Objective-Vascular smooth muscle cells (SMCs), activated by growth factors after arterial injury, migrate and proliferate to expand the intima of the blood vessel. During intimal expansion, proliferation is suppressed and an increasingly large proportion of the neointimal mass is composed of newly synthesized extracellular matrix (ECM). We sough to determine whether the ECM heparan sulfate proteoglycan (HSPG) perlecan, which inhibits SMC proliferation in vitro, also accumulates and limits SMC proliferation during neointimal expansion. Methods and Results-Perlecan expression and accumulation were analyzed by immunohistochemistry and in situ hybridization during neointima formation after balloon catheter injury to the rat carotid artery. Perlecan expression was low in uninjured vessels and up to 7 days after injury, during maximal SMC proliferation. By 14 days after injury, perlecan was dramatically increased, and immunostaining remained heavy throughout the advanced lesion, 35 to 42 days after injury. Finally, explants of intimal tissue from 35-to 42-day neointimal lesions were digested with glycosaminoglycanases to determine whether endogenous HSPGs inhibit intimal SMC proliferation. SMCs within HS-depleted, but not chondroitinase ABC-treated or mock-incubated, explants were found to proliferate in response to plateletderived growth factor BB. Key Words: heparan sulfate â
˘ perlecan â
˘ neointimal hyperplasia â
˘ vascular smooth muscle â
˘ proliferation A ccumulated evidence indicates that extracellular matrix (ECM) proteins provide both permissive and inhibitory modulation of the cellular responses to growth factors. [1][2][3] Thus, changes in the amounts and types of ECM proteins that are deposited during the development of the atherosclerotic lesion may modify the effects of growth factors during vascular pathogenesis. However, mechanisms by which the ECM may inhibit intimal smooth muscle cell (SMC) proliferation in the ECM-rich advanced lesion remain unresolved. Considerable previous work has suggested that the glycosaminoglycan chains of heparan sulfate proteoglycans (HSPGs), and heparin, are potent inhibitors of SMC proliferation in vitro. 4 -6 Conversely, HS lyases appear to accelerate the conversion of the SMC phenotype from a quiescent, contractile state to a rapidly growing, "synthetic" state. 7 Pioneering studies demonstrated that heparin infusion dramatically suppresses the early wave of medial SMC proliferation that is required for the formation of a neointima after injury to the rat carotid artery. 8 Moreover, heparin was found to inhibit SMC cell growth in vitro, 9,10 suggesting that heparinlike molecules, such as vascular HSPGs, may be endogenous inhibitors of vascular SMC proliferation.
Conclusions-HSPGsProteoglycans are among the ECM proteins that are deposited within the late neointimal lesion. [11][12][13][14] Perlecan is an ECM HSPG that is a potent modulator of cellular phenotype and proliferation 3,15,16 and a major vascular wall basement membrane component. 17,18 The induction of perlecan expres...