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D-dimer antigen: current concepts and future prospects.

Publication ,  Journal Article
Adam, SS; Key, NS; Greenberg, CS
Published in: Blood
March 26, 2009

The D-dimer antigen is a unique marker of fibrin degradation that is formed by the sequential action of 3 enzymes: thrombin, factor XIIIa, and plasmin. First, thrombin cleaves fibrinogen producing fibrin monomers, which polymerize and serve as a template for factor XIIIa and plasmin formation. Second, thrombin activates plasma factor XIII bound to fibrin polymers to produce the active transglutaminase, factor XIIIa. Factor XIIIa catalyzes the formation of covalent bonds between D-domains in the polymerized fibrin. Finally, plasmin degrades the crosslinked fibrin to release fibrin degradation products and expose the D-dimer antigen. D-dimer antigen can exist on fibrin degradation products derived from soluble fibrin before its incorporation into a fibrin gel, or after the fibrin clot has been degraded by plasmin. The clinical utility of D-dimer measurement has been established in some scenarios, most notably for the exclusion of VTE. This article consists of 2 sections: in the first, the dynamics of D-dimer antigen formation is discussed and an overview of commercially available D-dimer assays is provided. The second section reviews available evidence for the clinical utilization of D-dimer antigen measurement in VTE, as well as emerging areas of D-dimer utilization as a marker of coagulation activation in other clinical settings.

Duke Scholars

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

March 26, 2009

Volume

113

Issue

13

Start / End Page

2878 / 2887

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Venous Thromboembolism
  • Pulmonary Embolism
  • Protein Structure, Tertiary
  • Models, Biological
  • Immunology
  • Immunoassay
  • Humans
  • Fibrin Fibrinogen Degradation Products
  • Fibrin
 

Citation

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Adam, S. S., Key, N. S., & Greenberg, C. S. (2009). D-dimer antigen: current concepts and future prospects. Blood, 113(13), 2878–2887. https://doi.org/10.1182/blood-2008-06-165845
Adam, Soheir S., Nigel S. Key, and Charles S. Greenberg. “D-dimer antigen: current concepts and future prospects.Blood 113, no. 13 (March 26, 2009): 2878–87. https://doi.org/10.1182/blood-2008-06-165845.
Adam SS, Key NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009 Mar 26;113(13):2878–87.
Adam, Soheir S., et al. “D-dimer antigen: current concepts and future prospects.Blood, vol. 113, no. 13, Mar. 2009, pp. 2878–87. Pubmed, doi:10.1182/blood-2008-06-165845.
Adam SS, Key NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009 Mar 26;113(13):2878–2887.

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

March 26, 2009

Volume

113

Issue

13

Start / End Page

2878 / 2887

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Venous Thromboembolism
  • Pulmonary Embolism
  • Protein Structure, Tertiary
  • Models, Biological
  • Immunology
  • Immunoassay
  • Humans
  • Fibrin Fibrinogen Degradation Products
  • Fibrin