Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
Blood Adv. 2022 Jul 12;6(13):3979-3990. doi: 10.1182/bloodadvances.2021006405.
The presence of blood flow influences the interaction between von Willebrand factor (VWF) and blood cells, affecting characteristics of forming blood clots. The interactions between coagulation and inflammation have mainly been studied in thrombosis models, but it remains unclear whether these interactions might also play a role in reduced bleeding in patients with bleeding disorders. In this systematic review, we provide an overview of the literature investigating the interactions between VWF and blood cells in flow models. For article selection, a systematic search was performed in Embase, Medline-Ovid, Cochrane Library, Web of Science databases, and Google Scholar. After selection, 24 articles were included. These articles describe direct or platelet-dependent interactions between VWF and neutrophils, monocytes, erythrocytes, or lymphocytes under different flow conditions. Almost all the described interactions required the presence of activated platelets. Only erythrocytes, monocytes, and natural killer cells were capable of directly binding the VWF multimers. Overall, interactions between VWF and blood cells mainly occurred in the presence of platelets. Because of the large variation in study design and used flow rates, further research is necessary to compare the results between studies and draw firm conclusions on when and under what conditions these interactions can occur. After our findings, many questions remained unanswered. This review might provide a starting point for future research. Extended knowledge on the influence of blood flow on VWF and blood cell interactions can contribute to improved understanding of the variation in bleeding in patients with bleeding disorders.
血流的存在会影响血管性血友病因子 (VWF) 与血细胞之间的相互作用，从而影响血栓形成的特征。凝血和炎症之间的相互作用主要在血栓形成模型中进行了研究，但尚不清楚这些相互作用是否也可能在出血性疾病患者的出血减少中发挥作用。在本系统评价中，我们综述了研究血流模型中 VWF 与血细胞相互作用的文献。为了进行文章选择，我们在 Embase、Medline-Ovid、Cochrane 图书馆、Web of Science 数据库和 Google Scholar 中进行了系统搜索。选择后，共纳入 24 篇文章。这些文章描述了在不同的流动条件下，VWF 与中性粒细胞、单核细胞、红细胞或淋巴细胞之间的直接或血小板依赖性相互作用。几乎所有描述的相互作用都需要激活的血小板的存在。只有红细胞、单核细胞和自然杀伤细胞能够直接结合 VWF 多聚体。总体而言，VWF 与血细胞之间的相互作用主要发生在血小板存在的情况下。由于研究设计和使用的流速存在很大差异，需要进一步的研究来比较研究结果，并就何时以及在何种条件下可以发生这些相互作用得出明确的结论。在我们的研究结果之后，仍有许多问题未得到解答。这篇综述可能为未来的研究提供一个起点。对血流对 VWF 和血细胞相互作用的影响的扩展知识有助于更好地理解出血性疾病患者出血变异性。
