Integrins are heterodimeric alpha/beta receptors that link the cytoskeleton with the extracellular matrix, thereby regulating several cell functions important in
atherosclerosis. In vitro, the
subtilisin/kexin-like
proprotein convertases (PCs), namely
PC5 and
furin, have been shown to be responsible for the endoproteolytic activation of the
alpha(v) integrin subunit. Based on their cleavage activity, these PCs are potential targets in
atherosclerosis. In the present study, we investigated the localization of
furin and
PC5 in different stages of human
atherosclerosis. Immunohistochemical analysis of
furin and
PC5 revealed their presence in vascular smooth-muscle cells and endothelial cells in atherosclerotic and non-atherosclerotic lesions. However, in the more advanced lesions,
furin and
PC5 staining was significantly expressed in macrophages/foam cells. In vitro, THP-1 derived macrophages contained
furin and
PC5, and maturation of monocytes to macrophages was accompanied by enhanced alpha(v)beta3 cell-surface expression. Inhibition of
furin/
PC5 with the specific pharmacological
furin-like PC-inhibitor dec-CMK inhibited alpha(v) endoproteolytic activation but did not abolish alpha(v)beta3 cell-surface expression. This indicates that
furin/
PC5 is required for alpha(v) endoproteolytic activation but not for alpha(v) routing and sorting to the cell surface. In conclusion, our study demonstrates that
furin and
PC5 are significantly expressed in mononuclear cells in advanced human atherosclerotic lesions, where they regulate alpha(v) endoproteolytic activation.