An elevated plasma fibrinogen level is an independent risk factor for cardiovascular disease. Therefore, an understanding of the regulation of fibrinogen expression is important. Inflammation and genetic variation of the fibrinogen  gene regulate plasma fibrinogen levels, and there are indications that inflammation and genetic variation interact. The aim of our study was to gain more understanding of the regulation of the inflammatory response of the fibrinogen  gene and to determine the effects of genetic variation. Luciferase reporter gene assays in hepatoma cells, mutation analysis, and electrophoretic mobility shift assays were used to investigate the transcriptional regulation of the fibrinogen  promoter. We identified a hepatocyte nuclear factor-3 (HNF-3) site located just upstream of previously identified interleukin-6 (IL6)-responsive sequences. This HNF-3 site is essential for a full response of the promoter to IL6, which is a new function for HNF-3. The activity of the CCAAT box/enhancer-binding protein site (located 18 nucleotides downstream of the HNF-3 site and important to the IL6 response) depends on the integrity of the HNF-3 site and vice versa, explaining the necessity of HNF-3 in the IL6 response of the fibrinogen  promoter. Furthermore, small interfering RNA to HNF-3 reduces the fibrinogen  mRNA levels. The rare T allele of the ؊148C/T polymorphism, which is present between the binding sites of HNF-3 and CCAAT box/ enhancer-binding protein, interferes with this mechanism, and this polymorphism is in our assay system the only genetic determinant of IL6-induced promoter activity among six polymorphisms in the fibrinogen  promoter.Inflammation is an important process in the development of cardiovascular disease, and increased plasma levels of inflammatory factors such as fibrinogen are consistently associated with an increased risk of cardiovascular disease (1-4). Inflammatory factors may play a dual role. On the one hand their plasma levels reflect the severity of inflammatory processes in the vessel wall, and on the other hand they can contribute directly to the development of the disease. Fibrinogen is present in the atherosclerotic plaque where it can contribute to the progression of atherosclerosis, for example by increasing the chemotaxis of smooth muscle cells and affecting the stability and structure of the plaque (5-8). Because of the relationship of fibrinogen with atherosclerosis, much attention has been paid to the regulation of fibrinogen levels under both basal and inflammatory conditions.The mature fibrinogen molecule is composed of three pairs of polypeptide chains: two ␣ chains, two  chains, and two ␥ chains; and in vitro functional studies showed that synthesis of the  chain is rate-limiting (9). Fibrinogen is expressed by the liver. Fibrinogen levels can strongly increase in response to intense acute phase stimuli such as trauma, surgery, or strenuous exercise, and fibrinogen levels are chronically elevated in the presence of mild (inflammatory) stimuli such as smoking...