Several studies have documented that N2 fixation in laboratory cu

Several studies have documented that N2 fixation in laboratory cultures of T. erythraeum increased when pCO2 was doubled from present-day atmospheric concentrations

(∼380 ppm) to projected future levels (∼750 ppm). We examined the interactive effects of light and pCO2 on two strains of T. erythraeum Ehrenb. (GBRTRLI101 and IMS101) in laboratory semicontinuous cultures. Elevated pCO2 stimulated gross N2-fixation rates in cultures growing at 38 μmol quanta · m−2 · s−1 (GBRTRLI101 and IMS101) and 100 μmol quanta · m−2 · s−1 (IMS101), but this effect Ulixertinib chemical structure was reduced in both strains growing at 220 μmol quanta · m−2 · s−1. Conversely, CO2-fixation rates increased significantly (P < 0.05) in response to high pCO2 under mid- and high irradiances only. These data imply that the stimulatory effect of elevated pCO2 on CO2 fixation and N2 fixation by T. erythraeum is correlated with light. The ratio of gross:net N2 fixation was also correlated with light and trichome length in IMS101. Our study suggests that elevated pCO2 may have a strong positive effect on Trichodesmium gross N2 fixation in intermediate and bottom layers of the euphotic zone, but perhaps not in light-saturated surface layers. Climate change models must consider the interactive effects of

multiple environmental variables on phytoplankton DAPT order and the biogeochemical cycles they mediate. “
“During secondary contact between phylogenetically closely related species (sibling species) having diverged in allopatry, the maintenance

of species integrity depends on intrinsic and extrinsic reproductive barriers. In kelps (Phaeophyceae), the observations of hybrids in laboratory conditions suggest that reproductive isolation is incomplete. However, not all interspecific crosses are successful, and very few hybrids have been observed in nature, despite the co-occurrence of many kelp species in sympatry. This suggests that there are reproductive barriers that maintain species integrity. In this study, we characterized the fine genetic structure of a secondary contact zone to clarify the extent of reproductive isolation between two sister species. In Lessonia nigrescens Bory (Laminariales, Phaeophyta) species complex, two cryptic species have been recently found selleck compound out from gene phylogenies, and—waiting for a formal taxonomic description—we used their geographic distribution to name them (northern and southern species). We studied 12 populations, distributed along 50 km of coastline, and employed two molecular approaches, assigning individuals to phylogenetic species according to a diagnostic mitochondrial marker (351 individuals analyzed) and quantifying interspecific gene flow with four microsatellite markers (248 individuals analyzed). No hybridization or introgression was revealed, indicating complete reproductive isolation in natural conditions.

24 Before

differentiation, the cells were cultured on Mat

24 Before

differentiation, the cells were cultured on Matrigel-coated tissue culture dishes using MEF-conditioned medium.25 The in vitro differentiation protocol was similar to our previously reported study and that of Hay et al.9 In brief, when human iPSCs had attained a confluence of 70%, the MEF-conditioned medium was replaced with Roswell Park Memorial Institute/B27 with 100 ng/mL activin A (PeproTech, London, UK), 50 ng/mL Wnt3a, and 10 ng/mL HGF (R&D Systems) for 3 days of endodermal induction. During the next step, the culture medium was replaced with hepatic commitment medium (knockout selleck screening library [KO]/DMEM containing 20% knockout serum replacement, 1 mM L-glutamine, 1% nonessential amino acids, 0.1 mM 2-mercaptoethanol, and 1% dimethyl sulfoxide). Finally, during the maturation step, the cells were culturing in Iscove’s

modified Dulbecco’s medium (IMDM) supplemented with 20 ng/mL oncostatin M (Invitrogen), 0.5 μM dexamethasone, and 50 mg/mL ITS premix (BD Biosciences, San Jose, CA). Details of the materials and methods used are described in the Supporting Information. Five- to 8-week-old NOD-SCID mice were purchased from National Laboratory Animal Center (Taipei, Taiwan). All the experimental NVP-LDE225 research buy procedures involving the use of animals were approved by the Animal Care Committee of the Taipei Veterans General Hospital. The lethality of CCl4 on NOD-SCID mice was tested by gavage. Hepatocyte-like cell transplants were performed at 24 hours after administration of CCl4 by intrasplenic injection, as previously reported.26 RNA was isolated from human iPSCs and human iPSC-derived hepatocyte-like cells, using

the RNeasy kit (Qiagen). Complementary DNA synthesis, fragmentation, hybridization, washing, staining, and scanning were check details performed at the National Research Progress for Genomic Medicine Microarray and Gene Expression Analysis Core Facility, National Yang-Ming University VYM Genome Research Center, Taiwan. To provide a visual impression of how the various sample groups are related, principal component analysis (PCA) was performed using the Partek Genomics Suite program (Partek Inc., St. Louis, MO). Array data of control iPSCs and differentiated hepatocyte-like cells were downloaded from the GEO database (accession number GSE14897).17 Human iPSC and ES cell colonies were plated onto a MEF feeder layer for several months with weekly passaging. Before hepatogenic differentiation, cells were passaged using Matrigel-coated feeder-free culture conditions.

The rationale of selecting one reference surface only was based o

The rationale of selecting one reference surface only was based on the evidence that the diffuse establishment of osteochondral damage in haemophilic arthropathy may allow one surface to be considered as representative of the overall status of the joint without significantly reducing the sensitivity

of the method. This also keeps the HEAD-US method reliable, easy and quick to perform. The protocol can be accomplished with portable ultrasound machines without any need for high-end or proprietary technology. An additive scoring scale has also been implemented as part of the HEAD-US method [47]. Generally speaking, MRI scoring scales have been widely used and approved as reference standards in haemophilia arthropathy trials, although rarely applied in clinical practice for diagnosis and outcome because of their complexity and extensive time requirements. In Trametinib concentration addition, it is difficult to harness the large selleck compound amount of information generated by MRI into effective information to influence a patient’s management. Similarly,

the existing ultrasound protocols are somewhat complex, with only trained readers potentially able to get an acceptable level of reproducibility. These existing protocols include the evaluation of poorly relevant structures or give an incomplete estimation of osteochondral damage compared with the potential offered by the HEAD-US technique. The HEAD-US scoring method has been specifically designed to be relatively simple and quick to complete in a busy practice allowing, at the same time, a reliable quantification of the two domains of disease: activity and damage. In contrast to other ultrasound scoring scales available, Doppler imaging has not been included due to the high inter- and intra-observer variability of results expected from inexperienced examiners, the need for high-end machines to get better performance and the lack of any evidence that hyperaemia detection

in chronic synovitis may impact the management of patients with haemophilia. We would expect the use of ultrasound as part of routine clinical examination by haemophilia specialists to optimize the diagnostic workflow, avoiding additional costs and long waiting lists for patients referred to imaging departments. Preliminary clinical experience with the integrated use of ultrasound in routine clinical assessment has made it feasible to screen learn more six joints in a single examination, and has enabled detection of subclinical bleeds and initial asymptomatic damage in an unexpectedly high percentage of cases. Especially in children, who have hyperlax joints and an immature skeleton, ultrasound has proved able to disclose severe joint involvement with high-grade synovitis and chondral abnormalities, despite a normal physical examination. The information on early joint involvement provided by ultrasound could guide the clinical management of haemophilia by influencing prophylaxis regimen decisions on a personalized basis in the future.

After 6 hours the medium was replaced by DMEM high glucose contai

After 6 hours the medium was replaced by DMEM high glucose containing 0.5% FBS. Twelve hours later, cells were treated with 1,000 IU/mL of recombinant human IFN-α-2a (Roferon-A Roche) for the times indicated (Fig. 4A). For siRNA experiments, Hep3B cells (50,000 cells/well) were seeded in 12-well plates. Cells were transfected using Lipofectamine-2000 (Invitrogen) and siRNA (Dharmacon) directed against signal transducer and activation of transcription 3 (STAT3) (SMARTpool) or scrambled siRNA (SCR) as control. Forty-eight hours later, cells were washed with phosphate-buffered saline (PBS) and incubated with 0.5% FBS Panobinostat cell line medium. The following day, cells were treated or not

with 1,000 IU/mL of IFN-α-2a. After 3 hours, RNA was extracted as described below. Hep3B

cells (40,000 cells/well) were seeded in 24-well plates. The next day, cells were transfected with 200 ng of pGL4-hepcidin (WT_2.7kb) promoter, pGL4-BMP-mutant, or pGL4-STAT3-mutant hepcidin promoter containing reporter vectors this website (Promega), together with 10 ng of a control plasmid containing the Renilla gene under the control of the cytomegalovirus (CMV) promoter, as described in detail elsewhere.18 Plasmid transfections were performed using Trans-IT-LT1 transfection reagent (Mirus) according to the manufacturer’s instructions. After 24 hours, cells were incubated with medium with or without 1,000 IU/mL of IFN-α-2a for 8 hours. Subsequently, cells were lysed in Passive Lysis Buffer (Promega) and luciferase activity was determined using the Dual-Luciferase-Reporter assay system (Promega) and a Centro LB 960 luminometer (Berthold Technologies). Total RNA was extracted using the Qiagen RNAeasy kit according to the manufacturer’s instructions (Qiagen). One μg of total RNA was reverse-transcribed in a 20 μL reaction using M-MLV reverse transcriptase (Fermentas) and random oligomers as primers. SYBR green quantitative real-time PCR (qPCR) was performed using the ABI

StepONE Plus Real Time PCR System (Applied Biosystems). The primers used have selleck chemical been detailed previously.19 Relative messenger RNA (mRNA) expression of the target genes was normalized to the GAPDH mRNA expression. In all, 2,000,000 Hep3B cells were plated in 10-cm dishes with DMEM high glucose (10% FBS). Twenty-four hours later the medium was replaced by DMEM high glucose containing 0.5% FBS. The following day, cells were treated or not with 1,000 IU/mL of IFN-α-2a (Roferon-A, Roche) for the times indicated (Fig 4B). Cells were lysed in lysis buffer (10 mM TRIS HCl, pH 7.4, 150 mM sodium chloride, 5 mM EDTA, 1% TritonX [Sigma], and phosphatase inhibitor cocktail PhosSTOP [Roche]) and protein quantification was performed using the bicinchoninic acid method (BCA, Pierce, Thermoscientific). Forty μg of total protein was separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS/PAGE) and transferred onto a nitrocellulose membrane (Protran BA83).

Images were adjusted for the slice intensity differences introduc

Images were adjusted for the slice intensity differences introduced by contiguous interleaved slice acquisition. Next, a 6-parameter rigid body realignment process was used to minimize movement-induced noise across all frames in all runs for each subject. Images were resliced by 3-dimensional cubic spline interpolation. Data were transformed into a common stereotactic space based on Talairach and Tournoux (1988) but using an in-house atlas composed of the average anatomy of 12 healthy young adults (ages 21-29 years) (see Lancaster et al; Snyder for methods).[38, 39] As part of the

atlas transformation, the data were resampled isotropically at 3 mm × 3 mm × 3 mm. Registration was accomplished via a 12-parameter affine warping of each individual’s MP-RAGE to the atlas target, using difference image variance LY2109761 research buy minimization as the objective

function. selleck screening library Subjects’ T2-weighted images were used as intermediate targets for transforming the BOLD images. The atlas-transformed images were checked against a reference average to ensure appropriate registration. Rs-fc preprocessing included removal of the linear trend, temporal band-pass filtering (0.009 Hz < f < 0.08 Hz), Gaussian blur of 2 voxels full-width half maximum, as well as regression of several “noise” parameters (6 motion parameters and signals from whole brain, white matter, and ventricles) and their time-based derivatives.[16, 40] Data volumes (ie, MR frames) likely to be contaminated with motion-related artifact that was not addressed by standard movement regression routines were identified and eliminated using a volume-censoring technique.[41] Data volumes with a frame-by-frame movement >0.5 mm or a whole brain change >0.5% were identified and eliminated. Rs-fc analyses (methods summarized in Fig. 1 —) employed a region of interest (ROI)-based approach using 5 a priori selected regions that participate in affective pain processing. Rs-fc maps were derived using 10 mm diameter spherical ROIs centered on: left anterior insula (Montreal Neurological Institute coordinates −35, 18, −1), right anterior insula (36, 19, −2), left amygdala (−21, −3,

−27), right amygdala (20, −3, −28), and anterior cingulate cortex (−1, 10, 32). Coordinates were selected based upon those reported in the pain find more and headache literature.[8, 42-45] For each seed, a resting-state time series was extracted separately for each subject by computing the mean of the BOLD intensity of all voxels enclosed by the seed region boundaries at each MR frame (time point). Correlations with this time series were calculated for each voxel in the brain, then Fisher Z-transformed to produce a functional connectivity map for each seed in each subject. To determine the rs-fc of the 5 affective pain ROIs, t-tests were used to identify functional connections with the 5 pain ROIs that differed from zero (P ≤ .01, uncorrected).

4:1, median age is 403 ± 146 years) from Northeast China (Jilin

4:1, median age is 40.3 ± 14.6 years) from Northeast China (Jilin Province and Heilongjiang Province), then the association between this polymorphism and response to antiviral treatment with PEG-IFNα-2a was analyzed. Results: In the chronic HBV infected patients who obtained a SVR, rs12979860 CC genotype

carries had a significantly higher proportion than that of non-CC genotype carriers (70.4% versus 29.1%, P < 0.05). A similar SVR rate were found between the rs12979860 CC and non-CC genotype carries both in the group who achieved EVR and in the group who failed to achieve an EVR but conventional treatment with 48-week Cytoskeletal Signaling inhibitor GSK-3 cancer (P > 0.05, respectively); However, among the patients who failed to achieve an EVR but extend the treatment to 72-week, compared with non-CC genotype carriers, rs12979860 CC genotype carriers had a significantly higher proportion for getting a SVR (86.5% versus 20.7%, P < 0.05). The average decrease of Knodell necroinflammatory

scores and Ishak fibrosis scores in rs12979860 CC genotype carriers were significantly higher than that of non-CC genotype carriers (P < 0.05, respectively). Multivariate analysis results indicated that baseline HBVDNA load ≤107copies/ml (2.61, 1.60-4.38, 0.013), rs12979860 CC genotype (3.14, 1.77-5.53, 0.001), with EVR (4.84,

1.99-12.17, 0.001) and extend the treatment to 72-week (2.33, 1.21-4.43, 0.001) were independent predictor of patients who were more likely to get a SVR. Conclusion: IL28B polymorphism is significantly associated with response to antiviral treatment with PEG-IFNα-2a in click here Northeast Chinese patients with HBV infection. Key Word(s): 1. Interleukin 28B; 2. SNP; 3. hepatitis B virus; 4. virological response; Presenting Author: FANPU JI Additional Authors: SHU ZHANG, ZHIFANG CAI, NA HUANG, HONGAN XUE, HONG DENG, SONG REN, ZONGFANG LI Corresponding Author: ZONGFANG LI Affiliations: Department of Infectious Disease, The Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University; Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University; National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University Objective: Cirrhotic patients with HCV infection have a high risk to develop hepatocellular carcinoma (HCC). Patients with HCV-related decompensated cirrhosis had been reported to benefit from IFN-based antiviral therapy.

Insulin resistance (IR) has been suggested to be such a factor fo

Insulin resistance (IR) has been suggested to be such a factor for double therapy with pegylated interferon/ribavirin. Younossi et al. review the data of the phase III REALIZE trial regarding the predictive value of homeostatic model assessment for IR (HOMA-IR). In this population of patients who failed previous double therapy, HOMA-IR was not associated with response in multivariate analysis and therefore is not helpful in clinical decision making in this context. (Hepatology selleck products 2013;58:1897-1906.) Treatment of hepatitis B with nucleos(t)ide analogs is very effective and easy to initiate, but much more difficult

to stop. The optimal duration of the treatment has important compliance and cost implications. Jeng et al. investigated the “APASL stopping rule” based on hepatitis B virus (HBV) viremia. They assessed the outcome of hepatitis B e antigen–negative patients who stopped entecavir after three negative HBV viremia determinations 6 months apart. In the year after cessation of treatment, hepatitis B relapsed in 45% of the patients. The relapse rate was 29% in patients Alectinib in vitro with a baseline viremia lower

than 2 × 105 IU/mL, the only identified predictive factor. These results may provide some guidance regarding when to stop oral treatment of HBV, but one should remain cautious, particularly with patients with cirrhosis. Rarely, withdrawal can trigger a flare with liver failure. (Hepatology 2013;58:1888-1896.)

Survival of patients treated for HCC can be divided into two distinct periods: the time up to progression and the time after progression. Since the SHARP trial, time to progression (TTP) has been used as the surrogate endpoint for overall survival. However, the factors determining postprogression survival have not been investigated. Intuitively, the pattern of progression should affect postprogression survival. Reig et al. performed this analysis in their collection of sorafenib-treated patients who demonstrated a progression. First, they show that TTP is indeed an independent predictor of overall survival, along with Child-Pugh progression. Second, they report that the Barcelona Clinic Liver Cancer stage at progression and the presence of new extrahepatic lesions or vascular invasion are independent predictors of postprogression survival. learn more In an era of second-line trials, these results have evident implications. (Hepatology 2013;58:2023-2031.) Studies investigating variceal bleeding typically exclude patients with HCC, so the outcome of variceal bleeding in these patients is unknown. Ripoll et al. matched 146 HCC patients with 146 without HCC for age and Child-Pugh class; all were admitted for variceal bleeding. Patients with HCC received secondary prophylaxis significantly less frequently and this was associated with shorter survival on multivariate analysis.

Perineal haematoma, a rare complication of vaginal birth, occurs

Perineal haematoma, a rare complication of vaginal birth, occurs with some frequency in women with bleeding disorders [18] and contributes to the increased incidence of postpartum haemorrhage. In women with bleeding disorders, haemorrhage, when it does occur, has frequently been reported to occur more than 2–3 weeks postpartum. In normal pregnancies, the median duration of bleeding after delivery is 21–27 days [57–59]. Clotting factors, which are elevated during pregnancy, return to pre-pregnancy levels within 14–21 days [60]. Because women generally continue to bleed after clotting factors have returned to pre-pregnancy levels, women with bleeding disorders may

be particularly vulnerable to delayed or secondary postpartum haemorrhage during Talazoparib in vivo this time. While delayed or secondary postpartum haemorrhage is rare, occurring after fewer than 1% of deliveries [61,62], delayed postpartum haemorrhage has been reported in 20–25% of women with VWD [63,64], 2–11% of haemophilia carriers [20,65] and 24% of women with factor XI deficiency [64]. Ideally, planning for pregnancy begins before conception. Prior to conception, or during pregnancy, women should be offered the opportunity to speak with a genetic counsellor regarding the inheritance of their bleeding disorder

[66] and with a paediatric haematologist regarding the care of a potentially affected child. Women and their families should be apprised of the full range of prenatal diagnostic options that exist (chorionic villus sampling, amniocentesis, foetal sex determination by ultrasound or foetal sex determination through Z-IETD-FMK concentration maternal plasma, if available) as well as the option of pre-implantation see more diagnosis, which has led to the successful live birth of at least one child [67]. The management of childbirth will depend on the needs of the mother and her potentially affected infant

at the time of delivery. Women at risk for severe bleeding should be referred for prenatal care and delivery to a centre where, in addition to specialists in high-risk obstetrics, there is a haemophilia treatment centre or a haematologist with expertise in haemostasis. Laboratory, pharmacy and blood bank support is essential. Prior to delivery, all women with bleeding disorders should have the opportunity to meet with an anesthetist. There is no consensus on the factor levels that are safe for regional anaesthesia, but if levels are at least 50%, and the rest of the coagulation studies are normal, regional anaesthesia may be considered safe. Prior to any invasive procedure such as chorionic villus sampling, amniocentesis or cervical cerclage, women at risk for severe bleeding should receive prophylaxis. DDAVP, if required during pregnancy, is generally thought to be safe for mother and foetus [68,69]. At the time of childbirth, DDAVP must be used with caution, if at all.

Perineal haematoma, a rare complication of vaginal birth, occurs

Perineal haematoma, a rare complication of vaginal birth, occurs with some frequency in women with bleeding disorders [18] and contributes to the increased incidence of postpartum haemorrhage. In women with bleeding disorders, haemorrhage, when it does occur, has frequently been reported to occur more than 2–3 weeks postpartum. In normal pregnancies, the median duration of bleeding after delivery is 21–27 days [57–59]. Clotting factors, which are elevated during pregnancy, return to pre-pregnancy levels within 14–21 days [60]. Because women generally continue to bleed after clotting factors have returned to pre-pregnancy levels, women with bleeding disorders may

be particularly vulnerable to delayed or secondary postpartum haemorrhage during MLN8237 chemical structure this time. While delayed or secondary postpartum haemorrhage is rare, occurring after fewer than 1% of deliveries [61,62], delayed postpartum haemorrhage has been reported in 20–25% of women with VWD [63,64], 2–11% of haemophilia carriers [20,65] and 24% of women with factor XI deficiency [64]. Ideally, planning for pregnancy begins before conception. Prior to conception, or during pregnancy, women should be offered the opportunity to speak with a genetic counsellor regarding the inheritance of their bleeding disorder

[66] and with a paediatric haematologist regarding the care of a potentially affected child. Women and their families should be apprised of the full range of prenatal diagnostic options that exist (chorionic villus sampling, amniocentesis, foetal sex determination by ultrasound or foetal sex determination through check details maternal plasma, if available) as well as the option of pre-implantation selleck chemicals diagnosis, which has led to the successful live birth of at least one child [67]. The management of childbirth will depend on the needs of the mother and her potentially affected infant

at the time of delivery. Women at risk for severe bleeding should be referred for prenatal care and delivery to a centre where, in addition to specialists in high-risk obstetrics, there is a haemophilia treatment centre or a haematologist with expertise in haemostasis. Laboratory, pharmacy and blood bank support is essential. Prior to delivery, all women with bleeding disorders should have the opportunity to meet with an anesthetist. There is no consensus on the factor levels that are safe for regional anaesthesia, but if levels are at least 50%, and the rest of the coagulation studies are normal, regional anaesthesia may be considered safe. Prior to any invasive procedure such as chorionic villus sampling, amniocentesis or cervical cerclage, women at risk for severe bleeding should receive prophylaxis. DDAVP, if required during pregnancy, is generally thought to be safe for mother and foetus [68,69]. At the time of childbirth, DDAVP must be used with caution, if at all.

Comparison of Wilate to a previous VWF-containing concentrate rev

Comparison of Wilate to a previous VWF-containing concentrate revealed similar VWF activity profiles. However, there were differences. Higher peak factor VIII levels were observed

(as expected given the higher dose of FVIII in Wilate) and there was some variation in FVIII elimination curves. Factor VIII in the historical VWF concentrate showed an initial plateau phase prior to the decay curve – a phenomenon not seen in the pharmacokinetic studies using Wilate. From their pharmacokinetic studies Austin et al. were able to individualize a patient’s treatment regimen and to optimize therapy for planned prophylaxis or surgery. They observed that optimal levels of VWF and factor VIII could generally be attained with Wilate using a dose of 20–60 IU kg−1 in steady state. Most importantly their results indicate a relevant interindividual variability of pharmacokinetic FK506 chemical structure parameters in the VWD population and enabled them Selleckchem Atezolizumab to remove some of the unpredictability associated with effective dosing. It is clear that pharmacokinetic studies provide valuable information for dosing and dosing frequency of VWF concentrate, and are useful in the familiarization phase of using newer VWF concentrates in the VWD patient population. In a prospective,

randomized crossover study, Kessler et al. observed significant pharmacokinetic diversity of FVIII in VWD patients treated with

two different von Willebrand (VWF)/factor VIII (FVIII) concentrates [62]. Possible underlying mechanisms for the different FVIII kinetics were discussed, but remained unclear. Based on the fact that a main difference between the evaluated VWF/FVIII concentrates was their VWF:RCo/FVIII:C-ratio, the hypothesis of VWF-dependent FVIII clearance was evaluated in detail. The main clearance mechanism of FVIII is still largely unclear learn more although clearance via the LRP receptor, asialo GP receptor and by protease cleavage has been suggested [71]. At least the latter is restricted to free FVIII, i.e. the very low amount of less than 5% VWF-unbound FVIII circulating in plasma. The major fraction of circulating FVIII, above 90%, is bound to VWF with very high affinity of around KD 0.2 nm. Although not evaluated in detail, there are no data implying that the VWF-bound FVIII dissociates from VWF before or during the clearance event of VWF, which is strongly suggestive of co-clearance of VWF-bound FVIII. With regard to VWF clearance, van Schooten et al. [72] demonstrated that VWF uptake by macrophages in the liver contributes to VWF clearance in vivo. VWF clearance has been shown to take place independent of multimeric size [73] and proteolytic cleavage by ADAMTS13 seems not to contribute to VWF clearance [74].