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Emerging data indicate that this step may be influenced by a variety of factors, some of which favour increased proteolysis and some of which compromise proteolysis. The former may predispose to bleeding, whilst the latter appears to be the underlying mechanism for thrombotic thrombocytopenic purpura (TTP). The new insights support the concept of \u2018risk\u2019 in bleeding, particularly in the case of type 1 von Willebrand disease (VWD), in much the same way that risk is considered in venous thrombosis. This review presents relevant current knowledge of VWF proteolysis by ADAMTS13, and a novel model of how this may be implicated in type 1 VWD is proposed, based on events at the vessel wall at a time of haemostatic challenge.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2006.06096.x","type":"journal-article","created":{"date-parts":[[2006,4,20]],"date-time":"2006-04-20T10:01:42Z","timestamp":1145527302000},"page":"457-467","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Insights into von Willebrand factor proteolysis: clinical implications"],"prefix":"10.1111","volume":"133","author":[{"given":"D. J.","family":"Bowen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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