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Abstract
von Willebrand factor (vWF) circulates in the blood in two distinct compartments. One, plasma vWF, is synthesized and released from endothelial cells; the second, synthesized by megakaryocytes, circulates in platelets primarily stored in the alpha granules. Recent experimental and clinical studies of von Willebrand's disease (vWD) indicate that platelet vWF plays an important role in the bleeding time determination and the degree of clinical bleeding in vWD. Platelet vWF is released from the platelet alpha granules by various agonists and then rebinds to the glycoprotein IIb/IIIa complex. Fibrinogen or monoclonal antibodies against this complex inhibit 60 to 70% of the expression of platelet vWF. Aspirin inhibits 80% of the adenosine diphosphate-induced platelet vWF surface expression, and the platelet vWF surface expression that is not inhibited by aspirin can be almost totally inhibited by disruption of the platelet cytoskeleton. Platelet vWF may, in part, be expressed in the open canalicular system prebound to a receptor. Transfusion studies have shown that correction of the bleeding time in severe vWD requires both plasma and platelet vWF. On the basis of numerous studies, we hypothesize that platelet vWF plays an important role in platelet interaction with the subendothelial surfaces under conditions of high shear stress. After platelet contact, platelet vWF is released, binds to the glycoprotein IIb/IIIa complex, and forms a bridge between the subendothelial surface and the platelet, which initiates and supports platelet spreading. Platelet vWF also acts as an intercellular bridge between platelets and thereby promotes platelet aggregation. This process is important not only in the initial steps of hemostasis but also in the process of thrombosis.
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Affiliation(s)
- H R Gralnick
- Hematology Service, Clinical Center, National Institutes of Health, Bethesda, Maryland
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Benson RE, Dodds WJ. Assessing the specificity of anti-canine-factor VIII-related antigen. Vet Immunol Immunopathol 1986; 11:21-30. [PMID: 3082063 DOI: 10.1016/0165-2427(86)90085-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Antibodies to canine factor VIII-related antigen should be monospecific to accurately study this protein's location in tissue and its structure. Because no uniformly accepted standard for monospecificity exists for anti-factor VIII-related antigen, we have compared the sensitivities of three common evaluation techniques--immunodiffusion, immunoelectrophoresis, and crossed immunoelectrophoresis. Unabsorbed rabbit anti-canine factor VIII-related antigen appeared monospecific against whole plasma by all three methods; however, multiple specificities were recognized against a plasma cryoconcentrate. These results demonstrate the insensitivity of the techniques under certain conditions, which can lead to erroneous interpretation of data.
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Gralnick HR, Williams SB, McKeown LP, Krizek DM, Shafer BC, Rick ME. Platelet von Willebrand factor: comparison with plasma von Willebrand factor. Thromb Res 1985; 38:623-33. [PMID: 3927508 DOI: 10.1016/0049-3848(85)90205-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Platelet von Willebrand factor (vWf) was compared to its plasma counterpart. The platelet vWf was different from plasma vWf in that the multimeric organization was different, larger multimers were present, and the ratio of vWf activity to antigen was higher. Platelet and plasma vWf were similar in their antigenic reactivity in the electroimmunoassay and by liquid phase radioimmunoassay. The amount of vWf activity in large platelets was significantly higher than in normal platelets while the antigen content, although somewhat higher, was not significant. These studies show differences between normal platelet and plasma vWf, and also suggest that platelet size must be considered when platelet vWf is measured in disease states.
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de Cataldo F, Baudo F, Redaelli R, Pezzetti L. Acquired factor VIII:C inhibitor (IgG) and positive direct Coombs' test (IgM) in a patient with lung carcinoma. Clinical course and immunochemical studies. SCANDINAVIAN JOURNAL OF HAEMATOLOGY 1984; 33:171-6. [PMID: 6433437 DOI: 10.1111/j.1600-0609.1984.tb02392.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
UNLABELLED A 73-year-old man with lung squamous-cell carcinoma simultaneously developed a factor VIII:C inhibitor and a transient positive direct Coombs' test. The factor VIII:C inhibitor was characterized as a mixture of IgG1, IgG2, IgG4 with kappa and lambda light chains. The Coombs' test was IgM-specific. TREATMENT blood transfusions (packed red cells), cyclophosphamide and prednisone. Bleeding subsided without factor VIII-replacement therapy. Before death, in spite of the tumour-mass progression, factor VIII:C was normal.
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Piovella F, Ricetti MM, Almasio P, Samaden A, Semino G, Ascari E. The effect of ticlopidine on human endothelial cells in culture. Thromb Res 1984; 33:323-32. [PMID: 6369618 DOI: 10.1016/0049-3848(84)90167-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The effect of ticlopidine at various concentrations (150, 30, 6 microM), has been studied on cultured endothelial cells derived from human umbilical cord vein. Ticlopidine affects the initial attachment of endothelial cells to artificial substrata and has an inhibitory effect on endothelial cell growth rate which correlates to the concentration of the chemical in the culture medium. These effects are related to a marked reduction of intra- and extracellular fibronectin as evidentiated by immunofluorescence. The drug seems to interfere with the formation of fibronectin filaments from intracellular granules. The reduction of fibronectin availability could affect platelet adhesion to subendothelium as well as endothelial cell repair, and subsequently influence the bleeding time. The inhibition of cell proliferation and its possible effect on the thickness of the vessel wall should be considered as additional mechanisms of action for this substance.
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Giddings JC, Brookes LR, Piovella F, Bloom AL. Immunohistological comparison of platelet factor 4 (PF4), fibronectin (Fn) and factor VIII related antigen (VIIIR:Ag) in human platelet granules. Br J Haematol 1982; 52:79-88. [PMID: 6810914 DOI: 10.1111/j.1365-2141.1982.tb03863.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Immunofluorescence microscopy was used to study the localization of platelet factor 4 (PF4), fibronectin (Fn) and factor VIII related antigen in washed normal platelets and those from patients with severe von Willebrand's disease (vWd). Platelets were prepared by an improved multi-unit modification of the Sayk chamber. This facilitated the preparation of samples with minimum disruption of platelets and readily permitted the demonstration of intact platelet granules by the immunological techniques used. The antigens were demonstrated by treating the same preparations sequentially with appropriate heterologous antisera and species specific fluorescein or rhodamine conjugated antisera. Comparison of the different antigens in identical platelets indicated that Fn and VIIIR:Ag were localized to the same granules as PF4 and the results were thus consistent with their presence in alpha granules. Fn and PF4, but not VIIIR:Ag, were present in platelet granules of patients with severe vWd. The antigens were always detected in the same granules, and major sub-populations of differently stained granules were not observed. The methods were applied to investigate normal platelets aggregated with collagen. Fn and VIIIR:Ag were detected in platelet granules after aggregation although the granules themselves were possibly differently distributed in these samples compared with the non-aggregated platelets. The localization of PF4 could not be reliably assessed in aggregated platelets by these methods. The techniques may be useful in localizing platelet antigens and studying release during aggregation.
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Bobrow MN, Rubin H, Lukton A. Production of antibodies to human factor VIII in the ascitic fluid of C57BL/6J mice. Thromb Res 1982; 25:465-73. [PMID: 6810493 DOI: 10.1016/0049-3848(82)90088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A method is described for the production of a murine antiserum to human factor VIII, and the quantitation of factor VIII related antigen using this antiserum. C57BL/6J mice were injected intraperitoneally with a mixture of factor VIII and complete Freund's adjuvant. Ascitic fluid developed after repeated innoculations for seven to eight weeks, and was subsequently tapped. Using this antiserum, factor VIII related antigen was quantitated by immunoelectrophoresis and enzyme immunoassay. This method provides a simple and economical way of producing an antiserum to factor VIII, and may also be applicable to other proteins available in submiligram quantities.
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Joshua DE, Exner T, Holmes D, Rickard KA, Kronenberg H. Antibodies to human factor VIII complex from BALB/c mice. Thromb Res 1981; 22:345-52. [PMID: 6795746 DOI: 10.1016/0049-3848(81)90127-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Davies BL, Furlong RA, Peake IR. Studies on the relationship between factor VIII related antigen (VIIIRAg) and factor VIII clotting antigen (VIIICAg) by immunoelectrophoresis and autoradiography using 125I anti VIIICAg. Thromb Res 1981; 22:87-96. [PMID: 6794178 DOI: 10.1016/0049-3848(81)90311-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Muller HP, van Tilburg NH, Bertina RM, Veltkamp JJ. Immunologic studies on the relationship between FVIII related antigen and FVIII procoagulant activity. Thromb Res 1980; 20:85-96. [PMID: 6782697 DOI: 10.1016/0049-3848(80)90059-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Cooper HA, Lee D, Lamb MA, Wagner RH. Structure-function of the factor VIII complex studied with an immobilized heteroantisera to VIII:C. Br J Haematol 1980; 44:149-60. [PMID: 6769458 DOI: 10.1111/j.1365-2141.1980.tb01192.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
An antibody was raised in rabbits to the small active fragment of human factor VIII, obtained by Ca2+ dissociation of a human factor VIII preparation made from a multidonor plasma pool. After absorption, the antibody neutralized the factor VIII coagulant activity of normal human plasma, but did not precipitate with any plasma or plasma fractions or neutralize von Willebrand factor (vwf) activity as measured by ristocetin aggregation of fixed washed platelets. Immune beads were prepared by CNBr binding of the partially purified rabbit antibody to 1% agarose beads. Non-immune beads were prepared with IgG fractions obtained from the rabbits before immunization and used throughout as a control. The amount of factor VIII coagulant activity (VII:C) removed from plasma by immune beads was time-dependent and proportional to the amount of beads used, but all of the VIII:C could not be readily removed. Removal of VIII:C by immune beads parallelled removal of factor VIII:antigen, but less VWF activity was removed. Immune beads could be blocked or saturated by treatment with large amounts of normal plasma, but not by von Willebrand disease plasma and only by some haemophilic plasma.
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Barrow ES, Reisner HM, Graham JB. The separation of Willebrand factor from factor VIII-related antigen. Br J Haematol 1979; 42:455-68. [PMID: 314303 DOI: 10.1111/j.1365-2141.1979.tb01154.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The three activities associated with factor VIII--coagulant (VIII:C), antigenic (VIIIR:Ag), and platelet agglutinating or Willebrand factor (VIIIR:WF)--have been separated by sequential antibody affinity chromatography, utilizing a rabbit antibody to factor VIII and a spontaneous human antibody to VIII:C. Normal plasma differentially lost its factor VIII-related antigen following passage over the rabbit antibody column. Subsequent passage of the VIIIR:Ag-depleted plasma over the human antibody column resulted in the loss of VIII:C activity, with retention of the Willebrand factor activity, antigen being partially recovered from the heterologous antibody column. These experiments demonstrate that it is possible to separate two of the factor VIII activities, VIIIR:Ag and VIIIR:WF, which are usually regarded as properties of a single molecule.
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Bouma BN, de Graaf S, Slot JW, Zimmerman TS. Human blood platelet factor VIII-related antigen : demonstration of release by alpha-chymotrypsin. Thromb Res 1979; 14:687-96. [PMID: 384591 DOI: 10.1016/0049-3848(79)90124-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Slot JW, Bouma BN, Montgomery R, Zimmerman TS. Platelet factor VIII-related antigen: immunofluorescent localization. Thromb Res 1978; 13:871-81. [PMID: 84410 DOI: 10.1016/0049-3848(78)90192-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Giddings JC, Shearn SA, Bloom AL. Platelet-associated coagulation factors: immunological detection and the effect of calcium. Br J Haematol 1978; 39:569-77. [PMID: 359034 DOI: 10.1111/j.1365-2141.1978.tb03627.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Normal platelets were examined by conventional coagulation methods and specific immunological techniques for the presence of platelet-associated coagulation factors. Platelets washed in buffer containing calcium chloride gave different results form those washed in the absence of calcium. Factor XI was not detected in washed platelets by any technique. Factor II and factor X were removed from platelets by washing in calcium-free buffer but not by calcium-containing buffer. Procoagulant factor VIII was readily removed or inactivated by washing in the presence or absence of calcium, but factor VIII related antigen was consistently demonstrated after multiple washes in either buffer. Factor V activity and antigen was detected in platelet suspensions after multiple washes although the presence of calcium in the washing buffer gave higher factor V assays and stronger immunological reactions than when calcium-free buffer was used. The results are consistent with the presence of calcium dependent binding sites in platelets which may have a role in the enhancement of factor V and phospholipid reactions.
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Sixma JJ, Over J, Bouma BN, Bloam AL, Peake IR. Predominance of normal low molecular weight forms of factor VIII in "variant" von Willebrand's disease. Thromb Res 1978; 12:929-35. [PMID: 354084 DOI: 10.1016/0049-3848(78)90288-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Yang HC, Duffy C, Levine PH. A simplified method for the production of heterologous antiserum to factor VIII related antigen. Thromb Res 1977; 11:463-70. [PMID: 411194 DOI: 10.1016/0049-3848(77)90200-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Giddings JC, Seligsohn U, Bloom AL. Immunological studies in combined factor V and factor VIII deficiency. Br J Haematol 1977; 37:257-64. [PMID: 603759 DOI: 10.1111/j.1365-2141.1977.tb06842.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Plasma samples from patients with inherited combined factor V and factor VIII deficiency were examined by immunological methods for the presence of factor V and Factor VIII-related antigens. A factor V-related antigen was consistently demonstrated in all plasma samples by inhibitor neutralization assay using a non-precipitating rabbit antibody. Factor VIII-related antigens were detected by inhibitor neutralization using human antibody and by electroimmunoassay using a precipitating rabbit antibody. The amounts of factor V and factor VIII-related antigens present in the patient's samples were similar to those found in normal human plasma. The findings confirm the presence of normal levels of factor VIII-related antigen in the plasma of these patients and suggest that inactive antigenic determinants of procoagulant factor V and procoagulant factor VIII are also present. The results are consistent with the possibility that a common precursor of porcoagulant factor V and factor VIII is defective in these patients.
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Sultan Y, Bouma BN, de Graaf S, Simeon J, Caen JP, Sixma JJ. Factor VIII related antigen in platelets of patients with Von Willebrand's disease. Thromb Res 1977; 11:23-30. [PMID: 329466 DOI: 10.1016/0049-3848(77)90065-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Shearn SA, Peake IR, Giddings JC, Humphrys J, Bloom AL. The characterization and synthesis of antigens related to factor VIII in vascular endothelium. Thromb Res 1977; 11:43-56. [PMID: 329467 DOI: 10.1016/0049-3848(77)90067-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Peake IR, Bloom AL. The use of an immunoradiometric assay for factor VIII related antigen in the study of atypical Von Willebrand's disease. Thromb Res 1977; 10:27-32. [PMID: 66769 DOI: 10.1016/0049-3848(77)90078-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Weinstein MJ, Deykin D, Davie EW. Quantitative determination of factor-VIII protein by two-stage gel electrophoresis. Br J Haematol 1976; 33:343-55. [PMID: 1084158 DOI: 10.1111/j.1365-2141.1976.tb03550.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A new method for the quantification of factor-VIII protein in plasma is described which utilizes only commercially available equipment and material. The procedure involves separation of factor VII from other plasma proteins by a two-stage sodium dodecyl sulphate gel electrophoretic technique and quantification of the protein by scanning densitometry. The plasma from normal individuals, haemophiliacs, obligate carriers of haemophilia and patients with von Willebrand's disease have been examined by this technique. In general, the data support the earlier findings obtained by quantitative immunoelectrophoresis. In addition, some abnormalities not detected by immunoelectrophoresis are observed by the gel electrophoresis technique.
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Benson RE, Bouma BN, Dodds WJ. Factor VIII-related antigen in canine hemophilia and Von Willebrand's disease: Variation when measured with different agaroses. Thromb Res 1975; 7:383-9. [PMID: 1081282 DOI: 10.1016/0049-3848(75)90032-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Coller BS, Hirschman RJ, Gralnick HR. Studies on the Factor VIII/von Willebrand factor antigen on human platelets. Thromb Res 1975; 6:469-80. [PMID: 1098217 DOI: 10.1016/0049-3848(75)90059-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Bouma BN, Hordijk-Hos JM, DeGraaf S, Sixma JJ, Van Mourik JA. Presence of factor VIII-related antigen in blood platelets of patients with Von Willebrand's disease. Nature 1975; 257:510-12. [PMID: 1080838 PMCID: PMC7086501 DOI: 10.1038/257510a0] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
VON WILLEBRAND'S disease (VWD) is an autosomally inherited disorder characterised by low factor VIII activity (antihaemophilic factor, AHF), prolonged bleeding time, reduced retention of platelets in a glass bead column and abnormal distocetin-induced platelet aggregation. The prolonged bleeding time in VWD has been attributed to the absence of a plasma factor, the von Willebrand factor (VWF), as shown by a correction of the bleeding time after infusion of normal and haemophilic plasmas1. Addition of purified factor VIII in vitro specifically corrects the abnormal platelet retention and ristocetin aggregation in VWD2–5, whereas transfusion of similar material into dogs with VWD also corrects the prolonged bleeding time (B.N.B., W. J. Dodds, J. A. van Mourik, J.J.S and W. P. Webster, unpublished). This led to the suggestion that factor VIII is closely related if not identical to VWF, although dissociation of factor VIII procoagulant activity from factor VIII-related antigen (F VIII-RA) is observed in certain conditions6,7. The plasma concentration of F VIII-RA is usually reduced in VWD suggesting a reduced synthesis of factor VIII (VWF)8. In contrast to this we now report the presence of normal concentrations of F VIII-RA in platelets of patients with VWD. This F VIII-RA supported aggregation induced by ristocetin in a washed platelet system9, a property of factor VIII which has been attributed to VWF activity.
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