Oxidative stress frequently leads to altered function of membrane proteins. Isoketals are highly reactive products of the isoprostane pathway of free radical-induced lipid peroxidation that rapidly form covalent protein adducts and exhibit a remarkable proclivity to form protein cross links in vitro. Examination of isoketal adducts from an animal model of oxidative injury revealed that initial adducts were formed by isoketals esterified in phospholipids, representing a novel oxidative injuryassociated modification of proteins by phospholipids. Maturation of adducts involved cleavage from phospholipids and conversion of adducts to a more stable chemical form that can be detected for extended periods. Because initial adducts were formed by phospholipidesterified isoketals, the functional consequence of isoketal adduction was examined using a model membrane protein (a cardiac K Ű channel). These studies revealed that isoketal adduction profoundly altered protein function, inhibiting potassium current in a dosedependent manner. These findings indicate that phospholipid-esterified isoketals rapidly adduct membrane proteins and that such modification can alter protein function, suggesting a generalized cellular mechanism for alteration of membrane function as a consequence of oxidative stress.Oxidative stress from the generation of free radicals has been implicated in the pathogenesis of a wide variety of human diseases including atherosclerosis, cancer, and neurodegenerative diseases (1-3). Fatty acids esterified in membrane phospholipids are a major target of attack by free radicals (4 -6). We have described previously the formation of a series of highly electrophilic â„-ketoaldehyde isomers in vitro, which we term isoketals (IsoKs) 1 (7), by rearrangement of endoperoxide intermediates in the isoprostane pathway of free radical-induced peroxidation of phospholipid-esterified arachidonic acid (8). Incorporation of oxygen at different sites of arachidonyl radical formation results in the formation of 8 structural isomers, each of which is composed of 4 racemic diastereoisomers (see Fig. 1A). Analogous molecules, termed neuroketals, are formed from the free radical-catalyzed oxidation of docosahexanoic acid and form protein adducts analogous to those described below for IsoKs (9).IsoKs adduct covalently with the â-amino group of lysine residues in vitro within seconds, which is orders of magnitude faster than has been reported for other products of lipid peroxidation, including 4-hydroxynonenal (7). This remarkable reactivity has precluded the detection of free IsoKs in vivo because of their sequestration as adducts. Therefore, we elucidated the nature of IsoK protein adducts in vitro as an initial step toward identifying the formation of IsoK adducts in vivo (7, 10). IsoKs initially form reversible Schiff base adducts which irreversibly cyclize to pyrroles. The pyrroles then undergo facile autoxidation to stable lactam and hydroxylactam adducts (see Fig. 1B) (7, 10). Consistent with this process, Schiff base adducts f...