Contrasting effects of urokinase and tissue-type plasminogen activators on neointima formation and vessel remodelling after arterial injury

Urokinase-type plasminogen activator (uPA) has been implicated in neointima formation and arterial lumen narrowing after angioplasty. To determine the specificity of the action of uPA on vessel remodelling after arterial injury we compared the effects of the recombinant urokinase- and tissue-type plasminogen activators on vessel morphology, cell migration and proliferation. We used a standard model of the balloon catheter injury of the rat carotid artery followed by the periadventitial application to the injured vessel of the one of the recombinant PAs or recombinant alpha(2)-antiplasmin (alpha-AP) in pluronic gel with further immunohistochemistry and morphometry. The perivascular application of alpha-AP immediately after injury attenuated the healing response, significantly reducing neointima size and neointimal SMC numbers. The periadventitial application to the injured artery of recombinant uPA stimulated neointima formation as well as cell proliferation and migration in vivo and induced greater reductions in lumen size than injury alone. In contrast, recombinant tissue-type plasminogen activator reduced the number of neointimal smooth muscle cells and the neointimal area and increased both the lumen area and the area encompassed by the external elastic laminae after balloon catheter injury of the rat carotid artery. In the meantime both PAs nearly doubled medial and adventitial SMC numbers in the vessels. We conclude that the ability to stimulate neointima formation and inward arterial remodelling is a specific property for urokinase plasminogen activator that could not be mimicked by tissue-type plasminogen activator. Copyright (C) 2004 S. Karger AG, Basel.