Lipoprotein oxidation: mechanistic aspects, methodological approaches and clinical relevance.

The oxidation of LDL is now commonly implicated as an initiator of atherosclerosis and a standard in-vitro LDL 'oxidizability' test is required. This review will discuss current problems and advances that have been made in our understanding of the molecular mechanisms of radical-mediated LDL oxidation and antioxidation, how they relate to the in-vitro assessment of the 'oxidizability' of LDL and how they may be relevant to in-vivo LDL oxidation. Tocopherol-mediated peroxidation is used as a novel model of LDL lipid oxidation to discuss why terms such as 'lag time' are features of the in-vitro oxidation conditions, rather than being inherent to LDL oxidation per se. In addition, we will also cover why it is premature, at present, to use one particular LDL oxidizability test as a standard.