Oxidation of low density lipoproteins in the pathogenesis of atherosclerosis.

Malondialdehyde (MDA)-modified and oxidized low density lipoproteins (LDL) have been demonstrated in atherosclerotic lesions. Elevated titers of autoimmune antibodies specific for MDA-modified LDL predicted the progression of carotid atherosclerosis and of myocardial infarction. Recently, elevated levels of MDA-modified LDL were detected in the plasma of patients with ischemic heart disease, whereas, elevated levels of oxidized LDL were detected in the plasma of patients with ischemic heart disease and of heart transplant patients with post-transplant cardiovascular disease. Although increased levels of autoimmune antibodies against oxidatively modified LDL and increased levels of oxidized LDL antigen appear to be associated with atherosclerotic cardiovascular disease, there is to date no direct proof of the causal role of oxidized LDL in atherothrombosis. However, the decreased risk of cardiovascular disease associated with the administration of antioxidants (e.g. vitamin E), estrogen supplementation and increased levels of high density lipoproteins (HDL) may, at least partially, be due to the inhibition of oxidation of LDL or to the reversal of the atherothrombotic effects of oxidized LDL.