Objective-Premature atherosclerosis is a characteristic feature of systemic lupus erythematosus, a prototypic autoimmune disease. The principle cellular and molecular mechanisms which underlie such accelerated atherosclerosis are indeterminate. Methods and Results-The pathophysiology of lupus-mediated atherogenesis was evaluated in a novel animal model involving transplantation of bone marrow cells from the lupus prone strain gld into Ldl-r Ϫ/Ϫ mice. Diet-induced atherogenesis in lethally-irradiated Ldl-r Ϫ/Ϫ mice transplanted with gld bone marrow cells resulted in accelerated atherosclerosis (ϩ65%) as compared with control mice transplanted with wild-type marrow cells. Enhanced atherogenesis was associated with enhanced activation of both B and T lymphocytes and with arterial inflammation involving endothelial cell activation, monocyte recruitment, and accumulation of apoptotic debris, macrophages, and CD4 T cells, but was independent of plasma lipid levels and renal function. Conclusions-Our data support the contention that despite the absence of both disturbed cholesterol homeostasis and renal dysfunction in autoimmune gld3Ldl-r Ϫ/Ϫ mice, lupus disease induces enhanced activation of the immune system and acts locally on the vasculature to induce inflammation, together with accumulation of apoptotic debris, macrophages, and CD4 T cells, thereby accelerating plaque progression. Key Words: atherosclerosis Ⅲ lupus Ⅲ arterial inflammation Ⅲ immune system Ⅲ apoptotic cells T he risk of cardiovascular disease (CVD) is significantly increased in the prototypic autoimmune disease, systemic lupus erythematosus (SLE). 1,2 The mechanisms underlying premature CVD in SLE may be related to accelerated atherosclerosis. 3,4 Such accelerated atherosclerosis potentially involves a combination of autoimmune-specific mechanisms and traditional cardiovascular risk factors (dyslipidemia, renal failure, and inflammation), although the central mechanisms involved are indeterminate. 2 Moreover, as most SLE patients are on active therapy (corticosteroids and other pharmacological agents), such agents might interfere with the atherogenic process 5 and lead to confounding findings. Therefore, identification of the mechanisms that contribute to disease progression might allow optimization of therapeutic approaches for prevention of CVD in SLE patients. In this setting, development of murine models may facilitate evaluation of the specific impact of autoimmunity on atherosclerosis progression and of the underlying mechanisms involved.Genetic studies of various strains of lupus-prone mice have identified at least 30 chromosomal regions of interest reflecting the multifactorial aspect of SLE. 6 In this context the use of various strains of lupus-prone mice and the study of their impact on atherogenesis may highlight the key molecular mechanisms that promote autoimmune-accelerated atherosclerosis. Mouse strains defective for the Fas/Fas L pathway (gld, lpr) present lupus-like autoimmune disorders comparable to those of human SLE. 6,7 Indeed, ...