The accumulation of lipid-loaded foam cells in the subendothelial space is an early event in the development of atherosclerosis (35). Recent evidence suggests that these foam cells are derived both from macrophages that originate from circulating monocytes and from vascular medial smooth muscle cells (27,36). Vascular smooth muscle cells migrate from the media to the intima of the arterial wall, where they proliferate, undergo structural and functional changes characteristic of a switch from a contractile to a synthetic phenotype, and are transformed into foam cells by actively taking up lipoprotein cholesterol through receptor-mediated endocytosis (27,28,36).Many studies have demonstrated that macrophage colonystimulating factor (M-CSF) is required for the differentiation, proliferation, and maturation of monocytes/macrophages (7,34). The effects of M-CSF are mediated through binding to specific, high-affinity surface receptors encoded by the c-fms proto-oncogene, which constitute one member of a family of growth factor receptors with an intrinsic tyrosine kinase activity (32). A recent study showed that transcription factor PU.1 plays a major role in macrophage gene regulation and development by directing the expression of the M-CSF receptor (38). We recently demonstrated the expression of the M-CSF receptor on vascular smooth muscle cells derived from the intima of arteriosclerotic lesions but not on normal vascular medial smooth muscle cells (17). We also showed that intimal smooth muscle cells isolated from atherosclerotic lesions show an increased rate of proliferation and tyrosine phosphorylation of the M-CSF receptor in response to M-CSF and are transformed into foam cells by taking up acetylated low-density lipoprotein (LDL) (17). The expression of c-fms in smooth muscle cells may initiate various biological events, including differentiation to monocyte/macrophagelike cells.We have shown that the combination of platelet-derived growth factor (PDGF)-BB with either epidermal growth factor (EGF) or fibroblast growth factor induces high levels of expression of c-fms in normal human medial smooth muscle cells to the extent apparent in intimal smooth muscle cells derived from atherosclerotic lesions or in monocyte-derived macrophages (15, 16). To investigate the mechanism by which growth factors induce c-fms expression in normal vascular smooth muscle cells, we have now examined the activity of the c-fms promoter and its interaction with transcription factors. We show here that a PU.1 binding site in the promoter region of c-fms plays an important role in the expression of c-fms in vascular smooth muscle cells.
MATERIALS AND METHODS
Cells.Human aortic medial smooth muscle cells were explanted by the method of . Cells were passaged three times by exposure to trypsin and seeded in 10 ml of Dulbecco's modified Eagle's medium (DMEM) (Gibco, Gaithersburg, Md.) containing 10% fetal bovine serum (FBS) in 100-mm-diameter dishes. Cells did not react with an antibody specific to macrophages, such as anti-CD14 antibody....