This article is available online at http://www.jlr.org ated by its receptor, the tyrosine kinase proto-oncogene c-fms (also known as Csf1r ). Interleukin-34 (IL-34) has been recently identifi ed as another ligand for CSF1-R; however, its role in atherosclerosis has yet to be elucidated. Infl ammatory disorders that display elevated levels of CSF-1 include arthritis, obesity, and atherosclerosis ( 7 ). The potential involvement of CSF-1 in atherosclerosis was fi rst suggested by the observation that CSF-1 is induced in endothelial cells by treatment with oxidized lipids ( 8 ) and is expressed at high levels in atherosclerotic lesions ( 8, 9 ). Subsequently, it was shown that osteopetrotic ( op/op ) mice carrying a Csf1 null mutation, either on an apolipoprotein E (apoE) Ϫ / Ϫ or a low density lipoprotein receptor null) background, showed a dramatic decrease in the size of atherosclerotic lesions ( 10-12 ).Several signifi cant issues concerning the role of CSF-1 in atherogenesis remain unresolved. First, the mechanism by which the CSF-1 defi ciency contributes to lesion development remains unclear. Because CSF-1 infl uences monocyte/macrophage growth and survival, likely mechanisms include decreased numbers of circulating monocytes; decreased monocyte recruitment to the artery wall; decreased monocyte/macrophage proliferation; decreased macrophage uptake of oxidized lipids; and increased monocyte/macrophage foam cell necrosis/apoptosis. Second, the source of the CSF-1 critical for lesion formation is unclear. Both macrophages and endothelial cells (EC) Abstract Previous studies have shown that colony stimulating factor-1 (CSF-1) defi ciency dramatically reduced atherogenesis in mice. In this report we investigate this mechanism and explore a therapeutic avenue based on inhibition of CSF-1 signaling. Lesions from macrophage colony stimulating factor-1 ( Csf1) +/ Ϫ mice showed increased numbers of apoptotic macrophages, decreased overall macrophage content, and infl ammation. In vitro studies indicated that CSF-1 is chemotactic for monocytes. Bone marrow transplantation studies suggested that vascular cell-derived, rather than macrophage-derived, CSF-1 is responsible for the effect on atherosclerosis. Consistent with previous studies, CSF-1 affected lesion development in a dose-dependent manner, suggesting that pharmacological inhibition of CSF-1 might achieve similar results. Indeed, we observed that treatment of hyperlipidemic mice with a CSF-1 receptor kinase inhibitor inhibited plaque progression. This observation was accompanied by a reduction in the expression of adhesion factors (ICAM-1), macrophage markers (F4/80), infl ammatory cytokines (Il-6, Il-1  ), and macrophage matrix degradation enzymes (MMP-9). We conclude that the M-CSF pathway contributes to monocyte recruitment and macrophage survival and that this pathway is a potential target for therapeutic intervention. -Shaposhnik, Z., X. Wang, and A. J. Lusis. Arterial colony stimulating factor-1 infl uences atherosclerotic lesions by regulating monocyte ...