Which compound secreted by vascular endothelial cells promotes platelet adhesion to sub‑endothelial collagen?

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Von Willebrand Factor (Answer: B)

The correct answer is B. Von Willebrand's Factor (vWF) is the compound secreted by vascular endothelial cells that promotes platelet adhesion to sub-endothelial collagen.

Mechanism of Action

vWF serves as the essential molecular bridge between exposed subendothelial collagen and platelet surface receptors, making it the primary mediator of platelet adhesion following vascular injury. 1

Synthesis and Storage

  • vWF is synthesized in endothelial cells and stored in specialized organelles called Weibel-Palade bodies 1
  • Upon vascular injury or various stimuli, vWF is released from these storage granules into circulation 1
  • The primary function of vWF is the promotion of platelet adhesion by anchoring platelets to the subendothelial matrix 1

Functional Mechanism

  • Platelet adhesion is initiated by cross-linking platelet surface glycoprotein Ib (GPIb) to exposed subendothelial collagen through vWF 2
  • This GPIb-vWF interaction constitutes the critical first step of the platelet response to vascular injury and precedes both platelet aggregation and the release reaction 2
  • Under high shear stress conditions (>1000 s⁻¹), vWF undergoes conformational changes from a globular to an unfolded state, exposing binding sites for platelet GPIb 3

Why the Other Options Are Incorrect

Platelet Derived Growth Factor (Option A)

  • PDGF is a mitogenic factor involved in cell proliferation and wound healing, not in the immediate adhesion of platelets to collagen
  • It does not function as a bridge between platelets and subendothelial matrix

Calcium (Option C)

  • While calcium is essential for platelet activation and coagulation cascade function, it is not secreted by endothelial cells specifically to promote platelet adhesion
  • Calcium acts as a cofactor in multiple steps but is not the adhesive molecule itself

Prostacyclin/PGI2 (Option D)

  • Prostacyclin is actually an anti-thrombotic agent secreted by endothelial cells
  • It inhibits platelet activation and promotes vasodilation, functioning opposite to what the question asks
  • This is a common pitfall—prostacyclin prevents rather than promotes platelet adhesion

Clinical Relevance

The vWF-collagen-platelet axis is critical for normal hemostasis 4. Deficiency or dysfunction of vWF leads to von Willebrand disease, the most common inherited bleeding disorder, characterized by impaired platelet adhesion and prolonged bleeding times 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Initial Platelet Adhesion via GPIb‑vWF Is Essential for Hemostasis

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Platelet Adhesion to Subendothelial Collagen

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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