Key Words: vascular remodeling Ⅲ vascular smooth muscle Ⅲ neointima Ⅲ restenosis Ⅲ chemokines T he response to mechanical vessel injury clinically encountered as restenosis after percutaneous interventions is characterized by the formation of neointimal tissue comprising primarily smooth muscle cells (SMCs) and leukocytes. 1,2 Although drug-eluting stents have significantly reduced the need for repeated target vessel revascularization, long-term treatment with inhibitors of platelet aggregation after drug-eluting stent implantation to avoid late stent thrombosis is still a significant constraint. 3 Impaired endothelial recovery of drug-eluting stents is caused by the unspecific antimigratory and antiproliferative activities of drugs like Rapamycin or Paclitaxel and has been identified as a major risk factor for late stent thrombosis. 4 Therefore, development of alternative drugs which inhibit specifically neointimal SMC accumulation would be preferable. Apart from proliferation of neointimal SMCs, recruitment of circulating smooth muscle progenitor cells (SPCs) contributes decisively to the accumulation of SMCs in the neointima. [5][6][7] The chemokine CXCL12 (CXC motif ligand 12) and its receptor CXC motif receptor (CXCR)4 regulate the mobilization and recruitment of SPCs after vascular injury, 5,6,8 without affecting re-endothelialization. 9 Early apoptosis of medial SMCs and the nonhypoxic activation of the transcription factor hypoxia- Original received November 10, 2009; revision received March 22, 2010; accepted March 24, 2010. In March 2010, the average time from submission to first decision for all original research papers submitted to Circulation Research was 13.3 days.From the Institute for Molecular Cardiovascular Research (P.S., E.K., T.A., R.T.A.M., Z.Z., S.A., U.S., X.L., M.v.Z., C.W., A.S.) and Interdisciplinary Center for Clinical Research BIOMAT within the Faculty of Medicine (P.S., X.L., R.T.A.M.), RWTH Aachen University, Germany; Cardiology Unit (E.K., P.R.), Medical Policlinic-City Center Campus, University of Munich, Germany; Polyphor Ltd (C.L.), Allschwill, Switzerland; and Cardiovascular Research Institute Maastricht (CARIM) 20,21 Among a variety of unsaturated LPA species, LPA20:4 (1-arachidonoyl-2-lyso-sn-glycero-3-phosphate) and the alkyl-ether analog 1-AGP18:1 (1-oleyl-2-lyso-sn-glycero-3-phosphate) have been shown to stimulate neointimal growth in rats most efficiently. 20 Although LPA serves as a mitogenic growth factor for SMCs in vitro, 22 the exact mechanism of LPA-induced neointima formation remains unclear. Interestingly, in contrast to mice with combined deficiency of LPA 1 and LPA 2 , neointimal hyperplasia after carotid ligation was enhanced in LPA 1 Ϫ/Ϫ mice. This finding suggests a major role of Edg family LPA receptors in vascular repair. 23 In vitro, unsaturated LPA induces CXCL12 expression, which is inhibited by the LPA 1 and LPA 3 receptor antagonist Ki16425. 24 We therefore hypothesize that any blocking of the LPA receptors LPA 1 and LPA 3 reduces CXCL12 expres...