The integrin alpha M beta 2 mediates a variety of events, adhesive, phagocytic, and inflammatory. Evidence has suggested that the functional events may be mediated by the "activated" conformational forms of alpha M beta 2 produced by appropriate stimulation of myeloid and monocytic lineage. The activation of alpha M beta 2 may be associated with new epitopes on alpha M beta 2, sites that may be related to the acquired receptor functions. Monoclonal antibodies were produced that preferentially bind neoepitopes expressed by activated alpha M beta 2. These anti-neo antibodies each inhibited three activation-associated specific receptor alpha M beta 2 functions, though to different extents. One set of anti-neo antibodies inhibited in a concordant manner the binding of factor X and of fibrinogen by > 90%, abolished the alpha M beta 2-initiated cellular coagulant response, and inhibited monocyte adhesion to unstimulated endothelial monolayers. A second set of anti-neo antibodies only diminished factor X and fibrinogen binding by approximately 40% to 50% but markedly suppressed Xa generation and only partially inhibited monocyte adherence to unstimulated endothelium. Concordance was observed between binding of factor X or fibrinogen and competence for leukocyte adhesion to unstimulated endothelium. Antibody competition assays segregated the anti-neo antibodies into the same two distinct sets, consistent with recognition of separate neoepitopes that are linked to alpha M beta 2 function. These data support the conclusion that the activated conformer of alpha M beta 2 that binds fibrinogen and factor X also mediates monocyte-endothelial interactions as well as the alternative cellular coagulation pathway.