Objective-Immune complexes containing oxidatively modified low-density lipoprotein (oxLDL) particles are deposited in human atherosclerotic lesions during atherogenesis. Here we studied whether OxLDL-IgG immune complexes (OxLDL-IgG ICs) affect survival of human monocytes. Methods and Results-As demonstrated by light microscopy, and analysis of cell proliferation, caspase-3 activity, and DNA fragmentation, OxLDL-IgG ICs promoted survival of cultured human monocytes by decreasing their spontaneous apoptosis. OxLDL-IgG ICs induced a concentration-dependent production of the major monocyte growth factor, monocyte colony-stimulating factor (M-CSF), by the monocytes, but its inhibition was without effect on OxLDL-IgG IC-induced monocyte survival. Rather, OxLDL-IgG ICs induced rapid phosphorylation of Akt, suggesting a direct anti-apoptotic effect mediated by cross-linking of Fc␥ receptors. Experiments with receptor blocking antibodies revealed that the OxLDL-IgG IC-induced monocyte survival was mediated by Fc␥ receptor I. Key Words: atherosclerosis Ⅲ monocytes Ⅲ oxLDL A therosclerosis is characterized by early accumulation of lipids and macrophages in the intimal layer of the arterial wall. Lipids, mainly derived from serum low-density lipoprotein (LDL) particles, accumulate in the extracellular matrix of the intima, were they are exposed to various modifications, such as oxidation. 1 The process may begin early in life as epitopes of oxLDL are found the aortic intima of human fetuses of hypercholesterolemic women, and this is followed by infiltration of monocytes in the intima. 2 OxLDL is recognized and taken up by macrophages via scavenger receptors, which are then transformed into lipid-filled foam cells. Modified lipids on the surface of oxLDL are biologically active and are recognized by various pattern recognition receptors of the innate immune system, notably by the Toll-like receptor 4 (TLR4). 3,4 OxLDL is also able to activate the adaptive immune system when antigen-presenting cells present peptides derived from oxLDL particle on MHC class II molecules for recognition by CD4 ϩ T cells, 5 which then leads to the production of antibodies specific for oxLDL. Consistently, human atherosclerotic lesions contain clones of CD4 ϩ T cells that recognize epitopes of oxLDL and respond to oxLDL stimulation by proliferation and cytokine production. 6 Moreover, antibodies against oxLDL are present in the circulation, and their levels have been shown to correlate positively with cardiovascular disease and its complications. [7][8][9] Human atherosclerotic lesions also contain IgG that recognizes oxLDL and OxLDL-IgG immune complexes (OxLDL-IgG IC). 10 When added to cultured macrophages, OxLDL-IgG ICs promote foam cell formation and induce the production of proinflammatory cytokines, oxygen radicals, and matrix metalloproteinases by the macrophages. [11][12][13] Infiltration of monocytes into the arterial intima involves their attachment to activated endothelium via vascular cell adhesion molecule (VCAM)-1, and transmigrat...