Abstract-Lectin-like oxidized LDL receptor-1 (LOX-1) is a newly identified receptor for oxidized LDL that is expressed by vascular cells. LOX-1 is upregulated in aortas of diabetic rats and thus may contribute to the pathogenesis of human diabetic atherosclerosis. In this study, we examined the regulation of human monocyte-derived macrophage (MDM) LOX-1 expression by high glucose and the role of LOX-1 in glucose-induced foam cell formation. Incubation of human MDMs with glucose (5.6 to 30 mmol/L) enhanced, in a dose-and time-dependent manner, LOX-1 gene and protein expression. Induction of LOX-1 gene expression by high glucose was abolished by antioxidants, protein kinase C (PKC), mitogen-activated protein kinases (MAPKs), nuclear factor-B (NF-B), and activated protein-1 (AP-1) inhibitors. In human MDMs cultured with high glucose, increased expression of PKC 2 and enhanced phosphorylation of extracellular signal-regulated protein kinase 1/2 was observed. Activation of these kinases was inhibited by the antioxidant N-acetyl-L-cysteine (NAC) and by the PKC inhibitor LY379196. High glucose also enhanced the binding of nuclear proteins extracted from human MDMs to the NF-B and AP-1 regulatory elements of the LOX-1 gene promoter. This effect was abrogated by NAC and PKC/MAPK inhibitors. Finally, high glucose induced human macrophage-derived foam cell formation through a LOX-1-dependent pathway. Overall, these results demonstrate that high glucose concentrations enhance LOX-1 expression in human MDMs and that this effect is associated with foam cell formation. Pilot data showing that MDMs of patients with type 2 diabetes overexpress LOX-1 support the relevance of this work to human diabetic atherosclerosis. Key Words: macrophages Ⅲ lectin-like oxidized low-density lipoprotein receptor-1 Ⅲ glucose Ⅲ diabetes Ⅲ foam cell formation T he prevalence, incidence, and mortality from all forms of cardiovascular diseases are increased in patients with diabetes. 1 Among the cardiovascular risk factors documented in diabetes, hyperglycemia appears as an independent risk factor for diabetic macrovascular complications. 2 Mechanisms through which hyperglycemia may promote the development of diabetic cardiovascular disease include glycoxidation and lipoxidation, increased oxidative stress, and protein kinase C (PKC) activation. [3][4][5][6][7][8] One of the earliest events in atherogenesis is the accumulation of oxidized LDL (oxLDL) in the intima and the subsequent uptake of this modified lipoprotein by macrophages, leading to foam cell formation. 9 One limiting factor for oxLDL uptake by endothelial cells is lectin-like oxLDL receptor-1 (LOX-1), a newly identified vascular receptor for oxLDL. 10 -12 Accumulating evidence indicates a key role for LOX-1 in atherogenesis. First, uptake of oxLDL by endothelial cells through LOX-1 induces endothelial dysfunction. Second, the two main LOX-1 ligands, oxLDL and advanced glycation end products (AGE), are implicated in the pathogenesis of atherosclerosis. 5,9 Third, expression of LOX-1 b...