Highlights
- •Macrophages are capable of recognizing and binding foreign or altered-self targets.
- •Modified LDL can be sensed and taken up by macrophages with a battery of scavenger receptors.
- •In atherosclerosis, lipid balance is deregulated that induces the inability of macrophages to completely recycle modified LDL.
Abstract
In atherosclerosis, serum lipoproteins undergo various chemical modifications that
impair their normal function. Modification of low density lipoprotein (LDL) such as
oxidation, glycation, carbamylation, glucooxidation, etc. makes LDL particles more proatherogenic. Macrophages are responsible for clearance
of modified LDL to prevent cytotoxicity, tissue injury, inflammation, and metabolic
disturbances. They develop an advanced sensing arsenal composed of various pattern
recognition receptors (PRRs) capable of recognizing and binding foreign or altered-self
targets for further inactivation and degradation. Modified LDL can be sensed and taken
up by macrophages with a battery of scavenger receptors (SRs), of which SR-A1, CD36, and LOX1 play a major role. However, in atherosclerosis, lipid balance is
deregulated that induces inability of macrophages to completely recycle modified LDL
and leads to lipid deposition and transformation of macrophages to foam cells. SRs
also mediate various pathogenic effects of modified LDL on macrophages through activation
of the intracellular signaling network. Other PRRs such Toll-like receptors can also
interact with modified LDL and mediate their effects independently or in cooperation
with SRs.
Graphical abstract

Graphical Abstract
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- An endothelial receptor for oxidized low-density lipoprotein.Nature. 1997; 386: 73-77
- Immunogenicity of homologous low density lipoprotein after methylation, ethylation, acetylation, or carbamylation: generation of antibodies specific for derivatized lysine.J. Lipid Res. 1984; 25: 1109-1116
- Carbamylated low-density lipoprotein: nontraditional risk factor for cardiovascular events in patients with chronic kidney disease.J. Ren. Nutr. 2012; 22: 134-138
- The AGE-receptor in the pathogenesis of diabetic complications.Diabetes Metab. Res. Rev. 2001; 17: 436-443
- Susceptibility of LDL and its subfractions to glycation.Curr. Opin. Lipidol. 2011; 22: 254-261
- Carbamylated low-density lipoprotein induces oxidative stress and accelerated senescence in human endothelial progenitor cells.FASEB J. 2011; 25: 1314-1322
- LDL biochemical modifications: a link between atherosclerosis and aging.Food Nutr. Res. 2015; 59: 29,240
- Modified low density lipoprotein and lipoprotein-containing circulating immune complexes as diagnostic and prognostic biomarkers of atherosclerosis and type 1 diabetes macrovascular disease.Int. J. Mol. Sci. 2014; 15: 12,807-12,841
- Enhanced macrophage degradation of low density lipoprotein previously incubated with cultured endothelial cells: recognition by receptors for acetylated low density lipoproteins.Proc. Natl. Acad. Sci. U. S. A. 1981; 78: 6499-6503
- Modification of low density lipoprotein by endothelial cells involves lipid peroxidation and degradation of low density lipoprotein phospholipids.Proc. Natl. Acad. Sci. U. S. A. 1984; 81: 3883-3887
- Mechanisms of LDL oxidation.Clin. Chim. Acta. 2010; 411: 1875-1882
- Contribution of neovascularization and intraplaque haemorrhage to atherosclerotic plaque progression and instability.Acta Physiol. (Oxford). 2015; 213: 539-553
- The two faces of the 15-lipoxygenase in atherosclerosis.Prostaglandins Leukot. Essent. Fat. Acids. 2007; 77: 67-77
- Impact of myeloperoxidase-LDL interactions on enzyme activity and subsequent posttranslational oxidative modifications of apoB-100.J. Lipid Res. 2014; 55: 747-757
- Comparative reactivities of various biological compounds with myeloperoxidase-hydrogen peroxide-chloride, and similarity of the oxidant to hypochlorite.Biochim. Biophys. Acta. 1985; 840: 204-210
- Human neutrophils employ the myeloperoxidase-hydrogen peroxide-chloride system to oxidize alpha-amino acids to a family of reactive aldehydes. Mechanistic studies identifying labile intermediates along the reaction pathway.J. Biol. Chem. 1998; 273: 4997-5005
- Comparative reactivity of the myeloperoxidase-derived oxidants HOCl and HOSCN with low-density lipoprotein (LDL): implications for foam cell formation in atherosclerosis.Arch. Biochem. Biophys. 2015; 573: 40-51
- Low-density lipoprotein modification occurring in human plasma. Possible mechanism of in vivo lipoprotein desialylation as a primary step of atherogenic modification.Atherosclerosis. 1998; 138: 183-195
- Role of oxidized low density lipoprotein in atherogenesis.J. Clin. Invest. 1991; 88: 1785-1792
- Macropinocytosis is the endocytic pathway that mediates macrophage foam cell formation with native low density lipoprotein.J. Biol. Chem. 2005; 280: 2352-2360
- Carbamoylation of amino acids and proteins in uremia.Kidney Int. 2001; : S102-S107
- Carbamylated darbepoetin derivative prevents endothelial progenitor cell damage with no effect on angiogenesis.J. Mol. Cell. Cardiol. 2009; 47: 781-788
- Protein carbamylation and cardiovascular disease.Kidney Int. 2015; 88: 474-478
- Carbamylated low-density lipoprotein induces death of endothelial cells: a link to atherosclerosis in patients with kidney disease.Kidney Int. 2005; 68: 173-178
- Post-translational modifications in rheumatoid arthritis and atherosclerosis: Focus on citrullination and carbamylation.J. Int. Med. Res. 2016; 44: 81-84
- Advanced glycation end products and oxidative stress in type 2 diabetes mellitus.Biomolecules. 2015; 5: 194-222
- Advanced glycation end products and diabetic complications.Korean J. Physiol. Pharmacol. 2014; 18: 1-14
- Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications.N. Engl. J. Med. 1988; 318: 1315-1321
- Lipid advanced glycosylation: pathway for lipid oxidation in vivo.Proc. Natl. Acad. Sci. U. S. A. 1993; 90: 6434-6438
- Site-specific modification of apolipoprotein B by advanced glycosylation end-products: implications for lipoprotein clearance and atherogenesis.Nephrol. Dial. Transplant. 1996; 11: 17-19
- Isolation, characterization, and metabolism of the glycated and nonglycated subfractions of low-density lipoproteins isolated from type I diabetic patients and nondiabetic subjects.Diabetes. 1995; 44: 1093-1098
- Diabetic cardiovascular disease induced by oxidative stress.Int. J. Mol. Sci. 2015; 16: 25,234-25,263
- The role of oxidative stress in the long-term glycation of LDL.Biofactors. 1997; 6: 111-124
- Why is glycated LDL more sensitive to oxidation than native LDL? A comparative study.Prostaglandins Leukot. Essent. Fat. Acids. 2000; 63: 177-186
- Sequential change in physicochemical properties of LDL during oxidative modification.Chem. Phys. Lipids. 2015; 193: 52-62
- Role of lysophosphatidylcholine (LPC) in atherosclerosis.Curr. Med. Chem. 2007; 14: 3209-3220
- Metabolism and atherogenic disease association of lysophosphatidylcholine.Atherosclerosis. 2010; 208: 10-18
- Morpho-functional Characterization of the Endothelium of the Aorta of Rabbits at Experimental Hypercholesterolemia.Thesis of Candidate of Science, Leningrad, USSR1983 (312 pp.)
- Transfer of low density lipoprotein into the arterial wall and risk of atherosclerosis.Atherosclerosis. 1996; 123: 1-15
- Retention of atherogenic lipoproteins in the artery wall and its role in atherogenesis.Nutr Metab Cardiovasc. 2012; 22 (Dis): 1-7
- Identification of the proteoglycan binding site in apolipoprotein B48.J. Biol. Chem. 2002; 277: 32,228-32,233
- Subendothelial retention of atherogenic lipoproteins in early atherosclerosis.Nature. 2002; 417: 750-754
- α5β1 integrin signaling mediates oxidized low-density lipoprotein-induced inflammation and early atherosclerosis.Arterioscler. Thromb. Vasc. Biol. 2014; 34: 1362-1373
- Scavenger receptor structure and function in health and disease.Cells. 2015; 4: 178-201
- In situ immunolocalization of lipoproteins in human arteriosclerotic tissue.Arterioscler. Thromb. 1993; 13: 133-146
- Intracellular localization of oxidized low-density lipoproteins in atherosclerotic plaque cells revealed by electron microscopy combined with laser capture microdissection.J. Histochem. Cytochem. 2005; 53: 793-797
- Monocyte recruitment and foam cell formation in atherosclerosis.Micron. 2006; 37: 208-222
- Macrophage-mediated cholesterol handling in atherosclerosis.J. Cell. Mol. Med. 2016; 20: 17-28
- Macrophage scavenger receptors.Curr. Opin. Lipidol. 1994; 5: 143-148
- Scavenger receptors in atherosclerosis: beyond lipid uptake.Arterioscler. Thromb. Vasc. Biol. 2006; 26: 1702-1711
- Standardizing scavenger receptor nomenclature.J. Immunol. 2014; 192: 1997-2006
- Selective adhesion of macrophages to denatured forms of type I collagen is mediated by scavenger receptors.Matrix Biol. 2000; 19: 61-71
- Binding site on macrophages that mediates uptake and degradation of acetylated low density lipoprotein, producing massive cholesterol deposition.Proc. Natl. Acad. Sci. U. S. A. 1979; 76: 333-337
- Role of macrophage scavenger receptors in atherosclerosis.Immunobiology. 2012; 217: 492-502
- Class A1 scavenger receptors in cardiovascular diseases.Br. J. Pharmacol. 2015; 172: 5523-5530
- Biochemistry and cell biology of mammalian scavenger receptors.Atherosclerosis. 2005; 182: 1-15
- Crystal structure of a scavenger receptor cysteine-rich domain sheds light on an ancient superfamily.Nat. Struct. Biol. 1996; 6: 228-232
- Murine M phi scavenger receptor: adhesion function and expression.Immunol. Lett. 1994; 43: 7-14
- Class A scavenger receptor-mediated adhesion and internalization require distinct cytoplasmic domains.J. Biol. Chem. 2003; 278: 34,219-34,225
- Scavenger receptors class A-I/II and CD36 are the principal receptors responsible for the uptake of modified low density lipoprotein leading to lipid loading in macrophages.J. Biol. Chem. 2002; 277: 49,982-49,988
- Caveolae-dependent endocytosis is required for class a macrophage scavenger receptor-mediated apoptosis in macrophages.J. Biol. Chem. 2011; 286: 8231-8239
- Glucose-regulated protein 78 inhibits scavenger receptor A-mediated internalization of acetylated low density lipoprotein.J. Mol. Cell. Cardiol. 2009; 47: 646-655
- The glucose-regulated proteins (GRP78 and GRP94): functions, gene regulation, and applications.Crit. Rev. Eukaryot. Gene Expr. 1994; 4: 1-18
- High glucose attenuates protein S-nitrosylation in endothelial cells: role of oxidative stress.Diabetes. 2007; 56: 2715-2721
- Expression of class A scavenger receptor is enhanced by high glucose in vitro and under diabetic conditions in vivo: one mechanism for an increased rate of atherosclerosis in diabetes.J. Biol. Chem. 2005; 280: 3355-3364
- ERK is integral to the IFN-γ-mediated activation of STAT1, the expression of key genes implicated in atherosclerosis, and the uptake of modified lipoproteins by human macrophages.J. Immunol. 2010; 185: 3041-3048
- Upregulation of macrophage-specific functions by oxidized LDL: lysosomal degradation-dependent and -independent pathways.Mol. Cell. Biochem. 2013; 372: 181-190
- A role for macrophage scavenger receptors in atherosclerosis and susceptibility to infection.Nature. 1997; 386: 292-296
- Reduced atherosclerotic lesions in mice deficient for total or macrophage-specific expression of scavenger receptor-a.Arterioscler. Thromb. Vasc. Biol. 2000; 20: 2593-2599
- Uptake of oxidized low-density lipoprotein in a THP-1 cell line lacking scavenger receptor a.Atherosclerosis. 2001; 158: 351-357
- Low-density lipoprotein from apolipoprotein E-deficient mice induces macrophage lipid accumulation in a CD36 and scavenger receptor class A-dependent manner.Arterioscler. Thromb. Vasc. Biol. 2005; 25: 168-173
- Effect of human scavenger receptor class a overexpression in bone marrow-derived cells on cholesterol levels and atherosclerosis in ApoE-deficient mice.Arterioscler. Thromb. Vasc. Biol. 2000; 20: 2600-2606
- Effect of human scavenger receptor class A overexpression in bone marrow-derived cells on lipoprotein metabolism and atherosclerosis in low density lipoprotein receptor knockout mice.J. Lipid Res. 2000; 41: 1402-1409
- Scavenger receptor deficiency leads to more complex atherosclerotic lesions in APOE3Leiden transgenic mice.Atherosclerosis. 1999; 144: 315-321
- Macrophage-specific expression of class A scavenger receptors in LDL receptor (−/−) mice decreases atherosclerosis and changes spleen morphology.J. Lipid Res. 2002; 43: 1201-1208
- Loss of SR-A and CD36 activity reduces atherosclerotic lesion complexity without abrogating foam cell formation in hyperlipidemic mice.Arterioscler. Thromb. Vasc. Biol. 2009; 29: 19-26
- Combinatorial pattern recognition receptor signaling alters the balance of life and death in macrophages.Proc. Natl. Acad. Sci. U. S. A. 2006; 103: 19,794-19,799
- Cholesterol-induced macrophage apoptosis requires ER stress pathways and engagement of the type A scavenger receptor.J. Cell Biol. 2005; 171: 61-73
- Local proliferation dominates lesional macrophage accumulation in atherosclerosis.Nat. Med. 2013; 19: 1166-1172
- CD36, a scavenger receptor implicated in atherosclerosis.Exp. Mol. Med. 2014; 46: e99
- The Human Scavenger Receptor CD36: glycosylation status and its role in trafficking and function.J. Biol. Chem. 2009; 284: 16,277-16,288
- Lysosomal integral membrane protein II binds thrombospondin-1. Structure-function homology with the cell adhesion molecule CD36 defines a conserved recognition motif.J. Biol. Chem. 1998; 273: 4855-4863
- Structural basis for the recognition of oxidized phospholipids in oxidized low density lipoproteins by class B scavenger receptors CD36 and SR-BI.J. Biol. Chem. 2010; 285: 4447-4454
- Class B scavenger receptors CD36 and SR-BI are receptors for hypochlorite-modified low density lipoprotein.J. Biol. Chem. 2003; 278: 47562-47,570
- Macrophage scavenger receptor CD36 is the major receptor for LDL modified by monocyte-generated reactive nitrogen species.J. Clin. Invest. 2000; 105: 1095-1108
- Identification on human CD36 of a domain (155–183) implicated in binding oxidized low-density lipoproteins (ox-LDL).Arterioscler. Thromb. Vasc. Biol. 1996; 16: 1033-1039
- Targeted disruption of the class B scavenger receptor CD36 protects against atherosclerotic lesion development in mice.J. Clin. Invest. 2000; 105: 1049-1056
- Continued inhibition of atherosclerotic lesion development in long term Western diet fed CD36o /apoEo mice.Atherosclerosis. 2007; 192: 123-130
- Absence of CD36 protects against atherosclerosis in ApoE knock-out mice with no additional protection provided by absence of scavenger receptor A I/II.Cardiovasc. Res. 2008; 78: 185-196
- Stem cell transplantation reveals that absence of macrophage CD36 is protective against atherosclerosis.Arterioscler. Thromb. Vasc. Biol. 2004; 24: 2333-2338
- EP 80317, a ligand of the CD36 scavenger receptor, protects apolipoprotein E-deficient mice from developing atherosclerotic lesions.FASEB J. 2005; 19: 1869-1871
- Loss of receptor-mediated lipid uptake via scavenger receptor A or CD36 pathways does not ameliorate atherosclerosis in hyperlipidemic mice.J. Clin. Invest. 2005; 115: 2192-2201
- CD36 ligands promote sterile inflammation through assembly of a Toll-like receptor 4 and 6 heterodimer.Nat. Immunol. 2010; 11: 155-161
- A specific CD36-dependent signaling pathway is required for platelet activation by oxidized low-density lipoprotein.Circ. Res. 2008; 102: 1512-1519
- A CD36-dependent signaling cascade is necessary for macrophage foam cell formation.Cell Metab. 2006; 4: 211-221
- Multimolecular signaling complexes enable Syk-mediated signaling of CD36 internalization.Dev. Cell. 2013; 24: 372-383
- Vav Guanine nucleotide exchange factors regulate atherosclerotic lesion development in mice.Arterioscler. Thromb. Vasc. Biol. 2013; 33: 2053-2057
- Vav protein guanine nucleotide exchange factor regulates CD36 protein-mediated macrophage foam cell formation via calcium and dynamin-dependent processes.J. Biol. Chem. 2011; 286: 36,011-36,019
- IRGM1 regulates oxidized LDL uptake by macrophage via actin-dependent receptor internalization during atherosclerosis.Sci. Rep. 2013; 3: 1867
- Activation of the p38 MAP kinase pathway is required for foam cell formation from macrophages exposed to oxidized LDL.APMIS. 2002; 110: 458-468
- Oxidized low density lipoprotein activates peroxisome proliferator-activated receptor-alpha (PPARalpha) and PPARgamma through MAPK-dependent COX-2 expression in macrophages.J. Biol. Chem. 2008; 283: 9852-9862
- Oxidized LDL-induced NF-kappa B activation and subsequent expression of proinflammatory genes are defective in monocyte-derived macrophages from CD36-deficient patients.Arterioscler. Thromb. Vasc. Biol. 2000; 20: 1953-1960
- Physiological and pathological roles of a multi-ligand receptor CD36 in atherogenesis; insights from CD36-deficient patients.Mol. Cell. Biochem. 2007; 299: 19-22
- Toll-like receptor signaling.J. Biol. Chem. 2003; 278: 38,105-38,108
- CD36 coordinates NLRP3 inflammasome activation by facilitating intracellular nucleation of soluble ligands into particulate ligands in sterile inflammation.Nat. Immunol. 2013; 14: 812-820
- Regulation of inflammasome signaling.Nat. Immunol. 2012; 13: 333-342
- Emigration of monocyte-derived cells from atherosclerotic lesions characterizes regressive, but not progressive, plaques.Proc. Natl. Acad. Sci. U. S. A. 2004; 101: 11,779-11,784
- Suppressed monocyte recruitment drives macrophage removal from atherosclerotic plaques of Apoe−/− mice during disease regression.J. Clin. Invest. 2011; 121: 2025-2036
- CD36 modulates migration of mouse and human macrophages in response to oxidized LDL and may contribute to macrophage trapping in the arterial intima.J. Clin. Invest. 2009; 119: 136-145
- Oxidized LDL/CD36 interaction induces loss of cell polarity and inhibits macrophage locomotion.Mol. Biol. Cell. 2012; 23: 3057-3068
- Lox-1: the multifunctional receptor underlying cardiovascular dysfunction.Circ. J. 2009; 73: 1993-1999
- Site-specific N-glycosylation identification of recombinant human lectin-like oxidized low density lipoprotein receptor-1 (LOX-1).Glycoconj. J. 2012; 29: 399-409
- LOX-1 in atherosclerosis: biological functions and pharmacological modifiers.Cell. Mol. Life Sci. 2013; 70: 2859-2872
- Expression of lectin-like oxidized low-density lipoprotein receptor-1 in human atherosclerotic lesions.Circulation. 1999; 99: 3110-3117
- The discovery of LOX-1, its ligands and clinical significance.Cardiovasc. Drugs Ther. 2011; 25: 379-391
- Requirements of basic amino acid residues within the lectin-like domain of LOX-1 for the binding of oxidized low-density lipoprotein.FEBS Lett. 2001; 499: 215-219
- Conserved C-terminal residues within the lectin-like domain of LOX-1 are essential for oxidized low-density-lipoprotein binding.Biochem. J. 2001; 355: 289-296
- Crystal structure of human lectin-like, oxidized low-density lipoprotein receptor 1 ligand binding domain and its ligand recognition mode to OxLDL.Structure. 2005; 13: 905-917
- The 1.4 angstrom crystal structure of the human oxidized low density lipoprotein receptor lox-1.J. Biol. Chem. 2005; 280: 13,593-13,599
- LOX-1, OxLDL, and atherosclerosis.Mediat. Inflamm. 2013; 2013: 152,786
- LOX-1-mediated effects on vascular cells in atherosclerosis.Cell. Physiol. Biochem. 2016; 38: 1851-1859
- Cholesterol-lowering drugs inhibit lectin-like oxidized low-density lipoprotein-1 receptor function by membrane raft disruption.Mol. Pharmacol. 2012; 82: 246-254
- The LOX-1 scavenger receptor and its implications in the treatment of vascular disease.Cardiol. Res. Pract. 2012; 2012: 632,408
- Identification of the lectin-like receptor for oxidized low-density lipoprotein in human macrophages and its potential role as a scavenger receptor.Biochem. J. 1998; 334: 9-13
- Effect of exposure of human monocyte-derived macrophages to high, versus normal, glucose on subsequent lipid accumulation from glycated and acetylated low-density lipoproteins.Exp. Diabetes Res. 2011; 2011: 851,280
- Hypoxia enhances lipid uptake in macrophages: role of the scavenger receptors Lox1, SRA, and CD36.Atherosclerosis. 2013; 229: 110-117
- LOX-1 augments oxLDL uptake by lysoPC-stimulated murine macrophages but is not required for oxLDL clearance from plasma.J. Lipid Res. 2009; 50: 1676-1684
- Interplay between CRP, atherogenic LDL, and LOX-1 and its potential role in the pathogenesis of atherosclerosis.Clin. Chem. 2016; 62: 320-327
- LOX-1 is implicated in oxidized low-density lipoprotein-induced oxidative stress of macrophages in atherosclerosis.Mol. Med. Rep. 2015; 12: 5335-5341
- Expression cloning of SR-BI, a CD36-related class B scavenger receptor.J. Biol. Chem. 1994; 269: 21,003-21,009
- Distinct mechanisms for OxLDL uptake and cellular trafficking by class B scavenger receptors CD36 and SR-BI.J. Lipid Res. 2007; 48: 2560-2570
- Minimally modified LDL binds to CD14, induces macrophage spreading via TLR4/MD-2, and inhibits phagocytosis of apoptotic cells.J Biol Chem. 2003; 132: 1561-1568
- The activation of CD14, TLR4, and TLR2 by mmLDL induces IL-1β, IL-6, and IL-10 secretion in human monocytes and macrophages.Lipids Health Dis. 2010; 9: 117
- OxLDL-mediated survival of macrophages does not require LDL internalization or signalling by major pattern recognition receptors.Biochem. Cell Biol. 2011; 89: 387-395
- Toll-like receptor 4 mediates oxidized LDL-induced macrophage differentiation to foam cells.J. Surg. Res. 2011; 171: e27-e31
- Activation of TLR2 and TLR4 by minimally modified low-density lipoprotein in human macrophages and monocytes triggers the inflammatory response.Hum. Immunol. 2010; 71: 737-744
- The role of TLR2, TLR4 and CD36 in macrophage activation and foam cell formation in response to oxLDL in humans.Hum. Immunol. 2014; 75: 322-329
Article info
Publication history
Published online: December 28, 2016
Accepted:
December 25,
2016
Received in revised form:
December 19,
2016
Received:
June 17,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.