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on September 13, 2004

Circulation. 2004
Published online before print September 13, 2004, doi: 10.1161/01.CIR.0000142610.10530.25
A more recent version of this article appeared on September 28, 2004
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Submitted on February 26, 2004
Revised on May 17, 2004
Accepted on May 20, 2004

Probucol Protects Against Smooth Muscle Cell Proliferation by Upregulating Heme Oxygenase-1

Yi-Mo Deng PhD, Ben J. Wu PhD, Paul K. Witting PhD, and Roland Stocker PhD*

From the Centre for Vascular Research, University of New South Wales, and the Department of Haematology, Prince of Wales Hospital, Sydney. Australia.

* To whom correspondence should be addressed. E-mail: r.stocker{at}unsw.edu.au.

Background--Evidence suggests that induction of heme oxygenase-1 (HO-1) inhibits proliferation of vascular smooth muscle cells and intimal thickening after arterial injury, and therapeutic molecules induce HO-1. Probucol is the only oral drug that inhibits restenosis in humans and intimal thickening in animals, although its underlying mechanism remains unclear.

Methods and Results--Aortas were harvested from New Zealand White rabbits fed normal or 0.75% (wt/wt) probucol-fortified chow, with or without endothelial denudation of the abdominal aorta on day 21, and analyzed for heme oxygenase and apoptosis. Uninjured aortas were harvested on day 21 and balloon-injured aortas on days 22 and 25. Probucol significantly increased mRNA of HO-1 assessed by real-time PCR and HO activity in aortas at all time points. Probucol also enhanced apoptosis of medial cells in the injured aorta, as evidenced by the TUNEL assay. Furthermore, probucol (100 µmol/L) increased HO-1 mRNA and HO activity when added to rabbit aortic smooth muscle cells (RASMCs) cultured in serum-free medium for 24 hours. Induction of HO-1 mRNA was inhibited by actinomycin D and was associated with inhibition of RASMC proliferation. This probucol-induced increase in HO-1 mRNA and inhibition of RASMC proliferation was prevented by the HO inhibitor Sn(IV) protoporphyrin or transfection with small interference RNA (siRNA) to knockdown HO-1, but not by inactive Cu(II) protoporphyrin or scrambled siRNA.

Conclusions--Probucol induces HO-1, and this contributes to the inhibition of vascular SMC proliferation. This novel finding may explain how probucol inhibits restenosis and highlights HO-1 as a target for therapeutic intervention against occlusive vascular disease.


Key words: angioplasty • antioxidants • atherosclerosis • endothelium • restenosis




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