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血小板与血管内皮 VWF 对血小板黏附与止血的贡献。

Contribution of platelet vs. endothelial VWF to platelet adhesion and hemostasis.

机构信息

Blood Research Institute, BloodCenter of Wisconsin, Department of Pediatrics, Medical College of Wisconsin, Children's Research Institute, Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA.

出版信息

J Thromb Haemost. 2012 Aug;10(8):1646-52. doi: 10.1111/j.1538-7836.2012.04797.x.

Abstract

BACKGROUND

von Willebrand factor (VWF) is a glycoprotein that plays an important role in primary hemostasis. VWF is synthesized and stored in endothelial cells (ECs) and megakaryocytes/platelets. Plasma VWF is primarily derived from ECs and is generally believed to be essential for hemostasis. VWF synthesized in megakaryocytes is stored in platelet α-granules, from which it is released following platelet activation. The relative contribution of VWF stored in ECs or megakaryocytes/platelets or present in plasma to hemostasis is not clear.

OBJECTIVES

We investigated whether EC-derived VWF plays the major role in hemostasis while the contribution of platelet-derived VWF is negligible, or if platelet-derived VWF also significantly contributes to hemostasis.

METHODS AND RESULTS

Mice expressing VWF only in ECs (EC-VWF) or platelets (Plt-VWF) were created by reciprocal bone marrow transplantation between C57BL/6J (WT) and VWF knockout mice (VWF-/-). Plasma VWF levels in EC-VWF were similar to WT. Plt-VWF mice had a trace amount of VWF in their plasma while VWF levels in platelet lysate were comparable to WT. Tail bleeding time was normal in EC-VWF. Interestingly, Plt-VWF showed partially corrected bleeding time and significantly decreased blood loss volume compared with VWF-/-. Adhesion of platelets perfused over immobilized collagen under shear stress was significantly higher in both EC-VWF and Plt-VWF compared with VWF-/-.

CONCLUSION

VWF synthesized in ECs is sufficient to support hemostasis in VWF-/- mice, and VWF produced in megakaryocytes/platelets can also contribute to hemostasis in the absence of EC-derived VWF.

摘要

背景

血管性血友病因子(VWF)是一种在初级止血中起重要作用的糖蛋白。VWF 在内皮细胞(ECs)和巨核细胞/血小板中合成和储存。血浆 VWF 主要来源于 ECs,通常被认为对止血至关重要。巨核细胞中合成的 VWF 储存在血小板α颗粒中,血小板激活后从其中释放。EC 或巨核细胞/血小板中储存的 VWF 或血浆中存在的 VWF 对止血的相对贡献尚不清楚。

目的

我们研究了内皮细胞来源的 VWF 是否在止血中起主要作用,而血小板来源的 VWF 作用可以忽略不计,或者血小板来源的 VWF 也对止血有显著贡献。

方法和结果

通过 C57BL/6J(WT)和 VWF 敲除(VWF-/-)小鼠之间的互惠骨髓移植,创建了仅在 EC 或血小板中表达 VWF 的小鼠(EC-VWF 或 Plt-VWF)。EC-VWF 的血浆 VWF 水平与 WT 相似。Plt-VWF 小鼠的血浆中 VWF 含量很少,而血小板裂解物中的 VWF 水平与 WT 相当。EC-VWF 的尾巴出血时间正常。有趣的是,与 VWF-/-相比,Plt-VWF 的出血时间部分纠正,且出血量明显减少。在剪切应力下,流过固定胶原的血小板的粘附在 EC-VWF 和 Plt-VWF 中均明显高于 VWF-/-。

结论

在 VWF-/-小鼠中,EC 合成的 VWF 足以支持止血,而巨核细胞/血小板产生的 VWF 在缺乏 EC 来源的 VWF 时也可以有助于止血。

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