All-trans retinoic acid modulates microvascular endothelial cell hemostatic properties

Marina Marchetti, Alfonso Vignoli, Maria Rosa Bani, Donatella Balducci, Tiziano Barbui, Anna Falanga

Research output: Contribution to journalArticlepeer-review


Background and Objectives. All-trans retinoic acid (ATRA) is an anti-tumor agent capable of controlling the hypercoagulable state associated with malignancy. Among hemostasis-regulating functions, ATRA modulates the procoagulant and fibrinolytic properties of endothelial cells (EC) from large vessels (HUVEC). In this study we investigated whether ATRA may affect the same activities of EC derived from microvessels (HMEC-1 cell line). Design and Methods. We studied the effects of ATRA on procoagulant (i.e. tissue factor, TF), fibrinolytic (i.e. tissue plasminogen activator and inhibitor, t-PA and PAI-1) and anticoagulant (i.e. thrombomodulin, TM) properties of HMEC-1, compared to HUVEC. The type of retinoic acid receptor (RAR) possibly involved was identified by using synthetic retinoid selective agonists or antagonists for RAR α, β or γ. The study was conducted with or without tumor necrosis factor (TNF)α to induce the expression of some endothelial hemostatic properties. Results. ATRA significantly inhibited TNFα-induced TF expression in HMEC-1 as well as HUVEC. ATRA increased t-PA antigen without significantly affecting PAI-1 expression, and counteracted the TNFα-induced t-PA decrease in both types of EC. Accordingly, t-PA activity was significantly increased by ATRA, even in the presence of TNFα. Finally, ATRA upregulated TM, and prevented TNFα-induced TM downregulation. The study with selective RARs agonists and antagonists indicated that RARα played a major role in t-PA and TM modulation, whereas all three receptors were involved in TF downregulation. Interpretation and Conclusions. This study provides the first evidence that ATRA increases antithrombotic potential also in microvascular EC, a very relevant compartment for tumor- and/or antitumor therapy-associated vascular complications.

Original languageEnglish
Pages (from-to)895-905
Number of pages11
Issue number8
Publication statusPublished - Aug 1 2003


  • Endothelium
  • Fibrinolysis
  • Retinoids
  • Thrombomodulin
  • Tissue factor

ASJC Scopus subject areas

  • Hematology


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