We have recently reported that the inhibition of endothelial cell COX-2 by non-steroidal anti-inflammatory drugs suppresses αVβ3- (but not α5β1-) dependent Rac activation, endothelial cell spreading, migration, and angiogenesis (Dormond, O., Foletti, A., Paroz, C., and Ruegg, C. (2001) Nat. Med. 7, 1041–1047). Here we investigated the role of the COX-2 metabolites PGE2 and TXA2 in regulating human umbilical vein endothelial cell (HUVEC) adhesion and spreading. We report that PGE2 accelerated αVβ3-mediated HUVEC adhesion and promoted Rac activation and cell spreading, whereas the TXA2 agonist U46619 retarded adhesion and inhibited spreading. We show that the cAMP level and the cAMP-regulated protein kinase A (PKA) activity are critical mediators of these PGE2 effects. αVβ3-mediated adhesion induced a transient COX-2-dependent rise in cAMP levels, whereas the cell-permeable cAMP analogue 8-brcAMP accelerated adhesion, promoted Rac activation, and cell spreading in the presence of the COX-2 inhibitor NS-398. Pharmacological inhibition of PKA completely blocked αVβ3-mediated adhesion. A constitutively active Rac mutant (L61Rac) rescued αVβ3-dependent spreading in the presence of NS398 or U46691, but did not accelerate adhesion, whereas a dominant negative Rac mutant (N17Rac) suppressed spreading without affecting adhesion. α5β1-mediated HUVEC adhesion, Rac activation, and spreading were not affected by PGE2, U46691, 8-brcAMP, or the inhibition of PKA. In conclusion, these results demonstrate that PGE2 accelerates αVβ3-mediated endothelial cell adhesion through cAMP-dependent PKA activation and induces αVβ3-dependent spreading via cAMP- and PKA-dependent Rac activation and may contribute to the further understanding of the regulation of vascular integrins αVβ3 by COX-2/PGE2during tumor angiogenesis and inflammation.