Abstract-Vascular smooth muscle cell (VSMC) proliferation is a key event in the development and progression of atherosclerotic lesions. Accumulating evidence suggests that lipoprotein lipase (LPL) produced in the vascular wall may exert proatherogenic effects. The aim of the present study was to examine the effect of LPL on VSMC proliferation. Incubation of growth-arrested human VSMCs with purified endotoxin-free bovine LPL for 48 and 72 hours, in the absence of any added exogenous lipoproteins, resulted in a dose-dependent increase in VSMC growth. Addition of VLDLs to the culture media did not further enhance the LPL effect. Treatment of growth-arrested VSMCs with purified human or murine LPL (1 g/mL) led to a similar increase in cell proliferation. Neutralization of bovine LPL by the monoclonal 5D2 antibody, irreversible inhibition, or heat inactivation of the lipase suppressed the LPL stimulatory effect on VSMC growth. Moreover, preincubation of VSMCs with the specific protein kinase C inhibitors calphostin C and chelerythrine totally abolished LPL-induced VSMC proliferation. In LPL-treated VSMCs, a significant increase in protein kinase C activity was observed. Treatment of VSMCs with heparinase III (1 U/mL) totally inhibited LPL-induced human VSMC proliferation. Taken together, these data indicate that LPL stimulates VSMC proliferation. LPL enzymatic activity, protein kinase C activation, and LPL binding to heparan sulfate proteoglycans expressed on VSMC surfaces are required for this effect. The stimulatory effect of LPL on VSMC proliferation may represent an additional mechanism through which the enzyme contributes to the progression of atherosclerosis. 6 The enzyme is also produced by monocyte-derived macrophages and vascular smooth muscle cells (VSMCs), 2 prominent cellular components of the atherosclerotic lesion. 7-9 Although plasma LPL activity tends to drive lipoprotein metabolism in a nonatherogenic direction, 10 -12 LPL produced in the vascular wall may act as a proatherogenic protein. Indeed, LPL has been shown to mediate uptake of lipoprotein particles by vascular cells, [13][14][15] to promote lipoprotein retention to the extracellular matrix, 16,17 to induce the expression of the proatherogenic cytokine tumor necrosis factor-␣, 18,19 and to enhance monocyte adhesion to endothelial cells. 20,21 Furthermore, recent studies indicate that LPL enhances cellular proteoglycan production 22 and promotes foam cell formation and atherosclerosis in vivo. 23 VSMC migration and proliferation are typical features of intimal hyperplasia and atherogenesis. 24 These biological processes are mediated by cytokines and growth factors released by infiltrating inflammatory cells and neighboring endothelial cells. 25 The proliferative response of VSMCs to various stimuli involves protein kinase C (PKC) activation. 26 -28 In light of our previous study demonstrating that LPL activates PKC in human mononuclear cells, 19 the present study was conducted to investigate whether LPL may exert a direct stimulatory effect ...