Biomarkers with predictive role in chronic advanced liver disease

Abstract

Background. Von Willebrand factor (VWF) is currently considered a biomarker of endothelial dysfunction, its determining role in the evolution of advanced chronic liver disease being highlighted, so that its high concentration has been associated with favoring the formation of thrombi in the intrahepatic circulation. Objective(s). The purpose of this work is to study the role of VWF in the progression of advanced chronic liver disease and highlight it as a non-invasive biomarker with a major predictive role. Materials and methods. To realize this analytical work, relevant scientific publications from medical databases such as PubMed, NCBI, Web of Science, which have been published in the last 5 years were selected and analyzed. The search terms used in English included: "chronic liver disease", "venous thrombosis" and "von Willebrand factor". Results. Increased levels of VWF, as well as the compensatory decrease in the ADAMTS13 enzyme, can condition endothelial damage, increase of factor VIII, platelet hyperaggregability and respectively the development of thrombotic events at the level of splanchnic circulation. Considering the significant role of endothelial dysfunction in the pathogenesis of portal hypertension, and consequently the prognosis of liver cirrhosis, VWF concentration acquires particular importance. In this context, the imbalance between VWF and ADAMTS13 has been implicated in the progression of advanced chronic liver disease and the exacerbation of portal hypertension. Conclusion(s). As a biomarker of endothelial dysfunction, VWF is also a noninvasive biomarker with an important predictive role in advanced chronic liver disease. In this way, the poor prognosis in patients with liver cirrhosis was correlated with the imbalance between VWF and ADAMTS13.