The development of a new vascular network is essential for the onset and progression of many pathophysiologic processes. Cyclooxygenase-2 displays a proangiogenic activity in in vitro and in vivo models, mediated principally through its metabolite prostaglandin E 2 (PGE 2 ). Here, we provide evidence for a novel signaling route through which PGE 2 activates the Alk5-Smad3 pathway in endothelial cells. PGE 2 induces Alk5-dependent Smad3 nuclear translocation and DNA binding, and the activation of this pathway involves the release of active TGF from its latent form through a process mediated by the metalloproteinase MT1-MMP, whose membrane clustering is promoted by PGE 2 . MT1-MMP-dependent transforming growth factor  (TGF) signaling through Alk5 is also required for PGE 2 -induced endothelial cord formation in vitro, and Alk5 kinase activity is required for PGE 2 -induced neovascularization in vivo. These findings identify a novel signaling pathway linking PGE 2 and TGF, 2 effectors involved in tumor growth and angiogenesis, and reveal potential targets for the treatment of angiogenesis-related disorders. (Blood. 2008; 112:1120-1128)
IntroductionGrowth of new vessels to ensure the supply of oxygen and nutrients to tissues is required for the establishment and progression of a variety of pathophysiologic situations, such as tumor development and metastasis, chronic inflammatory diseases, and vascular retinopathies. In the adult, this is achieved mainly by angiogenesis, in which new vessels grow out from a preformed vascular system. The formation of new capillaries by endothelial cells (ECs) is regulated by an exquisite balance between pro-and antiangiogenic factors. 1 A number of proangiogenic factors have been shown to increase the expression of cyclooxygenase-2 (COX-2). 2 COX-2 is an oxygenase that catalyzes the conversion of arachidonic acid to prostaglandin H 2 , which is in turn metabolized by diverse specific terminal synthases to form distinct prostanoids (prostaglandins and thromboxanes). 3 Evidence supporting the involvement of COX-2 in angiogenesis includes the impairment of neovessel formation in COX-2 knockout (KO) mice and the fact that specific COX-2 inhibitors block angiogenesis-like processes in in vitro and in vivo models. 3 A major product of COX-2 activity is prostaglandin E 2 (PGE 2 ). PGE 2 signals via 4 G-protein-coupled receptors (GPCR), named EP1 to EP4. These receptors each signal through distinct G-protein subunits, thereby initiating diverse downstream signaling pathways. EP1 usually couples to Gq, which activates PLC␥ to produce an increase in intracellular calcium concentration. EP2 and EP4 couple to Gs, with subsequent activation of PKA and increased cAMP synthesis. In contrast, signaling via EP3 often results in decreased cAMP concentrations, owing to the receptor coupling to Gi subunits. 4 In addition to these receptors, PGE 2 transactivates tyrosine kinase receptors, either through intracellular mechanisms or, in the case of epidermal growth factor receptor, through the metallo...