Summary
Protein S is an anticoagulant protein that circulates in plasma in complex with C4b-binding
protein (C4BP) or in free form. Deficiency of protein S increases the risk of venous
thrombosis. Measurement of free protein S, as compared to total levels, has been shown
to be superior for prediction of protein S deficiency. We studied the effects of different
handling protocols for an immuno- and a ligand (C4BP)-based assay for free protein
S. When the assay was performed at 37° C, the levels of free protein S in plasma from
protein S deficient patients were approximately twice those obtained at room temperature.
The reason for this phenomenon was that plasmas from protein S deficient patients
exhibited a time-, temperature-, and dilution-dependent increase in free protein S,
which was more pronounced than corresponding dilution of the normal plasma that was
used to create the standard curve. These findings demonstrate the importance of assay
procedure and sample handling in assays for free protein S.
Keywords
Protein S - C4BP - complex - assay - coagulation