AMP-activated protein kinase (AMPK) is a stress-activated protein kinase that is regulated by hypoxia and other cellular stresses that result in diminished cellular ATP levels. Here, we investigated whether AMPK signaling in endothelial cells has a role in regulating angiogenesis. Hypoxia induced the activating phosphorylation of AMPK in human umbilical vein endothelial cells (HUVECs), and AMPK activation was required for the maintenance of pro-angiogenic Akt signaling under these conditions. Suppression of AMPK signaling inhibited both HUVEC migration to VEGF and in vitro differentiation into tube-like structures in hypoxic, but not normoxic cultures. Dominant-negative AMPK also inhibited in vivo angiogenesis in Matrigel plugs that were implanted subcutaneously in mice. These data identify AMPK signaling as a new regulator of angiogenesis that is specifically required for endothelial cell migration and differentiation under conditions of hypoxia. As such, endothelial AMPK signaling may be a critical determinant of blood vessel recruitment to tissues that are subjected to ischemic stress.Angiogenesis is central feature of normal embryonic and post-natal development, and this process plays a critical role in the neovascularization that is associated with tumor growth and occlusive vascular diseases (1-3). A large body of evidence has shown that vascular angiogenic growth factors promote angiogenesis through activation of MAP kinase (4) and phosphatidylinositol 3-kinase (PI3K)-Akt/PKB (5) intracellular signaling pathways. However, the signaling molecules involved in angiogenic cellular responses under conditions of hypoxic stress is incompletely understood.AMP-activated protein kinase (AMPK) 1 is a metabolite-sensing protein kinase that shares amino acid sequence homology with yeast SNF1 (6, 7). In myocytes, AMPK is activated by increases in the AMP:ATP ratio, which is brought about by hypoxia/anoxia (8 -10), vigorous exercise and muscle contraction (11-14) or pressure-overload hypertrophy (15). Under these conditions, AMPK is activated by a conformational change after binding AMP (16,17), and by phosphorylation by its upstream kinase AMPK kinase (AMPKK) (17-19). Upon activation, AMPK phosphorylates and down-regulates several anabolic enzymes including 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase (16,20), acetyl-CoA carboxylase (ACC) (16, 21), sn-glycerol-3-phosphate acetyltransferase (22, 23), and glycogen synthase (24); thereby diminishing metabolite flux through synthetic pathways that consume ATP. AMPK activation also accelerates -oxidation of fatty acid, which promotes ATP production (25, 26).Endothelial nitric-oxide synthase (eNOS) residue 1177 (in human) is a substrate for both Akt (27, 28) and AMPK (29). Phosphorylation of eNOS at this residue leads to enzyme activation and nitric oxide (NO) production. AMPK is reported to phosphorylate eNOS in cardiac myocytes under hypoxic conditions (29), but it is not clear whether NO production by endothelial cells is regulated by this reaction. Recently, AMPK ...