Role of the von Willebrand factor in atherogenesis.

The von Willebrand factor is a high molecular weight protein which is synthesized by endothelial cells and appears in plasma and platelets. The main function of the factor is in mediating the adherence of platelets to the deendothelialized vessel wall. Animals with congenital deficiency of the factor do not develop the atherosclerotic lesions found in their normal counterparts. Elevated levels of the von Willebrand factor are observed in patients with atherosclerotic peripheral vascular disease, myocardial infarction, and diabetics with proliferative retinopathy. These increases in the factor may be due to the increased turnover rates of platelets and endothelial cells commonly seen in these disorders. Whether elevated levels of the von Willebrand protein constitute a unique risk factor for the development of atherosclerosis and vascular occlusive disease should be determined by studies currently in progress.