Increased interferon (IFN)-Collateral arteries alleviate symptoms of ischemia in patients with arterial obstructive disease. Circulating monocytes play an essential role in the growth of collateral arteries (1). We recently performed a monocyte mRNA expression study in patients with single vessel subtotal coronary artery stenosis. Genome-wide expression analysis demonstrated that increased expression of interferon (IFN) 2 - as well as IFN downstream genes is associated with insufficient coronary collateral artery growth, suggesting a potential anti-arteriogenic effect of this glycoprotein. In a murine model, application of IFN indeed resulted in an attenuated arteriogenic response upon femoral artery occlusion (2).In the current study, we investigated gene expression profiles of stimulated monocytes from patients with chronic total coronary occlusions. In contrast to patients with subtotal occlusions as previously studied, these patients can be considered to be in a stable phase of collateralization in which collateral artery growth has been maximally triggered and has reached its plateau phase.The mechanisms via which IFN exerts its anti-arteriogenic effects are unresolved. It is hitherto unknown if inhibition of IFN signaling results in stimulation of collateral artery growth. Vascular smooth muscle cells (VSMC) display a high rate of proliferation during arteriogenesis (3). In growing arteriolar anastomoses, they change from a contractile toward a proliferative phenotype (4). We therefore analyzed the effects of IFN application and inhibition in in vitro models of VSMC cell cycling and proliferation and on monocyte apoptosis. In vivo, the effects of inhibition of IFN were tested in mice lacking the subunit 1 of the IFN␣/ receptor (IFNAR1 Ϫ/Ϫ mice) (5).
MATERIALS AND METHODSPatient Study-The investigation conforms to the principles outlined in the Declaration of Helsinki and was approved by the institutional medical ethics committee (Ref. no. MEC 06/186). After giving informed consent, 50 Caucasian patients were included who underwent percutaneous coronary intervention (PCI) of a total coronary occlusion. Patients were considered eligible if they had symptoms of angina pectoris for Ն4 weeks and total chronic occlusion (CTO) of a coronary artery. Exclusion criteria were previous