Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital

Enhanced processing of von Willebrand factor reflects disease severity and discriminates severe portal hypertension in cirrhosis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. The prevention and management of Crohn's disease postoperative recurrence: results from the Y-ECCO/ClinCom 2019 Survey

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Challenges and obstacles in the transition process through the eyes of the gastroenterologist

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Vitamin D deficiency in a European inflammatory bowel disease inception cohort: an Epi-IBD study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Poor concordance between liver stiffness and non-invasive fibrosis scores in HIV infection without viral hepatitis

    Publikation: Bidrag til tidsskriftKort undersøgelseForskningpeer review

  2. Nonalcoholic Fatty Liver Disease Impairs the Liver-Alpha Cell Axis Independent of Hepatic Inflammation and Fibrosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: Portal hypertension in cirrhosis is associated with endothelial dysfunction, impaired wound healing, and decreased platelet count. Increased von Willebrand factor (VWF) formation has been suggested as a compensatory mechanism, but the role of VWF processing has not been directly assessed. The aim was to measure the processing of activated VWF (VWF-A) in addition to VWF release (VWF-N) to investigate the association of primary hemostasis with disease activity and portal hypertension in liver cirrhosis.

PARTICIPANTS AND METHODS: Plasma samples from 105 participants undergoing liver vein catheterization and with liver cirrhosis of varying severity were included in the study together with 20 controls without liver disease. Competitive enzyme-linked immunosorbent assay format was used to estimate biomarkers of VWF turnover using neo-epitope-specific monoclonal antibodies.

RESULTS: VWF-N levels and VWF-A levels were significantly elevated in cirrhotic patients compared with controls (P<0.0001), and both markers could discriminate mild from severe cirrhosis (VWF-N, P<0.0001; VWF-A, P<0.05). Both markers correlated well with increasing portal hypertension and could identify patients with clinically significant portal hypertension (VWF-N, area under the curve: 0.78; VWF-A, area under the curve: 0.67). Only VWF-A significantly separated compensated from decompensated patients (P<0.05).

CONCLUSION: The data indicate that both VWF release and processing of active VWF are increased in cirrhosis, reflecting ongoing wound healing initiation. VWF-N and VWF-A may specifically contain information to assess the presence and severity of PHT as an early indicator of cirrhosis, and for acute damage in decompensated cirrhosis. Whether the increased wound healing affects long-term outcome needs to be addressed in future studies.

TidsskriftEuropean journal of gastroenterology & hepatology
Udgave nummer8
Sider (fra-til)1040-1048
Antal sider9
StatusUdgivet - aug. 2019

ID: 56562205