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. Author manuscript; available in PMC: 2010 Feb 22.
Published in final edited form as: Nature. 2000 Sep 14;407(6801):233–241. doi: 10.1038/35025203

Figure 5.

Figure 5

Foam-cell formation. Highly oxidized aggregated LDL is formed in the vessel as a result of the action of reactive oxygen species (ROS) and the enzymes sphingomyelinase (SMase), secretory phospholipase 2 (sPLA2), other lipases, and myeloperoxidase (MPO). The oxidized aggregated LDL is recognized by macrophage scavenger receptors such as SR-A, CD36 and CD68. Scavenger receptor expression is mediated by cytokines such as tumour necrosis factor-α (TNF-α) and interferon-γ (IFN-γ). Foam cells secrete apolipoprotein E (apoE), which may facilitate removal of excess cellular cholesterol. The death of foam cells leaves behind a growing mass of extracellular lipids and other cell debris.