Leukotrienes are potent proinflammatory lipid mediators synthesized from arachidonic acid via the actions of 5-lipoxygenase and 5-lipoxygenase-activating protein.Cysteinyl leukotrienes (cysLTs) are a subfamily of leukotriene molecules, thus termed because of a common cysteine moiety in their respective structures. The cysLTs, leukotriene C 4 , D 4 , and E 4 (LTC 4 , D 4 , and E 4 , respectively), exert their effects by binding to sequenced G-protein-coupled receptors: cysteinyl leukotriene receptor 1 (CysLT 1 R), cysteinyl leukotriene receptor 2 (CysLT 2 R), and a novel CysLT E receptor (GPR99).3 CysLT 1 R binds LTD 4 preferentially to LTC 4 , whereas CysLT 2 R binds LTD 4 and LTC 4 with equal affinity. Both receptors bind LTE 4 , the most stable and abundant cysLT, with weak affinity. 4 In contrast, GPR99 displays preferential binding affinity for LTE 4 , with weak affinity for LTC 4 and LTD 4 . Objective-Transgenic overexpression of the human cysteinyl leukotriene receptor 2 (CysLT 2 R) in murine endothelium exacerbates vascular permeability and ischemia/reperfusion injury. Here, we explore the underlying mechanisms of CysLT 2 R activation-mediated inflammation and delineate the relative contributions of endogenous murine CysLT 2 R and the transgene-derived receptor. Approach and Results-We created a novel mouse with only endothelial-expressed CysLT 2 R (endothelium-targeted overexpression mice [EC]/CysLT 2 R-knockout mice [KO]) by crossing EC with KO to dissect the role of endothelial CysLT 2 R in tissue injury. Surprisingly, we discovered that damage in EC/KO mice was not elevated (24% versus 47% EC) after ischemia/reperfusion. We examined vascular permeability and leukocyte recruitment/rolling responses in the cremaster vasculature after cysteinyl leukotriene (cysLT) stimulation. Mice possessing transgenic endothelial CysLT 2 R overexpression, whether EC or EC/KO, when stimulated with cysLTs, exhibited vascular hyperpermeability, declining leukocyte flux, and a transient increase in slow-rolling leukocyte fraction. and coronary endothelial cells. 9 CysLT 2 R research had been previously hampered by a lack of selective pharmacological agents, 10 the majority of work instead using the nonselective cysLT antagonist/partial agonist 11 or genetic models of CysLT 2 R expression modulation. 11,12 However, recent studies have characterized 2 novel CysLT 2 R-selective antagonists: HAMI3379 13 and BayCysLT 2 , [14][15][16] which are proving to be useful as tools in eicosanoid research.There is evidence linking cysLTs to cardiovascular disease and inflammation. Expression of components of the leukotriene synthesis pathway is found in human atherosclerotic lesions.17 Furthermore, genetic polymorphisms in 5-lipoxygenase pathway genes have been correlated to increased myocardial infarction and stroke risk in some populations 18 but not all. 19,20 CysLT 2 R can mediate vascular permeability, 12,21 susceptibility to gastrointestinal tract inflammation, 22 and increased vulnerability to ischemic injury in the heart 11 a...