Intravascular injury to arteries can result in thickening of the intimal smooth muscle layer adjacent to the lumen by migration and proliferation of cells from the underlying medial smooth muscle layer accompanied by deposition of extracellular matrix. This pathological response, which decreases lumen diameter, might, in part, be the result of the access of smooth muscle cells to plasma and platelet-derived growth factors as a consequence of denudation of the overlying confluent monolayer of vascular endothelial cells. Injured rat carotid arteries were treated by i.v. administration of acidic fibroblast growth factor, a heparin-binding protein that is chemotactic and mitogenic for vascular endothelial cells. The growth factor treatment resulted in dose-dependent inhibition of intimal thickening with parallel promotion of endothelial regeneration over the injured area. Therefore, acidic fibroblast growth factor might be efficacious in the prevention of restenosis caused by intimal thickening following angioplasty in humans.Arterial architecture consists of an inner nonthrombogenic monolayer of vascular endothelial cells residing on a basement membrane covering thin intimal and thicker underlying medial layers of smooth muscle. Response to extensive arterial endothelial injury is characterized by migration and proliferation of medial smooth muscle cells into the intima, perhaps mediated by plasma-and platelet-derived growth factors, with the accumulation of extracellular matrix resulting in thickening of the intimal layer thereby decreasing vascular lumen diameter (1-3).In animal models of limited arterial injury, spontaneous endothelial regeneration results in the cessation of both smooth muscle cell proliferation and intimal thickening (4)(5)(6). However, since vascular endothelium appears to have a limited ability to spontaneously repopulate denuded areas, repair of larger intravascular injuries can be incomplete (7). Therefore, specific mitogenic and chemotactic stimulation of vascular endothelial cells might promote arterial repair.Several vascular endothelial cell mitogens have been identified, including platelet-derived endothelial cell growth factor (8), vascular endothelial cell growth factor (9-11), and many (12, 13), but not all (14), members of the fibroblast growth factor (FGF) family. The heparin-binding FGF family is composed of seven known homologous members. Acidic FGF (aFGF), one of the more extensively characterized family members, is both mitogenic (15) and chemotactic (16) for vascular endothelial cells in vitro and promotes blood vessel growth, or angiogenesis, in vivo (15,17,18). We describe the results of a series of experiments demonstrating that aFGF also both promotes repair of experimentally damaged rat arterial endothelium and inhibits the accompanying pathological intimal thickening. Adjusted for body weight, the i.v. infusion rates of aFGF and animal group sizes, n, were 2.9 (n = 3), 26 (n = 5), 130 (n = 8), 270 (n = 9), and 870 (n = 5) pg'kg-1 hr-1 and 2.6 (n = 9) and 27 (n ...