Atherosclerosis is a chronic pathological condition, and can take decades to develop severe atheromatous lesions in humans . Foam cells appear even in early stages of atherosclerosis, and the accumulation of large numbers of foam cells is often observed in advanced lesions.
Oxidative modification of LDL is implicated in atherogenesis. A key early event is believed to be the conversion of LDL into a form capable of being recognized by “scavenger” or “oxidized LDL” receptors, whose surface expression is not diminished upon exposure to excess cholesterol
One potential pathway for LDL modification and conversion into a high-uptake form in vivo may involve reactive nitrogen species derived from nitric oxide (nitrogen monoxide, NO), a long-lived free radical that is formed by multiple vascular wall cells