Circulating desialylated low density lipoprotein

Accumulation of lipids is the central event in the development of atherosclerotic lesion. Circulating low-density lipoprotein (LDL) particles are known to be the major source of cholesterol and other lipids stored in atherosclerotic plaque. However, not all LDL particles possess atherogenic properties. In order to induce lipid accumulation in arterial cells, LDL particles have to undergo modifications. Although among such modifications the oxidation remains the most studied one, other atherogenic LDL modifications have been described. According to a series of studies conducted with blood serum and LDL from atherosclerotic patients, desialylation is one of the earliest if not the first atherogenic modification of LDL. Desialylation occurs in the bloodstream and is followed by a cascade of other modifications, including the reduction of LDL particle size and increase of its density, acquisition of negative electrical charge, oxidation and formation of highly atherogenic complexes. In this mini-review we will discuss the concept of multiple atherogenic modification of LDL leading to initiation and progression of atherosclerosis.