Abstract-Monolayers of human umbilical vein endothelial cells were activated with 50 U/mL interleukin-1␣ (IL-1␣) for 3 hours and simultaneously conditioned with shear stresses of 0, 0.68, or 13.2 dyne/cm 2 in a parallel-plate flow chamber. In the presence of an inflow buffer containing 100 nmol/L factor X and 10 nmol/L factor VII, production of factor Xa, a measure of functional tissue factor (TF), was determined as the product of outflow concentration of factor Xa (chromogenic assay performed under quasi-static flow conditions after the shear period) and flow rate. Similarly, production of TF pathway inhibitor (TFPI) was estimated as the product of antigenic TFPI (by enzyme-linked immunosorbent assay) in the supernatant and flow rate. In parallel experiments, total RNA was isolated for determination of amplification products of TF mRNA by reverse transcription-polymerase chain reaction. We found that shear stress reduced factor Xa production (meanϮSE; nϭnumber of experiments) from 13.33Ϯ1.14 (nϭ16) fmol/minϫcm 2 at 0 shear stress to 5.70Ϯ2.51 (nϭ5) and 0.54Ϯ0.54 (nϭ4) fmol/minϫcm 2 at shear stresses of 0.68 and 13.2 dyne/cm 2 , respectively. At the same time, immunogold labeling showed that TF antigen on the endothelial surface increased Ͼ5-fold with shear stress, whereas TFPI antigen on the surface increased 2-fold. The secretion of TFPI (appearance of new supernatant TFPI) rose from 7.4Ϯ2.4 (nϭ12) ϫ10 Ϫ3 fmol/minϫcm 2 at 0 shear stress to 23.7Ϯ7.3 (nϭ9) and 50.2Ϯ14.3 (nϭ4) ϫ10 Ϫ3 fmol/minϫcm 2 at 0.68 and 13.2 dyne/cm 2 , respectively. TF mRNA amplification products were not markedly changed by shear stress. We conclude that acute application of shear stress reduces functional, but not antigenic, expression of TF by intact, activated endothelial cell monolayers in a manner associated with shear stress-augmented endothelial cell secretion of TFPI. Key Words: tissue factor Ⅲ endothelial cells Ⅲ shear stress Ⅲ tissue factor pathway inhibitor T issue factor (TF) is the membrane-bound glycoprotein that serves as the nonenzymatic cofactor for factor VII/VIIa in the initiation of blood coagulation, whereas TF pathway inhibitor (TFPI), its principal inhibitor, binds to both activated factor X and the ternary complex formed by TF, factor VIIa, and factor Xa. Both TF and TFPI are synthesized by endothelial cells (ECs), the former usually only after cell activation. 1 With regard to increasing shear stress, functional TF has been shown to increase over a wide range of shear stress for a noncellular system of lipid bilayers, to which has been added exogenous TF that has been immobilized on the inner surface of a glass tube. 2 A similar increase has been demonstrated for monolayers of human fibroblasts, 3 which express TF in the absence of cytokine activation. With respect to monolayers of activated human ECs, however, the dependence on shear stress is more complex, passing through a maximum with respect to shear stress under 1 set of conditions 3 or decreasing monotonically with shear stress under another. 4 Prior work h...