Abstract-A specific lectinlike endothelial receptor for oxidized low density lipoprotein (LOX-1), distinct from the scavenger receptor in monocytes/macrophages, has been identified and cloned. In this study, we examined the regulation of LOX-1 by oxidized low density lipoprotein (ox-LDL) and determined the role of LOX-1 in ox-LDL-induced apoptosis of cultured human coronary artery endothelial cells (HCAECs). Incubation of HCAECs with ox-LDL (40 g/mL), but not native LDL, for 24 hours markedly increased LOX-1 expression (mRNA and protein). After 48 hours of preincubation of HCAECs with a specific antisense to LOX-1 mRNA (antisense LOX-1), ox-LDL-mediated upregulation of LOX-1 was suppressed (PϽ0.01). In contrast, treatment of HCAECs with sense LOX-1 had no effect. Recent studies show that cytokine tumor necrosis factor (TNF)-␣ 4 and fluid shear stress 5 markedly upregulate LOX-1 gene expression in endothelial cells. Another study 6 has shown that LOX-1 expression is dramatically increased in hypertensive rats. A more recent study from our laboratory 7 has demonstrated that angiotensin II upregulates LOX-1 expression as well as the uptake of ox-LDL in human coronary artery endothelial cells (HCAECs).It is widely appreciated that LDL, especially its oxidatively modified form (ox-LDL), is a critical factor in atherogenesis.Endothelial dysfunction elicited by ox-LDL has been identified in the course of atherogenesis and its complications. 8 LDL is oxidized in vascular endothelial cells to a highly injurious product that results in characteristic cell dysfunction in large arteries and resistant vessels. Endothelial dysfunction (ie, loss of vasodilation, vasoconstriction, thrombosis, and inflammation) occurs before and throughout the development of atherosclerosis and particularly during plaque rupture. Ox-LDL appears to induce this cellular dysfunction in a timeand concentration-dependent manner. 9 Recent studies show that apoptosis, which is a common accompaniment of atherosclerosis, is induced by ox-LDL in cultured vascular smooth muscle cells, 10 monocytes/macrophages, 11 and human endothelial cells. 12 The mechanisms of ox-LDL-mediated apoptosis, particularly in endothelial cells, and of its relation with LOX-1 have not been defined.Nuclear factor (NF)-B, a transcription factor, regulates the transcription of a variety of cellular genes, including injury response and growth control. 13 Activation of NF-B is