Key Points• RNA splicing of the first intron of the von Willebrand factor gene is essential for expression in the endothelium.• RNA splicing may play a role in mediating endothelial cell heterogeneity.We previously demonstrated that the first intron of the human von Willebrand factor (vWF) is required for gene expression in the endothelium of transgenic mice. Based on this finding, we hypothesized that RNA splicing plays a role in mediating vWF expression in the vasculature. To address this question, we used transient transfection assays in human endothelial cells and megakaryocytes with intron-containing and intronless human vWF promoter-luciferase constructs. Next, we generated knockin mice in which LacZ was targeted to the endogenous mouse vWF locus in the absence or presence of the native first intron or heterologous introns from the human b-globin, mouse Down syndrome critical region 1, or hagfish coagulation factor X genes. In both the in vitro assays and the knockin mice, the loss of the first intron of vWF resulted in a significant reduction of reporter gene expression in endothelial cells but not megakaryocytes. This effect was rescued to varying degrees by the introduction of a heterologous intron. Intron-mediated enhancement of expression was mediated at a posttranscriptional level. Together, these findings implicate a role for intronic splicing in mediating lineage-specific expression of vWF in the endothelium. (Blood. 2013;121(21):4404-4412) Introduction Von Willebrand factor (vWF) is a plasma protein that mediates platelet hemostatic function and stabilizes coagulation factor VIII. vWF plays a particularly important role in platelet adhesion and aggregation at sites of high shear rates.1 Expression of vWF is restricted to endothelial cells and platelets. vWF is differentially expressed in the vasculature. For example, vWF protein and mRNA levels are higher in veins, compared with arteries, 2,3 and in venules compared with arterioles. 4 Within the microvasculature, vWF is expressed at particularly low levels in the liver. Expression of vWF also varies between neighboring endothelial cells. 5 The elucidation of the mechanisms underlying vWF expression may provide important insights into the molecular basis of vascular diversity.The structural organization of the mouse, human, and bovine vWF promoter-proximal region is closely related. [6][7][8] The first exon (11 to 1 246 in human vWF) encodes the 59 untranslated sequence. The second exon contains the ATG translational start site. Exons 1 and 2 are separated by an intron (1247 to 11475 in human vWF). To study mechanisms of vWF gene regulation, we have previously used a plug-insocket approach in which a single copy of a vWF promoter-LacZ cassette is targeted to the Hprt locus of mice. Using this strategy, we showed that a region of the human vWF gene (termed vWF2, between 22182 and the end of the first intron) directed expression in the vasculature of the brain, heart and skeletal muscle, but not in other organs such as aorta, lung, liver, spleen, ...