Abstract-In human coronary atheromas, the numbers of degranulated mast cells and of apoptotic smooth muscle cells (SMCs) are increased. Accordingly, the possibility exists that mast cells participate in the regulation of SMC apoptosis in the lesions. Mast cells isolated from the serosal cavities of rats were stimulated to release their secretory granules. The neutral protease chymase, present in the exocytosed granules, was found to induce apoptosis when added to rat aortic SMCs in culture. The chymase-induced apoptosis of SMCs was detected by flow cytometry, microscopic analysis of cellular morphology, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL), and electrophoretic demonstration of DNA laddering. Chymase induced SMC apoptosis in a dose-and time-dependent manner, and its proteolytic activity was essential for the proapoptotic effect. In addition to rat chymase, recombinant human chymase was also found to induce apoptosis of human coronary artery SMCs in culture. Key Words: apoptosis Ⅲ smooth muscle Ⅲ atherosclerosis Ⅲ mast cells Ⅲ chymase S mooth muscle cells (SMCs) are the main cellular component in atherosclerotic lesions, and their number and activity largely determine the thickness of the intima. 1 During the final stages of atherosclerosis, the clinical relevance of the thickness of the intima is apparent: a thick intima (fibrous cap) overlying a lipid-rich core of an atheroma protects it from rupturing, whereas a thin cap predisposes it to rupture. 2 The concept has been put forward that the fibrous cap of an atheroma is a dynamic structure in which connective tissue matrix is produced and maintained by SMCs. 3 Accordingly, reduced production of the extracellular matrix due to decreased SMC number, either by necrotic or apoptotic cell death, would weaken the cap and potentiate the risk of cap rupture.Recent findings have demonstrated that SMCs of human coronary and carotid atheromas undergo apoptosis. 4 -7 Interestingly, it has been shown that SMCs isolated from human coronary atherosclerotic plaques are more prone to apoptosis than are SMCs from normal vessels. 8 The SMCs undergoing apoptosis are localized mainly in the fibrous caps of the atheromas and are accompanied by the presence of inflammatory cells. 6,9 In the inflammatory infiltrates, mast cells are also present. 10 -12 Our previous investigations have used isolated rat serosal mast cells, which, like human mast cells, release on stimulation an array of vasoactive mediators, proteoglycans, and neutral proteases. 13,14 The rat mast cells have been shown to be a useful model for studying various molecular aspects relevant to human atherogenesis. 15 Chymase is contained in the cytoplasmic granules of rat serosal mast cells and, on their degranulation, is secreted within expelled granules. 14 In the extracellular fluid, the soluble components of the exocytosed granules (ie, histamine, chondroitin sulfate proteoglycans, and a fraction of heparin sulfate proteoglycans) are solubilized and released from the granules. ...