Leukocyte adhesion and subendothelial emigration, constant hallmarks of early atherogenesis, have been ascribed to the action of oxidized low-density lipoprotein (oxLDL). Using intravital fluorescence microscopy in the skinfold-chamber model in hamsters, we have previously shown that systemic administration of oxLDL stimulates leukocyte adhesion in vivo through a mechanism that depends on the generation and/or action of both leukotrienes and superoxide radicals. On the basis of the fact that oxygen radical-catalyzed peroxidation of phospholipids results in the generation of fragments with short sn2 residues, which besides authentic platelet-activating factor (PAF), activate the receptor for PAF on leukocytes and thereby induce leukocyte adhesion, we asked whether pretreatment of hamsters with a specific PAF receptor antagonist (WEB2170; 1 mg/kg of body weight IV, 10 minutes before oxLDL) attenuates leukocyte adhesion after injection of oxLDL (4 mg/kg of body weight IV, oxidized by 7.5 /unol/L Cu J+ for 18 hours at 3TC). We demonstrate herein that in contrast to untreated control animals in which oxLDL elicited rolling and adhesion of circulating leukocytes to the endothelium of venules and arterioles, oxLDL-induced leukocyte adhesion was significantly attenuated in WEB2170-pretreated animals. These changes cannot be ascribed to alterations of microhemodynamic parameters and, hence, wall shear conditions. This finding indicates that oxLDL-induced leukocyte/endothelium interaction involves the PAF receptor, which may function both as a receptor for authentic PAF or for PAF-Iike lipids that are generated in a free radical-catalyzed peroxidation of phospholipids. In vitro and in vivo experiments have demonstrated that oxLDL induces the chemotactic accumulation and adhesion of leukocytes to endothelial cells. 58 Both the peroxidative modification of LDL 910 and the stimulation of leukocyte adhesion by oxLDL 11 can be inhibited by superoxide dismutase (SOD), thus suggesting that these events involve a superoxide radical-dependent peroxidation of LDL and membrane phospholipids.Uncontrolled oxygen radical-catalyzed peroxidation of phospholipids results in the generation of numerous fragmented phospholipids, some of which activate leu-