Editor’s Note: The 32nd International Society on Thrombosis and Haemostasis (ISTH 2024) Congress was held in Bangkok, Thailand, from June 22 to June 26, 2024. As the most influential international event in the field of thrombosis and haemostasis, the ISTH Congress attracts thousands of top experts and scholars from around the world each year, with its profound academic impact and rich academic content. "Oncology Frontier - Hematology Frontier" is dedicated to synchronously delivering cutting-edge academic information. Here, we highlight outstanding research findings to provide academic reference information for the field of hematological diseases.

Research Background

Globally, traditional methods for measuring plasma fibrinogen levels, especially the Clauss Fibrinogen Test (CCT) based on plasma coagulation reactions, have been widely adopted. Despite its widespread use, this method is susceptible to interference from fibrin degradation products (FDPs) during the measurement process. For generally healthy individuals, such interference may not be significant. However, in clinical settings, especially when dealing with bleeding complications, this interference becomes a significant issue. When low fibrinogen levels are detected, distinguishing whether this result truly reflects a low fibrinogen state or is caused by interference from high fibrinolysis is crucial.

This distinction is critical for guiding appropriate treatment strategies, as the management of bleeding varies significantly based on the underlying causes. For most bleeding conditions, particularly those closely related to high fibrinolysis, current treatment strategies have notable limitations. In traditional medical practice, when patients have low fibrinogen levels, physicians typically choose to administer purified fibrinogen concentrate (FC) or fresh frozen plasma (FFP) as treatments. However, in addressing the complex condition of high fibrinolysis, the efficacy of FFP is often significantly reduced due to dilution effects, and the application of FC also shows considerable variability. Therefore, there is an urgent need for more in-depth and systematic research into the underlying mechanisms of bleeding.

To address current challenges, this study introduced the True Fibrinogen Assay (TFT), a novel testing method. TFT differentiates between fibrinogen deficiency and hyperfibrinolysis as the causes of bleeding. TFT’s uniqueness lies in its resistance to interference from fibrin intermediates or their derivatives, providing accurate and specific information about fibrinogen levels. The introduction of TFT is expected to significantly enhance the understanding of abnormal fibrinogenemia and potentially become a new means of improving bleeding treatment and prevention.

Research Methods and TFT Detection Principle

The study systematically evaluated the two detection methods under different concentrations of FDPs. Unlike traditional methods, the TFT detection method demonstrated resistance to FDP interference, allowing for a more accurate assessment of actual fibrinogen levels in the presence of fibrinolytic products.

Research Results and Conclusion

Analysis of samples from healthy populations showed that individuals previously identified by CCT as having low fibrinogen levels exhibited significantly different fibrinogen levels, exceeding 1 g/L, when tested with the new TFT method. TFT was subsequently applied to samples from patients with chronic liver disease, showing a closer correlation between fibrinogen levels and FV levels. In summary, TFT, a novel fibrinogen detection method, demonstrated higher specificity compared to CCT. In the presence of interfering fibrinolytic products, particularly in bleeding complications, it provided more accurate fibrinogen level detection. This technological advancement holds significant and important application prospects for optimizing evaluation and treatment strategies in relevant clinical conditions. Therefore, the high-specificity fibrinogen detection method outperforms the conventional Clauss method.

Expert Profile

San Pun, Ph.D.

• Founder and CEO of AiMorphous Health
• Senior Scientist in the field of life sciences
• Rich experience in the development of biomarkers and diagnostic products in clinical practice