A key angiogenic role of monocyte chemoattractant protein-1 in hemangioendothelioma proliferation. Am J Physiol Cell Physiol 287: C866 -C873, 2004. First published May 26, 2004 10.1152/ajpcell.00238. 2003.-Angiomatous lesions are common in infants and children. Hemangioendotheliomas (HE) represent one type of these lesions. Endothelial cell proliferation and the development of vascular/blood cell-filled spaces are inherent in the growth of HE. Therefore, understanding mechanisms that regulate the proliferation of these lesions should provide key insight into mechanisms regulating angiogenesis. A murine model was used to test the significance of monocyte chemoattractant protein (MCP)-1 in HE proliferation. EOMA cells, a cell line derived from a spontaneously arising murine HE, generate these lesions with 100% efficiency when injected subcutaneously into syngeneic mice. MCP-1 produced by EOMA cells recruit macrophages, which were shown to induce angiogenic behavior in EOMA cells by stimulating transwell migration and inducing sprout formation on type I collagen gels. When EOMA cells were injected into MCP-1 Ϫ/Ϫ mice, only 50% of the mice developed tumors, presumably because the low levels of MCP-1 expressed by the injected EOMA cells were enough to overcome any host deficits of this chemokine. When EOMA cells were coinjected with a neutralizing antibody to MCP-1, tumors failed to develop in any of the treated mice, including syngeneic 129P3, C57Bl/6 (wild type), and MCP-1 Ϫ/Ϫ . These results present the first evidence that MCP-1 is required for HE proliferation and may promote the growth of these lesions by stimulating angiogenic behavior of endothelial cells. This study has produced the first in vivo evidence of a complete response for any neoplasm, specifically a vascular proliferative lesion, to anti-MCP-1 therapy in animals with intact immune systems. endothelium; vascular; macrophage; redox; angiogenesis ANGIOMATOUS DISEASES AFFECT up to 3% of all children (31). Included in the scope of these pathological conditions are vascular neoplasms ranging in severity from benign infantile hemangiomas to malignant angiosarcomas. Hemangioendothelioma (HE) represents a vascular neoplasm of borderline or intermediate malignancy (8). It does not metastasize; however, in humans, the mortality rate for HE ranges from 12 to 24%. This lesion is associated with the development of KasabachMerritt syndrome (36, 47), a consumptive coagulopathy with a 20 -30% mortality rate (9). Vascular neoplasms are highly angiogenic because the growth of these lesions entails endothelial cell proliferation with the development of perfused vascular spaces. The fact that humans with proliferating hemangiomas can have urinary bFGF levels elevated 25-to 50-fold higher than those of healthy volunteers (37) attests to the degree of angiogenic activity associated with vascular neoplasms. Investigators at our laboratory (3) recently demonstrated that halting the growth of HE arrests angiogenesis that is inherent in this process and that these events ar...