Abstract-Chronic inflammation in atherosclerosis is responsible for plaque instability through alterations in extracellular matrix. Previously, we demonstrated that major histocompatibility class II (MHC II) transactivator (CIITA) in a complex with regulatory factor for X box 5 (RFX5) is a crucial protein mediating interferon (IFN)-␥-induced repression of collagen type I gene transcription in fibroblasts. This article demonstrates that, in smooth muscle cells (SMCs), IFN-␥ dramatically increases the expression of CIITA isoforms III and IV, with no increase in expression of CIITA isoform I. Expression of CIITA III and IV correlates with decreased collagen type I and increased MHC II gene expression. Exogenous expression of CIITA I, III, and IV, in transiently transfected SMCs, represses collagen type I promoters (COL1A1 and COL1A2) and activates MHC II promoter. Levels of CIITA and RFX5 increase in the nucleus of cells treated with IFN-␥. Moreover, simvastatin lowers the IFN-␥-induced expression of RFX5 and MHC II in addition to repressing collagen expression. However, simvastatin does not block the IFN-␥-induced expression of CIITA III and IV, suggesting a CIITA-independent mechanism. This first demonstration that RFX5 and CIITA isoforms are expressed in SMCs after IFN-␥ stimulation suggest that CIITA could be a key factor in plaque stability in atherosclerosis. Key Words: collagen Ⅲ CIITA isoform Ⅲ RFX Ⅲ MHC II Ⅲ SMCs A therosclerosis is a complex inflammatory and fibroproliferative process in which the immune system 1-3 and the extracellular matrix environment 4 play an important role in the pathogenesis of disease. Initially, atherosclerotic lesions consist of fatty streaks that can develop into mature lesions containing macrophages, T lymphocytes, smooth muscle cells (SMCs), a necrotic core, and a fibrous cap containing extracellular matrix components. Clinical complications of atherosclerosis arise when plaques rupture. Instability of the atherosclerotic plaques is a result of an unbalanced synthesis and degradation of extracellular matrix components including collagens. 5 Collagen type I, composed of 2 proteins, ␣1(I) and ␣2(I), transcribed by 2 separate genes, COL1A1 and COL1A2, is the most abundant fibrillar protein secreted by SMCs in atherosclerotic lesions 6 and by SMCs in culture. 7 A lower content of collagen has been observed in atherosclerotic lesions that are prone to rupture. 8 However, the mechanism by which the collagen content decreases in plaques has not been fully elucidated.Chronic inflammation in atherosclerosis is accompanied by secretion of cytokines, a major one being the interferon (IFN)-␥, which is secreted by T lymphocytes and macrophages. 9,10 IFN-␥ decreases collagen gene expression and activates major histocompatibility class II (MHC II) gene transcription through similar transcription regulatory proteins, RFX5 and CIITA, in fibroblast cells. [11][12][13] However, little is known about the expression and the mechanism of regulation of collagen and MHC II genes by IFN-␥ in SMC...