Background-Laminins are major components of basement membranes, well located to interact with platelets upon vascular injury. Laminin-111 (α 1 β 1 γ 1 ) is known to support platelet adhesion but is absent from most blood vessels, which contain isoforms with the α 2 , α 4 , or α 5 chain. Whether vascular laminins support platelet adhesion and activation and the significance of these interactions in hemostasis and thrombosis remain unknown. Methods and Results-Using an in vitro flow assay, we show that laminin-411 (α 4 β 1 γ 1 ), laminin-511 (α 5 β 1 γ 1 ), and laminin-521 (α 5 β 2 γ 1 ), but not laminin-211 (α 2 β 1 γ 1 ), allow efficient platelet adhesion and activation across a wide range of arterial wall shear rates. Adhesion was critically dependent on integrin α 6 β 1 and the glycoprotein Ib-IX complex, which binds to plasmatic von Willebrand factor adsorbed on laminins. Glycoprotein VI did not participate in the adhesive process but mediated platelet activation induced by α 5 -containing laminins. To address the significance of platelet/laminin interactions in vivo, we developed a platelet-specific knockout of integrin α 6 . Platelets from these mice failed to adhere to laminin-411, laminin-511, and laminin-521 but responded normally to a series of agonists. α 6 β 1 -Deficient mice presented a marked decrease in arterial thrombosis in 3 models of injury of the carotid, aorta, and mesenteric arterioles. The tail bleeding time and blood loss remained unaltered, indicating normal hemostasis. Conclusions-This study reveals an unsuspected important contribution of laminins to thrombus formation in vivo andsuggests that targeting their main receptor, integrin α 6 β 1 , could represent an alternative antithrombotic strategy with a potentially low bleeding risk. (Circulation. 2013;128:541-552.)Key Words: blood platelets ◼ integrin α 6 β 1 ◼ laminin ◼ thrombosis

Washed treated and untreated PCs have similar functional, morphologic, and proteomic characteristics provided that PLTs are suspended in an appropriate medium during testing.