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The calcium channel blocker amlodipine exerts its anti-proliferative action via p21^(Waf1/Cip1) gene activation

ROLF ZIESCHE^*, VENTZISLAV PETKOV^*, CHRISTOPHER LAMBERS^*, PAUL ERNE and LUTZ-HENNING BLOCK^*,1

^* Department of Internal Medicine IV, University of Vienna, Austria; and
Department of Cardiology, Kantonsspital Luzern, Switzerland

¹Correspondence: University Hospital Vienna, Department of Internal Medicine IV, Währinger Gürtel 18-20, A-1090 Vienna, Austria. E-mail: lutz-henning.block{at}akh-wien.ac.at

Proliferation of vascular smooth muscle cells (VSMC) contributes to the progression of atherosclerotic plaques. Calcium channel blockers have been shown to reduce VSMC proliferation, but the underlying molecular mechanism remains unclear. p21^(Waf1/Cip1) is a potent inhibitor of cell cycle progression. Here, we demonstrate that amlodipine (10^–6 to 10^–8 M) activates de novo synthesis of p21^(Waf1/Cip1) in vitro. We show that amlodipine-dependent activation of p21^(Waf1/Cip1) involves the action of the glucocorticoid receptor (GR) and C/EBP-. The underlying pathway apparently involves the action of mitogen-activated protein kinase or protein kinase C, but not of extracellular signal-related kinase or changes of intracellular calcium. Amlodipine-induced p21^(Waf1/Cip1) promoter activity and expression were abrogated by C/EBP- antisense oligonucleotide or by the GR antagonist RU486. Amlodipine-dependent inhibition of cell proliferation was partially reversed by RU486 at 10^–8 M (58%±29%), antisense oligonucleotides targeting C/EBP- (91%±26%), or antisense mRNAs targeting p21^(Waf1/Cip1) (96%±32%, n=6); scrambled antisense oligonucleotides or those directed against C/EBP-ß were ineffective. The data suggest that the anti-proliferative action of amlodipine is achieved by induction of the p21 ^(Waf1/Cip1) gene, which may explain beneficial covert effects of this widely used cardiovascular therapeutic drug beyond a more limited role as a vascular relaxant.—Ziesche, R., Petkov, V., Lambers, C., Erne, P., Block, L.-H. The calcium channel blocker amlodipine exerts its anti-proliferative action via p21^(Waf1/Cip1) gene activation.

Key Words: VSMC • glucocorticoid receptor • intracellular calcium • CCB