Increased Expression of Urokinase during Atherosclerotic Lesion Development Causes Arterial Constriction and Lumen Loss, and Accelerates Lesion Growth

Overexpression of urokinase plasminogen activator (uPA) in endothelial cells can decrease intravascular thrombosis. However, expression of uPA is increased in atherosclerotic human arteries, which suggests that uPA might accelerate atherogenesis. To investigate whether elevated uPA expression accele...

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Published in:Proceedings of the National Academy of Sciences - PNAS Vol. 99; no. 16; pp. 10665 - 10670
Main Authors: Falkenberg, Mårten, Tom, Clifford, DeYoung, Mary Beth, Wen, Shan, Linnemann, Ruth, Dichek, David A.
Format: Journal Article
Language:English
Published: United States National Academy of Sciences 06-08-2002
National Acad Sciences
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Summary:Overexpression of urokinase plasminogen activator (uPA) in endothelial cells can decrease intravascular thrombosis. However, expression of uPA is increased in atherosclerotic human arteries, which suggests that uPA might accelerate atherogenesis. To investigate whether elevated uPA expression accelerates atherogenesis, we cloned a rabbit uPA cDNA and expressed it in carotid arteries of cholesterol-fed rabbits. uPA gene transfer increased artery-wall uPA activity for at least 1 week, with a return to baseline by 2 weeks. One week after gene transfer, uPA-transduced arteries were constricted, with significantly smaller lumens and thicker walls, but no difference in intimal or medial mass. Two weeks after gene transfer, uPA- and control-transduced arteries were morphologically indistinguishable. By 4 weeks, however, uPA-transduced arteries had 70% larger intimas than control-transduced arteries (P < 0.01) and smaller lumens (P < 0.05). Intimal lesions appeared to be of similar composition in uPA- and control-transduced arteries, except that degradation of elastic laminae was evident in uPA-transduced arteries. These data suggest that elevated uPA expression in atherosclerotic arteries contributes to intimal growth and constrictive remodeling leading to lumen loss. Antagonists of uPA activity might, therefore, be useful in limiting intimal growth and preventing constrictive remodeling. Overexpression of uPA in endothelial cells to prevent intravascular thrombosis must be reconsidered, because this intervention could worsen underlying vascular disease.
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To whom reprint requests should be addressed. E-mail: ddichek@u.washington.edu.
M.F. and C.T. contributed equally to this work.
This paper was submitted directly (Track II) to the PNAS office.
Edited by Eugene Braunwald, Partners HealthCare System, Inc., Boston, MA, and approved June 20, 2002
Data deposition: The rabbit urokinase cDNA sequence has been deposited in the GenBank database (accession no. ).
ISSN:0027-8424
1091-6490
DOI:10.1073/pnas.162236599