Von Willebrand factor for the liver: Friend or foe?

Abstract

In the recent publication, Starlinger et al. (1) demonstrated that von Willebrand factor (vWF) was involved in platelet-mediated liver regeneration (LR) following partial hepatectomy. In recent years, increasing evidence indicates that vWF plays critical roles in various hepatic pathophysiological processes. These findings make vWF both friend and foe for the liver.Many studies have reported the promotion of vWF in the progression of virus hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). In patients with chronic hepatitis, plasma level of vWF-Ag is significantly higher compared to the healthy population and vWF-Ag level is increasing with stage of fibrosis. Furthermore, a higher level of vWF-Ag can independently predict ascites, variceal bleeding, and mortality in patients with cirrhosis. (2) Moreover, Liu et al. (3) highlighted that vWF was positively correlated with the tumor grade and tumor node metastasis stage in HCC. In addition, vWF promoted the invasion and migration of HCC cells in vitro. (3) Despite its adverse role in HCC progress, there is growing evidence from experimental and clinical studies indicating that VWF can prevent tumor dissemination. (4) The protective role of VWF against metastasis is mainly attributed to its antiangiogenic potential and proapoptotic properties. (4) In addition, vWF may also play a protective role in acute liver injury (ALI). Sun et al. (5) recently established the animal model of ALI in mice by the intraperitoneal injection of carbon tetrachloride. They found that vWF deficiency was associated with more severe liver injury. (5) Furthermore, vWF deficiency was shown to facilitate the activation of the mitogenactivated protein kinase signaling pathway in injured liver tissues.In conclusion, vWF can produce both protective and detrimental effects in the pathophysiological process of the liver. On the one hand, it may promote LR, relieve ALI, and inhabit metastasis. On the other hand, it is involved in the disease progression of liver cirrhosis and HCC. Therefore, further work should be encouraged so that vWF-modulating drugs can find a place in the liver diseases.