The plasminogen activator inhibitor-1 (PAI-1) expression can be enhanced by hypoxia and other stimuli leading to the mobilization of intracellular calcium. Thus, it was the aim of the present study to investigate the role of calcium in the hypoxia-dependent PAI-1 expression. It was shown that the Ca 2؉ -ionophore A23187 and the cell permeable Ca 2؉ -chelator BAPTA-AM (
IntroductionPlasminogen activator inhibitors (PAIs) appear to play a major regulatory role in physiologic processes such as fibrinolysis and tissue regeneration as well as a number of pathophysiologic conditions such as cancer metastasis, myocardial infarction, thrombosis, or type 2 diabetes. Among 2 identified inhibitors, PAI-1 and PAI-2, PAI-1 is the primary physiologic inhibitor of both tissuetype and urokinase-type plasminogen-activator (tPA and uPA, respectively). PAI-1, as a member of the SERPIN (Serine Protease Inhibitor) family, is a single chain, 50-kDa glycoprotein that can be produced by platelets, vascular endothelial cells, vascular smooth muscle cells, and some other nonvascular cell types such as hepatocytes. [1][2][3] Moreover, a factor known as protein C inhibitor (PCI), which can be synthesized in liver and some other steroidresponsive organs, was proposed to be named PAI-3. 4 We and others have shown that PAI-1 gene expression can be induced by hypoxia via binding of the transcription factor hypoxiainducible factor-1 (HIF-1) to hypoxia response elements (HREs) in the PAI-1 gene promoter. 5,6 HIF-1 is a heterodimer composed of HIF-1␣ and HIF-1 (arylhydrocarbon receptor nuclear translocator [ARNT]). Under normoxia, HIF-1␣ is constitutively degraded after binding the von Hippel-Lindau (VHL) protein which targets HIF-1␣ for ubiquitination and proteasomal destruction. 7,8 The binding of VHL to HIF-1␣ is specified by the hydroxylation of the key amino acids proline 402 and 564 in the oxygen-dependent degradation domain (ODDD) of HIF-1␣. The hydroxylation reaction can be carried out by a family of newly identified HIF-1␣ prolyl hydroxylases (PHDs). [9][10][11][12] Because the activity of these enzymes is aside from Fe 2ϩ , ascorbate, and 2-oxoglutarate, also dependent on the presence of O 2 , their activity decreases under hypoxia. Thus, under hypoxia HIF-1␣ is stabilized, accumulates, and translocates into the nucleus where it dimerizes with ARNT and binds to HREs in regulatory regions of target genes such as PAI-1.In addition to hypoxia, several other stimuli have been shown to induce PAI-1 at the transcriptional level, including phorbol esters, 13 inflammatory cytokines, 14 transforming growth factor , 15 angiotensin, and insulin. 16 An important intracellular messenger which has been implicated to have an effect on hypoxia-and hormone-dependent gene expression is intracellular calcium. 17,18 Calcium ions (Ca 2ϩ ) are released usually in response to inositol triphosphate (IP3) from the endoplasmic reticulum (ER) serving as intracellular calcium store. However, it remains open whether an increase in Ca 2ϩ as possibly observed unde...