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Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:481-488

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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:481.)
© 2001 American Heart Association, Inc.


Brief Review

HDL and the Inflammatory Response Induced by LDL-Derived Oxidized Phospholipids

Mohamad Navab; Judith A. Berliner; Ganesamoorthy Subbanagounder; Susan Hama; Aldons J. Lusis; Lawrence W. Castellani; Srinivasa Reddy; Diana Shih; Weibin Shi; Andrew D. Watson; Brian J. Van Lenten; Deven Vora; Alan M. Fogelman

From the Departments of Medicine (M.N., J.A.B., G.S., S.H., A.J.L., L.W.C., S.R., D.S., W.S., A.D.W., B.J.V.L., D.V., A.M.F.); Pathology (J.A.B.); Microbiology, Immunology, and Molecular Genetics (A.J.L.); and Human Genetics (A.J.L.), UCLA School of Medicine, Los Angeles, Calif.

Correspondence to Alan M. Fogelman, MD, Department of Medicine, UCLA School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095-1736. E-mail afogelman{at}mednet.ucla.edu

Abstract—Oxidation of low density lipoprotein (LDL) phospholipids containing arachidonic acid at the sn-2 position occurs when a critical concentration of "seeding molecules" derived from the lipoxygenase pathway is reached in LDL. When this critical concentration is reached, the nonenzymatic oxidation of LDL phospholipids produces a series of biologically active, oxidized phospholipids that mediate the cellular events seen in the developing fatty streak. Normal high density lipoprotein (HDL) contains at least 4 enzymes as well as apolipoproteins that can prevent the formation of the LDL-derived oxidized phospholipids or inactivate them after they are formed. In the sense that normal HDL can prevent the formation of or inactivate these inflammatory LDL-derived oxidized phospholipids, normal HDL is anti-inflammatory. HDL from mice that are genetically predisposed to diet-induced atherosclerosis became proinflammatory when the mice are fed an atherogenic diet, injected with LDL-derived oxidized phospholipids, or infected with influenza A virus. Mice that were genetically engineered to be hyperlipidemic on a chow diet and patients with coronary atherosclerosis, despite normal lipid levels, also had proinflammatory HDL. It is proposed that LDL-derived oxidized phospholipids and HDL may be part of a system of nonspecific innate immunity and that the detection of proinflammatory HDL may be a useful marker of susceptibility to atherosclerosis.


Key Words: HDL • LDL • atherosclerosis • oxidized phospholipids




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