Objective-Neutrophil gelatinase-associated lipocalin (NGAL) modulates the activity of matrix metalloproteinase (MMP) 9, an important mediator of vascular remodeling and plaque instability in atherosclerosis. This study aimed to analyze the expression of NGAL in atherosclerotic plaques and myocardial infarction (MI). Methods and Results-Atherosclerotic apolipoprotein E (apoE)Ϫ/Ϫ ϫ low-density lipoprotein receptor (LDLR) Ϫ/Ϫ and C57BL/6J control mice were exposed to brief hypoxic stress (10 minutes of 10% oxygen). Expression of the mouse NGAL homolog (24p3) and MMP-9 was analyzed 48 hours later by quantitative RT-PCR, immunohistochemistry, and zymography. Hypoxic stress increased NGAL/24p3 mRNA in the cardiac vasculature. NGAL/24p3 was also increased in atherosclerotic plaques of apolipoprotein E Ϫ/Ϫ ϫ LDLR Ϫ/Ϫ mice compared with C57BL/6J mice. Mice developing MI exhibited the highest plaque mRNA expression of NGAL/24p3 and MMP-9. Zymography revealed strong proteolytic activity in areas rich in 24p3 and MMP-9 protein. Immunohistochemistry performed on human carotid endarterectomy specimens and control tissue from the internal mammary artery showed colocalization of MMP-9 and NGAL with macrophages in the atherosclerotic plaques. Conclusions-NGAL/24p3 is increased in atherosclerotic plaques and MI. Colocalization with MMP-9 in areas with high-proteolytic activity suggests a role for NGAL/24p3 in modulating the MMP-9-mediated remodeling of plaques and infarcted hearts. Key Words: atherosclerosis Ⅲ myocardial infarction Ⅲ hypoxia Ⅲ matrix metalloproteinase Ⅲ remodeling C omplications to coronary atherosclerosis leading to myocardial infarction were previously believed to be because of the physical obstruction of the vessel lumen; however, 60% to 70% of myocardial infarctions (MIs) result from nonocclusive plaques. 1-4 Current evidence instead suggest that physical disruption of atherosclerotic plaques triggers thrombus formation, which may lead to MI. 5-7 The 2 major precipitating factors of thrombus formation are disruption of the plaque cap and erosion of its endothelial lining. Inflammation within the atherosclerotic plaque has been suggested to promote the progression toward plaque disruption by causing plaque instability. 8 Inflammatory mediators found in the atheroma have been shown to inhibit smooth muscle growth and collagen production and to augment matrix metalloproteinase (MMP) activity. 9 -12 This can result in decreased collagen content and weakening of plaque structure, leaving the fibrous cap prone to rupture.MMPs are a family of endopeptidases capable of degrading the molecular components of the extracellular matrix. They play important roles in a variety of pathological processes, such as atherosclerosis and tumor cell invasion. In particular, gelatinase B (MMP-9) is thought to be associated with diseases such as abdominal aortic aneurysm, atherosclerosis, and plaque rupture. 13 In cancer patients, urinary highmolecular weight MMPs have been shown to be independent predictors of metastatic cancers,...

Neutrophil gelatinase-associated lipocalin (NGAL) has recently emerged as an important modulator of cell homeostasis. Elevated plasma NGAL levels, possibly because of activation of blood leukocytes, are associated with atherosclerosis. However, little is known about induction of NGAL expression in blood vessels. Using a rat carotid artery injury model, we found that NGAL was highly induced in the intima after angioplasty but was attenuated by adenovirus-mediated expression of a dominant-negative mutant of inhibitor of nuclear factor (NF)-B kinase ␤ (dnIKK␤). Expression of NGAL mRNA and protein was also up-regulated in an NF-B-dependent manner in rat and human vascular smooth muscle cells (SMCs) in response to interleukin-1␤ stimulation. Rat SMC-produced NGAL was present as mono-and homomeric forms in the cytosol and in a complex containing matrix metalloproteinase-9 (MMP-9) after secretion. In agreement with levels of NGAL, proteolytic activity of MMP-9 was markedly high in the intima of injured vessels and in the culture supernatant of activated intimal SMCs but was reduced in the vessels transduced with dnIKK␤. The present study reveals a previously unrecognized vascular response to angioplastic injury, characterized by NF-B-dependent expression of NGAL in vascular SMCs. Furthermore, SMC-produced NGAL interacts with MMP-9, a mechanism by which NGAL may modulate MMP-9 proteolytic activity in the vascular repair process.

Thromboxane A(2) (TXA(2)) is a potent prothrombotic and immune modulating lipid mediator, which is implicated in cardiovascular diseases, in particular, atherosclerotic lesion development and thrombogenicity. Here, we tested the hypothesis that thromboxane synthase (TXAS), the obligate enzyme required to synthesize TXA(2), is expressed within the human atherosclerotic lesion, thus potentially contributing to TXA(2) synthesis and disease development. In an animal study, different atherosclerosis-prone mouse strains were investigated and compared with control mice. In a patient study (n = 134), endarterectomies of carotid atherosclerotic lesions were compared with non-atherosclerotic arteries (n = 11). Expression of TXAS was evaluated by real-time quantitative reverse transcription PCR and immunohistochemistry. TXAS mRNA expression was increased within the vascular wall in mouse models of atherosclerosis with advanced lesions. In humans, TXAS was expressed in the atherosclerotic lesion, associated with increased inflammatory cells, in particular M2 polarized macrophages, and increased in atherosclerotic lesions of patients with recent symptoms of thrombotic events. Production of TXA(2) by plaque tissue, verified by gas chromatography-mass spectrometry, increased after addition of arachidonic acid or lipopolysaccharide, and was inhibited by the TXAS inhibitor furegrelate. The findings suggest that intraplaque TXA(2) generation may contribute to the development of atherosclerosis and its thrombotic complications in humans.