VON WILLEBRAND FACTOR AS NEW NONINVASIVE PREDICTOR OF PORTAL HYPERTENSION, DECOMPENSATION AND MORTALITY IN PATIENTS WITH LIVER CIRRHOSIS

Abstract

O ver the last 20 years, investigators have gained much insight into the structure and function of vWF by studying its molecular and cellular biology. Such studies have helped us to understand the clinical manifestations of vWF and develop assays for laboratory diagnosis, the classification of vWD and its variants, and the rationale for therapy. VWF is a large multimeric glycoprotein present in blood plasma and produced by the endothelium and subendothelial connective tissue. vWF plays an important role in primary hemostasis at sites of vascular trauma or injury Platelet subendothelial adhesion by acting as a bridge between platelet receptors and subendothelial structures (Mendolicchio and Ruggeri, 2005). Chronic liver diseases (CLDs) are characterized by progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. Clinically it is defined as any hepatitis lasting for 6 months or longer (Goldberg, 2009). Whatever the etiology, the fibrogenic processes within the liver share similar features including the presence of an inflammatory state due to infiltrating leukocytes and macrophages and activation of ECM-producing cells and leads to progressive scarring and liver cirrhosis (Friedman, 2003).