Where does von Willebrand factor go?
Gary E. Gilbert VA BOSTON HEALTHCARE SYSTEM VWF is removed from the blood by macrophages rather than scavenger receptors, suggesting a possible strategy for improving treatment of VWD and hemophilia. In clinical hematology, von Willebrand factor (VWF) is a bit like the actor Jake Gyllenhaal: we care about him because of who clings to his arm rather than for any inherent quality. VWF is the consort for factor VIII, and many hematologists care more that VWF brings factor VIII to the party than getting to chat with VWF. This is unfair to VWF, of course. VWF is also essential for normal hemostasis and mild von Willebrand disease(VWD), due to partial deficiency of VWF, is more common than hemophilia A. However, we all know how bad bleeding can be when factor VIII is absent, so we care whether VWF is able to protect factor VIII. Thus, we also care whether factor VIII stays with VWF, even when it is removed from the blood by a clearance pathway. VWF is an unusually large protein. It differs f
