The purinergic nucleotide ATP is released from stressed cells and is implicated in vascular inflammation. Glucocorticoids are essential to stress responses and are used therapeutically, yet little information is available that describes the effects of glucocorticoids on ATP-induced inflammation. In a human microvascular endothelial cell line, extracellular ATP-induced interleukin (IL)-6 secretion in a dose-and time-dependent manner. When cells were pretreated with dexamethasone, a prototypic glucocorticoid, ATP-induced IL-6 production was enhanced in a time-and dose-dependent manner. Mifepristone, a glucocorticoid receptor antagonist, blocked these effects. ATP-induced IL-6 release was significantly inhibited by a phospholipase C inhibitor (88 Ϯ 1%, p Ͻ 0.001). Cells treated with dexamethasone induced mRNA expression of the purinergic P2Y 2 receptor (P2Y 2 R) 1.8-Ϯ 0.1-fold and, when stimulated with ATP, enhanced Ca 2ϩ release and augmented IL-6 mRNA expression. Silencing of the P2Y 2 R by its small interfering RNA decreased ATP-induced IL-6 production by 81 Ϯ 1% (p Ͻ 0.001). Dexamethasone enhanced the transcription rate of P2Y 2 R mRNA and induced a dose-related increase in the activity of the P2Y 2 R promoter. Furthermore, dexamethasoneenhanced ATP induction of adhesion molecule transcription and augmented the release of IL-8. Dexamethasone leads to an unanticipated enhancement of endothelial inflammatory mediator production by extracellular ATP via a P2Y 2 R-dependent mechanism. These data define a novel positive feedback loop of glucocorticoids and ATP-induced endothelial inflammation.