COX-2-dependent prostaglandin (PG) E 2 synthesis regulates macrophage MMP expression, which is thought to destabilize atherosclerotic plaques. However, the administration of selective COX-2 inhibitors paradoxically increases the frequency of adverse cardiovascular events potentially through the loss of anti-inflammatory prostanoids and/or disturbance in the balance of pro-and anti-thrombotic prostanoids. To avoid these collateral effects of COX-2 inhibition, a strategy to identify and block specific prostanoid-receptor interactions may be required. We previously reported that macrophage engagement of vascular extracellular matrix (ECM) triggers proteinase expression through a MAPK erk1/2 -dependent increase in COX-2 expression and PGE 2 synthesis. Here we demonstrate that elicited macrophages express the PGE 2 receptors EP1-4. When plated on ECM, their expression of EP2 and EP4, receptors linked to PGE 2 -induced activation of adenylyl cyclase, is strongly stimulated. Forskolin and dibutryl cyclic-AMP stimulate macrophage matrix metalloproteinase (MMP)-9 expression in a dose-dependent manner. However, an EP2 agonist (butaprost) has no effect on MMP-9 expression, and macrophages from EP2 null mice exhibited enhanced COX-2 and MMP-9 expression when plated on ECM. In contrast, the EP4 agonist (PGE 1 -OH) stimulated macrophage MMP-9 expression, which was inhibited by the EP4 antagonist ONO-AE3-208. When compared with COX-2 silencing by small interfering RNA or inhibition by celecoxib, the EP4 antagonist was as effective in inhibiting ECM-induced proteinase expression. In addition, ECM-induced MMP-9 expression was blocked in macrophages in which EP4 was silenced by small interfering RNA. Thus, COX-2-dependent ECM-induced proteinase expression is effectively blocked by selective inhibition of EP4, a member of the PGE 2 family of receptors.Atherosclerosis is a chronic inflammatory disease characterized by lipid accumulation, macrophage recruitment, smooth muscle proliferation, and fibrosis (1, 2). Macrophage proteinase expression compromises the structural integrity of atherosclerotic lesions by degrading components of the extracellular matrix (ECM), 2 which contributes to lesion ulceration or rupture and subsequent sequelae of thrombosis, myocardial infarction, and stroke (3-6). A substantial body of evidence has identified cyclooxygenase (COX)-2 as a targetable component of the signaling pathway responsible for increased proteinase expression by macrophages in atherosclerotic lesions. COX metabolizes arachidonic acid to an unstable endoperoxide, which is then converted to the principal prostaglandins (PG) by specific synthases (7,8). COX-2 expression is elevated in atherosclerotic lesions (9 -14). PGE 2 , an important mediator of the inflammatory response, stimulates proteinase expression by a variety of cells including macrophages (15-18). Both PGE synthase and matrix metalloproteinase (MMP) activities are elevated in regions of symptomatic plaques rich in macrophages and susceptible to rupture (13,19). Moreover, tr...