Although load-induced mechanical signals play a key role in bone formation and maintenance of bone mass and structure, the cellular mechanisms involved in the translation of these signals are still not well understood. Recent identification of a novel flow-induced mechanosignaling pathway involving VEGF in osteoblasts and the known VEGF regulation of actin reorganization in various cell types has led us to hypothesize that fluid shear stress-induced Vegf up-regulation underlies the actin cytoskeleton adaptation observed in osteoblasts during mechanotransduction. Our results show that MC3T3-E1 cells secrete significant VEGF in response to 5 h of pulsatile fluid shear stress (PFSS; 5 dynes/cm 2 at 1 Hz), whereas expression of VEGF receptors (VEGFR-1, VEGFR-2, or NRP1) is unaffected. These receptors, in particular VEGFR-2, participate in PFSSinduced VEGF release. Exposure to flow-conditioned medium or exogenous VEGF significantly induces stress fiber formation in osteoblasts that is comparable with PFSS-induced stress fiber formation, whereas VEGF knockdown abrogates this response to PFSS, thereby providing evidence that flow-induced VEGF release plays a role in actin polymerization. Using neutralizing antibodies against the receptors and VEGF isoforms, we found that soluble VEGFs, in particular VEGF 164 , play a crucial role in transient stress fiber formation during osteoblast mechanotransduction, most likely through VEGFR-2 and NRP1. Based on these data we conclude that flow-induced VEGF release from osteoblasts regulates osteoblast actin adaptation during mechanotransduction and that VEGF paracrine signaling may provide potent cross-talk among bone cells and endothelial cells that is essential for fracture healing, bone remodeling, and osteogenesis.Bone mass and integrity are maintained by bone remodeling, a dynamic process that requires coordination and synchronization of osteoblasts, osteoclasts, and endothelial cells. During bone remodeling, osteoblasts deposit bone matrix, whereas osteoclasts erode it; this process is followed by angiogenesis to redistribute blood supply. Bone remodeling is stimulated by various physical loads imposed to the skeleton, and failure to properly respond and adapt to these mechanical stimuli results in bone loss or fragility (1). Although it is widely established that load-induced mechanical signals are essential for maintaining skeletal health, the precise cellular mechanisms whereby bone cells translate mechanical signals into biochemical responses are still not completely elucidated. It is well known, however, that mechanical loading is perceived by bone cells in the form of shear stress generated by load-induced fluid flow through the bone lacunary-canalicular porosity and that shear stress-released mechanosignaling molecules such as ATP and prostaglandin E 2 play key roles in bone mechanotransduction and remodeling. On a similar note, our recent studies using the unbiased high throughput method of cDNA microarray analysis indicated that in addition to ATP and prostaglandins...