Abstract-To characterize novel signaling pathways that underlie NAD(P)H oxidase-mediated signaling in atherosclerosis, we first examined differences in thrombin-induced gene expression between wild-type and p47phox Ϫ/Ϫ (NAD[P]H oxidase-deficient) VSMC. Of the 9000 genes analyzed by cDNA microarray method at the G 1 /S transition point, 76 genes were similarly and significantly modulated in both the cell types, whereas another 22 genes that encompass various functional groups were regulated in NAD(P)H oxidase-dependent manner. Among these 22 genes, thrombininduced NAD(P)H oxidase-mediated regulation of Klf15, Igbp1, Ak4, Adamts5, Ech1, Serp1, Sec61a2, Aox1, Aoh1, Fxyd5, Rai14, and Serpinh1 was shown for the first time in VSMC. The role of NAD(P)H oxidase in the regulation of a subset of these genes (CD44, BMP4, Id1, and Id3) was confirmed using modulators of reactive oxygen species (ROS) generation, a ROS scavenger and in gain-of-function experiments. We then characterized regulation of these genes in restenosis and atherosclerosis. In both apoE Ϫ/Ϫ mice and in a mouse vascular injury model, these genes are regulated in NAD(P)H oxidase-dependent manner during vascular lesion formation. Based on these findings, we propose that NAD(P)H oxidase-dependent gene expression in general, and the CD44 and BMP4-Id signaling pathway in particular, is important in restenosis and atherosclerosis. Key Words: vascular smooth muscle cells Ⅲ reactive oxygen species Ⅲ microarray Ⅲ redox regulation T he development of molecular therapies for atherosclerosis has lagged behind other diseases, perhaps because of the complexity of redundant signaling pathways that govern vascular cell function. Although the precise role of reactive oxygen species (ROS) in vascular smooth muscle cell (VSMC) biology remains controversial, the importance of ROS generation in signaling is not. In VSMC, several signal transduction pathways induced by growth factors and cytokines are mediated by ROS generated by the activation of membrane-bound NAD(P)H oxidase. 1 The VSMC NAD(P)H oxidase includes membrane-bound components: Nox1/4 and p22phox; and cytosolic components: Rac1 and p47phox. 2 A third cytosolic component, p67phox, found in other vascular cells, is not present in VSMC. 3 Recently, p67phox and also p47phox homologs have been reported in VSMC. 2 The key role of p47phox in NAD(P)H oxidase activation in response to agonist stimulation and subsequent increase in cell proliferation was demonstrated using wild-type and p47phox Ϫ/Ϫ VSMC. 4 With few exceptions, 5 predominant data support strong association of ROS with atherosclerosis. ApoE Ϫ/Ϫ
/ p47phoxϪ/Ϫ mice have lower levels of aortic ROS production and less atherosclerosis than apoE Ϫ/Ϫ mice. 4 Other mouse models with altered levels of manganese superoxide dismutase (SOD2) 6 and p66Shc 7 have produced a consistent theme that increased levels of vascular ROS promote, whereas decreased levels reduce atherogenesis. ROS may enhance atherosclerosis by several mechanisms. Increased ROS production enhances...