The extracellular matrix (ECM) of tissues is susceptible to modification by inflammation-associated oxidants. Considerable data support a role for hypochlorous acid (HOCl), generated by the leukocytederived heme-protein myeloperoxidase (MPO) in these changes. HOCl can modify isolated ECM proteins and cell-derived matrix, with this resulting in decreased cell adhesion, modulated proliferation and gene expression, and phenotypic changes. Whether this arises from free HOCl, or via site-specific reactions is unresolved. Here we examine the mechanisms of MPO-mediated changes to human coronary smooth muscle cell ECM. MPO is shown to co-localize with matrix fibronectin as detected by confocal microscopy, and bound active MPO can initiate ECM modification, as detected by decreased antibody recognition of fibronectin, versican and type IV collagen, and formation of protein carbonyls and HOCl-mediated damage. These changes are recapitulated by a glucose/glucose oxidase/MPO system where low continuous fluxes of H 2 o 2 are generated. HOCl-induced modifications enhance Mpo binding to ecM proteins as detected by eLiSA and Mpo activity measurements. these data demonstrate that MPO-generated HOCl induces ECM modification by interacting with ECM proteins in a site-specific manner, and generates alterations that increase MPO adhesion. This is proposed to give rise to an increasing cycle of alterations that contribute to tissue damage.The extracellular matrix (ECM) is essential for the homeostasis of tissues. In the case of the artery wall, the vascular basement membrane plays a key role in supporting and determining endothelial and smooth muscle cell survival and function 1 . This ECM forms a specialized and distinct microenvironment, with the biomacromolecules (e.g., collagens, laminins, fibronectin, perlecan, versican, elastin, nidogen, syndecans) that comprise this material, and a myriad of associated materials (e.g., cytokines, growth factors) dictating the shape and function of the artery wall, and the nature and behavior of the associated vascular cells 2 . Due to the lower turnover rate of many ECM materials (cf. estimated half-lives of 60-70 days and 74 years for arterial collagen and elastin, respectively 3,4 ), and the low levels of antioxidant defense systems in extracellular environments 5 , ECM components and proteins in biological fluids appear to be particularly susceptible to oxidant damage. These factors result in a gradual accumulation of damage in the ECM with both aging and disease, including within the artery wall during the development of atherosclerosis (reviewed 2,6 ). At least some of this damage appears to arise via the formation of oxidants generated by the leukocyte-derived heme enzyme myeloperoxidase (MPO) 7 .Alterations to the structure and properties of ECM has been associated with the progression of atherosclerosis 8 . Previous studies have shown that approximately 70% of the oxidation products detected on proteins extracted from human atherosclerotic lesions are present on ECM proteins 7 , consist...