Inducible secretion of large, biologically potent von Willebrand factor multimers.

von Willebrand factor (vWf) secreted constitutively by human endothelial cells was compared to that released from Weibel-Palade bodies after stimulation. The majority of constitutively secreted molecules were dimeric and contained both pro-vWf and mature subunits. In contrast, the vWf released by the calcium ionophore A23187 or thrombin consisted of only very large multimers of mature subunits. The large multimers are known to be more active in in vitro platelet binding assays, and their absence in vivo results in a bleeding disorder. Endothelial cells therefore concentrate a special subclass of very large and biologically potent vWf multimers in Weibel-Palade bodies, presumably available for release in response to vascular injury.