cell pellet. High haematocrits were set by removing part of the plasma and resuspending the cells in the remaining plasma.
Low haematocrits were obtained by adding plasma which had been obtained from another aliquot of the same blood as already described.
The experimental results are shown in the following table:
Haematocrit (%] Clotting times [s]
uncorrected corrected Example 7:
Voltammetric method In addition to the described amperometric measuring methods, it is also possible to use voltammetric measuring methods. In this case the voltage between the electrodes is not set to be constant, but rather the voltage is changed linearly from an initial value to a final value and subsequently returned to the initial value. This process can be repeated several times over the entire measurement period. In this method the current is then plotted against the voltage and when this is repeated, one obtains a nested set of current-voltage curves (cyclovoltammograms). If the voltage range is suitable, oxidation peaks and reduction peaks of the electron carrier are formed in these curves.
An example of such consecutive voltammograms is shown in fig. 2. A sweep through the potential range 100 to 600 mV and back was repeated over the entire measurement period.
The height of these peaks is directly proportional to the concentration of the electron carrier provided that other redox-active substances are not co-oxidized or co-reduced in the covered potential range and thus additionally contribute to the current. Such an interference may be ignored when measuring a concentration change.
If the current values for the peak maxima or the areas enclosed by the curves (corresponding to the charge turnover) of the individual current voltage loops are plotted against time, one also obtains a picture of the concentration change of the electron carrier over the measurement period in a time raster given by the cycle period. The charge content (sum of the current values/measurement density) of the consecutive cyclic voltammograms is plotted over time in fig.3. The difference in the time course between the normal coagulation range and the result of a Marcumar test person (with retarded blood clotting) can be seen.
The time at which the charge of a cyclic voltammogram starts to increase and how rapidly this occurs is of primary interest in order to determine or read a clotting time. Hence this means when does coagulation start (thrombin is activated) and how rapidly does this occur (how rapidly is how much thrombin additionally activated). For this reason, as shown in fig. 4, the time derivative is calculated from the curves of fig. 3 i.e. dQ to dt. The maximum slope is the maximum in the time derivative. The time t of the maximum can be read as the clotting time.
The following result is then obtained for the examples shown in figures 3 and 4:
Time until maximum dQ/dt Measurement Normal range Marcumar test person
Electochemical aPTT test a) Test composition:
The test composition used in this example corresponded to the composition described in l.Lb).
b) Formulation of the bulk reagent:
Concentration Substance Function of the Supplier (in brackets allowed substance range according to the invention) 0.6 % (0.1-5 %) Avicel RC 591 film former FMC corporation (carboxylated micro-crystalline cellulose) 2 % (0-5 %) Natrosol 250 thickener Aqualon M
0.05 % (0-5 %) Polyox 750 film former Union Carbide 0.9 % (0.05-5 Triton X100 detergent Sigma %) 200 mM HEPES buffer Roche ( 10-500 mM) 0.1 % BSA stabilizing proteinRoche Diagnostics (0.01-I %) (bovine serum albumin) 0.6 mg/ml soy bean activator of Sigma the (0.05-10 mg/ml) phosphatides extrinsic path of plasmatic coagulation 1 mg/ml bovine sulfatideactivator of Life Science the (0.1-10 mg/ml) extrinsic path Research of plasmatic coagulation 50 mM p-nitroso-bis- type 2 mediator Roche ( 1- 250 mM) hydroxyethylaniline c) Metering and drying ~l of this suspension was metered on the sensor described under l.Lb) and dried on a belt dryer or in a drying cabinet at 30 to 50°C.
d) Results of the measurement for the aPTT test An aPTT test was carried out with the sensor described above using whole blood samples to which 0 to 0.35 U heparin per ml was added (heparin spike). A
potential of 300 mV was applied and the time was read at a threshold value of 0.5 ~A.
The results are shown in the following table:
Heparin concentration Clotting time [U/ml] [s]
0.15 79 0.25 117 0.35 164 Example 6:
Compensation of the haematocrit effect I. Description of the method:
In chronoamperometric or voltammetric measuring methods the current resulting from an oxidation or reduction depends on the haematocrit when using whole blood as the analyte. Hence in evaluation methods which are based on a defined current threshold to determine the clotting time, different clotting times are determined depending on the haematocrit.
The haematocrit can be measured by a special measurement algorithm and used to correct the current measurements. For this purpose a brief measurement of the apparent resistance of the sensor wetted with blood is carried out before the actual chronoamperometric measurement. For this an alternating voltage with a frequency of 2 kHz and an amplitude of about 10 mV is applied between the working electrode and the counterelectrode and the resulting effective value of the alternating current flowing through the sensor is measured. The apparent resistance Z of the sensor filled with the blood sample is obtained by dividing the effective value of the applied voltage with the effective value of the alternating current. This apparent resistance Z is dependent on the temperature and the haematocrit of the blood. Under thermostatted isothermal conditions it is thus possible to measure the haematocrit in the blood independent of the concentration of the actual electron carrier (mediator).
The current values of the actual chronoamperometric detection measurement (imess) can then be corrected using the following formula in order to thus obtain results (i~orl) which are independent of the haematocrit content:
lcorr = lmess X ( (Z - Zmedian) x ~.~~ 1 -t- 1 ) in which Z is the apparent resistance of the actual measurement and Zmeaian is the apparent resistance of the average of many blood samples and is derived as the result of a batch calibration.
II. Experimental procedure IL 1 Preparation of the dry chemistry format for the PT test:
Compensation for the haematocrit effect is demonstrated using a PT test as an example. The test composition used in this example corresponded to the composition described in example 1 under Ib). The formulation used was identical to formulation 2 described in section IIa) of example I.
IL2. Setting the haematocrit values Fresh venous blood was cooled on an ice bath to 0°C. Aliquots were separated in a bench centrifuge into erythrocytes and cell pellet. High haematocrits were set by removing part of the plasma and resuspending the cells in the remaining plasma.
Low haematocrits were obtained by adding plasma which had been obtained from another aliquot of the same blood as already described.
The experimental results are shown in the following table:
Haematocrit (%] Clotting times [s]
uncorrected corrected Example 7:
Voltammetric method In addition to the described amperometric measuring methods, it is also possible to use voltammetric measuring methods. In this case the voltage between the electrodes is not set to be constant, but rather the voltage is changed linearly from an initial value to a final value and subsequently returned to the initial value. This process can be repeated several times over the entire measurement period. In this method the current is then plotted against the voltage and when this is repeated, one obtains a nested set of current-voltage curves (cyclovoltammograms). If the voltage range is suitable, oxidation peaks and reduction peaks of the electron carrier are formed in these curves.
An example of such consecutive voltammograms is shown in fig. 2. A sweep through the potential range 100 to 600 mV and back was repeated over the entire measurement period.
The height of these peaks is directly proportional to the concentration of the electron carrier provided that other redox-active substances are not co-oxidized or co-reduced in the covered potential range and thus additionally contribute to the current. Such an interference may be ignored when measuring a concentration change.
If the current values for the peak maxima or the areas enclosed by the curves (corresponding to the charge turnover) of the individual current voltage loops are plotted against time, one also obtains a picture of the concentration change of the electron carrier over the measurement period in a time raster given by the cycle period. The charge content (sum of the current values/measurement density) of the consecutive cyclic voltammograms is plotted over time in fig.3. The difference in the time course between the normal coagulation range and the result of a Marcumar test person (with retarded blood clotting) can be seen.
The time at which the charge of a cyclic voltammogram starts to increase and how rapidly this occurs is of primary interest in order to determine or read a clotting time. Hence this means when does coagulation start (thrombin is activated) and how rapidly does this occur (how rapidly is how much thrombin additionally activated). For this reason, as shown in fig. 4, the time derivative is calculated from the curves of fig. 3 i.e. dQ to dt. The maximum slope is the maximum in the time derivative. The time t of the maximum can be read as the clotting time.
The following result is then obtained for the examples shown in figures 3 and 4:
Time until maximum dQ/dt Measurement Normal range Marcumar test person
Claims (15)
1. Electrochemical sensor based on dry chemistry for determining blood coagulation or individual coagulation factors which has at least two electrodes on an inert support as well as a dry reagent, characterized in that the reagent contains a protease substrate which is composed of a peptide residue that can be cleaved off by a protease of the blood coagulation system and is bound to a phenylenediamine residue via an amide bond at its carboxyl end, characterized in that the reagent also contains a dye-oxidoreductase which is able to catalyse the conversion of a quinone diimine into a phenylenediamine.
2. Electrochemical sensor as claimed in claim 1, characterized in that it contains two electrodes which are composed of the same material.
3. Electrochemical sensor as claimed in claim 2, characterized in that the electrode material is palladium or gold.
4. Electrochemical sensor as claimed in one of the claims 1 or 3, characterized in that the protease is thrombin and the protease substrate is a thrombin substrate.
5. Electrochemical sensor as claimed in claim 4, characterized in that the thrombin substrate is a compound of formula VI, in which R1 denotes an alkyl residue, a hydroxyalkyl residue or hydrogen, R2 denotes a hydroxyalkyl residue or hydrogen and R3 denotes hydrogen, halogen, alkoxy or alkylthio.
6. Electrochemical sensor as claimed in one of the claims 1 - 5, characterized in that the dye-oxidoreductase is glucose-dye-oxidoreductase.
7. System for measuring blood coagulation containing an electrochemical sensor and an instrument for measuring current, characterized in that a sensor as claimed in one of the claims 1 - 6 is used as the sensor.
8. Method for determining blood coagulation by means of an electrochemical sensor, characterized in that a constant voltage is applied to a sensor as claimed in one of the claims 1 - 6, the blood sample to be examined is applied to the sensor in such a manner that the reagent and the electrodes are moistened and the current flowing between the electrodes is measured over time.
9. Method as claimed in claim 8, characterized in that it is used to measure the prothrombin time (PT), the activated partial prothrombin time (aPTT) or the activated clotting time (ACT).
10. Method as claimed in claim 8 or 9, characterized in that the determination of the blood clotting time is corrected for haematocrit influence by means of an impedance measurement,
11. Reagent for the determination of blood coagulation containing a protease substrate which is composed of a peptide residue that can be cleaved off by a protease of the blood coagulation system and is bound via its carboxyl end and an amide linkage to a phenylenediamine residue, characterized in that it contains a dye-oxidoreductase.
12. Reagent as claimed in claim 11, characterized in that the dye-oxidoreductase is glucose-dye-oxidoreductase.
13. Reagent as claimed in claim 11 or 12, characterized in that the protease is thrombin and the protease substrate is a thrombin substrate.
14. Method for determining blood coagulation by means of an electrochemical sensor, characterized in that a voltage that changes linearly is applied to a sensor as claimed in one of the claims 1 - 6, the blood sample to be examined is applied to the sensor in such a way that the reagent and the electrodes are moistened and the current flowing between the electrodes is measured over time.
15. Method as claimed in claim 14, characterized in that the determination of the blood clotting time is corrected for haematocrit influence by means of an impedance measurement.
Applications Claiming Priority (7)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE10007910.5 | 2000-02-21 | ||
| DE10007910 | 2000-02-21 | ||
| US18405900P | 2000-02-22 | 2000-02-22 | |
| US60/184,059 | 2000-02-22 | ||
| DE10016775.6 | 2000-04-04 | ||
| DE10016775A DE10016775A1 (en) | 2000-02-21 | 2000-04-04 | Electrochemical sensor for determining blood coagulation, a corresponding blood coagulation measurement system and a method for determining blood coagulation |
| PCT/EP2001/001848 WO2001063271A1 (en) | 2000-02-21 | 2001-02-19 | Electrochemical sensor for determining blood clotting, corresponding system for measuring blood clotting and method for determining blood clotting |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2400651A1 true CA2400651A1 (en) | 2001-08-30 |
Family
ID=27213672
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002400651A Abandoned CA2400651A1 (en) | 2000-02-21 | 2001-02-19 | Electrochemical sensor for determining blood clotting, corresponding system for measuring blood clotting and method for determining blood clotting |
Country Status (6)
| Country | Link |
|---|---|
| EP (1) | EP1261861B1 (en) |
| JP (1) | JP2003524184A (en) |
| AT (1) | ATE278186T1 (en) |
| AU (1) | AU2001233785A1 (en) |
| CA (1) | CA2400651A1 (en) |
| WO (1) | WO2001063271A1 (en) |
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| US9795747B2 (en) | 2010-06-02 | 2017-10-24 | Sanofi-Aventis Deutschland Gmbh | Methods and apparatus for lancet actuation |
| US9427532B2 (en) | 2001-06-12 | 2016-08-30 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| US7025774B2 (en) | 2001-06-12 | 2006-04-11 | Pelikan Technologies, Inc. | Tissue penetration device |
| US9226699B2 (en) | 2002-04-19 | 2016-01-05 | Sanofi-Aventis Deutschland Gmbh | Body fluid sampling module with a continuous compression tissue interface surface |
| US8579831B2 (en) | 2002-04-19 | 2013-11-12 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US9795334B2 (en) | 2002-04-19 | 2017-10-24 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus for penetrating tissue |
| US8784335B2 (en) | 2002-04-19 | 2014-07-22 | Sanofi-Aventis Deutschland Gmbh | Body fluid sampling device with a capacitive sensor |
| US7547287B2 (en) | 2002-04-19 | 2009-06-16 | Pelikan Technologies, Inc. | Method and apparatus for penetrating tissue |
| US9248267B2 (en) | 2002-04-19 | 2016-02-02 | Sanofi-Aventis Deustchland Gmbh | Tissue penetration device |
| US7708701B2 (en) | 2002-04-19 | 2010-05-04 | Pelikan Technologies, Inc. | Method and apparatus for a multi-use body fluid sampling device |
| US9314194B2 (en) | 2002-04-19 | 2016-04-19 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| US8702624B2 (en) | 2006-09-29 | 2014-04-22 | Sanofi-Aventis Deutschland Gmbh | Analyte measurement device with a single shot actuator |
| US8574895B2 (en) | 2002-12-30 | 2013-11-05 | Sanofi-Aventis Deutschland Gmbh | Method and apparatus using optical techniques to measure analyte levels |
| WO2006001797A1 (en) | 2004-06-14 | 2006-01-05 | Pelikan Technologies, Inc. | Low pain penetrating |
| GB0316075D0 (en) * | 2003-07-09 | 2003-08-13 | Molecular Sensing Plc | Protease detection assay |
| WO2005033659A2 (en) | 2003-09-29 | 2005-04-14 | Pelikan Technologies, Inc. | Method and apparatus for an improved sample capture device |
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| SE0303249D0 (en) * | 2003-12-02 | 2003-12-02 | Inst Polymerutveckling Ab | Hematocrit and analyte concentration determination |
| EP1706026B1 (en) | 2003-12-31 | 2017-03-01 | Sanofi-Aventis Deutschland GmbH | Method and apparatus for improving fluidic flow and sample capture |
| WO2006011062A2 (en) | 2004-05-20 | 2006-02-02 | Albatros Technologies Gmbh & Co. Kg | Printable hydrogel for biosensors |
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| FR2874385B1 (en) * | 2004-08-18 | 2006-12-08 | Biopep Sa | METHOD AND DEVICE FOR MEASURING ENZYMA ACTIVITY IN A BIOLOGICAL FLUID |
| DK1742063T3 (en) * | 2005-07-07 | 2010-12-20 | Asulab Sa | System for differential determination of the amount of a proteolytic enzyme in a body fluid |
| EP1918718A1 (en) * | 2006-10-31 | 2008-05-07 | Roche Diagnostics GmbH | Methods and devices for electrochemical determination of factor Xa inhibitors in blood samples |
| TWI516601B (en) * | 2007-10-26 | 2016-01-11 | 環球生物醫療感測器私人有限公司 | Apparatus and method for electrochemical detection |
| US8603768B2 (en) * | 2008-01-17 | 2013-12-10 | Lifescan, Inc. | System and method for measuring an analyte in a sample |
| EP2265324B1 (en) | 2008-04-11 | 2015-01-28 | Sanofi-Aventis Deutschland GmbH | Integrated analyte measurement system |
| EP2144061A1 (en) | 2008-07-11 | 2010-01-13 | F. Hoffmann-Roche AG | Continuous method for inline application of tensides on coated sensor film |
| US9375169B2 (en) | 2009-01-30 | 2016-06-28 | Sanofi-Aventis Deutschland Gmbh | Cam drive for managing disposable penetrating member actions with a single motor and motor and control system |
| EP2371284A1 (en) * | 2010-03-24 | 2011-10-05 | C A Casyso AG | Method and apparatus for determining at least one evaluation parameter of a blood sample |
| US8965476B2 (en) | 2010-04-16 | 2015-02-24 | Sanofi-Aventis Deutschland Gmbh | Tissue penetration device |
| EP2395353B1 (en) * | 2010-06-09 | 2018-08-22 | Apex Biotechnology Corp. | Device and method for measuring prothrombin time and hematocrit by analyzing change in reactance in a sample |
| DE102011006349A1 (en) * | 2011-03-29 | 2012-10-04 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Device and method for detecting, measuring and / or influencing the clotting of blood systems |
| EP2524965A1 (en) * | 2011-05-16 | 2012-11-21 | The Swatch Group Research and Development Ltd. | Increase in storage lifetime of a thrombin sensor |
| CN106170702B (en) * | 2013-12-25 | 2018-09-21 | 株式会社日立高新技术 | Automatic analysing apparatus and analysis method |
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| CN105259227B (en) * | 2015-11-10 | 2017-10-17 | 华东交通大学 | A kind of blood coagulation enzyme assay method of molecular imprinting electrochemical sensor |
| WO2017141961A1 (en) * | 2016-02-16 | 2017-08-24 | 生化学工業株式会社 | Electrochemical measurement using phenylenediamine derivative |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3061860D1 (en) * | 1979-04-24 | 1983-03-17 | Marcel Jozefonvicz | Process for the determination of proteases and antiproteases |
| US6150174A (en) * | 1997-03-05 | 2000-11-21 | Diametrics Medical, Inc. | Method for measurement of whole blood coagulation parameters |
| DE69941563D1 (en) * | 1999-02-23 | 2009-12-03 | Asulab Sa | Electrochemical system for the determination of blood clotting time |
-
2001
- 2001-02-19 AT AT01905800T patent/ATE278186T1/en not_active IP Right Cessation
- 2001-02-19 AU AU2001233785A patent/AU2001233785A1/en not_active Abandoned
- 2001-02-19 JP JP2001562186A patent/JP2003524184A/en not_active Ceased
- 2001-02-19 EP EP01905800A patent/EP1261861B1/en not_active Expired - Lifetime
- 2001-02-19 WO PCT/EP2001/001848 patent/WO2001063271A1/en active IP Right Grant
- 2001-02-19 CA CA002400651A patent/CA2400651A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| JP2003524184A (en) | 2003-08-12 |
| AU2001233785A1 (en) | 2001-09-03 |
| ATE278186T1 (en) | 2004-10-15 |
| EP1261861B1 (en) | 2004-09-29 |
| WO2001063271A1 (en) | 2001-08-30 |
| EP1261861A1 (en) | 2002-12-04 |
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