IntroductionThe initial adhesion of platelets to the extracellular matrix of injured blood vessels is mediated at high shear rates by von Willebrand factor (VWF) interaction with glycoprotein (GP) Ib-IX-V. 1 Additionally, engagement of GP Ib-IX-V by VWF is thought to contribute to stable platelet adhesion by generating intracellular signals necessary for activation of ␣IIb3. Indeed, ␣IIb3 activation and platelet thrombus formation have been observed under a number of experimental conditions following platelet interaction with VWF. [2][3][4][5][6] Furthermore, specific biochemical responses have been documented under the same conditions, including induction of Ca 2ϩ fluxes and activation of tyrosine, serine-threonine, and lipid kinases. 7,8 Consequently, GP Ib-IX-V may function as a signaling receptor and an adhesion receptor.GP Ib-IX-V is a complex of 4 transmembrane polypeptides. 9-11 Although the cytoplasmic tail of each subunit lacks a catalytic domain, each may interact directly or indirectly with proteins that can transmit intracellular signals. For example, the cytoplasmic tail of GP Ib␣ can interact directly with filamin, GP Ib␣ and Ib with 14-3-3-, and GP Ib and GP V with calmodulin. 12-15 GP Ib-IX-V can be coimmunoprecipitated from platelets with signaling molecules, including Src family kinases, 16 phosphatidylinositol 3-kinase (PI 3-kinase) 17 and Src homology 2 domain-containing inositol polyphosphate 5-phosphatase-2 (SHIP-2). 18 Furthermore, VWF-dependent platelet activation may require localization of GP Ib-IX-V to lipid rafts, membrane structures implicated in cellular signaling. 19 Although there is good evidence for a functional link between GP Ib-IX-V and ␣IIb3, 2 critical questions remain: Is GP Ib-IX-V itself capable of transducing signals in platelets, and, if so, to what extent do these signals participate in the activation of ␣IIb3? Several factors have conspired to make it difficult to answer these questions. First, a subpopulation of GP Ib-IX-V in platelets may be associated with immunoreceptor tyrosine activation motif (ITAM)-bearing proteins that can signal in their own right, including the Fc␥RIIA receptor and the FcR ␥-chain. 20,21 Second, platelets express numerous receptors for soluble and matrix-associated agonists, and some of the agonists (eg, adenosine diphosphate [ADP], thromboxane A 2 ) are released by adherent platelets. 22 Third, VWF not only interacts with GP Ib-IX-V through its A1 domain but also with ␣IIb3 through its C1 domain. 1 Thus, outside-in signals stimulated by VWF binding to ␣IIb3 can confound analysis of GP Ib-IX-V signaling. 23 Finally, studies of GP Ib-IX-V signaling under static conditions have frequently utilized nonphysiological mediators, such as botrocetin or ristocetin, to promote VWF binding to GP Ib-IX-V, complicating data interpretation further.Thus, despite the publication of many important studies on the molecular contributors to signaling responses downstream of GP Ib-IX-V, most to date have failed to consistently employ conditions to avoi...