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Arteriosclerosis, Thrombosis, and Vascular Biology
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Volume 26, Issue 9; September 1, 2006

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EditorialsBack

IL-20 and Atherosclerosis: Another Brick In the Wall

Giuseppina Caligiuri, Srini V. Kaveri, and Antonino Nicoletti
Arterioscler Thromb Vasc Biol. 2006;26:1929-1930, doi:10.1161/01.ATV.0000237564.81178.bb.
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Hydrogen Peroxide: Watery Fuel for Change in Vascular Biology

Frank M. Faraci
Arterioscler Thromb Vasc Biol. 2006;26:1931-1933, doi:10.1161/01.ATV.0000238355.56172.b3.
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Arteries or Veins?: VEGF Helps EPCs Choose Their cAMP

Jean-Sébastien Silvestre and Ziad Mallat
Arterioscler Thromb Vasc Biol. 2006;26:1934-1935, doi:10.1161/01.ATV.0000236220.06886.e3.
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Brief ReviewsBack

Anne Hamik, Baiqiu Wang, and Mukesh K. Jain
Arterioscler Thromb Vasc Biol. 2006;26:1936-1947; published online before print June 15 2006, doi:10.1161/01.ATV.0000232542.42968.e3.
Abstract | Full Text | PDF
Angiogenesis is essential for normal development and homeostasis. Inadequate angiogenesis results in ischemia whereas overzealous angiogenesis can contribute to tumor development. In recent years, several transcription factors have been identified as directors of the angiogenic process. These factors and the mechanisms by whidch they exert their effects are reviewed.  

Joerg Herrmann, Lilach O. Lerman, Debabrata Mukhopadhyay, Claudio Napoli, and Amir Lerman
Arterioscler Thromb Vasc Biol. 2006;26:1948-1957; published online before print June 22 2006, doi:10.1161/01.ATV.0000233387.90257.9b.
Abstract | Full Text | PDF
Atherogenesis is the pathobiological process, which underlies atherosclerotic cardiovascular disease and evolves in the 3 stages of initiation, progression, and complication to clinical significance. Of note, this process is associated with neovascularization, and it was not until recently that the implications of angiogenesis in atherogenesis were delineated. This article gives an updated overview on this topic and briefly reflects on the similarities with neovessel formation in carcinogenesis.  

Amy E. Griel, Elizabeth H. Ruder, and Penny M. Kris-Etherton
Arterioscler Thromb Vasc Biol. 2006;26:1958-1965; published online before print June 22 2006, doi:10.1161/01.ATV.0000233384.97125.bd.
Abstract | Full Text | PDF
Dietary recommendations for carbohydrate intake have evolved across the decades. Early recommendations focused on meeting micronutrient intake requirements; recent guidelines acknowledge of the role of carbohydrates and dietary fat in reducing risk for cardiovascular disease. A review of the evidence is important to address the controversies associated with a high-carbohydrate diet.  

Gregory J. del Zoppo and Richard Milner
Arterioscler Thromb Vasc Biol. 2006;26:1966-1975; published online before print June 15 2006, doi:10.1161/01.ATV.0000232525.65682.a2.
Abstract | Full Text | PDF
In the central nervous system matrix adhesion receptors are uniquely expressed by the cells comprising the microvascular compartment, and by neurons and their supporting glial cells. This review examines current information about cell adhesion receptor expression within the cerebral microvasculature and surrounding tissue, and their potential roles during the vascular responses to local injury.  

 

Vascular BiologyBack

Haruhiko Ohtsu, Peter J. Dempsey, Gerald D. Frank, Eugen Brailoiu, Sadaharu Higuchi, Hiroyuki Suzuki, Hidekatsu Nakashima, Kunie Eguchi, and Satoru Eguchi
Arterioscler Thromb Vasc Biol. 2006;26:e133-e137; published online before print July 13 2006, doi:10.1161/01.ATV.0000236203.90331.d0.
Abstract | Full Text | PDF
By using vascular smooth muscle cells, we demonstrate that a metalloprotease ADAM17 is responsible for epidermal growth factor receptor transactivation and subsequent protein synthesis induced by angiotensin II. The findings demonstrate a previously missing molecular mechanism by which angiotensin II promotes vascular hypertrophy.  

Haruhiko Ohtsu, Peter J. Dempsey, Gerald D. Frank, Eugen Brailoiu, Sadaharu Higuchi, Hiroyuki Suzuki, Hidekatsu Nakashima, Kunie Eguchi, and Satoru Eguchi
Arterioscler Thromb Vasc Biol. 2006;26:1976.
Abstract | Full Text | PDF  

Takami Yurugi-Kobayashi, Hiroshi Itoh, Timm Schroeder, Akiko Nakano, Genta Narazaki, Fumiyo Kita, Kentoku Yanagi, Mina Hiraoka-Kanie, Emi Inoue, Toshiaki Ara, Takashi Nagasawa, Ursula Just, Kazuwa Nakao, Shin-Ichi Nishikawa, and Jun K. Yamashita
Arterioscler Thromb Vasc Biol. 2006;26:1977-1984; published online before print June 29 2006, doi:10.1161/01.ATV.0000234978.10658.41.
Abstract | Full Text | PDF | Data Supplement
Previously, we have reported an embryonic stem cell differentiation system for blood vessels. In this study, we induced arterial and venous endothelial cells (ECs) in vitro and demonstrated that adrenomedullin/cAMP is a novel pathway to activate Notch signaling in ECs and is required to induce arterial ECs from vascular progenitors.  

Yi Chu, Robert Piper, Simon Richardson, Yoshimasa Watanabe, Pragnesh Patel, and Donald D. Heistad
Arterioscler Thromb Vasc Biol. 2006;26:1985-1990; published online before print June 29 2006, doi:10.1161/01.ATV.0000234921.88489.5c.
Abstract | Full Text | PDF
Mechanisms of endocytosis of EC-SOD were examined. The findings indicate that EC-SOD, but not the gene variant EC-SODR213G, is endocytosed into endothelial cells through clathrin-mediated pathway, but does not translocate to the nucleus. Impairment of endocytosis may contribute to high plasma levels of EC-SODR213G.  

Minako Yamaoka-Tojo, Taiki Tojo, Ha Won Kim, Lula Hilenski, Nikolay A. Patrushev, Lynn Zhang, Tohru Fukai, and Masuko Ushio-Fukai
Arterioscler Thromb Vasc Biol. 2006;26:1991-1997; published online before print June 8 2006, doi:10.1161/01.ATV.0000231524.14873.e7.
Abstract | Full Text | PDF | Data Supplement
The present study demonstrates that IQGAP1 is required for establishment of basal cell-cell contacts in endothelial cells. It may also function to link VEGF receptor2 to the adherens junctions, thereby promoting reactive oxygen species-dependent tyrosine phoshorylation of VE-cadherin and loss of cell-cell contacts during VEGF-induced angiogenesis.  

Tetsuya Ishikawa, Masamichi Eguchi, Mika Wada, Yo Iwami, Kayoko Tono, Hideki Iwaguro, Haruchika Masuda, Tetsuro Tamaki, and Takayuki Asahara
Arterioscler Thromb Vasc Biol. 2006;26:1998-2004; published online before print June 22 2006, doi:10.1161/01.ATV.0000233359.74484.77.
Abstract | Full Text | PDF | Data Supplement
Tissue regeneration requires both growth factor and extracellular matrix. We established FNCBD-VEGF121, consisting of the fibronectin collagen-binding domain and vascular endothelial growth factor 121. FNCBD-VEGF121 stably maintains an optimally high and local concentration of VEGF with collagen matrix and stimulates cellular activity in situ, supplying a vascular niche regeneration.  

Vesselina G. Cooke, Meghna U. Naik, and Ulhas P. Naik
Arterioscler Thromb Vasc Biol. 2006;26:2005-2011; published online before print June 29 2006, doi:10.1161/01.ATV.0000234923.79173.99.
Abstract | Full Text | PDF | Data Supplement
JAM-A was implicated to regulate FGF-2-induced angiogenesis. We have generated JAM-A null mice and found that these mice have distorted Mendelian and sex ratios. Using ex vivo and in vivo angiogenesis assays, we show that ablation of JAM-A impaired FGF-2-induced angiogenesis.  

Rebecca J. Steagall, Antonio E. Rusiñol, Quynh A. Truong, and Zhihua Han
Arterioscler Thromb Vasc Biol. 2006;26:2012-2018; published online before print July 6 2006, doi:10.1161/01.ATV.0000235720.61091.c7.
Abstract | Full Text | PDF | Data Supplement
We characterized the HSPA12B expression in mice and HSPA12B involvement in angiogenesis. Uniquely among HSP70s, HSPA12B is expressed predominantly in vascular endothelium, induced during angiogenesis, and essential for angiogenesis and cell migration. HSPA12B interacts with multiple proteins in a yeast 2-hybrid screening. HSPA12B is the first characterized endothelium-specific chaperone.  

Yujuan Zheng, Masato Murakami, Hiroyuki Takahashi, Mai Yamauchi, Atsushi Kiba, Sachiko Yamaguchi, Naoyuki Yabana, Kari Alitalo, and Masabumi Shibuya
Arterioscler Thromb Vasc Biol. 2006;26:2019-2026; published online before print June 22 2006, doi:10.1161/01.ATV.0000233336.53574.a1.
Abstract | Full Text | PDF | Data Supplement
We report here that chimeric VEGF-ENZ7/PlGF composed of Orf-VirusNZ7-derived VEGF-ENZ7 and human PlGF1 induces strong angiogenic response, less monocyte/macrophage recruitment, and low vascular leakage in vivo because of its VEGFR-2 specificity. The unique receptor binding property may shed light on VEGF-ENZ7/PlGF as a novel candidate molecule for therapeutic angiogenesis.  

Keith R. Brunt, Keith K. Fenrich, Gholam Kiani, M. Yat Tse, Stephen C. Pang, Christopher A. Ward, and Luis G. Melo
Arterioscler Thromb Vasc Biol. 2006;26:2027-2034; published online before print July 13 2006, doi:10.1161/01.ATV.0000236204.37119.8d.
Abstract | Full Text | PDF | Data Supplement
Oxidative stress induces smooth muscle cell apoptosis in the atherosclerotic plaque, leading to plaque instability. Heme oxygenase-1 (HO-1) exerts anti-oxidant, anti-inflammatory, and anti-apoptotic effects in the vessel wall. Here we report that the cytoprotective effect of HO-1 against pro-oxidant-induced apoptosis is mediated through codependent interaction with the survival gene Akt.  

Naris Thengchaisri, Travis W. Hein, Wei Wang, Xin Xu, Zhenbo Li, Theresa W. Fossum, and Lih Kuo
Arterioscler Thromb Vasc Biol. 2006;26:2035-2042; published online before print June 22 2006, doi:10.1161/01.ATV.0000233334.24805.62.
Abstract | Full Text | PDF | Data Supplement
Overproduction of reactive oxygen species such as hydrogen peroxide (H2O2) has been implicated in various cardiovascular diseases. Treatment of isolated coronary arterioles with H2O2 specifically attenuated endothelium-dependent NO-mediated dilation through the upregulation of arginase. Activation of this pathway may contribute to vascular dysfunction associated with oxidative stress.  

Arthur C.M. Mulders, Mariëlle C. Hendriks-Balk, Marie-Jeanne Mathy, Martin C. Michel, Astrid E. Alewijnse, and Stephan L.M. Peters
Arterioscler Thromb Vasc Biol. 2006;26:2043-2048; published online before print July 20 2006, doi:10.1161/01.ATV.0000237569.95046.b9.
Abstract | Full Text | PDF | Data Supplement
Sphingolipid metabolites can be formed locally in the vascular wall. AT1 receptor stimulation by angiotensin II induces a sphingosine kinase-dependent endothelial NO synthase activation via phosphatidylinositol 3-kinase/Akt and calcium-dependent pathways. This may be of importance during, or alternatively under pathological circumstances leading to, reduced NO bioavailability and endothelial dysfunction.  

Kae Fukuyama, Toshihiro Ichiki, Ikuyo Imayama, Hideki Ohtsubo, Hiroki Ono, Yasuko Hashiguchi, Akira Takeshita, and Kenji Sunagawa
Arterioscler Thromb Vasc Biol. 2006;26:2049-2055; published online before print June 22 2006, doi:10.1161/01.ATV.0000233358.87583.01.
Abstract | Full Text | PDF | Data Supplement
The molecular mechanism of anti-atherosclerotic effects of thyroid hormone is poorly defined. We showed in the present study that thyroid hormone inhibits cAMP response element binding protein activity and suppresses angiotensin II-induced cytokine expression and hypertrophy of vascular smooth muscle cells, which may be involved in anti-atherosclerotic effect.  

Peng Liu, Sarita Patil, Mauricio Rojas, Alan M. Fong, Susan S. Smyth, and Dhavalkumar D. Patel
Arterioscler Thromb Vasc Biol. 2006;26:2056-2062; published online before print June 29 2006, doi:10.1161/01.ATV.0000234947.47788.8c.
Abstract | Full Text | PDF
The chemokine receptor CX3CR1 has been implicated in the pathogenesis of vascular diseases. In a guidewire-induced femoral artery injury model, the CX3CR1 ligand (CX3CL1) was induced by arterial injury. CX3CR1 deficiency protected mice from developing intimal hyperplasia as a result of decreased monocyte trafficking to the lesion and VSMC proliferation.  

A. Schepers, D. Eefting, P.I. Bonta, J.M. Grimbergen, M.R. de Vries, V. van Weel, C.J. de Vries, K. Egashira, J.H. van Bockel, and P.H.A. Quax
Arterioscler Thromb Vasc Biol. 2006;26:2063-2069; published online before print July 6 2006, doi:10.1161/01.ATV.0000235694.69719.e2.
Abstract | Full Text | PDF
Involvement of MCP-1 in vein graft intimal hyperplasia (IH) was studied. MCP-1 was detected by immunohistochemistry in murine vein grafts and cultured human saphenous veins. Functional involvement of MCP-1 was assessed by exposure to a MCP-1-antagonist. This reduced IH in both models and inhibited smooth muscle cell proliferation in vitro.  

Tomoya Kono, Hajime Kubo, Chikashi Shimazu, Yoshihide Ueda, Meiko Takahashi, Kentoku Yanagi, Naoya Fujita, Takashi Tsuruo, Hiromi Wada, and Jun K. Yamashita
Arterioscler Thromb Vasc Biol. 2006;26:2070-2076; published online before print May 11 2006, doi:10.1161/01.ATV.0000225770.57219.b0.
Abstract | Full Text | PDF
To understand the process of the differentiation of lymphatic endothelial cells (LECs), we succeeded in differentiating LECs from embryonic stem (ES) cells, revealing the requirements of VEGF-C, Ang1, and other unknown factors for LEC differentiation. This ES cell system would be useful for better understanding the process of LEC differentiation.  

Edward Choke, Matthew M. Thompson, Joseph Dawson, W. Richard W. Wilson, Saiqa Sayed, Ian M. Loftus, and Gillian W. Cockerill
Arterioscler Thromb Vasc Biol. 2006;26:2077-2082; published online before print June 29 2006, doi:10.1161/01.ATV.0000234944.22509.f9.
Abstract | Full Text | PDF | Data Supplement
This study investigated the extent of neovascularization in abdominal aortic aneurysm rupture and demonstrated increased medial neovascularization and overexpression of proangiogenic cytokines at aneurysm rupture edge. Further investigations into the role of angiogenesis in aneurysm rupture may open novel therapeutic avenues to prevent aneurysm rupture.  

 

Atherosclerosis and LipoproteinsBack

Minoru Takaoka, Shiro Uemura, Hiroyuki Kawata, Kei-ichi Imagawa, Yukiji Takeda, Kimihiko Nakatani, Noriyuki Naya, Manabu Horii, Shigeru Yamano, Yoshihiro Miyamoto, Yasunao Yoshimasa, and Yoshihiko Saito
Arterioscler Thromb Vasc Biol. 2006;26:2083-2089; published online before print June 15 2006, doi:10.1161/01.ATV.0000232528.93786.0a.
Abstract | Full Text | PDF | Data Supplement
To elucidate whether AMI exacerbate neointimal hyperplasia and restenosis after PCI, we simultaneously generated experimental models of AMI and femoral artery injury in the same mice. We demonstrate that AMI itself augments neointimal hyperplasia after vascular injury by stimulating signaling via TNF-{alpha}, TNFR1, and IL-6.  

Wei-Yu Chen, Bor-Chih Cheng, Meei-Jyh Jiang, Mei-Yi Hsieh, and Ming-Shi Chang
Arterioscler Thromb Vasc Biol. 2006;26:2090-2095; published online before print June 15 2006, doi:10.1161/01.ATV.0000232502.88144.6f.
Abstract | Full Text | PDF | Data Supplement
We investigated the association between IL-20 and atherosclerosis. IL-20 and its receptors are expressed in the atherosclerosis plaques of human and mice. In vitro, oxidized LDL and hypoxia induced IL-20. In vivo, IL-20 promoted atherosclerosis in apoE-/- mice. Thus, we postulate that IL-20 is a proatherogenic cytokine.  

Anu Tuominen, Yury I. Miller, Lotte F. Hansen, Y. Antero Kesäniemi, Joseph L. Witztum, and Sohvi Hörkkö
Arterioscler Thromb Vasc Biol. 2006;26:2096-2102; published online before print June 22 2006, doi:10.1161/01.ATV.0000233333.07991.4a.
Abstract | Full Text | PDF | Data Supplement
A natural anticardiolipin antibody (LRO1) binding to oxidized cardiolipin (oxCL), oxidized LDL, apoptotic cells, and atherosclerotic lesions was cloned from a nonimmunized LDLR-/- mouse. These data demonstrate that oxCL is an important antigenic determinant in vivo and gives insight into the pathogenic events of diseases with increased titers of aCL antibodies.  

Patrick M. Winter, Anne M. Neubauer, Shelton D. Caruthers, Thomas D. Harris, J. David Robertson, Todd A. Williams, Anne H. Schmieder, Grace Hu, John S. Allen, Elizabeth K. Lacy, Huiying Zhang, Samuel A. Wickline, and Gregory M. Lanza
Arterioscler Thromb Vasc Biol. 2006;26:2103-2109; published online before print July 6 2006, doi:10.1161/01.ATV.0000235724.11299.76.
Abstract | Full Text | PDF
{alpha}{nu}ß3-Targeted paramagnetic nanoparticles were used to detect early atherosclerosis, to deliver an antiangiogenic drug, and to quantitatively assess neovascular response. This dual molecular imaging drug-delivery agent suggests that nanomedicine may provide an opportunity to intervene in the clinical progression of atherosclerosis, particularly in asymptomatic patients.  

Veerle Persy, Andrei Postnov, Ellen Neven, Geert Dams, Marc De Broe, Patrick D’Haese, and Nora De Clerck
Arterioscler Thromb Vasc Biol. 2006;26:2110-2116; published online before print July 13 2006, doi:10.1161/01.ATV.0000236200.02726.f7.
Abstract | Full Text | PDF
Chronic renal failure (CRF) is a major risk factor for cardiovascular disease, with enhanced vascular calcification as a prominent feature. In this study, we demonstrated that in vivo micro-CT scanning is a sensitive, reproducible method to detect and quantify aortic calcification in living CRF rats, opening perspectives for future interventional studies.  

Brian J. Bennett, Marta Scatena, Elizabeth A. Kirk, Marcello Rattazzi, Rebecca M. Varon, Michelle Averill, Stephen M. Schwartz, Cecilia M. Giachelli, and Michael E. Rosenfeld
Arterioscler Thromb Vasc Biol. 2006;26:2117-2124; published online before print July 13 2006, doi:10.1161/01.ATV.0000236428.91125.e6.
Abstract | Full Text | PDF
The effect of OPG inactivation in advanced atherosclerotic lesions from apoE-/- mice was investigated. OPG is a key mediator of bone resorption and has been associated with human and mouse atherosclerosis. OPG inactivation results in larger and more calcified advanced lesions in the innominate arteries of older apoE-/- mice.  

Shoba Shetty, Erik R.M. Eckhardt, Steven R. Post, and Deneys R. van der Westhuyzen
Arterioscler Thromb Vasc Biol. 2006;26:2125-2131; published online before print June 22 2006, doi:10.1161/01.ATV.0000233335.26362.37.
Abstract | Full Text | PDF
PI3K regulates the cell surface expression of SR-BI and, consequently, selective lipid uptake from HDL. Along with demonstrating a novel post-translational regulation of SR-BI in hepatocytes, this study also suggests the possibility of impaired cholesterol clearance via SR-BI under conditions of decreased PI3K activity seen in insulin resistance.  

Daniele Versari, Joerg Herrmann, Mario Gössl, Dallit Mannheim, Katherine Sattler, Fredric B. Meyer, Lilach O. Lerman, and Amir Lerman
Arterioscler Thromb Vasc Biol. 2006;26:2132-2139; published online before print June 15 2006, doi:10.1161/01.ATV.0000232501.08576.73.
Abstract | Full Text | PDF | Data Supplement
We evaluated the ubiquitin-proteasome system in relation to atherosclerosis clinical manifestation. Carotid plaques from patients with symptomatic disease showed accumulation of ubiquitin conjugates and lower proteasome activity, along with increased oxidative stress and apoptosis, as compared with asymptomatic patients. These data suggest a potential interplay between oxidative stress and ubiquitin-proteasome system activity in atherosclerosis pathophysiology.  

Gian Paolo Fadini, Saverio Sartore, Mattia Albiero, Ilenia Baesso, Ellen Murphy, Mirko Menegolo, Franco Grego, Saula Vigili de Kreutzenberg, Antonio Tiengo, Carlo Agostini, and Angelo Avogaro
Arterioscler Thromb Vasc Biol. 2006;26:2140-2146; published online before print July 20 2006, doi:10.1161/01.ATV.0000237750.44469.88.
Abstract | Full Text | PDF | Data Supplement
Endothelial progenitor cells (EPCs) have been implicated in adult neovasculogenesis and maintenance of endothelial homeostasis. In this study, we provide evidence that number and function of EPCs correlate with severity of peripheral atherosclerosis in type 2 diabetic patients.  

Christian Herder, Jens Baumert, Barbara Thorand, Stephan Martin, Hannelore Löwel, Hubert Kolb, and Wolfgang Koenig
Arterioscler Thromb Vasc Biol. 2006;26:2147-2152; published online before print July 6 2006, doi:10.1161/01.ATV.0000235691.84430.86.
Abstract | Full Text | PDF | Data Supplement
The study investigates whether elevated serum concentrations of the chemokines MCP-1, IL-8, and IP-10 precede coronary events in a prospective case-cohort design. Baseline concentrations of all 3 chemokines were significantly higher in cases compared with noncases, but the associations with CHD risk were no longer statistically significant in multivariable analysis.  

 

ThrombosisBack

Laure Sarda-Mantel, Michèle Coutard, François Rouzet, Olivier Raguin, Jean-Marc Vrigneaud, Florence Hervatin, Geneviève Martet, Ziad Touat, Pascal Merlet, Dominique Le Guludec, and Jean-Baptiste Michel
Arterioscler Thromb Vasc Biol. 2006;26:2153-2159; published online before print July 20 2006, doi:10.1161/01.ATV.0000237605.25666.13.
Abstract | Full Text | PDF
Data of the present study show that 99mTc-annexin-V permits functional imaging of mural thrombus renewal activity in vivo in an experimental model of abdominal aortic aneurysm (AAA), and ex vivo in human AAAs.  

Alexis Klein, Valérie Deckert, Martina Schneider, Fabienne Dutrillaux, Arlette Hammann, Anne Athias, Naig Le Guern, Jean-Paul Pais de Barros, Catherine Desrumaux, David Masson, Xian-Cheng Jiang, and Laurent Lagrost
Arterioscler Thromb Vasc Biol. 2006;26:2160-2167; published online before print July 6 2006, doi:10.1161/01.ATV.0000235699.98024.11.
Abstract | Full Text | PDF
In vitro {alpha}-tocopherol enrichment of isolated erythrocytes, as well as accumulation of {alpha}-tocopherol in circulating erythrocytes of phospholipid transfer protein-deficient mice, led to fewer externalized phosphatidylserine molecules. This was associated with impaired procoagulant activity, and lower circulating levels of D-dimer, which is known to reflect thrombus formation in vivo.  

Cornelia J.F. de Wolf, Rosemiek M.J. Cupers, Rogier M. Bertina, and Hans L. Vos
Arterioscler Thromb Vasc Biol. 2006;26:2168-2174; published online before print July 13 2006, doi:10.1161/01.ATV.0000236202.39165.eb.
Abstract | Full Text | PDF
The important anticoagulant Protein S forms inactive complexes with complement component 4b-binding protein (C4BP), which is a known acute phase reactant. This raises the question how Protein S gene (PROS1) transcription is regulated during acute phase. Here we show that PROS1 transcription is upregulated by IL-6 via the STAT3 pathway.  

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