Objective-Our goal was to examine the influence of indirubin-3Ј-monoxime (I3MO), a natural product-derived cyclin-dependent kinase inhibitor, on vascular smooth muscle cell (VSMC) proliferation in vitro, experimentally induced neointima formation in vivo, and related cell signaling pathways. Methods and Results-I3MO dose-dependently inhibited platelet-derived growth factor (PDGF)-BB-induced VSMC proliferation by arresting cells in the G 0 /G 1 phase of the cell cycle as assessed by 5-bromo-2Ј-deoxyuridine incorporation and flow cytometry. PDGF-induced activation of the kinases Akt, Erk1/2, and p38 MAPK was not affected. In contrast, I3MO specifically blocked PDGF-, interferon-␥-, and thrombin-induced phosphorylation of signal transducer and activator of transcription 3 (STAT3). Human endothelial cells (EA.hy926) responded to I3MO with increased endothelial nitric oxide synthase activity as assessed via Key Words: indirubin Ⅲ vascular smooth muscle cell Ⅲ proliferation Ⅲ neointima Ⅲ STAT3 R estenosis is the major factor hampering the beneficial effect of angioplasty and stenting. Vascular smooth muscle cell (VSMC) proliferation, next to local vascular inflammation, is a critical factor in neointima formation and vascular lumen loss during restenosis. Thus, one current strategy to maintain proper vascular function after angioplasty is to inhibit VSMC proliferation by targeting cell cycle regulation, eg, by drug-eluting stents. 2,3 Two products, the rapamycin-eluting Cypher stent and the paclitaxel-eluting Taxus stent, were approved by the US Food and Drug Administration in 2003 and 2004, respectively. Although successfully introduced into the market, there are now concerns about an increased risk of late stent thrombosis. 4 Thus, compounds inhibiting neointima formation with mechanisms differing from those of rapamycin and paclitaxel 5 may have the potential to be efficient with fewer side effects.Indirubin, a red isomer of indigo, is the active ingredient of the traditional Chinese medicinal formulation Danggui Longhui Wan, used against chronic myelocytic leukemia. 6 Enzyme-based in vitro studies have indicated that indirubin and its derivatives are potent inhibitors of the cyclindependent kinases (CDKs) 1, 2, 4, and 5. 6 -9 Furthermore, different indirubin derivatives showed antitumor activity in several human cancer cells. 6,10 -14 Moreover, for indirubin-3Ј-monoxime (I3MO), an in vitro antiinflammatory and anticancer activity had been described on the basis of the inhibition of tumor necrosis factor-induced nuclear factor B activation and the subsequent suppression of antiapoptotic and proproliferative gene expression. 14 The aim of this study was to investigate the potential use of I3MO in the prevention of restenosis. We therefore analyzed a possible effect on platelet-derived growth factor (PDGF)-
MethodsAn expanded Methods section can be found in the Supplemental Data, available online at http://atvb.ahajournals.org.
Cell CultureVSMCs were isolated from male Sprague-Dawley rat thoracic aortas by enzyma...