Mitzner. Pulmonary ischemia induces lung remodeling and angiogenesis. J Appl Physiol 100: 587-593, 2006. First published October 6, 2005 doi:10.1152/japplphysiol.00029.2005.-Cellular remodeling during angiogenesis in the lung is poorly described. Furthermore, it is the systemic vasculature of the lung and surrounding the lung that is proangiogenic when the pulmonary circulation becomes impaired. In a mouse model of chronic pulmonary thromboembolism, after left pulmonary artery ligation (LPAL), the intercostal vasculature, in proximity to the ischemic lung, proliferates and invades the lung (12). In the present study, we performed a detailed investigation of the kinetics of remodeling using histological sections of the left lung of C57Bl/6J mice after LPAL (4 h to 20 days) or after sham surgery. New vessels were seen within the thickened visceral pleura 4 days after LPAL predominantly in the upper portion of the left lung. Connections between new vessels within the pleura and pulmonary capillaries were clearly discerned by 7 days after LPAL. The visceral pleura and the lung parenchyma showed intense tissue remodeling, as evidenced by markedly elevated levels of both proliferating cell nuclear antigen and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling positive cells. Rapidly dividing cells were predominantly macrophages and type II pneumocytes. The increased apoptotic activity was further quantified by caspase-3 activity, which showed a sixfold increase relative to naive lungs, by 24 h after LPAL. Because sham surgeries had little effect on measured parameters, we conclude that both thoracic wound healing and pulmonary ischemia are required for systemic neovascularization.histology; apoptosis; caspase-3 THE PROCESS OF NEW VESSEL growth induced by tissue ischemia requires an orchestrated series of local cellular events. New vessel formation follows an organized progression of changes, including matrix dissolution, cell migration, and proliferation (3). Pulmonary ischemia resulting from chronic pulmonary embolism or other forms of pulmonary artery obstruction lead to proliferation of the systemic circulation within and surrounding the lung (4,7,8,18). The bronchial and intercostal vasculatures respond to pulmonary ischemia due to pulmonary artery obstruction with rapid neovascularization. It is interesting to note that the pulmonary vasculature appears not to be responsive in this setting. In general, the pulmonary artery is not proangiogenic, except in rare circumstances, as a secondary source of perfusion in some lung carcinomas (11). Unlike other organs, the lung is unique in that pulmonary ischemia is not accompanied by tissue hypoxia. Our laboratory previously developed a mouse model of lung angiogenesis and quantified new systemic perfusion of the lung following left pulmonary artery ligation (LPAL) (12). Rapid neovascularization occurs, and systemic perfusion of the lung can be measured 5 days after pulmonary artery ligation. However, unlike most other species, new vessel growth appear...