Previous studies in this laboratory established that low density lipoprotein (LDL) incubated with cultured endothelial cells, smooth muscle cells, or macrophages undergoes a free radical-catalyzed oxidative modification that generates lipid peroxides and extensive structural changes in the LDL molecule. The oxidatively modified LDL strongly inhibited chemotactic responses of the mouse resident peritoneal macrophage. The present studies show that this oxidized LDL does not inhibit the motility of mouse monocytes and actually exhibits a chemotactic activity for human monocytes; the chemotactic activity of the oxidized LDL resides in the lipid fraction. These findings allow us to propose a pathogenetic sequence by which elevated plasma LDL levels, followed by oxidative modification in the arterial wall, could sufficiently account for the generation of the lipid-laden foam cells and the initiation of the fatty streak, the earliest well-defined lesion in atherogenesis.Accumulation of lipid in the arterial intima is central to the development of atherosclerosis. Intimal lipid accumulates intracytoplasmically in foam cells, which are derived both from medial smooth muscle cells (1, 2) and monocyte-derived macrophages (3)(4)(5), the latter probably being quantitatively more important (3-5). Exactly how monocytes are recruited and retained in the artery wall remains unclear, but probably the initial event is adhesion to the endothelial surface (3) followed by penetration that is influenced by a chemotactic factor(s). Many different factors chemotactic for monocytes have been described (6); the relative importance of these remains uncertain. Crude extracts of whole aorta contain chemotactic activity (7), and cultured arterial smooth muscle cells and macrophages release chemotactic activity into the culture medium (8). We recently described release of chemotactic activity for mouse resident peritoneal macrophages from cultured aortic endothelial cells (9) and showed that oxidatively modified low density lipoprotein (LDL) inhibited the chemotactic response of the macrophage. In the present studies we confirm the finding of Berliner et al. (10) that endothelial cell-conditioned medium is chemotactic also for human monocytes. However, oxidatively modified LDL, instead of inhibiting the motility of monocytes actually enhances their motility. We further show that the chemotactic activity resides in the lipid fraction of the modified LDL, presumably in one or another peroxidized lipid component. Thus oxidative modification of LDL, in addition to favoring the accumulation of cholesterol stores in developing foam cells (11), could play a role in recruitment and retention of monocyte/macrophages into the subendothelial space and, finally, may contribute to atherogenesis through injury to endothelial cells.
MATERIALS AND METHODSHam's F-10 medium and fetal bovine serum were from HyClone (Logan, UT); female Swiss Webster mice were from Simonsen Laboratories (Gilroy, CA); Ficoll/Hypaque, bovine serum albumin, zymosan A, fucoidi...