Abstract-The molecular differences between native-type collagen type I fibrils (NC) and their pepsinated monomers (PC) were used to uncover receptors involved in platelet-collagen interaction along the adhesion-activation axis. The platelet-depositing capacity of NC and PC under blood flow and their adhesive properties and respective morphologies, aggregation, procoagulant capacity, and tyrosine phosphorylation were compared under different cationic milieus, including or excluding the glycoprotein (GP) Ia/IIa. NC was consistently a more preferable and activating substrate than PC during flow (5 minutes) and in platelet aggregation. In PPACK-treated blood, both NC (3.3-fold) and PC (2.7-fold) increased platelet attachment on elevation of the shear rate from 500 to 1640 s
Ϫ1, whereas in citrated blood, adhesion and thrombus growth on PC were negligible under the high shear rate, unlike on NC (1.9-fold increase). The complete lack of platelet deposition on PC in citrated blood could be overcome by restoring physiological Mg 2ϩ concentration, and in contrast to NC, platelets interacting with PC were highly dependent on Mg 2ϩ during adhesion, aggregation, and procoagulant response. Monoclonal antibody (mAb 131.7) against GP IV inhibited platelet deposition to NC in citrated blood (2 minutes) by 49%, which was not further increased by coincubation with mAb against GP Ia (6F1). These results stress the importance of GP Ia/IIa in shear-resistant platelet deposition on collagen monomers. In native fibers, however, the preserved quaternary structure with telopeptides activates additional platelet receptors capable of substituting GP Ia/IIa and GP IV. Pathophysiological platelet-collagen interactions include bleeding disorders due to either defective receptors or autoantibodies 2,3,5 or to impaired collagen synthesis, 6 -8 indicating several functional determinants on both the platelets and collagen.Thus far, glycoprotein (GP) Ia/IIa, integrin ␣ 2  1 , has been recognized as the major platelet receptor for collagen in primary adhesion, and accordingly, dysfunctional GP Ia/IIa associates with prolonged bleeding tendencies in patients. 9 -11 Although GP IV has been implicated in the very early phases of adhesion, the impact of GP IV, 12-14 as well as the other receptor candidates, 15-17 on hemostasis has remained unsettled. GP VI is involved in collagen-induced platelet activation, evidenced both by a poor aggregation response in patients lacking this receptor 5 and by collagen-related peptides that likely induce strong platelet aggregation in normal platelets via this receptor. 18,19 However, patients lacking GP VI have only mild bleeding tendencies, 5 and under blood flow, the collagen-related peptides are unable to retain firm adhesion. 20 Qualitative differences in collagen preparations complicate the identification of the determinants in plateletcollagen interaction. The term "native collagen fibers" has been used to cover a spectrum of preparations, from suspensions of native fibrils (eg, Horm) to dialysed fibrils...