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. 2014 Jul-Aug;40(4):373-9.
doi: 10.1590/s1806-37132014000400004.

Evaluation of von Willebrand factor in COPD patients

[Article in English, Portuguese]
Thiago Prudente Bártholo  1 , Cláudia Henrique da Costa  2 , Rogério Rufino  2
Affiliations

Evaluation of von Willebrand factor in COPD patients

[Article in English, Portuguese]
Thiago Prudente Bártholo et al. J Bras Pneumol. 2014 Jul-Aug.

Abstract
in English, Portuguese

Objective: To compare the absolute serum von Willebrand factor (vWF) levels and relative serum vWF activity in patients with clinically stable COPD, smokers without airway obstruction, and healthy never-smokers.

Methods: The study included 57 subjects, in three groups: COPD (n = 36); smoker (n = 12); and control (n = 9). During the selection phase, all participants underwent chest X-rays, spirometry, and blood testing. Absolute serum vWF levels and relative serum vWF activity were obtained by turbidimetry and ELISA, respectively. The modified Medical Research Council scale (cut-off score = 2) was used in order to classify COPD patients as symptomatic or mildly symptomatic/asymptomatic.

Results: Absolute vWF levels were significantly lower in the control group than in the smoker and COPD groups: 989 ± 436 pg/mL vs. 2,220 ± 746 pg/mL (p < 0.001) and 1,865 ± 592 pg/mL (p < 0.01). Relative serum vWF activity was significantly higher in the COPD group than in the smoker group (136.7 ± 46.0% vs. 92.8 ± 34.0%; p < 0.05), as well as being significantly higher in the symptomatic COPD subgroup than in the mildly symptomatic/asymptomatic COPD subgroup (154 ± 48% vs. 119 ± 8%; p < 0.05). In all three groups, there was a negative correlation between FEV1 (% of predicted) and relative serum vWF activity (r2 = -0.13; p = 0.009).

Conclusions: Our results suggest that increases in vWF levels and activity contribute to the persistence of systemic inflammation, as well as increasing cardiovascular risk, in COPD patients.

OBJETIVO:: Comparar os níveis séricos absolutos e a atividade sérica em percentual do fator de von Willebrand (FvW) em pacientes com DPOC clinicamente estáveis, tabagistas sem obstrução das vias aéreas e em indivíduos saudáveis que nunca fumaram.

MÉTODOS:: Foram incluídos no estudo 57 indivíduos, em três grupos: DPOC (n = 36), tabagista (n = 12) e controle (n = 9). Todos os participantes realizaram radiografia do tórax, espirometria e exame de sangue durante a fase de seleção. Os níveis séricos absolutos e a atividade sérica em percentual do FvW foram obtidos por turbidimetria e ELISA, respectivamente. A escala Medical Research Council modificada foi utilizada para classificar pacientes como sintomáticos ou assintomáticos/pouco sintomáticos no grupo DPOC (ponto de corte = 2).

RESULTADOS:: Os níveis absolutos do FvW no grupo controle foram significativamente menores que os nos grupos tabagista e DPOC: 989 ± 436 pg/mL vs. 2.220 ± 746 pg/mL (p < 0,001) e 1.865 ± 592 pg/mL (p < 0,01). Os valores em percentual de atividade do FvW no grupo DPOC foram significativamente maiores que no grupo tabagista (136,7 ± 46,0% vs. 92,8 ± 34,0%; p < 0,05), assim como foram significativamente maiores no subgrupo DPOC sintomático que no subgrupo DPOC assintomático/pouco sintomático (154 ± 48% vs. 119 ± 8%; p < 0,05). Houve uma correlação negativa entre o VEF1 (% do previsto) e os níveis em percentual de atividade do FvW nos três grupos (r2 = −0,13; p = 0,009).

CONCLUSÕES:: Nossos resultados sugerem que aumentos nos níveis de FvW e de sua atividade contribuem para a manutenção da inflamação sistêmica e o aumento do risco cardiovascular em pacientes com DPOC.

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Figures

Figure 1
Figure 1. Absolute serum von Willebrand factor (vWF) levels in the groups studied.
Figure 2
Figure 2. Relative serum von Willebrand factor (vWF) activity. In A, comparison between the smoker and COPD groups. In B, comparison between the symptomatic COPD and mildly symptomatic/asymptomatic COPD subgroups as defined by the modified Medical Research Council (mMRC) scale scores.
Figure 3
Figure 3. Relationship between relative serum von Willebrand factor (vWF) activity and FEV1 (% of predicted; r2 = -0.13; p = 0.0099).
Figura 1
Figura 1. Níveis séricos absolutos do fator de Von Willebrand (FvW) nos grupos estudados.
Figura 2
Figura 2. Níveis séricos do percentual de atividade do fator de Von Willebrand (FvW). Em A, comparação entre os grupos tabagista e DPOC. Em B, comparação entre os subgrupos DPOC sintomáticos e DPOC assintomáticos/pouco sintomáticos de acordo com os escores da escala Medical Research Council modificada (MRCm).
Figura 3
Figura 3. Relação entre os valores do percentual de atividade do fator de Von Willebrand (FvW) e VEF1 em porcentagem do previsto (r2 = -0,13; p = 0,0099).
See this image and copyright information in PMC

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