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2018 ; 8
(1
): 10945
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Cellular stress induces erythrocyte assembly on intravascular von Willebrand
factor strings and promotes microangiopathy
#MMPMID30026593
Nicolay JP
; Thorn V
; Daniel C
; Amann K
; Siraskar B
; Lang F
; Hillgruber C
; Goerge T
; Hoffmann S
; Gorzelanny C
; Huck V
; Mess C
; Obser T
; Schneppenheim R
; Fleming I
; Schneider MF
; Schneider SW
Sci Rep
2018[Jul]; 8
(1
): 10945
PMID30026593
show ga
Microangiopathy with subsequent organ damage represents a major complication in
several diseases. The mechanisms leading to microvascular occlusion include von
Willebrand factor (VWF), notably the formation of ultra-large von Willebrand
factor fibers (ULVWFs) and platelet aggregation. To date, the contribution of
erythrocytes to vascular occlusion is incompletely clarified. We investigated the
platelet-independent interaction between stressed erythrocytes and ULVWFs and its
consequences for microcirculation and organ function under dynamic conditions. In
response to shear stress, erythrocytes interacted strongly with VWF to initiate
the formation of ULVWF/erythrocyte aggregates via the binding of Annexin V to the
VWF A1 domain. VWF-erythrocyte adhesion was attenuated by heparin and the
VWF-specific protease ADAMTS13. In an in vivo model of renal ischemia/reperfusion
injury, erythrocytes adhered to capillaries of wild-type but not VWF-deficient
mice and later resulted in less renal damage. In vivo imaging in mice confirmed
the adhesion of stressed erythrocytes to the vessel wall. Moreover, enhanced
eryptosis rates and increased VWF binding were detected in blood samples from
patients with chronic renal failure. Our study demonstrates that stressed
erythrocytes have a pronounced binding affinity to ULVWFs. The discovered
mechanisms suggest that erythrocytes are essential for the pathogenesis of
microangiopathies and renal damage by actively binding to ULVWFs.