101. Emerging mechanisms to modulate VWF release from endothelial cells
- Author
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Thomas D. Nightingale and Sammy El-Mansi
- Subjects
Blood Platelets ,0301 basic medicine ,Endothelium ,Myocardial Infarction ,Thrombotic thrombocytopenic purpura ,Cell Communication ,Biochemistry ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Von Willebrand factor ,hemic and lymphatic diseases ,von Willebrand Factor ,medicine ,Weibel–Palade body ,Humans ,Secretion ,Hemostasis ,Secretory Pathway ,Acquired Thrombotic Thrombocytopenic Purpura ,Purpura, Thrombotic Thrombocytopenic ,Weibel-Palade Bodies ,biology ,business.industry ,Endothelial Cells ,Cell Biology ,Single-Domain Antibodies ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Gene Expression Regulation ,030220 oncology & carcinogenesis ,Organelle Size ,Immunology ,cardiovascular system ,biology.protein ,Rituximab ,Caplacizumab ,business ,medicine.drug - Abstract
Agonist-mediated exocytosis of Weibel-Palade bodies underpins the endothelium's ability to respond to injury or infection. Much of this important response is mediated by the major constituent of Weibel-Palade bodies: the ultra-large glycoprotein von Willebrand factor. Upon regulated WPB exocytosis, von Willebrand factor multimers unfurl into long, platelet-catching 'strings' which instigate the pro-haemostatic response. Accordingly, excessive levels of VWF are associated with thrombotic pathologies, including myocardial infarction and ischaemic stroke. Failure to appropriately cleave von Willebrand Factor strings results in thrombotic thrombocytopenic purpura, a life-threatening pathology characterised by tissue ischaemia and multiple microvascular occlusions. Historically, treatment of thrombotic thrombocytopenic purpura has relied heavily on plasma exchange therapy. However, the demonstrated efficacy of Rituximab and Caplacizumab in the treatment of acquired thrombotic thrombocytopenic purpura highlights how insights into pathophysiology can improve treatment options for von Willebrand factor-related disease. Directly limiting von Willebrand factor release from Weibel-Palade bodies has the potential as a therapeutic for cardiovascular disease. Cell biologists aim to map the WPB biogenesis and secretory pathways in order to find novel ways to control von Willebrand factor release. Emerging paradigms include the modulation of Weibel-Palade body size, trafficking and mechanism of fusion. This review focuses on the promise, progress and challenges of targeting Weibel-Palade bodies as a means to inhibit von Willebrand factor release from endothelial cells.
- Published
- 2021
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