Abstract-Decorin is an extracellular matrix (ECM) proteoglycan that may modify vascular smooth muscle cell (SMC) function by altering the response to growth factors and the accumulation of ECM proteins during vascular injury. To investigate these possibilities in vivo, decorin was overexpressed at the site of arterial injury by cell-mediated gene transfer. Fischer rat SMCs were transduced in vitro with a retroviral construct that contained the bovine decorin gene and were subsequently seeded into injured rat carotid arteries. A species-specific antibody to bovine decorin and polymerase chain reaction primers were used to detect bovine decorin and distinguish it from endogenous rat decorin.Immunohistochemical and Northern analyses of rat carotid arteries revealed only low levels of rat decorin expression up to 8 weeks after balloon injury. However, after cell-mediated transfer of bovine decorin, strong expression of bovine decorin was verified by immunohistochemistry and reverse transcriptase-polymerase chain reaction. Four weeks after injury, the intimal area in vessels seeded with bovine decorin-overexpressing SMCs was significantly reduced by 35Ϯ4% (meanϮSEM, nϭ9; PϽ0.01). Decorin overexpression also induced a higher intimal nuclear density and decreased volume of ECM. Specifically, immunostaining for versican and fibronectin was markedly reduced. In contrast, immunostaining for collagen type I was increased, and electron microscopy confirmed that collagen accumulation was altered. Key Words: proteoglycans Ⅲ smooth muscle cells Ⅲ extracellular matrix Ⅲ gene therapy Ⅲ hyperplasia I ntimal hyperplasia and subsequent arterial stenosis frequently reduce the long-term benefits of therapeutic vascular interventions in patients. The mechanisms leading to the development of neointimal hyperplasia in response to arterial injury involve increased migration, proliferation, and synthesis of the extracellular matrix (ECM) by smooth muscle cells (SMCs). 1,2 Increased migration and proliferation of SMCs, which occur early after injury, are responsible for the formation of a highly cellular intimal lesion. The intimal lesion continues to expand after cell migration and proliferation cease as a result of ECM synthesis and accumulation. The majority of efforts to inhibit intimal hyperplasia have focused on inhibition of SMC proliferation and migration. However, inhibition of ECM accumulation could also be an effective strategy because the ECM constitutes Ϸ80% of the volume of the intimal lesion after 4 weeks. Moreover, the phenotype and behavior of SMCs are influenced through interactions between ECM receptors at the surface of SMCs and specific ECM ligands. [3][4][5][6] Decorin is a member of the family of small leucine-rich proteoglycans. [7][8][9] The core protein of decorin contains 1 dermatan sulfate side chain near the amino terminal of the core protein and 2 independent binding domains for collagen type 1 and transforming growth factor (TGF)- 1 . 10 Decorin was chosen for the present study because it has previously be...