Factor VIII and von Willebrand factor interaction: biological, clinical and therapeutic importance

Haemophilia. 2010 Jan;16(1):3-13. doi: 10.1111/j.1365-2516.2009.02005.x. Epub 2009 Apr 16.


The interaction of factor VIII (FVIII) with von Willebrand Factor (VWF) is of direct clinical significance in the diagnosis and treatment of patients with haemophilia A and von Willebrand disease (VWD). A normal haemostatic response to vascular injury requires both FVIII and VWF. It is well-established that in addition to its role in mediating platelet to platelet and platelet to matrix binding, VWF has a direct role in thrombin and fibrin generation by acting as a carrier molecule for the cofactor FVIII. Recent studies show that the interaction affects not only the biology of both FVIII and VWF, and the pathology of haemophilia and VWD, but also presents opportunities in the treatment of haemophilia. This review details the mechanisms and the molecular determinants of FVIII interaction with VWF, and the role of FVIII-VWF interaction in modulating FVIII interactions with other proteases, cell types and cellular receptors. The effect of defective interaction of FVIII with VWF as a result of mutations in either protein is discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Coagulation / physiology*
  • Factor VIII / biosynthesis
  • Factor VIII / metabolism
  • Factor VIII / physiology*
  • Genetic Therapy
  • Hemophilia A / immunology
  • Hemophilia A / therapy*
  • Hemostasis / physiology
  • Humans
  • von Willebrand Diseases / immunology
  • von Willebrand Diseases / therapy*
  • von Willebrand Factor / biosynthesis
  • von Willebrand Factor / metabolism
  • von Willebrand Factor / physiology*


  • von Willebrand Factor
  • Factor VIII