LDL-metabolism of the arterial wall--new implications for atherogenesis.

Increasing evidence arising from experimental work and epidemiological studies through the last few years shows an important role of LDL antioxidants in the pathogenesis of the early atherosclerotic lesions characterized by macrophagocytic foam cells. Also the maturation of the atherosclerotic lesion evolving from the fatty streak could be driven by pathological peroxidation of the LDL in the arterial wall. The search for new drugs against atherosclerosis should therefore include compounds that increase stability of LDL and reduce formation of cholesteryl ester formation in the foam cells via the scavenger receptor pathway. The aim of such a strategy is to keep LDL in the protective LDL-receptor-mediated pathway of the liver, and to reduce LDL trapping by the arterial wall.