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Stroke. 2003;34:1783-1789
Published online before print June 12, 2003, doi: 10.1161/01.STR.0000078371.00577.76
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(Stroke. 2003;34:1783.)
© 2003 American Heart Association, Inc.


Original Contributions

Possible Role of Parathyroid Hormone–Related Protein as a Proinflammatory Cytokine in Atherosclerosis

José Luis Martín-Ventura, BS; Mónica Ortego, PhD; Pedro Esbrit, PhD; Miguel Angel Hernández-Presa, PhD; Luis Ortega, MD Jesús Egido, MD

From the Vascular Research Laboratory (J.L.M-V., M.O., M.A.H-P., J.E.) and Bone and Mineral Research Laboratory (P.E.), Fundación Jiménez Díaz, Autónoma University; and Department of Pathology, Hospital Clínico San Carlos (L.O.), Madrid, Spain.

Correspondence to Jesús Egido, MD, Vascular Research Laboratory, Fundación Jiménez Díaz, Avenida Reyes Católicos 2, 28040 Madrid, Spain. E-mail jegido{at}fjd.es

Background and Purpose— Parathyroid hormone–related protein (PTHrP) is a vasodilator peptide. In addition, PTHrP appears to affect vascular growth and to be a mediator of inflammation in rheumatic and brain disorders. We examined the possible role of PTHrP in the inflammatory process in atherosclerosis

Methods— We immunohistochemically analyzed the cellular localization of PTHrP, the type 1 PTH/PTHrP receptor (PTH1R), and monocyte chemoattractant protein-1 (MCP-1) in 26 human carotid atherosclerotic plaques.

Results— The inflammatory region of plaques was characterized by high PTHrP, PTH1R, and MCP-1 immunostaining in relation to the cap (0.75±0.1 versus 0.29±0.04, 0.5±0.1 versus 0.25±0.05, 0.72±0.2 versus 0.29±0.05, respectively; P<0.05). PTHrP and MCP-1 were colocalized in both resident and inflammatory cells in the plaque. Moreover, in cultured vascular smooth muscle cells (VSMC), PTHrP(1–36) increased MCP-1 mRNA (3-fold at 6 hours) and MCP-1 protein (2.5-fold at 24 hours). This effect was inhibited by either PTHrP(7–34) or various protein kinase A inhibitors and by the nuclear factor-{kappa}B (NF-{kappa}B) inhibitor parthenolide. Furthermore, PTHrP(1–36) elicited an increase in NF-{kappa}B activation in VSMC. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin inhibited the PTHrP(1–36) induction of both NF-{kappa}B activity and MCP-1 overexpression, and this was reversed by mevalonate.

Conclusions— PTHrP appears to be a novel proinflammatory mediator in the atheroma lesion and may contribute to the instability of carotid atherosclerotic plaques. Our data provide a new rationale to understand the mechanisms involved in the beneficial effects of statins in atherosclerosis.


Key Words: atherosclerosis • carotid arteries • inflammation • monocyte chemoattractant protein-1 • parathyroid hormone–related protein




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