. ATP-induced mitogenesis is mediated by cyclic AMP response element-binding protein-enhanced TRPC4 expression and activity in human pulmonary artery smooth muscle cells. Am J Physiol Cell Physiol 287: C1192-C1201, 2004. First published June 30, 2004 doi:10.1152/ajpcell.00158.2004.-Extracellular ATP and intracellular cyclic AMP response element-binding protein (CREB, a transcription factor) promote cell proliferation in many cell types. The canonical transient receptor potential (TRPC) channels, which putatively participate in forming store-and receptor-operated Ca 2ϩ channels, have been implicated in the pulmonary vascular remodeling processes. A link between extracellular ATP, CREB activation, and TRPC4 channel expression and activity has not been shown in human pulmonary artery smooth muscle cells (PASMC). Long-term (24 -48 h) treatment of human PASMC with a low dose (100 M) of ATP, which did not trigger a transient rise in free cytosolic Ca 2ϩ concentration ([Ca 2ϩ ]i) when applied acutely to the cells, caused marked increases in CREB phosphorylation and TRPC4 protein expression. The time course indicated that the ATP-mediated CREB phosphorylation preceded TRPC4 upregulation, whereas transfection of a nonphosphorylatable CREB mutant abolished ATP-mediated TRPC4 expression. Furthermore, treatment of human PASMC with ATP also enhanced the amplitude of capacitative Ca 2ϩ entry (CCE) induced by passive store depletion, whereas the small interfering RNA specifically targeting TRPC4 attenuated ATP-mediated increases in TRPC4 expression and CCE amplitude and inhibited ATP-induced PASMC proliferation. These data suggest that low-dose ATP exerts part of its mitogenic effect in human PASMC via CREB-mediated upregulation of TRPC4 channel expression and activity and the subsequent increase in CCE and [Ca 2ϩ ]i.capacitative Ca 2ϩ entry; proliferation; vascular smooth muscle NUCLEOTIDES SUCH AS ATP, ADP, AND UTP act as extracellular messengers and play an important role in regulating vascular tone and cell proliferation and differentiation (12,18,25,41,56). Intracellular ATP is an essential molecular energy source, while extracellular ATP, which can be released from vascular endothelial cells (44, 71), damaged vessel walls (4), hypoxic myocardium (15), and aggregating platelets (29), serves as a potent vasoconstrictor (20, 24) and smooth muscle and endothelial cell mitogen (7,19). ATP also can be released from perivascular nerves as an excitatory neurotransmitter (6). The contractile and mitogenic effects of extracellular ATP on vascular smooth muscle cells (VSMC) are mediated by activation of a family of G protein-coupled receptors, P 2 purinoceptors (including at least 6 subtypes: P 2X , P 2Y , P 2T , P 2U , P 2Z , and P 2D ), which are linked to phospholipases and adenylate cyclase (7, 65). Activation of P 2 purinoceptors by ATP and UTP (24) in pulmonary artery smooth muscle cells (PASMC) causes pulmonary vasoconstriction and in fibroblasts promotes the progression of pulmonary vascular remodeling by stimulating f...