Abstract-Vascular endothelial growth factor (VEGF) has been implicated in the reendothelialization of the vascular wall after balloon injury. This study investigated whether thrombin, which is formed during activation of the coagulation cascade at sites of vascular injury, upregulates VEGF expression in vascular smooth muscle cells (VSMCs). VEGF expression was assessed in native and cultured VSMCs by Northern blot analysis and reverse transcription-polymerase chain reaction and the release of VEGF protein by immunoassay. ␣-Thrombin time-and concentration-dependently increased VEGF mRNA levels, mainly that mRNA coding for the soluble splice variant VEGF 164/165 , and stimulated the release of VEGF protein. These effects required the proteolytic activity of thrombin and were mimicked by a thrombin receptor activating-peptide. Upregulation of VEGF expression was also induced by conditioned medium from ␣-thrombin-stimulated VSMCs. Both the early and the delayed ␣-thrombin-induced VEGF expressions were attenuated by antioxidants and by diphenyleneiodonium. ␣-Thrombin-induced VEGF release was significantly reduced by a platelet-derived growth factor (PDGF)-, a transforming growth factor (TGF)-␤-, and a basic fibroblast growth factor (bFGF)-neutralizing antibody. Thrombin caused a redox-sensitive upregulation of expression of VEGF in VSMCs through a direct and an indirect effect, which was dependent on the endogenous formation of PDGF, TGF-␤, and bFGF. Upregulation of VEGF expression may represent an important mechanism by which the coagulation cascade contributes to the regeneration of the endothelial lining at sites of balloon injury.

Vascular injury after balloon angioplasty results in the rapid activation of platelets leading to the release of growth factors and vasoactive substances. In addition, up-regulation of tissue factor (TF) and an increased production of reactive oxygen species (ROS) have been detected at sites of vascular injury. We investigated whether platelet-derived products (PDP) released from activated human platelets increase ROS production, resulting in the induction of TF expression in vascular smooth muscle cells (SMC). PDP induced a time- and concentration-dependent increase in ROS generation in cultured SMC that was mediated mainly by PDGF-AB and TGF-beta1 and impaired by the flavin inhibitor diphenylene iodonium. Increased ROS formation was associated with enhanced mRNA levels of the small NAD(P)H oxidase subunit p22phox or its smooth muscle isoform. Transient transfection with a p22phox antisense vector decreased PDP-induced ROS generation. PDP up-regulated TF mRNA expression, which was redox sensitive and reduced by transfection of the p22phox antisense vector. In addition, PDP-stimulated reporter gene activity of two TF promoter constructs was decreased by coexpression of the p22phox antisense vector. These results indicate that activated platelets up-regulate TF expression and that this response involves ROS generation and a p22phox-containing NAD(P)H oxidase in SMC.

1 The possibility that the antiproliferative e ect of cyclic GMP-and cyclic AMP-dependent vasodilators involves an impaired progression of vascular smooth muscle cells (VSMC) through the cell cycle and expression of cyclins, which in association with the cyclin-dependent kinases control the transition between the distinct phases of the cell cycle, was examined. 2 FCS (10%) stimulated the transition of quiescent VSMC from the G0/G1 to the S phase (maximum within 18 ± 24 h and then to the G2/M phase (maximum within 22 ± 28 h). Sodium nitroprusside and 8-Br-cyclic GMP, as well as forskolin and 8-Br-cyclic AMP markedly reduced the percentage of cells in the S phase after FCS stimulation. 3 FCS stimulated the low basal protein expression of cyclin D1 (maximum within 8 ± 24 h) and E (maximum within 8 ± 38 h) and of cyclin A (maximum within 14 ± 30 h). The stimulatory e ect of FCS on cyclin D1 and A expression was inhibited, but that of cyclin E was only minimally a ected by the vasodilators. 4 FCS increased the low basal level of cyclin D1 mRNA after a lag phase of 2 h and that of cyclin A after 12 h. The vasodilators signi®cantly reduced the FCS-stimulated expression of cyclin D1 and A mRNA. 5 These ®ndings indicate that cyclic GMP-and cyclic AMP-dependent vasodilators inhibit the proliferation of VSMC by preventing the progression of the cell cycle from the G0/G1 into the S phase, an e ect which can be attributed to the impaired expression of cyclin D1 and A.

Aggregating human platelets induce VEGF mRNA expression in cultured SMC and the subsequent release of VEGF protein. This effect can be attributed to a supra-additive action of PDGF(AB) and TGF-beta(1) and may represent a novel mechanism by which platelets contribute to the recovery of the endothelial lining at sites of balloon-injured arteries.

Certain cytokines stimulate the expression of the inducible nitric oxide synthase (iNOS) in vascular smooth muscle cells (VSMCs) and in many other cell types. The large amounts of nitric oxide (NO) generated by iNOS in the vascular wall contribute to the unrelenting hypotension in septic shock. Because septic patients are often treated with barbiturates, we examined the effect of these anesthetic agents on the expression of iNOS in VSMCs. The induction of iNOS was elicited either in cultured rat aortic SMCs [interleukin-1beta (IL-1beta), 60 U/ml for 24 h] or in endothelium-denuded segments of the rabbit carotid artery [IL-1beta (100 U/ml) for 7 h]. The activity of iNOS was assessed by the accumulation of nitrite in the conditioned medium of cultured VSMCs and by the hyporeactivity of carotid arteries to phenylephrine. Moreover, iNOS protein abundance was determined by Western blot analysis, iNOS messenger RNA (mRNA) by reverse transcription followed by the polymerase chain reaction (PCR), and activation of the transcription factor NF-kappaB by gel electrophoretic mobility-shift analysis of nuclear extracts from VSMCs. The IL-1beta-stimulated increase in nitrite formation, iNOS protein, and mRNA abundance in VSMCs was significantly augmented in the presence of thiopental (100 microM), whereas methohexital, hexobarbital, pentobarbital, and phenobarbital were without effect. The potentiating effect of thiopental was observed only when the barbiturate was administered during the first 2 h of the 24-h incubation period of cultured VSMCs with IL-1beta. Thiopental did not affect the IL-1beta-stimulated activation of NF-kappaB in VSMCs. This barbiturate also significantly augmented the hyporeactivity to phenylephrine in carotid arteries exposed to IL-1beta, an effect that was abolished by N(G)-nitro-L-arginine. Exposure of either cultured or native VSMCs to thiopental alone did not stimulate iNOS expression. These findings demonstrate that the thiobarbiturate thiopental, but not oxybarbiturates, augments the IL-1beta-stimulated synthesis of NO in both cultured and native VSMCs. This effect of thiopental is the result of an increased expression of iNOS, involving most likely mechanisms distinct from NF-kappaB activation. The use of thiopental for long-term treatment of septic patients might possibly potentiate the biosynthesis of NO in the vascular wall and thus cause a further deterioration of the hemodynamic state.