Landscape and Spectrum of VWF Variants in Type 2 von Willebrand Disease: Insights from a German Patient Cohort

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Hamideh Yadegari - , University of Bonn (Author)
  • Susan Halimeh - , Rhine-Ruhr Coagulation Center (GZRR) (Author)
  • Alexander Krahforst - , University of Bonn (Author)
  • Anna Pavlova - , University of Bonn (Author)
  • Behnaz Pezeshkpoor - , University of Bonn (Author)
  • Jens Müller - , University of Bonn (Author)
  • Bernd Pötzsch - , University of Bonn (Author)
  • Arijit Biswas - , University of Bonn (Author)
  • Natascha Marquardt - , University of Bonn (Author)
  • Ute Scholz - , Center for blood clotting disorders Leipzig (Author)
  • Heinrich Richter - , Hemophilia Center Münster (Author)
  • Heiner Trobisch - , MVZ for Interdisciplinary Medicine Duisburg GmbH (Author)
  • Karin Liebscher - , St. Georg Hospital Leipzig (Author)
  • Martin Olivieri - , Ludwig Maximilian University of Munich (Author)
  • Karolin Trautmann-Grill - , Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden (Author)
  • Oliver Tiebel - , Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus Dresden (Author)
  • Ralf Knöfler - , Department of Paediatrics, University Hospital Carl Gustav Carus Dresden (Author)
  • Johannes Oldenburg - , University of Bonn (Author)

Abstract

Introduction von Willebrand disease (VWD) type 2 arises from variants in von Willebrand factor (VWF) that disrupt its essential hemostatic functions. As per ISTH guidelines, it is classified as type 2A, 2B, 2M, and 2N based on the affected VWF roles. Objectives This population-based study aims to uncover the genotype and laboratory phenotypes in type 2 VWD, providing insights into underlying genetics and genotype-phenotype associations. Patients/Methods Our cohort included 247 patients from 196 families. Patients were characterized through multiple VWF phenotypic assays and genetic analyses, including DNA sequencing, copy number variation evaluations, and bioinformatic assessments. Results A total of 86 index patients (IPs, 44%) were diagnosed with type 2A, the most prevalent subtype. Additionally, 27 IPs (14%) were diagnosed with type 2N, 24 IPs (12%) with type 2B, 17 IPs (9%) with type 2M, and 42 IPs categorized as type U VWD carried VWD-associated variants but could not be assigned to a specific subtype. VWF variants were detected in 187 out of 196 (95%) individuals. A total of 222 VWF variants were identified: 187 missense (84%), 22 null alleles (10%), 5 regulatory (2%), 6 gene conversions (3%), and 2 silent variants (1%). Many variants were recurrent in our cohort, resulting in 114 distinct variants. Of these, 45 (39%) were novel. Conclusion Our data expands the spectrum of disease-associated variants in VWF, including many newly identified variants. This provides valuable insights for accurate diagnosis and personalized treatment. Additionally, the significant genetic heterogeneity among type 2 patients highlights the challenges in sub-classification.

Details

Original languageEnglish
Pages (from-to)156-178
JournalThrombosis and haemostasis
Volume126
Issue number2
Early online date5 Jun 2025
Publication statusPublished - Feb 2026
Peer-reviewedYes

External IDs

PubMed 40393667

Keywords

ASJC Scopus subject areas

Keywords

  • genetic variation, type 2 von Willebrand disease, von Willebrand disease, von Willebrand factor