Binding of von Willebrand factor (VWF) to GPThe GP Ib-IX-V complex consists of four leucine-rich, type I transmembrane polypeptides, two linked by disulfide bonds (GP Ib␣ and GP Ib), and two linked noncovalently (GP IX and GP V). The postulated subunit stoichiometry is 2:2:2:1, respectively (1-3), and each platelet expresses ϳ25,000 copies of GP Ib (4, 5). Interaction between GP Ib-IX and its principal ligand, von Willebrand factor (VWF), 1 mediates platelet capture onto exposed extracellular matrices under conditions of flow (6, 7); consequently, it is required for initial platelet adhesion during hemostasis (8). In addition, recent studies using platelets and heterologous expression systems, such as CHO cells, have concluded that GP Ib-IX can function as an excitatory receptor whose occupancy by VWF leads to up-regulation of other platelet responses, most notably platelet aggregation and spreading mediated by integrin ␣ IIb  3 (reviewed in Ref. 8). These stimulatory properties of GP Ib-IX may be facilitated by: 1) direct interactions of the cytoplasmic tails of GP Ib-IX with intracellular proteins, such as 14-3-3 (9 -13), calmodulin (14), and the cytoskeletal protein filamin A (15, 16); and 2) direct or indirect interactions of GP Ib-IX with other signaling receptors, such as Fc␥ RIIA (17, 18), or signaling receptor subunits, such as the FcR ␥ chain (19). However, the precise mechanism(s) whereby VWF binding to GP Ib-IX triggers ␣ IIb  3 -dependent functions remains unclear.One structural change in the GP Ib-IX complex that could play a role in its adhesive and signaling functions is oligomerization or clustering within the plane of the plasma membrane. For example, GP Ib-IX might exist as individual 2:2:2:1 complexes or as a series of larger-order oligomers, either constitutively or in response to VWF binding. Consistent with the latter, it has long been known that there is a correlation between VWF multimer size and GP Ib-IX-mediated platelet function, as seen in variant von Willebrand disease patients lacking the largest VWF multimers (20) and in patients with thrombotic thrombocytopenic purpura, in whom ultra-large VWF multimers may cause pathological platelet thrombi (21). Further support for the functional significance of GP Ib-IX clustering comes from the following observations: 1) the binding of multivalent but not monovalent forms of VWF or antibodies to GP Ib-IX stimulates platelets (22), 2) a subset of palmitoylated GP Ib-IX complexes may be organized into highdensity patches within platelet membrane lipid rafts (23), and 3) deletion of the binding sites on GP Ib␣ for 14-3-3 and filamin A increases the lateral mobility of GP Ib-IX in the plane of the membrane, a possible prerequisite for regulated clustering of this receptor (24).Based on these considerations, we hypothesized that clustering of GP Ib-IX may play a prominent role in the adhesive and signaling functions of this receptor. Because multivalent ligands like VWF or anti-GP Ib-IX antibodies may have effects in addition to clustering of t...