D-PDMP inhibits ox-LDL induced LCS activity and atherosclerosis development. Oxidized LDL (ox-LDL) activates LacCer synthase (LCS) to produce large quantities of LacCer, which stimulates the activity of NADPH oxidase. Concomitantly, there is an increase in the generation of superoxide radicals (ROS). ROS mediates p44MAPK phosphorylation thereby stimulating c-fos expression, promoting cell proliferation of vascular-smooth-muscle cells further to angiogenesis and generation of atherosclerosis. D-PDMP, a potent inhibitor of LCS, impaired ox-LDL mediated induction of LCS activity thereby inhibiting the above pathway.