Abstract-Three well-defined laminar flow profiles were created to distinguish the influence of a gradient in shear and steady shear on platelet-derived growth factor A (PDGF-A) and monocyte chemoattractant protein-1 (MCP-1) expression in human endothelial cells. The flow profiles (16 dyne/cm 2 maximum shear stress) were ramp flow (shear stress smoothly transited at flow onset), step flow (shear stress abruptly applied at flow onset), and impulse flow (shear stress abruptly applied for 3 s only). Ramp flow induced only minor expression of PDGF-A and did not increase MCP-1 expression.Step flow increased PDGF-A and MCP-1 mRNA levels 3-and 2-fold at 1.5 hours, respectively, relative to ramp flow. In contrast, impulse flow increased PDGF-A and MCP-1 expression 6-and 7-fold at 1.5 hours, and these high levels were sustained for at least 4 hours. These results indicate that a temporal gradient in shear (impulse flow and the onset of step flow) and steady shear (ramp flow and the steady component of step flow) stimulates and diminishes the expression of PDGF-A and MCP-1, respectively. NO synthase inhibitor N G -amino-L-arginine (L-NAA) was found to markedly enhance MCP-1 and PDGF-A expression induced by step flow, but decrease their expression induced by impulse flow, in a dose-dependent manner. NO donor spermine-NONOate (SPR/NO) dose-dependently reduced the MCP-1 and PDGF-A expression induced by impulse flow. Moreover, impulse flow was found to stimulate sustained (4 hours) IB-␣ degradation and egr-1 mRNA induction. L-NAA prevented IB-␣ degradation, whereas SPR/NO increased IB-␣ resynthesis 2 hours after impulse flow. The exact nature and influence of local shear involved in endothelial dysfunction leading to susceptibility for atherogenesis, however, remains unclear. Endothelial cells (EC) throughout the vasculature experience a variety of flow environments both with spatial variances and with temporal gradients in wall shear stress. In the venous system wall shear stress is lower and minimal gradients in shear stress exist because of the nonpulsatile nature of the blood flow. In the arterial system the flow conditions are generally assumed to be laminar and to present the endothelium with a high mean wall shear stress in addition to large temporal gradients in shear stress. At arterial bifurcations and curvatures, locations known to be highly prone to atherogenesis, disturbed flow patterns may develop that result in low mean wall shear stress, but still present the EC with large temporal gradients in shear stress. 3 These observations, combined with other in vitro evidence, 4 -6 suggest that gradients in shear and steady shear represent different biomechanical stimuli that differentially regulate local endothelial function by distinct signaling pathway, and thus contribute to the characteristic distribution pattern of atherosclerosis.A host of endothelial genes exhibit differential responses to shear stress stimuli that may be involved in the focal localization of atherogenic plaques. 7 The application of step shear...