1. Emerging mechanisms to modulate VWF release from endothelial cells.
- Author
-
El-Mansi S and Nightingale TD
- Subjects
- Blood Platelets drug effects, Blood Platelets metabolism, Blood Platelets pathology, Brain Ischemia genetics, Brain Ischemia metabolism, Brain Ischemia pathology, Cell Communication drug effects, Cell Communication genetics, Endothelial Cells drug effects, Endothelial Cells metabolism, Endothelial Cells pathology, Gene Expression Regulation, Hemostasis drug effects, Hemostasis genetics, Humans, Myocardial Infarction genetics, Myocardial Infarction metabolism, Myocardial Infarction pathology, Organelle Size drug effects, Purpura, Thrombotic Thrombocytopenic genetics, Purpura, Thrombotic Thrombocytopenic metabolism, Purpura, Thrombotic Thrombocytopenic pathology, Rituximab therapeutic use, Secretory Pathway drug effects, Secretory Pathway genetics, Single-Domain Antibodies therapeutic use, Weibel-Palade Bodies genetics, Weibel-Palade Bodies metabolism, Weibel-Palade Bodies pathology, von Willebrand Factor biosynthesis, von Willebrand Factor genetics, Brain Ischemia drug therapy, Fibrinolytic Agents therapeutic use, Myocardial Infarction drug therapy, Purpura, Thrombotic Thrombocytopenic drug therapy, Weibel-Palade Bodies drug effects, von Willebrand Factor antagonists & inhibitors
- 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., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF