PO20 | DYSFUNCTION OF THE ADAMTS-13/VON WILLEBRAND FACTOR AXIS, MEDIATED BY NETOSIS, AS A DRIVER OF PROTHROMBOTIC STATE AND UNFAVORABLE PROGNOSIS IN ONCOGYNECOLOGICAL PATIENTS
V. Bitsadze1, E. Beloborodova2, J. Khizroeva1, A. Solopova1, M. Tretyakova1, N. Gashimova1, K. Grigoreva1, A. Tatarintseva1, J. Christophe Gris1|3, I. Elalamy1|4|5, G. Gerotziafas1|4|5, A. Makatsariya1 | 1Department of Obstetrics, Gynecology and Perinatal Medicine, N. F. Filatov Clinical Institute of Children’s Health, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2Clinic MEDSI Network of Medical Centers in Moscow, Russia; 3Faculty of Pharmaceutical and Biological Sciences, Montpellier University, France; 4Department Hematology and Thrombosis Center, Medicine Sorbonne University, Paris, France; 5Hospital Tenon, Paris, France
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Introduction. An imbalance between von Willebrand factor (VWF) and its primary protease, ADAMTS-13, plays a crucial role in the pathogenesis of microthrombosis and endotheliopathy. The aim of this work was to study the functioning of the ADAMTS-13/VWF axis and its interaction with thromboinflammatory reactions (NETosis) in oncogynecological patients undergoing antitumor therapy.
Methods. The study included 262 patients (cancer of the endometrium, ovaries, cervix, and breast). The concentration of VWF, the antigen concentration and activity of ADAMTS-13, its inhibitor levels, NETosis markers (CitH3, MPO), and hemostasis activation markers were determined dynamically (before and after surgical treatment/chemotherapy).
Results. Oncogynecological patients exhibited a significant increase in VWF concentration and a decrease in ADAMTS-13 concentration/activity (p<0.0001). The VWF/ADAMTS-13 ratio was significantly elevated in all groups, with a maximum after chemotherapy (6.42 vs. 0.94 in the control). A strong negative correlation was found between NETosis markers (CitH3, MPO) and ADAMTS-13 parameters in patients with ovarian cancer (ρ up to -0.69, p<0.01). The increase in VWF and the VWF/ADAMTS-13 ratio after chemotherapy strongly correlated with coagulation activation (TAT complexes, p<0.05).
Conclusions. An acquired deficiency of ADAMTS-13, induced in part by active NETosis, combined with increased VWF release leads to a critical disruption of microthrombosis regulation. The assessment of the ADAMTS-13/VWF axis, together with NETosis markers, is a promising tool for stratifying the risk of thrombosis and disease prognosis, as well as a target for pathogenetically based therapy.
Downloads
Citations
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Most read articles by the same author(s)
- Società Italiana di Emostasi e Trombosi, PO07 | PLATELET INHIBITION BY THE NOVEL NITRIC OXIDE-DONOR NITROSOOXYPROPANOL , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO34 | INVESTIGATORS’ DECISIONS ON ANTICOAGULATION AFTER EXTENDED API-CAT TREATMENT FOR CANCER VENOUS THROMBOEMBOLISM , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO64 | MANAGEMENT OF BLEEDING RISK IN PATIENTS WITH HEPATOCELLULAR CARCINOMA RECEIVING SYSTEMIC THERAPY: A SURVEY OF CLINICAL PRACTICE , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO65 | OVARIC CANCER PRESENTING WITH COLD-AGGLUTININ MEDIATED HEMOLYTIC ANEMIA, PULMONARY THROMBOEMBOLISM AND DEEP VEIN THROMBOSIS , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO18 | THE THROMBO-INFLAMMATION AXIS AS PREDICTOR OF TOXICITY IN PATIENTS TREATED WITH CAR-T CELLS , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO27 | URINE QUALITATIVE ASSESSMENT OF DIRECT ORAL ANTICOAGULANTS IN ROUTINE CLINICAL PRACTICE , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO67 | TARGETED THERAPIES FOR CANCER AND THE RISK OF ARTERIAL AND VENOUS THROMBOEMBOLISM , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO49 | PROPHYLACTIC ANTICOAGULATION DECISIONS IN HIGH-RISK PATIENTS RECEIVING CANCER-DIRECTED THERAPY: ANALYSIS OF THE VERMONT METHOD , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO68 | RISK OF VENOUS THROMBOEMBOLISM IN PATIENTS WITH CANCER AND MIGRAINE: A COHORT ANALYSIS AMONG DANISH NATIONAL HEALTH SURVEY PARTICIPANTS , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
- Società Italiana di Emostasi e Trombosi, PO29 | CANADIAN INSIGHTS INTO THE MANAGEMENT OF BREAKTHROUGH THROMBOSIS , Bleeding, Thrombosis and Vascular Biology: Vol. 5 No. s1 (2026)
