New developments in von Willebrand disease.

New developments in von Willebrand disease.
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DOI:
10.1111/bjh.16681
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发表时间:
2020-11
影响因子:
6.5
通讯作者:
O'Donnell JS
O'Donnell JS
中科院分区:
医学2区
文献类型:
--
作者:
Fogarty H;Doherty D;O'Donnell JS

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血管性血友病(VWD)是最常见的遗传性出血性疾病。它与可显著影响生活质量的粘膜皮肤出血表型相关。尽管其流行和相关的发病率,诊断和分型的VWD继续构成重大的临床挑战。这在一定程度上是由于正常人群血浆VWF水平在很大范围内变化,以及VWF在体内发挥的多种不同生理功能。近年来,在阐明VWF的生物学作用方面取得了重大进展。在定义支撑定量和定性VWD的病理生理机制方面也取得了重大进展。特别是,已经开发了一些新的实验室分析方法,能够更精确地评估VWF活性的具体方面。在这篇综述中,我们讨论了VWD诊断领域的这些最新进展,并考虑了这些进展如何影响临床诊断算法在常规临床实践中的应用。此外,我们回顾了有关管理VWD患者的各种治疗方案的一些重要最新进展。
Von Willebrand disease (VWD) constitutes the most common inherited human bleeding disorder. It is associated with a mucocutaneous bleeding phenotype that can significantly impact upon quality of life. In spite of its prevalence and associated morbidity, the diagnosis and sub-classification of VWD continue to pose significant clinical challenges. This is in part attributable to the fact that plasma VWF levels vary over a wide range in the normal population, together with the multiple different physiological functions played by VWF in vivo. Over recent years, significant progress has been achieved in elucidating the biological roles of VWF. Significant advances have also been made into defining the pathophysiological mechanisms underpinning both quantitative and qualitative VWD. In particular, a number of new laboratory assays have been developed that enable more precise assessment of specific aspects of VWF activity. In this review, we discuss these recent developments in the field of VWD diagnosis, and consider how these advances can impact upon clinical diagnostic algorithms for use in routine clinical practice. In addition, we review some important recent advances pertaining to the various treatment options available for managing patients with VWD.
自我管理的出血评估工具的生成和优化及其作为对von Willebrand疾病的筛查测试的验证。
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