Abstract-This study was performed to investigate whether the expression of p21 Sdi1/Cip1/Waf1 , one of the cyclin-dependent kinase inhibitor proteins, could be regulated by nitric oxide (NO) and might account for the antiproliferative effect of NO. Quiescent adventitial fibroblasts were stimulated to proliferate by serum addition and by NO donors added during different phases of the cell cycle. [ 3 H]Thymidine incorporation was markedly reduced by S-nitroso-N-acetylpenicillamine (SNAP) added either with serum at quiescence or at later time point in the cell cycle. Northern and Western blot analyses showed that addition of SNAP either at quiescence or 15 hours after serum addition induced a rapid induction of p21 mRNA and protein. Immunoprecipitation studies and electrophoretic mobility shift analysis indicate that the treatment of cells with SNAP induced the phosphorylation of p53 (a tumor suppressor protein) and enhanced the ability of p53 to bind DNA when SNAP was added during the cell cycle. The increased expression of p21 mRNA or p53 activation during late G 1 or S phase was also caused by addition of 8-bromo-cGMP and effectively blocked by a specific inhibitor of the soluble guanylate cyclase. Furthermore, this response to SNAP was blocked by an inhibitor of protein kinase G. These studies implicate NO as a potential regulator of the cell cycle in aortic adventitial fibroblasts through a cGMP-mediated transcriptional mechanism involving the induction of p21. Key Words: nitric oxide Ⅲ p21 Sdi1/Cip1/Waf1 Ⅲ cell cycle Ⅲ adventitial fibroblasts I n vascular biology, the control of cell proliferation is an important aspect of the changes occurring in atherosclerosis, restenosis, and hypertension. Recent work has implicated nitric oxide (NO) as a potentially important regulatory substance with regard to vascular growth and proliferation, because increased NO production has been associated with antiproliferative effects, countering the responses to a variety of growth-promoting agonists, including angiotensin II, endothelin, and platelet-derived growth factor. Many studies have documented the antiproliferative effects of NO on vascular smooth muscle cells, and this phenomenon has been ascribed to mechanisms that are both cGMP dependent 1 and cGMP independent 2 and include inhibition of thymidine kinase 3 and ribonucleotide reductase. 4,5 Additionally, activation of a cAMP-dependent protein kinase by cGMP has been implicated. 6 A recent study 7 has used cultured vascular smooth muscle cells to show that NO addition results in p21 mRNA and protein induction, which might account for the antiproliferative effect of NO. The p21/Waf1/Cip1 gene encodes a protein classified as a cyclin-dependent kinase inhibitor that acts by either directly suppressing the activity of cyclin-dependent kinase complexes or by forming a complex with proliferating cell nuclear antigen. The overall effect is to arrest cell proliferation during the cell cycle by preventing DNA replication in S phase. 8,9 The results described in vascular smooth...