ABSTRACT
The protein C anticoagulant pathway plays a fundamental role in the control of coagulation system and inflammatory response. It has been well established that physiological levels of shear stress induce endothelial structural change and modulate gene and protein expression. However, the role of shear stress in protein C pathway remains unknown. In the present study, we evaluated the effect of shear stress on the activation of protein C as well as on the expression of endothelial protein C receptor (EPCR) and thrombomodulin (TM) in human umbilical vein endothelial cells (HUVECs) which were exposed to TNF-alpha alone, shear stress alone, and TNF-alpha under shear stress. We found: (1) Either TNF-alpha or shear stress alone significantly reduced EPCR expression and protein C activation in HUVECs; and simultaneous exposure of HUVECs to TNF-alpha and shear stress resulted in a further decrease of EPCR expression and protein C activation (P<0.05); (2) Simultaneous exposure of HUVECs to TNF-alpha and shear stress resulted in the increase of soluble EPCR level more significantly than did the exposure of HUVECs to either TNF-alpha or shear stress alone (P<0.05); (3) Shear stress significantly increased TM expression on HUVECs, whereas TNF-alpha inhibited TM expression; shear stress could strongly neutralize TNF-alpha's inhibitive effect on TM expression. We therefore conclude that shear stress may play an important role in protein C pathway, which may be fulfilled by regulating EPCR expression and TM expression in endothelial cells.