1. Cellular hypertrophy and/or a reduced rate of apoptosis could increase airway smooth muscle mass. As cardiotrophin-1 (CT-1) induces hypertrophy and inhibits apoptosis in cardiomyocytes, we tested for the expression and effects of CT-1 in human bronchial smooth muscle cells (HBSMC). 2. CT-1 was detected in abundance in normal adult human lung and was expressed in both fetal and adult HBSMC. 3. Following serum deprivation, CT-1 was released by reintroduction of serum and by TGF-beta 2/IL-4 in fetal but not adult cells. TGF-beta 2/IL-4 triggered the release of CT-1 in serum-fed adult cells. Hypoxia and strain had no effect on the release of CT-1. 4. CT-1 reduced the apoptosis induced both by serum deprivation and by Fas antibody/TNF-alpha treatment in adult cells, with greater efficacy than other members of the IL-6 superfamily. The MAPK/ERK kinase inhibitor PD98059 (1-10 microM) reduced the effect of CT-1. Fetal cells were more resistant to apoptosis. 5. CT-1 (10 ng ml-1) induced a significant increase in cell size as judged by protein/DNA ratios and flow cytometry. No effects on smooth muscle alpha-actin or vimentin proteins were noted, although CT-1 qualitatively alters the cytostructural distribution of SM22, an actin filament-associated protein, and increased SM22 protein abundance. No effect on proliferation or migration was evident. 6. These data suggest CT-1 expression primarily in fetal and synthetic HBSMC phenotypes. By reducing the rates of apoptosis and inducing hypertrophy, CT-1 may contribute to increased smooth muscle mass in airway disease.