Background The binding of urokinase-type plasminogen activator (uPA) to its receptor (uPAR) on cell surfaces has the potential to influence degradation of extracellular matrix (ECM). Thus, uPA bound to monocyte/macrophages and its interactions with plasminogen activator inhibitors types 1 and 2 (PAI-1 and PAI-2) may modify atherogenesis by altering cell-associated proteolytic activity, degradation of ECM, and neointimal formation at sites of vascular injury.Methods and Results To determine whether the expression of proteins on the surface of cells involved in fibrinolysis changes in human cells in response to mediators implicated in atherogenesis, we exposed U937 cells (an immortal human monocyte-like cell line) to transforming growth factor- beta (TGF- beta) and to thrombin. Induction of uPAR mRNA occurred with TGF- beta (5 ng/mL) in a time-dependent fashion (P=.05; n=4). Thrombin (5 National Institutes of Health (NIH) U/mL) increased uPAR mRNA by 2.8-fold above control (n=4) without altering PAI-1 mRNA or protein synthesis (n=4). The increase in uPAR gene expression in cells exposed to either TGF- beta or thrombin translated into a functional increase in cell-surface proteolytic activity. Under control conditions, U937 cells expressed PAI-2 but not PAI-1 mRNA. PAI-2 mRNA expression increased (P<.05; n=4) with thrombin (5 NIH U/mL) but was suppressed by TGF- beta (5 ng/mL). TGF- beta induced PAI-1 mRNA within 6 hours accompanied by a 9-fold increase in PAI-1 protein from 6 hours (2.3+-1.9 ng/mL) to 24 hours (20.0+-9.6 ng/mL, P=.005; n=3) paralleled by increased synthesis as shown in metabolic labeling experiments with Sulfur-35-methionine and immunoprecipitation of labeled PAI-1. PAI-1 mRNA and protein expression were seen in human coronary artery atherectomy specimens as well and were localized to analogous monocyte/macrophages and to smooth muscle cells as judged from results of in situ hybridization and immunocytochemistry studies.Conclusions The results indicate that there is induction of PAI-1 and uPAR in U937 cells exposed to TGF- beta and thrombin. In atheroma, analogous processes may modulate early migration of luminal monocytes into the subintimal space and proteolysis of ECM. Thus, cell surface, monocyte-directed fibrinolysis may influence atherosclerosis, restenosis, or both. (Circulation. 1994;90:1927-1934.)