Endothelin-1 is a potent vasoconstrictor and comitogen for vascular smooth muscle. As such, it has been implicated in pulmonary vascular remodeling and in the development of pulmonary hypertension. Prostacyclin has been shown to be an effective therapy for human pulmonary hypertension, reducing morbidity and mortality, although the mechanism of its action is unknown. Here, we show that the combination of TNF-␣ and IFN-␥ induces the release of endothelin-1 from human pulmonary artery smooth muscle cells via increased transcription of prepro endothelin-1. The release of endothelin-1 and the transcription of prepro endothelin-1 mRNA were inhibited by the activity of coinduced cyclooxygenase-2. Endothelin-1 release was also inhibited by a prostacyclin-mimetic (cicaprost). Thus, under inflammatory conditions, in which vascular smooth muscle is an important source of endothelin-1, the induction of cyclooxygenase-2 represents an endogenous "braking" mechanism. In addition, the beneficial effects of prostacyclin in the treatment of pulmonary hypertension may be caused, at least in part, by the inhibition of endothelin-1 release. Finally, we suggest that these observations may help to explain why patients with pulmonary hypertension experience exacerbations after taking indomethacin and that the newly introduced selective cyclooxygenase-2 inhibitors may increase endothelin-1 production in susceptible patients, leading to vascular remodeling and the development of pulmonary hypertension.In healthy subjects, pulmonary vascular tone and remodeling is controlled by the balanced, local release of vasoactive mediators, which are chiefly produced by the endothelium, and they act on the underlying smooth muscle. These mediators include the vasodilators nitric oxide and prostacyclin (PGI 2 ) and the vasoconstrictor endothelin-1 (ET-1). Under inflammatory conditions, these control mechanisms are lost, leading to pulmonary vascular dysfunction, characterized by vasoconstriction and proliferation of vascular smooth muscle (Wort and Evans, 1999). Clinically, this leads to the development of increased pulmonary vascular resistance and the development of pulmonary hypertension. ET-1, a 21-amino acid peptide, is formed from big-ET-1 by the action of membrane-bound metalloproteases termed "endothelin-converting enzymes" (ECEs) (Schmidt et al