However, one could hypothesize that in Black people this proagregant state is counterbalanced by other physiological mechanisms such as a more efficient fibrinolysis or a more efficient cleavage of vWF by alternative proteolytic pathways [27, 28], which may at least in part account for the better prognosis of TTP in Black people. This evidence concerns the gene VWF and thrombotic thrombocytopenic purpura.