1 Along with arterial smooth muscle cells, they give rise to lipid-laden arterial plaque cells, termed foam cells.2 " 4 The intracellular neutral lipid within foam cells is cholesteryl ester, largely synthesized from lipoprotein-derived cholesterol. A great deal of attention has been focused on the mechanism by which lipoprotein cholesterol enters cells in such excess, especially in view of the stringent regulation of low density lipoprotein (LDL) receptor activity by cell cholesterol content. 5 The existence of a distinct receptor for certain species of modified LDL, termed the scavenger receptor, has been described in human macrophages, 67 macrophage cell lines, 8 and mouse peritoneal macrophages. 9 The activity of this receptor is regulated by a number of factors including cell density, 10 modified LDL uptake led to the suggestion that cholesteryl ester overload of macrophages in vivo could be accounted for by modification of LDL within the arterial wall and subsequent uptake by the scavenger receptor. 15 In line with this, it has already been shown 15 ' 16 that cultured endothelial cells and arterial smooth muscle cells can modify LDL in vitro to allow its recognition by the macrophage scavenger receptor. In addition, a protein has been isolated from vascular wall plaque lesions which is recognized by this binding site.