1 In this study the mitogenic effects in human cultured tracheal smooth muscle cells of endothelin-l (ET-1), ET-3, and sarafotoxin S6c (S6c), the ETB receptor-selective agonist, were explored either alone or in combination with the potent mitogen, epidermal growth factor (EGF). 2 In confluent, growth-arrested human airway smooth, neither ET-1 (0.01 nM-1 Mm) nor (0.001 nM-1 Mm) or S6c (0.01 nM-1 yM) induced cell proliferation, as assessed by [3H]-thymidine incorporation. In contrast, EGF (1.6 PM-16 nM) produced concentration-dependent stimulation of DNA synthesis (EC50 of about 0.06 nM). The maximum increase of about 60 fold above control, elicited by 16nM EGF, was similar to that obtained with 10% foetal bovine serum (FBS). EGF (0.16-16nM) also produced a concentration-dependent increase in cell counts, whereas ET-1 (1 -100 nM) was without effect on this index of mitogenesis. 3 ET-1 (1 -100 nM) potentiated EGF-induced proliferation of human tracheal smooth muscle cells. For example, ET-1 (100nM), which alone was without significant effect, increased by 3.0 to 3.5 fold the mitogenic influence of EGF (0.16 nM). The potentiating effect of ET-1 on EGF-induced proliferation was antagonized by BQ-123 (3pM), the ETA receptor antagonist, but was unaffected by the ETB receptor antagonist BQ-788 (lOM). 4 Neither ET-3 (1-100 nM) nor S6c (1-100 nM) influenced the mitogenic effects of EGF (0.16-1.6 nM). 5 ['251]-ET-I binding studies revealed that on average the ratio of ETA to ETB receptors in human cultured tracheal smooth muscle cells was 35:65 (±3; n=4), confirming the predominance of the ETB receptor subtype in human airway smooth muscle. 6 These data indicate that ET-1 alone does not induce significant human airway smooth muscle cell proliferation. However, it potently potentiated mitogenesis induced by EGF, apparently via an ETA receptor-mediated mechanism. These findings suggest that ET-1, a mediator detected in increased amounts in patients with acute asthma, may potentiate the proliferative effects of mitogens and contribute to the airway smooth muscle hyperplasia associated with chronic severe asthma.