Repeated endothelial cell injury has been suggested as an initiating factor in atherogenesis. Dying or dead endothelial cells have been shown to make significant contributions to the local enhancement of transendothelial macromolecular transport. Since cigarette smoking is one of the major risk factors for atherosclerosis, we examined the hypothesis that smoking accelerates atherogenesis by increasing the frequency of endothelial cell death and hence transendothelial macromolecular transport. Sixteen male Sprague-Dawley rats were given nicotine at a weight-adjusted dose of 5 mg/kg body wt per day in their drinking water over a period of 6 weeks. A group of 16 age-matched male Sprague-Dawley rats not exposed to nicotine and maintained over the same time period served as the control group. In en face preparations of thoracic aorta, immunoglobulin G-containing dying or dead endothelial cells were identified by the indirect immunoperoxidase method, and endothelial leakage to Evans blue-albumin (EBA) complexes (5 minutes after intravenous injection) was visualized by fluorescence microscopy. The results showed that in nicotine-treated rats, 51% of dead endothelial cells were associated with EBA leakage, which was responsible for 57% of total EBA leaky foci. C igarette smoking is generally accepted to be one of the major risk factors for coronary heart disease. 1 -6 The potential for developing coronary heart disease in male cigarette smokers is approximately two times greater than in male nonsmokers.
7Large epidemiological surveys have shown that the incidence of morbidity and mortality from coronary heart disease increases progressively with the number of cigarettes smoked. 68 Smoking cessation has been demonstrated to be associated with a decline in cardiovascular death.9 Autopsy studies have also revealed the increased occurrence of advanced atherosclerotic le-