Pathway through which gut microbiota modulate a prothrombotic effect. Gut microbial–derived products pass through the portal circulation to the liver, where they stimulate TLR2 signaling in hepatic sinusoidal endothelial cells. This signaling results in enhanced VWF synthesis and secretion. The consequent significant increase in plasma VWF levels enhances platelet accumulation at sites of arterial injury. See Figure 7 in the article by Jäckel et al that begins on page 542.