Burdick, Monica M., and Konstantinos Konstantopoulos. Platelet-induced enhancement of LS174T colon carcinoma and THP-1 monocytoid cell adhesion to vascular endothelium under flow. Am J Physiol Cell Physiol 287: C539 -C547, 2004. First published April 14, 2004 10.1152/ajpcell.00450.2003.-This study was undertaken to characterize the adhesion of LS174T colon adenocarcinoma cells to 4-h TNF-␣-stimulated human umbilical vein endothelial cells (HUVECs) under flow in the presence and absence of platelets and erythrocytes. Cell binding to HUVECs was significantly enhanced by simultaneous perfusion of thrombin-activated, but not resting, platelets. This increase was achieved via a platelet bridging mechanism whereby a previously tethered LS174T cell (primary tether) captures a free-flowing cell (secondary tether) that subsequently attaches to the endothelium downstream of the already adherent cell. The total number of tumor cells tethering to HUVECs and the percentage of secondary tethers relative to the total amount of cell tethering depended on platelet concentration and wall shear stress. At 0.8 dyn/cm 2 and a platelet-to-LS174T cell ratio of 25:1, the total amount of cell tethering nearly doubled as a result of platelet-induced enhancement compared with the amount without platelet perfusion. Moreover, the percentage of secondary tethers increased from background levels (Ͻ5%) in the absence of platelets to ϳ60% at a platelet-to-LS174T cell ratio of 25:1. Platelet-mediated secondary tethering is not limited to LS174T colon carcinoma cells, as THP-1 monocytoid cells also displayed this pattern of interaction. Secondary tethering was dependent on both platelet P-selectin and ␣IIb3-integrin for LS174T cells and P-selectin alone for THP-1 cells. Furthermore, platelet-mediated secondary tethering of both cell types occurred in the presence of red blood cells. Altogether, these results reveal a novel role for platelets in promoting cell binding to endothelium through a secondary tethering mechanism. P-selectin; ␣ IIb3-integrins; shear stress HEMATOGENOUS METASTASIS is a highly regulated, multistep process in which cancerous cells separate from a primary tumor, migrate across blood vessel walls into the vasculature, and then disperse to establish secondary colonies throughout the body. It has been proposed that tumor cells follow an adhesion cascade similar to that of leukocytes during the inflammatory response to immunologic insults. In this model, leukocytes first tether and roll on activated endothelium lining the blood vessel before they firmly adhere and ultimately extravasate into the tissue space. The occurrence of homotypic leukocyte-leukocyte interactions may provide a potential mechanism to augment recruitment to sites of inflammation, thereby enhancing attachment above direct leukocyte-endothelial cell interactions (primary tethers) (2, 36). In this phenomenon known as secondary tethering, a previously tethered leukocyte forms a brief adhesive interaction with a free-flowing leukocyte before subsequently attach...