Language

English

Publication Date

12-1-2025

Journal

Journal of Clinical Laboratory Medicine

DOI

10.1002/jcla.70122

PMID

41047907

PMCID

PMC12699199

PubMedCentral® Posted Date

10-6-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: The soluble C5b-9 (sC5b-9) is a soluble form of the Terminal Complement Complex (TCC) that is released into the circulation with elevated levels, associated with increased morbidity and mortality in patients with complement-mediated inflammatory conditions. With the advent of eculizumab and ravulizumab, proper testing for diagnoses and therapeutic monitoring is warranted.

Methods: We evaluated both the analytical and clinical performance of the Quidel Microvue sC5b-9 Plus enzyme immunoassay. Analytical performance was evaluated with precision, linearity, interference studies, and correlation with a reference laboratory. Reference intervals were established using control donor samples [n = 26; median age 18.5 years (range 2-59)]. Clinical performance of the assay was assessed using plasma samples of patients who (i) developed transplant-associated thrombotic microangiopathy [n = 10; median age 14 years (range 3-19)], (ii) had reduced ADAMTS13 activity [n = 6; median age 16 years (range 9-18)], and (iii) developed acquired Von-Willebrand disease [n = 10; median age 18.5 years (range 0.5-18)].

Results: The assay showed acceptable intra and inter-precision at both low and high levels. Linearity ranged from 12.6 to 160.66 ng/mL, while accuracy and method correlation studies with a reference laboratory yielded a correlation coefficient (R) of 0.96. The reference range in control donors was established at ≤ 268.0 ng/mL. Clinical performance of the assay in patients' plasma revealed elevated sC5b-9 levels suggesting complement activation in these patient cohorts compared with control levels.

Conclusion: The Quidel Microvue sC5b-9 plus EIA assay demonstrated acceptable analytical performance and clinical utility for monitoring complement activation in patients. Further studies are needed to correlate sC5b-9 levels with existing markers of complement activation.

Keywords

Humans, Complement Membrane Attack Complex, Child, Adolescent, Child, Preschool, Young Adult, Middle Aged, Male, Adult, Female, Reproducibility of Results, Immunoenzyme Techniques, Reference Values, Thrombotic Microangiopathies, analytical precision, complement activation, eculizumab, ravulizumab, transplant‐associated thrombotic microangiopathy, Von‐willebrand disease

Published Open-Access

yes

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