Human low-density lipoprotein (LDL) oxidized with Cu 2ϩ or the radical generator 2,2′-azobis(2-methyl-propionamidine) hydrochloride (AAPH) induces apoptosis in mature human monocyte-derived macrophages as assessed by staining with fluorescein-isothiocyanate-labeled annexin V, by terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling, and by staining of the 7A6 mitochondrial antigen. Oxidized LDL-induced apoptosis was dose and time dependent and clearly distinct from apoptosis induced by serum deprivation. Human autologous serum and lipoprotein-deficient human serum prevented apoptosis induced by oxidized LDL. Supplementation of serum-free culture medium with 25 µM ascorbic or isoascorbic acid only partially protected macrophages from apoptosis, whereas dehydroascorbic acid (DHAA) completely inhibited apoptosis induced by either Cu 2ϩ -or AAPH-oxidized LDL. Apoptosis was also inhibited by the structural analogue alloxan. Both cyclic multiketones dosedependently inhibited oxidized LDL-induced apoptosis with IC 50 in the submicromolar range. Prior loading of macrophages with ascorbic acid did not prevent the induction of apoptosis. Apoptosis was reduced by more than 90% after treatment of oxidized LDL with DHAA, whereas after incubation with either ascorbic or isoascorbic acid there was no such reduction. Removal of free DHAA by gel filtration did not reverse the inactivation. Parameters of LDL oxidation such as electrophoretic mobility, A-tocopherol content, thiobarbituric-acid-reactive subtances and lipid peroxide levels did not correlate to apoptotic activity. Also, binding and uptake of Texas-red-labeled oxidized LDL was not prevented by DHAA. Dithiothreitol-treatment of oxidized LDL, however, reduced the apoptotic activity by 76%. Our results suggest that oxidized thiols on apoB may be essential for the induction of apoptosis by oxidized LDL in human macrophages.Focal adhesion of monocytes to dysfunctional endothelium tween lesion initiation and progression, on the one hand, and regression, on the other [10]. In vitro, however, human macrois considered the beginning of lesion formation, which is characterized by subendothelial clusters of monocyte-derived macro-phages too were shown to succumb to the toxic effects of OxLDL within less than a day of culture [13]. OxLDL induces phages [1Ϫ3]. Little is known about the biochemical changes involved in prelesional events in humans [4], but compelling apoptosis and compromises membrane integrity, suggesting that at least some macrophages undergo oncosis when treated with evidence suggests that the accumulation of atherogenic plasmaderived lipoproteins is the fundamental event in the activation OxLDL [14]. Both types of cell death were shown to occur in human atherosclerotic plaques [15]. Atherogenesis, however, is of cellular reactions [3]. The evolution of early lesions into advanced plaques is not yet fully understood but the initiation of a slow, multistages process. Hence factors must exist which prevent premature macrophage death induced by OxLDL, ...