Abstract-Mice with inactivated genes are increasingly used as models of human atherosclerosis. The aim of the present study was to determine whether the characteristic age-related distributions of lipid deposition seen around human arterial branches are replicated in such mice. Lesions occur downstream of branch ostia in immature human aortas, but these regions are spared in adult vessels, with lesions occurring more frequently at the sides or upstream of the branches. We determined the pattern of lipid staining around 102 intercostal branch ostia from apolipoprotein E/low density lipoprotein receptor double-knockout mice aged 9 to 20 weeks by using en face microscopy and a frequency-mapping technique. Lesion prevalence was high in the ostium and the region immediately surrounding it. Frequencies were 2.12Ϯ0.30 (meanϮSEM, nϭ11) times higher upstream than downstream (PϽ0.01), but the pattern did not resemble the adult human pattern: there were no peaks in frequency at the sides or upstream of the branch, and there was no sparing downstream. Furthermore, a patch of sparing upstream of the branch was seen, which has not been reported for human vessels, and there was no trend toward a more upstream pattern with age. We conclude that knockout mice may not be a suitable model in which to investigate localizing factors. Key Words: apolipoprotein E Ⅲ LDL receptor Ⅲ knockout mice Ⅲ atherosclerosis Ⅲ distribution M any recent studies have used mice with inactivated genes as models of human atherosclerosis. Inducing disease in normal mice, even of susceptible strains, requires prolonged administration of high-cholesterol diets with toxic additives, and the resulting lesions tend to be restricted to fatty streaks in the aortic root. [1][2][3][4] The genetically modified mice, in contrast, develop more advanced, more widely distributed lesions on Western or normal mouse diets while retaining the advantages of small size and fast breeding. Furthermore, they allow investigation of the effects of single gene products on lesion development.The true value of the new models, however, depends on the extent to which their disease resembles that occurring in human arteries. The present study addresses this similarity; more specifically, it is concerned with the nonuniform distribution of disease within the vasculature. The patchy occurrence of human atherosclerosis has attracted considerable attention because it demonstrates the existence of significant local risk factors. The determination of lesion distributions in models is an important test of the similarity to human disease and also indicates whether the models can be used to investigate localizing factors. The issue is particularly important for knockout mouse models because of their widespread and increasing use and because they could be used for investigating local risk factors at the single gene level.The distribution of lesions has previously been studied in apoE knockout [5][6][7] and LDL receptor (LDLR) knockout 8 mice.In both models, disease preferentially affects the fo...