Objective-Protease nexin-1 (PN-1), a serpin constitutively expressed by vascular smooth muscle cells and endothelial cells, inhibits thrombin, plasminogen activators, and plasmin and can thus be expected to play a role in vascular biology. The present study addressed the question of PN-1 expression in human atherothrombosis. Methods and Results-Immunohistochemistry and biochemical studies confirmed that PN-1 was expressed at a moderate level in the medial layer of normal human arteries and showed that PN-1 expression was increased in atherothrombotic lesions. In early noncomplicated plaques, PN-1 was associated with infiltrating mononuclear cells. A strong PN-1 signal was observed in advanced lesions, principally in intraplaque hemorrhage-related structures. Monocytes/macrophages and platelets were identified as the main sources of PN-1 within atherothrombotic material. Isolated human monocytes and platelets both expressed high levels of active PN-1, and monocyte PN-1 expression was upregulated, at both messenger and protein levels, in response to stimulation by lipopolysaccharides. In contrast, PN-1 expression was downregulated during their differentiation into macrophages which were shown to produce degraded forms of PN-1. Key Words: protease nexin-1 â
ą atherosclerosis â
ą inflammatory cells â
ą thrombin A disequilibrium between proteases and antiproteases increasingly appears to be critical in the pathogenicity of atherothrombosis, via the modulation of the size of the plaque, its stability, and its progression toward rupture. Serine protease inhibitors, termed serpins, may be important in regulating protease activity in arterial lesions. Although plasma antithrombin could theoretically diffuse into the inner vessel layer when endothelial permeability is increased, no thrombin-antithrombin complexes could be detected in the vessel wall. 1 There is substantial evidence that plasminogen activator inhibitor (PAI)-1, an essential serpin of the fibrinolytic system, may contribute to the development of coronary artery disease. 2 However it is difficult to draw global conclusions regarding the role (protective or deleterious) of PAI-1 in the development of atherosclerosis.
Conclusions-PlateletsVascular endothelial cells 3,4 and smooth muscle cells 5 produce another serpin named protease nexin-1 (PN-1). PN-1 is a powerful inhibitor of thrombin and also inhibits urokinase-type plasminogen activator (uPA), tissue plasminogen activator (tPA), and plasmin. Its action is potentiated by glycosaminoglycans (GAGs) such as heparan sulfates. 6 In contrast to antithrombin and PAI-1, PN-1 is barely detectable in plasma but is produced by various cell types. It was first identified in the central nervous system as glia-derived nexin and has been shown to inhibit the effects of thrombin on neuronal, as well as glial cells. 7 Pericellular serpins play a pivotal role in the physiology of tissue serine proteases. Catabolism of PN-1/protease complexes occurs in fibroblasts by internalization and intracellular degradation. 8 Recently PN-1...