Spermine improves oxidative stress in macrophages exposed to HG/ox-LDL independent of Nrf2. Macrophages were divided into six groups, control group (PBS), HG/ox-LDL group (25 mmol/l D-Glu and 100 µg/ml ox-LDL treatment for 24 h) and Spermine group (5 µM spermine pretreatment for 30 min followed by the addition of 25 mmol/l D-Glu and 100 µg/ml ox-LDL treatment for 24 h), Spermien+ML385+HG/ox-LDL group (5 µM spermine and ML385 pretreatment for 30 min followed by the addition of 25 mmol/l D-Glu and 100 µg/ml ox-LDL treatment for 24 h), ML385 group (5 µM ML385) and ML385+HG/ox-LDL group (5 µM ML385 and 5 mmol/l D-Glu and 100 µg/ml ox-LDL treatment for 24 h). DCFH-DA was used to evaluated ROS level. GSH, SOD and MDA levels in cell lysates were detected. HO-1 and NQO-1 level in lysates was analysis by western blotting. (A and B) Fluorescence microscopy showed the total ROS level. (C) MDA level. (D) SOD activity. (E) GSH level. (F and G) Protein level of HO-1 and NQO-1. *P<0.05, **P<0.01 compared with the control group; #P<0.05, ##P<0.01 compared with the HG/ox-LDL group. $P<0.05, $$P<0.01 compared with the spermine group. %P<0.05 compared with the HG/ox-LDL group. HG, high glucose; ox-LDL, oxidized low-density lipoprotein; Nrf2, nuclear factor erythroid 2-related factor 2; D-Glu, D-glucose; DCFH-DA. 2',7'-Dichlorodihydrofluorescein diacetate; ROS, reactive oxygen species; GSH, glutathione; SOD, superoxide dismutase; MDA, malondialdehyde; NQO-1, NADPH quinone oxidoreductase-1; NS, no statistical significance.