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Synapse Research Institute was founded in 1999 as a research institute to explore thrombin generation (TG). Synapse is the inventor and patent holder of the “Calibrated Automated Thrombinography (CAT) assay”.
The CAT assay is able to detect both thrombotic and bleeding tendencies. There is increasing awareness amongst scientists and medical doctors that measuring TG can reflect the coagulation state of a patient in vitro.
The thrombin generation assay, which relies on the cleavage of a chromogenic substrate specific to thrombin, is conducted using the calibrated automated thrombogram (CAT) and the associated Thrombinoscope software. Each CAT test involves two fluorescence measurements within the same plasma sample (Figure 1A). In the measurement well, tissue factor (TF) and synthetic phospholipid vesicles are introduced to plasma to initiate coagulation and induce thrombin formation. In the calibration well, a known quantity of substrate-converting activity, known as the “thrombin calibrator,” is added to plasma without activating coagulation. This calibrator comprises thrombin bound to α2-macroglobulin (α2M-thrombin), a form of thrombin impervious to inhibition by plasma protease inhibitors. A combination of CaCl2 and a fluorogenic substrate is then dispensed into both wells, and the resulting fluorescence is continuously recorded in real-time using a fluorometer. From these measurements, parameters such as the endogenous thrombin potential (ETP), peak thrombin concentration (peak), lag time until thrombin formation, time to peak (ttPeak), and velocity index are calculated (Figure 1B).
