Evaluation of von Willebrand factor in COPD patients

Abstract

OBJECTIVE: To compare the absolute serum von Willebrand factor (vWF) levels and relative serum vWF activity in patients with clinically stable COPD, smokers without airway obstruction, and healthy never-smokers. METHODS: The study included 57 subjects, in three groups: COPD (n = 36); smoker (n = 12); and control (n = 9). During the selection phase, all participants underwent chest X-rays, spirometry, and blood testing. Absolute serum vWF levels and relative serum vWF activity were obtained by turbidimetry and ELISA, respectively. The modified Medical Research Council scale (cut-off score = 2) was used in order to classify COPD patients as symptomatic or mildly symptomatic/asymptomatic. RESULTS: Absolute vWF levels were significantly lower in the control group than in the smoker and COPD groups: 989 ± 436 pg/mL vs. 2,220 ± 746 pg/mL (p < 0.001) and 1,865 ± 592 pg/mL (p < 0.01). Relative serum vWF activity was significantly higher in the COPD group than in the smoker group (136.7 ± 46.0% vs. 92.8 ± 34.0%; p < 0.05), as well as being significantly higher in the symptomatic COPD subgroup than in the mildly symptomatic/asymptomatic COPD subgroup (154 ± 48% vs. 119 ± 8%; p < 0.05). In all three groups, there was a negative correlation between FEV1 (% of predicted) and relative serum vWF activity (r2 = −0.13; p = 0.009). CONCLUSIONS: Our results suggest that increases in vWF levels and activity contribute to the persistence of systemic inflammation, as well as increasing cardiovascular risk, in COPD patients.

<p>Increased von Willebrand Factor Processing in COPD, Reflecting Lung Epithelium Damage, Is Associated with Emphysema, Exacerbations and Elevated Mortality Risk</p>

“…This is in line with a previous study showing increased VWF activity in symptomatic subjects, but interestingly no change in total VWF was found in that study. 8 We speculate that this is due to the endothelial release of VWF being a more dynamic process, while total VWF reflect a ratio between synthesis and degradation of VWF, which might not be significantly changed in symptomatic disease. Notably, no change was observed of either VWF biomarker when dividing the cohort into GOLD severity groups.…”

“…This was also highlighted by the fact that VWF-A had a better association with symptomatic disease than VWF-N. Previous studies have found VWF-antigen but not VWF activity, 8 to be increased in exacerbating patients. 34,35 The VWF-A assay targets a neo-epitope within the A2-domain of VWF, which arises from ADAMTS13-cleavage which is specific for active VWF.…”

“…The pathophysiological changes that occur in COPD are not limited to the lungs, and the disease etiology is characterized by an increasing degree of systemic inflammation and endothelial damage, 6,15,17 also evident from previous studies finding VWF to be increased in COPD. 8 Since VWF processing is central to the primary response of wound healing, biomarkers measuring the dynamic processing of VWF could potentially aid in characterizing the pathophysiological changes in COPD. The activity of VWF can be investigated by several methods, for example by the use of ristocetin-dependent platelet aggregation, 36 albeit this method measures only VWF-processing indirectly and has been reported to be less sensitive at low VWF levels.…”

Review of biomarkers to assess the effects of switching from cigarettes to modified risk tobacco products

“…Levels are increased in smokers and fall to non-smoker levels 3-6 weeks after smoking cessation. Von Willebrand factor vWF Related to thrombosis and CVD (O'Callaghan et al 2005) (especially in CVD patients) as well as respiratory disease (Bartholo et al 2014, Holz et al 2014. Only limited evidence that smoking cessation leads to a decrease in vWF levels.…”

Διερεύνηση Του Ρόλου Της Ενδοκάνης Στις Παροξύνσεις Της Χρόνιας Αποφρακτικής Πνευμονοπάθειας

“…Αντιθέτως, τα επίπεδα παρόξυνσης τόσο του vWF:Ag όσο και της CRP, συσχετίσθηκαν σημαντικά με το βαθμό δύσπνοιας κατά mMRC, ενώ επιπροσθέτως το χρονικό διάστημα μέχρι την εμφάνιση της πρώτης παρόξυνσης διαφοροποιήθηκε σημαντικά μεταξύ των ασθενών με τις υψηλότερες και χαμηλότερες τιμές του vWF:Ag. Τα ευρήματα αυτά είναι συμβατά με μελέτες που έχουν δημοσιευθεί στο παρελθόν, οι οποίες έχουν συσχετίσει τους συγκεκριμένους βιοδείκτες με διάφορες παραμέτρους βαρύτητας της νόσου[213,221,[224][225][226].Αξίζει τον κόπο να γίνει αναφορά στο γεγονός ότι, αν και όχι σε επίπεδο στατιστικής σημαντικότητας, τα επίπεδα της ενδοκάνης ήταν υψηλότερα κατά την παρόξυνση σε σχέση με τη σταθερή νόσο, καθώς και στους ασθενείς με ΧΑΠ έναντι των μαρτύρων. Οι παρατηρήσεις αυτές βρίσκονται σε συμφωνία με τη θεωρία που υποστηρίζει την επιδείνωση της ενδοθηλιακής δυσλειτουργίας κατά τις παροξύνσεις, η οποία έχει επιβεβαιωθεί σε μελέτες, με τη χρήση του δείκτη της διαμεσολαβούμενης από τη ροή του αίματος αγγειοδιαστολής (FMD) και βιοδεικτών όπως ο vWF[135,227,228].…”