Distinct and concerted functions of von Willebrand factor and fibrinogen in mural thrombus growth under high shear flow

• Published in: Blood Vol. 100; no. 10; pp. 3604 - 3610
• Main Authors: Matsui, Hideto, Sugimoto, Mitsuhiko, Mizuno, Tomohiro, Tsuji, Shizuko, Miyata, Shigeki, Matsuda, Michio, Yoshioka, Akira
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15.11.2002; The Americain Society of Hematology
• Subjects: Afibrinogenemia - blood; Biological and medical sciences; Blood coagulation. Blood cells; Case-Control Studies; Collagen; Fibrinogen - metabolism; Fibrinogen - physiology; Fundamental and applied biological sciences. Psychology; General aspects, investigation methods, hemostasis, fibrinolysis; Heart Diseases - etiology; Heart Diseases - metabolism; Humans; Kinetics; Microscopy, Video; Molecular and cellular biology; Perfusion; Platelet Adhesiveness; Stress, Mechanical; Thrombosis - etiology; Thrombosis - metabolism; von Willebrand Diseases - blood; von Willebrand Factor - metabolism; von Willebrand Factor - physiology; Human; Hemostasis; Shear flow; Thrombus; Fibrinogen; Hemodynamics; Willebrand factor; Adhesion; In vitro
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2002-02-0508

Using a perfusion chamber and confocal laser scanning microscopy, we analyzed the interplay of von Willebrand factor (VWF) and fibrinogen during thrombus growth on a collagen surface under physiologic high shear rate conditions. During initial thrombogenesis, platelet thrombi were constructed totally by VWF, not by fibrinogen. Fibrinogen accumulated predominantly inside the growing thrombi as a function of time, whereas the thrombus surfaces directly exposed to flow were occupied constantly by VWF throughout the observation period. In perfusion of afibrinogenemia (AF) blood lacking both plasma and platelet fibrinogen, the final height and volume of thrombi were significantly reduced compared with controls, albeit the area of surface coverage was normal. The impaired thrombus growth in AF was only partially corrected by the addition of purified fibrinogen to AF blood, whereas the addition of purified VWF to blood of severe von Willebrand disease (VWD) completely normalized the defective thrombus growth in this disease. Thus, the initial 2-dimensional thrombus expansion involves only VWF, whereas the time-dependent accumulation of fibrinogen, released from activated platelets, acts as a core adhesive ligand, increasing thrombus strength and height and resulting in 3-dimensional thrombus development against rapid blood flow.