Overview of OxLDL and Its Impact on Cardiovascular Health: Focus on Atherosclerosis
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Updated: Nov 19, 2025

Quantitative Analysis of Cellular Composition in Advanced Atherosclerotic Lesions of Smooth Muscle Cell Lineage-Tracing Mice
Published on: February 20, 2019
Anastasia V Poznyak1, Nikita G Nikiforov2,3,4,5, Alexander M Markin4
1Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow, Russia.
Insights
Atherosclerosis involves complex LDL modifications beyond simple oxidation. Oxidized LDL (oxLDL) plays a dual role in inflammation, highlighting its importance in cardiovascular disease development.
Area of Science:
- Cardiovascular Science
- Lipid Metabolism
- Inflammation Biology
Background:
- Cardiovascular pathologies are leading global causes of mortality.
- Atherosclerosis, a chronic disease, leads to myocardial infarction and stroke.
- The interplay between inflammation and lipid metabolism in atherogenesis is not fully understood.
Purpose of the Study:
- To review the role of oxidized LDL (oxLDL) in atherosclerosis.
- To explore the multiple LDL modification theory.
- To discuss the dual inflammatory properties of oxLDL.
Main Methods:
- Literature review of recent investigations on LDL modifications.
- Analysis of the cascade of LDL modifications in atherogenesis.
- Examination of oxLDL's interaction with cellular inflammatory pathways.
Main Results:
- LDL undergoes multiple modifications, not just oxidation, influencing atherogenesis.
- Oxidation is a late stage in the LDL modification cascade.
- Oxidized LDL exhibits both pro-inflammatory and anti-inflammatory effects.
Conclusions:
- Oxidized LDL is a critical factor in atherosclerosis development.
- Understanding oxLDL's complex roles is key to clarifying atherogenesis.
- Further research into oxLDL mechanisms is warranted for cardiovascular disease insights.
Abstract:
Cardiovascular pathologies maintain the leading position in mortality worldwide. Atherosclerosis is a chronic disease that can result in a variety of serious complications, such as myocardial infarction, stroke, and cardiovascular disease. Inflammation and lipid metabolism alterations play a crucial role in atherogenesis, but the details of relationships and causality of these fundamental processes remain not clear. The oxidation of LDL was considered the main atherogenic modification of LDL within the vascular wall for decades. However, recent investigations provided a growing body of evidence in support of the multiple LDL modification theory. It suggests that LDL particles undergo numerous modifications that change their size, density, and chemical properties within the blood flow and vascular wall. Oxidation is the last stage in this cascade resulting in the atherogenic properties. Moreover, recent investigations have discovered that oxLDL may have both anti-inflammatory and pro-inflammatory properties. Oxidized LDL can trigger inflammation through the activation of macrophages and other cells. After all, oxidized LDL is still a promising object for further investigations that have the potential to clarify the unknown parts of the atherogenic process. In this review, we discuss the role of oxLDL in atherosclerosis development on different levels.
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