The importance of the second messengers calcium (Ca 2؉ ) and diacylglycerol (DAG) in platelet signal transduction was established more than 30 years ago. Whereas protein kinase C (PKC) family members were discovered as the targets of DAG, little is known about the molecular identity of the main Ca 2؉ sensor(s). We here identify Ca 2؉ and DAG-regulated guanine nucleotide exchange factor I (CalDAG-GEFI) as a critical molecule in Ca 2؉ -dependent platelet activation. CalDAG-GEFI, through activation of the small GTPase Rap1, directly triggers integrin activation and extracellular signalregulated kinase-dependent thromboxane A 2 (TxA 2 ) release. CalDAG-GEFIdependent TxA 2 generation provides crucial feedback for PKC activation and granule release, particularly at threshold agonist concentrations. PKC/P2Y12 signaling in turn mediates a second wave of Rap1 activation, necessary for sustained platelet activation and thrombus stabilization. Our results lead to a revised model for platelet activation that establishes one molecule, CalDAG-GEFI, at the nexus of Ca 2؉ -induced integrin activation, TxA 2 generation, and granule release. The preferential activation of CalDAG-GEFI over PKC downstream of phospholipase C activation, and the different kinetics of CalDAG-GEFI-and PKC/P2Y12-mediated Rap1 activation demonstrate an unexpected complexity to the platelet activation process, and they challenge the current model that DAG/PKC-dependent signaling events are crucial for the initiation of platelet adhesion.
IntroductionPlatelet thrombus formation at sites of vascular injury is a complex and dynamic process that occurs in several phases. 1,2 Platelet preactivation and tethering (transient adhesion) are mediated by the interaction of glycoprotein (GP) lb␣ with matrix-bound von Willebrand factor, particularly in conditions of high shear. Platelet activation and firm adhesion are then triggered by collagen exposed in the vessel wall and/or locally generated thrombin. Sustained integrin activation and the formation of stable thrombi further depend on persistent costimulatory signaling provided by the second wave agonists, thromboxane A 2 (TxA 2 ) and adenosine 5Ј-diphosphate (ADP), which are released from activated platelets. [3][4][5] The central biochemical event in platelet aggregation is the agonist-induced inside-out activation of ␣ IIb  3 integrin. Most platelet agonists initiate intracellular signaling through the activation of phospholipase C (PLC), followed by the generation of the second messengers calcium (Ca 2ϩ ) and diacylgycerol (DAG). DAG is critical for protein kinase C (PKC) activation, a key event in platelet granule release and integrin activation. Platelets express at least 6 PKC isoforms, which have activating as well as inhibitory roles in platelet activation. [6][7][8][9][10] Early studies with calcium ionophores established a role of Ca 2ϩ in integrin activation, TxA 2 generation, and granule release. 11-13 Initially, Ca 2ϩ -binding classical isoforms of PKC were suggested as the cell's main signal integ...