Coagulation factor VIII is vital for increasing global coagulation after physical exercise

Abstract

Background In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). Aim To validate these results, we repeated the study in a larger cohort. We also examined if the exercise‐induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. Methods We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. Results Rotational thromboelastometry (ROTEM) and thrombin generation assay‐calibrated automated thrombogram (TGA‐CAT) showed significantly increased coagulation capacity after maximal exercise in healthy controls but not in patients with severe HA. VWF antigen and activity levels increased significantly in both groups, whereas FVIII:C only showed a significant increase in the control group. No statistically significant differences were seen between FVIII pharmacokinetic results obtained with and without exercise. Conclusion Our findings do not support the presence of a FVIII‐independent mechanism that increases global coagulation, but rather underscores the importance of FVIII in mediating the increased coagulation capacity seen after exercise. Our results could not support the hypothesis that exercise‐induced increased levels of VWF for patients with severe HA lead to a prolonged effect of factor concentrate administered just before exercise.

The association of von willebrand factor and its cleaving protease (ADAMTS13) with health behaviours in young black and white adults: the African-PREDICT study

“…A study investigating the effects of strenuous exercise on haemostasis found strenuous exercise to increase endothelial activation leading to an increase in vWF plasma levels (83). This study, together with other cross-sectional studies reported that excessive physical activity has a pro-thrombotic effect by increasing plasma levels of FVIII and vWF, platelet reactivity, and activation of the immune system (84)(85)(86)(87). Other studies have yielded conflicting results, and this may have been due to variation in the methodology used, type of exercise, intensity, duration and the population studied.…”

Influencing factors for preparation of platelet-rich plasma in horses

“…In P1, however, the concentration was obtained in most animals after two to three attempts, and in P2, it was obtained always at first. Moreover, the mean platelet count obtained in P2 was higher than in P1, and even within the controversial range (5.16 times above baseline), there is dilution possibility, final platelet concentration adjustment, and PRP use from platelet-poor plasma (PPP) (Fusegawa, Goto, Handa, Kawada, & Ando, 1999;Cattaneo, Lecchi, Zighetti, & Lussana, 2007;Ljungkvist, Olofsson, Funding, Berntorp, & Zetterberg, 2019), while nonconcentrated P1 samples had to be discarded.…”

Factor VIII: A Dynamic Modulator of Hemostasis and Thrombosis in Trauma

“…In subjects with severe hemophilia A, FVIII release is obtunded, and peak thrombin generation (TG) remains low and unchanged, while TG peak is enhanced in control individuals after exercise. 25 The correlation between stress level and FVIII/VWF release has also been demonstrated between high-dose (presumably stress-free) and low-dose fentanyl anesthesia for cardiac surgical patients. 27…”

“…A moderate but transient physical exercise (~15 minutes) elevates circulating epinephrine levels, which mediates a systemic release of FVIII/VWF in healthy individuals. 25,26 Activated partial thromboplastin time (aPTT) is shortened (23 seconds versus baseline 27 seconds) at 10 minutes postexercise, while prothrombin time (PT) does not change. In subjects with severe hemophilia A, FVIII release is obtunded, and peak thrombin generation (TG) remains low and unchanged, while TG peak is enhanced in control individuals after exercise.…”

“…In subjects with severe hemophilia A, FVIII release is obtunded, and peak thrombin generation (TG) remains low and unchanged, while TG peak is enhanced in control individuals after exercise. 25 The correlation between stress level and FVIII/VWF release has also been It is secreted as a heterodimer with copper ion (Cu)-linked heavy chain (A1, A2, and a part of B domains) and light chain (A3, C1, and C2 domains). Upward (red) triangles indicate potential cleavage sites for FVIII activation.…”