control group TnAAbs control group TnAAbs control group TnAAbs0

102030405060708090

100110120130140150160

p=0.81

p=0.095

cTnII-C complex

cT

nI

reco

ve

ry (

%)

cTn complex

p<0.05

μ

[41-60] [54-73] [67-86] [80-99] [119-138][132-152][145-164][171-190][184-203][223-242][275-288]

0

10

20

30

40

50

60

70

80

90

100

110

120

130

TnT199 TnT7E7 TnT105 TnT2 TnT1A11 TnT9 TnT122TnT8 TnT175 TnT25

cTnT-specific mAbs and their epitope specificity, aar

cT

nT

re

co

ve

ry (

%)

TnAAbs plasma

Control plasma

TnT124

● ■

1. TnAAbs are not specific to the cTnI per se but instead to the structural

epitopes formed by cTnI and cTnT polypeptide chains

2. The effect of TnAAbs on cTnI measurements is less pronounced in AMI

blood samples than in the samples with spiked ternary cTnI-cTnT-TnC

complex

3. The negative effect of TnAAbs on cTnI measurements is more

noticeable in the early AMI samples (first few hours after the event) rather

than in the late AMI samples

4-9h 10-19h 22-36h0

10

20

30

40

50

60

70

80

90

100

cT

nI re

covery

(%

)

Hours after onset of AMI symptoms

Standard I-C

complex recovery

Standard cTnI-cTnT-TnC

complex recovery

μ

40 45 50 55 60 65 70 75 80 85 90 95

Elution volume (ml)

CP

S

Normal plasma

TnAAbs-plasma

2000

3000

4000

5000

6000

7000

8000

9000

10000

11000

12000cTnI-TnC complex in buffer

40 45 50 55 60 65 70 75 80 85 90 95

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

11000

CP

S

Elution volume (ml)

TnAAbs-plasma

Normal plasma

cTnT in buffer

40 45 50 55 60 65 70 75 80 85 90 95

Normal plasma

TnAAbs-plasma

Elution volume (ml)

CP

S

2000

3000

4000

5000

6000

7000

8000

9000

10000

11000

12000

cTnI-cTnT-TnC complex in bufferBA C

TnI19C7

[41-49]

TnI560

[83-93]

C-TnI

N’C-TnC

N-TnT

C-TnT

N-TnC

TnT7E7

[223-242]

TnAAbs putative epitope

within IT arm

T1-TnT