We investigated the effect of chronic exposure (3 days) with low-density lipoprotein (LDL) and oxidized (Ox)-LDL on the unstimulated and stimulated formation of prostacyclin (6-keto-prostaglandin [PG]F, O ) and total inositol phosphates (IPs) by cultured bovine aortic endothelial cells. Neither basal nor bradykinin-stimulated (1 to 10 nmol/L) formation of 6-keto-PGF,,, was affected by LDL, except at the highest concentration of bradykinin tested (100 nmol/L). In the presence of the antioxidants N-acetyl-L-cysteine (NAC, 10 junol/L) or vitamin E (100 ^.mol/L), basal and bradykininstimulated formation of 6-keto-PGF, o was potentiated by 20 /ig protein/mL of LDL. Ox-LDL decreased unstimulated formation of the eicosanoid from 3.1 ±0.2 pg/jig protein in control cells to 1.6±0.1 and 0.5±0.1 pg/^g protein after 3-day incubation with 5 and 20 /xg protein/mL of Ox-LDL, respectively (P<.05). As in the basal state, Ox-LDL decreased F or many years, it was accepted that injury to the endothelium triggered the atherosclerotic lesion, but studies in a number of laboratories show that fatty-streak lesions can and do develop under an intact endothelial layer. Circulating monocytes penetrate between endothelial cells, enter the intima, and there become loaded with lipoprotein-derived lipids.