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DDAVP enhances platelet adherence and platelet aggregate growth on human
artery subendothelium
KS Sakariassen, M Cattaneo, A v.d. Berg, ZM Ruggeri, PM Mannucci and JJ Sixma
The effect of intravenous 1-deamino (8-D-arginine)vasopressin (DDAVP)
administration on platelet interaction with human artery subendothelium was
investigated with flowing blood from five normal individuals and 12
patients with von Willebrand's disease (vWD). Three of the patients were
diagnosed as vWD subtype I, four as subtype IIa, and five as subtype IIb.
DDAVP administration to normals enhanced platelet adherence, in parallel
with increasing plasma levels of factor VIII- related antigen ( FVIIIR :Ag)
and ristocetin cofactor activity ( FVIIIR :RCF). Platelet aggregate
formation was transiently increased within 90 minutes. Platelet adherence
in patient blood before DDAVP infusion was subnormal. In patients with
subtype I, administration of DDAVP normalized the bleeding time, enhanced
the platelet adherence, and transiently improved the platelet aggregate
formation. The platelet adherence was more corrected than would have been
expected on the basis of the FVIIIR :Ag and FVIIIR :RCF levels. In patients
with subtype IIa, infusion of DDAVP increased the FVIIIR :Ag levels
approximately threefold, without affecting the FVIIIR :RCF levels, and in
only two of four patients was a transiently enhanced platelet adherence
with a corresponding shortening of the bleeding time observed. In patients
with subtype IIb, administration of DDAVP increased the FVIIIR :Ag levels
about threefold and the FVIIIR :RCF levels five to tenfold, but decreased
the platelet adherence significantly. The bleeding time values were not
normalized. A close association between the bleeding time values and
corresponding platelet adherence values before and after DDAVP infusion was
observed. Normalization of the bleeding time was paralleled with
normalization of platelet adherence. We conclude that DDAVP improves the
primary hemostasis by causing enhanced FVIII- vWF-mediated platelet
adherence. DDAVP has little or no effect on the bleeding time in patients
with subtype IIa and subtype IIb, because the platelet adherence is not
normalized.
Volume 64,
Issue 1,
pp. 229-236,
07/01/1984
Copyright © 1984 by The American Society of Hematology
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