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(Circulation Research. 1996;78:44-49.)
© 1996 American Heart Association, Inc.


Articles

Regulation of Matrix Metalloproteinases and Plasminogen Activator Inhibitor-1 Synthesis by Plasminogen in Cultured Human Vascular Smooth Muscle Cells

Elaine Lee, Douglas E. Vaughan, Smruti H. Parikh, Alan J. Grodzinsky, Peter Libby, Michael W. Lark, Richard T. Lee

From the Harvard-MIT Division of Health Sciences and Technology (E.L., A.J.G., R.T.L.), Cambridge, Mass; the Cardiology Division (D.E.V.), Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, Tenn; the Cardiovascular Division (S.H.P., P.L., R.T.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; and Merck Research Laboratories (M.W.L.), Rahway, NJ.

Correspondence to Richard T. Lee, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail rtlee@bics.bwh.harvard.edu.


*    Abstract
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*Abstract
down arrowIntroduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
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Abstract Plasmin and matrix metalloproteinases (MMPs) both participate in extracellular matrix remodeling. This study examined the effects of tumor necrosis factor-{alpha} (TNF-{alpha}) and plasminogen on collagenase, stromelysin, and plasminogen activator inhibitor-1 (PAI-1) synthesis by cultured human vascular smooth muscle cells (SMCs). TNF-{alpha} induced the concentration-dependent synthesis of collagenase and stromelysin, which remained predominantly in proenzyme forms, as determined by Western analysis of culture media. In contrast, plasminogen and plasmin not only increased secretion of MMPs but also induced cleavage to their active forms. The serine protease inhibitor aprotinin inhibited this activation of MMPs by plasminogen and plasmin. TNF-{alpha} reduced plasminogen-induced activation of MMPs, suggesting induction of an inhibitor of plasmin generation, such as PAI-1. Enzyme-linked immunosorbent assay of culture media showed that TNF-{alpha} (10 ng/mL) increased PAI-1 secretion by 4.2-fold compared with control (105.5±9.6 versus 24.9±1.7 ng/mL, n=3). Surprisingly, plasminogen also increased PAI-1 secretion by vascular SMCs (3.6-fold over control). These results demonstrate coordination of cytokines and serine proteases in regulating MMP secretion and activation. In addition, the induction of PAI-1 by TNF-{alpha} and plasminogen suggests a negative-feedback mechanism to limit both plasmin-mediated and MMP-mediated matrix degradation.


Key Words: collagenase • stromelysin • vascular smooth muscle • plasmin • plasminogen


*    Introduction
up arrowTop
up arrowAbstract
*Introduction
down arrowMaterials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Vascular remodeling occurs in response to hemodynamic stimuli, biochemical mediators, or injury.1 Remodeling may involve changes in the number and distribution of cells as well as changes in the quantity and composition of extracellular matrix. The modification of extracellular matrix depends on both synthesis and degradation of matrix molecules. In vascular tissue, SMCs synthesize collagen and proteoglycans, the principal components of vascular matrix.2 3 Interstitial collagenase and stromelysin are MMPs, which degrade matrix components, and SMCs can produce these proteases.4 5 Macrophages, which can accumulate in diseased vascular tissue, may also be an important source of MMPs.6

The MMPs are secreted in zymogen form and require extracellular activation. The serine protease plasmin can activate latent collagenase and stromelysin in vitro and may perform this role in vivo in some tissues.7 8 Plasmin, in turn, must be generated from plasminogen by plasminogen activators, and plasmin may directly degrade several components of extracellular matrix. Vascular SMCs can synthesize plasminogen activators as well as plasminogen activator inhibitors.9 10 Plasmin may also regulate remodeling beyond its role in activating latent MMPs; Werb and Aggeler11 reported that cultured fibroblasts treated with plasmin increase collagenase secretion. Therefore, regulation of vascular extracellular matrix degradation can occur at multiple levels involving the secretion and activation of MMPs. Furthermore, TIMPs may inhibit the activity of the activated enzymes.

Several cytokines potently modulate extracellular matrix synthesis and degradation. For example, interleukin-1, platelet-derived growth factor, and transforming growth factor-ß increase the synthesis of collagen and proteoglycans by cultured vascular SMCs.12 13 14 15 16 Interleukin-1 and TNF-{alpha} also induce interstitial collagenase and stromelysin synthesis by vascular SMCs.17 Since these cytokines are present in the blood vessel wall in certain pathological conditions, these observations may have in vivo relevance.

The present study investigated the role of plasminogen, with and without TNF-{alpha}, on the synthesis and activation of MMPs by cultured human vascular SMCs. We report that both plasminogen and TNF-{alpha} induce the synthesis of collagenase and stromelysin and that plasminogen also induces cleavage of the latent MMPs to the active forms. In addition, both plasminogen and TNF-{alpha} induce PAI-1, providing a negative-feedback mechanism for the matrix degradation response. These results demonstrate coordination of cytokines and serine proteases in regulating matrix remodeling by MMPs.


*    Materials and Methods
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up arrowAbstract
up arrowIntroduction
*Materials and Methods
down arrowResults
down arrowDiscussion
down arrowReferences
 
Materials
DMEM, Ham's F-12 medium, and Limulus amebocyte lysate test kit were obtained from BioWhittaker; fetal calf serum, from Hyclone Laboratories; tissue culture dishes, from Costar; ascorbate-2-phosphate, from Wako Pure Chemical Industries; nonessential amino acids, human Lys-plasminogen, kringle 1-3 and kringle 4 from human plasminogen, aprotinin, and endotoxin from Escherichia coli 0111:B4, from Sigma Chemical Co; insulin and transferrin, from Collaborative Research; TNF-{alpha}, from Genzyme; plasmin and goat anti-human plasminogen IgG, from Enzyme Research Laboratories; Centricon-10 microconcentrators, from Amicon; enhanced chemiluminescence detection system, from Amersham; goat anti-rabbit IgG antibody with horseradish peroxidase, from Bio-Rad Laboratories; and ELISA kits, from Biopool AB. Rabbit anti-human antibodies to human collagenase and stromelysin were prepared as previously described.18

Cell Culture
Medial-layer explants were cultured from unused portions of human saphenous veins from coronary bypass surgery. The culture medium was DMEM with 10% fetal calf serum, 25 mmol/L HEPES, 100 U/mL penicillin, 100 µg/mL streptomycin, 1.25 µg/mL amphotericin B, and 2 mmol/L L-glutamine. This medium is selective for SMCs over endothelial cells.19 Cells in some experiments were stained for {alpha}-actin. Unlike cultured rat vascular SMCs, cultured human vascular SMCs do not uniformly stain for {alpha}-actin. Approximately 50% of cells in the present study stained positively; this level is similar to other human vascular SMC preparations in our laboratories. Human dermal fibroblasts used as a control did not stain for {alpha}-actin (<5%).

SMCs from the explants were grown in tissue culture flasks. At confluence, the cells were split 1:3 by using 0.25% trypsin and EDTA. The cells were cultured in monolayers for two to six passages before use in experiments.

Treatment With Plasminogen and TNF-{alpha}
Cells were plated in 22- or 35-mm culture wells at 1 to 2.5x104 cells per square centimeter and 0.26 mL/cm2 of medium. The medium was the same as that described above and was further supplemented with 0.07 mmol/L ascorbate-2-phosphate, 0.1 mmol/L nonessential amino acids, and 0.75 mmol/L sodium sulfate. After 2 days, the medium was removed and replaced with 0.13 mL/cm2 of fresh medium. After 2 more days, serum was removed from the wells by washing four times with 0.26 mL/cm2 of IT medium (equal volumes of DMEM and Ham's F-12, with 12.5 mmol/L HEPES, 100 U/mL penicillin, 100 µg/mL streptomycin, 1.25 µg/mL amphotericin B, 1.5 mmol/L L-glutamine, 0.07 mmol/L ascorbate-2-phosphate, 0.1 mmol/L nonessential amino acids, 0.75 mmol/L sodium sulfate, 1 µmol/L insulin, and 5 µg/mL transferrin). After the last wash, 0.13 mL/cm2 of IT medium was added to each well. The IT medium was changed at 24 hours. At 48 hours, the IT medium was changed again, and human plasminogen and/or recombinant human TNF-{alpha} was added to the wells. Cells were also treated with human plasminogen kringles, human plasmin, or aprotinin in some experiments. The media were collected after 24 hours of treatment. Some wells were counted for total and viable cells by using trypan blue exclusion after collagenase and trypsin digestion of the cell layer; none of the treatments significantly changed cell numbers or cell viability. Each treatment was performed at least twice in independent experiments.

Because bacterial endotoxin can induce a variety of products, including MMPs and PAI-1,20 21 22 unused media containing 100 µg/mL of plasminogen or plasmin were assayed for endotoxin by using the chromogenic Limulus amebocyte lysate test.23 The plasminogen sample contained 8 pg/mL, and the plasmin sample contained 56 pg/mL endotoxin. Unused medium containing 2 trypsin inhibitor units per milliliter of aprotinin was similarly assayed and contained 150 pg/mL endotoxin. TNF-{alpha} is tested by the manufacturer for endotoxin level by gel clot test, and a concentration of 10 ng/mL TNF-{alpha} contains 0.02 pg/mL endotoxin. To test for possible effects due to the contaminating endotoxin, some cells were treated for 24 hours with up to 10 ng/mL of endotoxin from E coli; no significant effect on PAI-1 or MMP synthesis was seen at the concentrations of endotoxin in these studies.

Electrophoresis and Immunoblotting (Western Analysis)
Because the levels of response varied with the cell source in these primary cultures of SMCs, media samples from a TNF-{alpha} concentration-response experiment were concentrated up to 20-fold in Centricon-10 centrifugal microconcentrators. All other samples were analyzed without concentration. Samples underwent electrophoresis on SDS–10% polyacrylamide gels under reducing conditions (SDS-PAGE). The proteins were transferred to nitrocellulose membranes, and an enhanced chemiluminescence detection system was used to detect collagenase or stromelysin. A 5% solution of nonfat dried milk in PBS containing 0.1% Tween 20 was used to block nonspecific binding and to dilute the primary and secondary antibodies. The primary antibodies were rabbit anti-human collagenase IgG (0.97 µg/µL, diluted 1:800 or 1:600) and rabbit anti-human stromelysin antiserum (diluted 1:400). The secondary antibody was goat anti-rabbit IgG conjugated with horseradish peroxidase.

ELISA for PAI-1
Media samples were assayed for PAI-1 as previously described.24 In brief, samples were incubated in microtiter plates coated with monoclonal antibodies against PAI-1, unbound antigen was washed off, and bound antigen was detected by addition of a second specific antibody conjugated to horseradish peroxidase. Standard curves were constructed from dilutions of purified PAI-1.


*    Results
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up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
*Results
down arrowDiscussion
down arrowReferences
 
Effect of Plasminogen and Plasmin on MMP Secretion and Activation
Western blot analysis demonstrated that plasminogen induced secretion of both collagenase and stromelysin in a concentration-dependent manner in vascular SMCs (Fig 1Down). In the absence of plasminogen, SMCs secreted little collagenase in its latent glycosylated and unglycosylated forms, although the lower molecular weight activated forms of the enzymes were not detectable (Fig 1ADown). Total collagenase secretion increased with plasminogen concentration, although the absolute amounts varied among experiments using SMCs from different sources. These differences are explained by the variability in the magnitude of response to stimuli in primary cultures of SMCs. Plasminogen levels of 50 or 100 µg/mL, depending on the particular experiment, were sufficient to cause activation of the collagenase to the smaller forms. The response of stromelysin secretion to plasminogen was similar (Fig 1BDown). Total stromelysin levels increased with plasminogen concentration. The unglycosylated and glycosylated activated forms appeared with 50 or 100 µg/mL plasminogen, but only the latent forms appeared at lower concentrations. Some cross-reactivity of the stromelysin antiserum with plasmin is evident near 60 kD.



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Figure 1. Concentration dependence of induction and activation of MMPs by plasminogen (Plgn). Cells were treated for 24 hours with the indicated concentrations of Plgn. Media samples underwent SDS-PAGE and immunoblotting with antibody to collagenase (A) or stromelysin (B). The larger molecular weight doublets represent the glycosylated and unglycosylated zymogens. The smaller molecular weight doublets represent their activated forms. The lanes marked Pg and Pm contain media with 100 µg/mL Plgn and plasmin, respectively, that had not been exposed to cells. (The identity of the higher molecular weight species recognized by the antiserum in the third lane is unknown.)

To explore further the induction of MMPs, vascular SMCs were cultured with plasmin (Fig 2Down). As in the experiments with plasminogen, Western blot analysis of the culture media showed that both collagenase and stromelysin were induced in a concentration-dependent manner by plasmin; furthermore, activation of the proenzymes to the active forms was also concentration dependent. Some cross-reactivity of the collagenase antiserum with plasmin is evident near 60 kD.



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Figure 2. Concentration dependence of induction and activation of MMPs by plasmin (Plmn). Cells were treated for 24 hours with the indicated concentrations of Plmn. Media samples underwent SDS-PAGE and immunoblotting with antibody to collagenase (A) or stromelysin (B). The lanes marked Pm contain media with 100 µg/mL Plmn that had not been exposed to cells.

Treatment of the SMCs with plasminogen lysine-binding-site fragments was performed to examine the possibility of a direct effect of plasminogen on MMP secretion. Kringle 4 did not affect MMP secretion, even at 10 times the molar concentration of plasminogen that increased MMP production (data not shown). Kringle 1-3 cross-reacted with the anti-collagenase and anti-stromelysin antisera and comigrated as a smear in the same molecular weight range as the activated MMPs.

Effect of Aprotinin on Induction of MMPs by Plasminogen and Plasmin
The activation of collagenase and stromelysin by 100 µg/mL plasminogen or plasmin was completely blocked by treatment with 2 trypsin inhibitor units per milliliter of the serine protease inhibitor aprotinin (Fig 3Down). Unexpectedly, aprotinin itself caused the induction of latent MMPs in the absence of cytokines, plasminogen, or plasmin. Plasminogen or plasmin combined with aprotinin did not increase collagenase levels above those induced by aprotinin alone. The results for the effects of aprotinin on stromelysin activation were similar (data not shown).



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Figure 3. Effect of aprotinin (Aprot) on the induction of MMPs by plasminogen (Pg) and plasmin (Pm). Cells were treated for 24 hours with 100 µg/mL Pg or 100 µg/mL Pm, with or without 2 trypsin inhibitor units per milliliter Aprot. Media samples underwent SDS-PAGE and immunoblotting with antibody to collagenase.

Effect of TNF-{alpha} on MMP Secretion and Activation
Vascular SMCs responded to 0, 0.1, 1, or 10 ng/mL TNF-{alpha} with a concentration-dependent increase of collagenase and stromelysin (data not shown). Most of the induced MMPs were in the latent forms, but a small amount appeared in the activated forms. These results are consistent with those of Galis et al,17 who reported that TNF-{alpha} induced de novo synthesis of these two enzymes by vascular SMC cultures. In the presence of 100 µg/mL plasminogen, the concentration of TNF-{alpha} had varying effects on total collagenase secretion in experiments using SMCs from different sources. However, the trend in activation state of collagenase was consistent among independent experiments. Although the collagenase was primarily in the active forms with 0, 0.1, and 1 ng/mL TNF-{alpha}, most of the collagenase appeared in the latent forms with 10 ng/mL TNF-{alpha} (Fig 4ADown), suggesting that TNF-{alpha} induced an inhibitor of MMP activation. The addition of TNF-{alpha} to 100 µg/mL plasminogen also had varying effects on total stromelysin secretion by SMCs in independent experiments. However, as with collagenase, 10 ng/mL TNF-{alpha} consistently inhibited plasminogen-induced activation of stromelysin, whereas lower concentrations of TNF-{alpha} allowed most of the stromelysin to be activated (Fig 4BDown).



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Figure 4. Effect of TNF-{alpha} on activation of plasminogen-induced MMPs. Cells were treated for 24 hours with 100 µg/mL plasminogen plus the indicated concentrations of TNF-{alpha}. Media samples underwent SDS-PAGE and immunoblotting with antibody to collagenase (A) or stromelysin (B).

Effects of TNF-{alpha} and Plasminogen on PAI-1 Secretion
The TNF-{alpha} inhibition of MMP activation by plasminogen suggested that TNF-{alpha} increased serine protease inhibitory activity. TNF-{alpha} has been shown to induce PAI-1 secretion in endothelial cells.22 Therefore, measurements of PAI-1 in the culture media were performed. As expected, TNF-{alpha} induced PAI-1 in a concentration-dependent manner; at 10 ng/mL, PAI-1 levels were 4.2-fold over control levels (Fig 5ADown). Surprisingly, plasminogen (Fig 5BDown) also induced PAI-1 in a concentration-dependent manner (3.6-fold over control at 100 µg/mL). The combination of TNF-{alpha} and plasminogen led to levels of PAI-1 that were significantly higher than levels reached by either one alone (Student's t test, P<.05) but less than would be expected if their effects were simply additive (Fig 5CDown). In a separate experiment, plasmin (100 µg/mL) induced PAI-1 levels more than ninefold over control levels.



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Figure 5. Individual and combined effects of TNF-{alpha} and plasminogen (Plgn) on induction of PAI-1 (A, TNF-{alpha}; B, Plgn; and C, Plgn with 10 ng/mL TNF-{alpha}). Cells were treated for 24 hours with the indicated concentrations of TNF-{alpha} and Plgn. PAI-1 levels were measured by ELISA.

Activity of PAI-1 Induced by TNF-{alpha}
To test the activity of the TNF-{alpha}–induced PAI-1, the conversion of plasminogen to plasmin in the absence or presence of TNF-{alpha} in SMC cultures was determined by Western blot analysis (Fig 6Down). In the absence of TNF-{alpha}, plasminogen was cleaved to plasmin, although the efficiency of the conversion varied among experiments using different sources of SMCs. In the presence of 10 ng/mL TNF-{alpha}, and therefore in the presence of PAI-1, plasminogen activation was almost completely blocked.



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Figure 6. Effect of TNF-{alpha} on conversion of plasminogen to plasmin. Cells were treated for 24 hours with 100 µg/mL plasminogen in the absence (Pg) or presence (Pg+T) of 10 ng/mL TNF-{alpha}. The lanes marked Pg* and Pm* contain media with 100 µg/mL plasminogen and plasmin, respectively, that had not been exposed to cells.


*    Discussion
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
*Discussion
down arrowReferences
 
The matrix degradation process is regulated at several levels. The MMPs are secreted in latent form and require activation, possibly by plasmin. Once the MMPs are activated, their activity may be inhibited by TIMPs. Vascular SMCs can produce not only matrix molecules and MMP zymogens but also plasminogen activators, plasminogen activator inhibitors, and TIMPs.4 Furthermore, vascular cells can vary the expression of plasminogen activator receptors to facilitate or decrease the activation of plasminogen.25 SMCs may also influence the degradation of plasminogen activators.26

In the present study, we found that plasminogen not only increases MMP secretion and activation but also induces PAI-1 secretion in SMCs. This concentration-dependent induction of PAI-1 synthesis by plasminogen suggests a negative-feedback mechanism for downregulating the effects of plasmin (Fig 7Down). If plasmin and MMPs were not tightly regulated, matrix degradation could proceed too rapidly for appropriate remodeling responses by the SMCs. The secretion of PAI-1 could have the dual negative-feedback effect of both downregulating plasmin-mediated degradation and downregulating MMP activation. This may provide the cell with a mechanism to control MMP activity even after the MMPs have been synthesized and secreted into the extracellular space. The cell specificity of this negative-feedback mechanism warrants further study, since Etingin et al27 found no effect of plasminogen on PAI-1 secretion by cultured vascular endothelial cells.



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Figure 7. Interactions of the plasminogen system with matrix degradation by vascular smooth muscle cells. TNF-{alpha} (TNF) and plasmin induce the production of latent MMPs (collagenase and stromelysin). Plasmin, which must be generated from plasminogen by plasminogen activator (PA), can activate the MMPs. TNF and plasmin also induce PAI-1. Induction of PAI-1 may represent a negative-feedback mechanism to downregulate matrix degradation both by limiting plasmin generation and by reducing activation of MMPs.

Although TNF-{alpha} increased MMP secretion in SMCs, the MMPs were largely in the latent zymogen forms. We also found that TNF-{alpha} at 1 ng/mL and higher concentrations can partially inhibit the activation of MMPs, even in the presence of plasminogen levels sufficient to activate MMPs in the absence of TNF-{alpha}. These results are consistent with the finding that TNF-{alpha} increases PAI-1, decreasing the amount of plasmin available to activate MMPs. Analysis by immunoblotting confirmed that PAI-1 induced by TNF-{alpha} almost completely inhibited the conversion of plasminogen to plasmin in SMC cultures. Consequently, at higher concentrations of TNF-{alpha}, there was much less plasmin available to induce MMP secretion, such that TNF-{alpha} played a greater role in increasing MMP levels. On the other hand, PAI-1 induced by plasminogen (or by plasminogen-derived plasmin) did not inhibit plasminogen-induced MMP activation, probably because sufficient plasmin was already generated to activate MMPs.

The level of matrix-bound PAI-1 may respond to stimuli differently from PAI-1 in the media. Functionally, matrix-bound PAI-1 is more stable and active.10 In the present study, only the free forms were assayed. A comparison of the levels of free and bound forms might provide more insight into their relative importance in matrix remodeling. Furthermore, changes in plasminogen activator levels may be occurring in parallel with changes in PAI-1 levels. Thus, although circumstantial evidence indicates that PAI-1 is inhibiting plasminogen activation, other plasminogen activator inhibitors synthesized by vascular SMCs such as PAI-2 and protease–nexin I28 may play significant roles as well.

The data of the present study are consistent with the hypothesis that induction and activation of MMPs by plasminogen are consequences of plasmin activity. The ability of aprotinin to inhibit plasminogen-induced MMP activation provides further evidence for the role of plasmin. However, aprotinin inhibits a wide variety of serine proteases; therefore, it is possible that its effects on MMP activation are via a different pathway. Similarly, the unexpected induction of latent MMPs by aprotinin in control experiments may be an indirect consequence of its inhibition of endogenous active serine proteases.

A direct plasmin-independent effect of plasminogen has not been excluded by these studies. Treatment of SMC cultures with kringle 4, a lysine-binding fragment of plasminogen,29 did not affect MMP levels, but the results of treatment with kringle 1-3, another lysine-binding fragment,29 were inconclusive. Kringle 5, which has a non–lysine-binding site, is the main site of interaction of plasminogen with cultured human umbilical vein endothelial cells30 and may play a role in interactions of plasminogen with receptors on SMCs. The effects of kringle 5 were not explored in the present study.

Plasmin can directly degrade many extracellular matrix molecules, including fibronectin, laminin, and proteoglycans.31 In addition, plasmin can regulate matrix degradation by increasing the secretion and activation of MMPs. Degradation of matrix may cause changes in cell-matrix interactions, changes in the local stresses on cells, and changes in cell shape. These changes could then signal the cell to express proteins that are necessary for remodeling, including MMPs and PAI-1. For example, fibroblasts express collagenase and stromelysin in response to agents that cause loss of stress fibers.32 In addition, Werb et al33 found that fibronectin fragments but not native fibronectin induced collagenase and stromelysin gene expression in the absence of obvious changes in cell shape, indicating that fibronectin degradation stimulates remodeling activity. Thus, it is possible that both matrix-receptor mechanisms and cytoskeletal changes may explain the induction of PAI-1 by plasminogen.


*    Selected Abbreviations and Acronyms
 
ELISA = enzyme-linked immunosorbent assay
MMP = matrix metalloproteinase
PAI-1, PAI-2 = plasminogen activator inhibitor-1 and -2
SMC = smooth muscle cell
TIMPs = tissue inhibitor of metalloproteinases
TNF-{alpha} = tumor necrosis factor-{alpha}


*    Acknowledgments
 
This study was supported in part by a grant from the American Heart Association (Massachusetts affiliate) and by a Merit Award from the Department of Veterans Affairs Research Service (Dr Vaughan). Dr E. Lee was supported by a Department of Defense National Science and Engineering Graduate fellowship. We thank Dr Marysia Muszynski for her excellent assistance with the Limulus amebocyte lysate test.

Received January 25, 1995; accepted September 11, 1995.


*    References
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowMaterials and Methods
up arrowResults
up arrowDiscussion
*References
 
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17. Galis ZS, Muszynski M, Sukhova GK, Simon-Morissey E, Unemori EN, Lark MW, Amento E, Libby P. Cytokine-stimulated vascular smooth muscle cells synthesize a complement of enzymes required for extracellular matrix digestion. Circ Res. 1994;75:181-189. [Abstract/Free Full Text]

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22. Sawdey M, Podor TJ, Loskutoff DJ. Regulation of type 1 plasminogen activator inhibitor gene expression in cultured bovine aortic endothelial cells: induction by transforming growth factor-ß, lipopolysaccharide, and tumor necrosis factor-{alpha}. J Biol Chem. 1989;264:10396-10401. [Abstract/Free Full Text]

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