The transforming growth factor- superfamily member bone morphogenetic protein-2 (BMP-2) is up-regulated in atherosclerotic arteries; however, its effects on the endothelium are not well characterized. Using microdissected coronary arterial endothelial cells (CAECs) and cultured primary CAECs, we demonstrated endothelial mRNA expression of BMP-2 and BMP-4. The proinflammatory cytokine tumor necrosis factor-␣ and H 2 O 2 significantly increased endothelial expression of BMP-2 but not BMP-4. In organ culture, BMP-2 substantially decreased relaxation of rat carotid arteries to acetylcholine and increased production of reactive oxygen species, events inhibited by pharmacologically blocking protein kinase C (PKC) or NAD(P)H oxidase. BMP-2 activated nuclear factor-〉 in CAECs, and BMP-2 and BMP-4 substantially increased adhesion of monocytic THP-1 cells, which was reduced by pharmacologically inhibiting p42/44 MAP kinase pathway (also by siRNA downregulating ERK-1/2) or PKC. Incubation of rat carotid arteries with BMP-2 ex vivo also increased adhesion of mononuclear cells to the endothelium, requiring p42/44 MAP kinase and PKC. Western blotting showed that in CAECs and carotid arteries BMP-2 elicited phosphorylation of p42/44 MAP kinase, which was reduced by blocking MAP kinase kinase and PKC. Collectively, expression of BMP-2 is regulated by proinflammatory stimuli, and increased levels of BMP-2 induce endothelial dysfunction, oxidative stress, and endothelial activation. The cytokine bone morphogenetic protein-2 (BMP-2), a transforming growth factor superfamily member, was originally detected in cartilage and bone 1 ; however, recent studies demonstrated that vascular endothelial and smooth muscle cells are also a significant source of BMPs.2-7 Genetic analysis of patients with primary pulmonary hypertension indicated that a vascular BMP-2/ BMP receptor system plays an important role in vascular physiology.8,9 BMP-2 is known to regulate a host of cellular functions, 2,4,5,10 including cardiovascular development, 10 neovascularization in bone 7 and tumors, 11 and smooth muscle cell chemotaxis.2 Endothelium-derived BMP-2 is osteoinductive 5,7 and hypotheses have been put forward that BMPs may contribute to vascular calcification. 3,5,12 Despite evidence for the physiological/ pathophysiological importance of BMP-2 the regulation of BMP-2 expression and the effects exerted by BMP-2 on endothelial function and phenotype have yet to be clearly elucidated.Previously, we have demonstrated that in coronary arteries in hyperhomocysteinemia vascular inflammation and up-regulation of tumor necrosis factor (TNF)-␣ is associated with an increased vascular BMP-2 expression. 13 Importantly, recent studies confirmed a striking up-regulation of BMPs in atherosclerotic lesions.2-4 BMP-4 (which is related to BMP-2 by its amino acid sequence but is transcribed from an entirely different gene) 4,6 was shown to exert proinflammatory effects by enhancing monocyte adhesion to the endothelium. On the basis of the aforementioned findings we h...