Related Experiment Video
Updated: May 16, 2026
Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Role of reduced ADAMTS13 in arterial ischemic stroke: a pediatric cohort study
Moritz Lambers1, Neil A Goldenberg, Gili Kenet
1Faculty of Medicine, University of Münster, Germany.
Insights
Reduced ADAMTS13 activity is a significant risk factor for pediatric arterial ischemic stroke (AIS). This finding supports a role for ADAMTS13 in the development of pediatric AIS.
Area of Science:
- Hematology
- Pediatric Neurology
- Thrombosis Research
Background:
- ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), also known as von Willebrand factor (VWF)-cleaving protease, has been suggested as a protective factor against stroke in adults and mice.
- Investigating ADAMTS13 in pediatric populations is crucial for understanding stroke pathogenesis in children.
Purpose of the Study:
- To investigate the association between ADAMTS13 activity and arterial ischemic stroke (AIS) in pediatric patients.
- To determine if reduced ADAMTS13 levels are a risk factor for pediatric AIS.
Main Methods:
- A case-control study involving 208 pediatric patients with AIS and 125 healthy children.
- Comparison of ADAMTS13 activity levels between patients and controls, with adjustments for VWF antigen (VWF:Ag), factor VIII activity (FVIII:C), blood group, and age.
Main Results:
- 22% of pediatric AIS patients had ADAMTS13 activity below the 10th percentile, compared to only 4% of controls (p < 0.001).
- Adjusted odds ratios indicated a significantly higher risk of AIS associated with lower ADAMTS13 activity (OR 7.30 for lowest percentile).
- No significant differences in ADAMTS13 levels were observed among different stroke subtypes in pediatric patients.
Conclusions:
- Reduced ADAMTS13 activity is implicated as a risk factor for pediatric AIS.
- These findings support a role for ADAMTS13 in the pathogenesis of pediatric arterial ischemic stroke.
Objective:
Previous studies in adults and mice have implicated ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), also known as von Willebrand factor (VWF)-cleaving protease, as a protective factor for stroke. Here we investigated ADAMTS13 in 208 pediatric patients with arterial ischemic stroke (AIS) and 125 population-based control children in a frequency-matched case-control study.
Methods:
The proportion of patients/controls with ADAMTS13 activity levels below and above the 10th percentile was compared. Additionally, in a quintile comparison, the proportion of patients versus controls in the lowest ADAMTS13 quintile was compared to those in the 2nd to 5th quintiles. Adjustment was performed for VWF antigen (VWF:Ag), factor VIII activity (FVIII:C), blood group, and age.
Results:
Forty-six of 208 patients (22%) showed ADAMTS13 levels below the 10th percentile, compared with 5 of 125 controls (4%; p < 0.001). Odds ratios/95% confidence intervals were 7.30/2.73-19.50 for the lowest percentile and 2.44/1.15-5.16 in the quintile comparison after adjustment for VWF:Ag, FVIII:C, blood group, and age. Comparing the proportion of patients with ADAMTS13 activity below the 10th percentile within the different stroke subtypes (undetermined, cardioembolic, steno-occlusive arteriopathies), no statistically significant differences were found (undetermined, 16 of 89; cardioembolic, 6 of 40; steno-occlusive arteriopathies, 24 of 79; p = 0.08). ADAMTS13 levels did not significantly differ among stroke subtypes (p = 0.29).
Interpretation:
Our findings implicate reduced ADAMTS13 activity as a risk factor for pediatric AIS, and support the concept that ADAMTS13 has a role in the pathogenesis of pediatric AIS.
Related Concept Videos
01:15Ischemic Stroke ll: Pathophysiology
01:15Ischemic Stroke l: Introduction