Abstract-Leukotriene B4 (LTB4) is a potent chemotactic agent that activates monocytes through the LTB4 receptor (BLTR). We tested the hypothesis that LTB4 receptor blockade would slow atherosclerotic progression by inhibiting monocyte recruitment. Homozygous low-density receptor knockout (LDLr Ϫ/Ϫ ) mice and apolipoprotein E deficient (apoE Ϫ/Ϫ ) mice were treated with a specific LTB4 receptor antagonist, CP-105,696, for 35 days. In apoE Ϫ/Ϫ mice, treatment with the LTB4 antagonist did not affect plasma lipid concentrations but significantly reduced CD11b levels both in vascular lesions and whole blood. Compared with age-matched controls, lipid accumulation and monocyte infiltration were significantly reduced in treated apoE Ϫ/Ϫ mice at all time points tested. Lesion area reduction was also demonstrated in LDLr Ϫ/Ϫ mice maintained on a high-fat diet. LTB4 antagonism had no significant effect on lesion size in mice possessing the null alleles for another chemotactic agent, monocyte chemoattractant protein-1 (MCP-1 Key Words: leukotriene B4 Ⅲ atherosclerosis Ⅲ monocyte chemoattractant protein-1 T he pathogenesis of atherosclerosis is a complex process, which involves the recruitment and activation of monocytes in the developing atherosclerotic lesion. 1 It is thought to initiate when circulating monocytes are first attracted to a site of vascular injury through the upregulation of adhesion molecules and chemotactic factors in the lesion. 2,3 Once attached to the vessel wall, monocytes, attracted by a gradient of chemotactic factors, migrate between the endothelial cells into the subendothelial space where they differentiate into macrophages and become lipid-laden foam cells. 2 A growing body of evidence suggests that the recruitment of monocytes is governed by cell-specific chemoattractants. Several molecules have chemotactic activity for monocytes, including N-formylmethionyl peptides exemplified by N-formylmethionyl-leucyl-phenylalanine (FMLP), the complement fragment C5a, the arachidonic acid metabolite leukotriene B4 (LTB4), 12-hydroxyeicosatetraenoic acid (12-HETE), and the chemoattractant monocyte chemotactic protein-1 (MCP-1). 4See page 361 and cover MCP-1 is the prototype of the CC chemokine  subfamily and exhibits the most potent chemotactic activity for monocytes. 5 MCP-1 is highly expressed in human atheromatous plaques, 6 and its overexpression contributes to the development of atherosclerosis in mouse models. 7 In hypercholesterolemic mice, a deficiency in either MCP-1 8 or the MCP-1 receptor (CCR2) 9 results in a marked decrease in atheromas and fewer monocytes in vascular lesions. However, at later stages of lesion development in these mice, differences in lesion size relative to wild type become less pronounced. These data suggest that other chemotactic factors are likely compensating for the lack of MCP-1.LTB4, a product of the 5-lipoxygenase pathway of arachidonic acid metabolism, is also a potent chemoattractant and proinflammatory mediator thought to be involved in the pathogenesis of several ...