Electronegative LDL: a useful biomarker of cardiovascular risk?

Chemical modification of LDL is a key event in atherogenesis. Modified LDL particles have the ability to act in all stages of atherosclerosis. LDL modified by different mechanisms shares an increase of the negative charge of the particle. A subfraction of LDL with an increased electronegative charge - named electronegative LDL (LDL(-)) - has been reported in blood and can be considered as a pool of modified LDL particles in circulation. LDL(-) displays inflammatory and apoptotic properties, is poorly recognized by LDL receptors and binds with high affinity to arterial proteoglycans. The proportion of LDL(-) in the blood is higher in patients who have a greater cardiovascular risk and active atherosclerosis. The heterogeneous origin of LDL(-) raises the possibility that its quantification could reflect the overall modification of LDL. Future studies conducted in large groups of patients are necessary to determine whether LDL(-) could be a useful biomarker to monitor the development of atherosclerosis.