PT - JOURNAL ARTICLE AU - Dongdong Wang AU - Yang Yang AU - Yingnan Lei AU - Nikolay T. Tzvetkov AU - Xingde Liu AU - Andy Wai Kan Yeung AU - Suowen Xu AU - Atanas G. Atanasov ED - Ma, Qiang TI - Targeting Foam Cell Formation in Atherosclerosis: Therapeutic Potential of Natural Products AID - 10.1124/pr.118.017178 DP - 2019 Oct 01 TA - Pharmacological Reviews PG - 596--670 VI - 71 IP - 4 4099 - http://pharmrev.aspetjournals.org/content/71/4/596.short 4100 - http://pharmrev.aspetjournals.org/content/71/4/596.full SO - Pharmacol Rev2019 Oct 01; 71 AB - Foam cell formation and further accumulation in the subendothelial space of the vascular wall is a hallmark of atherosclerotic lesions. Targeting foam cell formation in the atherosclerotic lesions can be a promising approach to treat and prevent atherosclerosis. The formation of foam cells is determined by the balanced effects of three major interrelated biologic processes, including lipid uptake, cholesterol esterification, and cholesterol efflux. Natural products are a promising source for new lead structures. Multiple natural products and pharmaceutical agents can inhibit foam cell formation and thus exhibit antiatherosclerotic capacity by suppressing lipid uptake, cholesterol esterification, and/or promoting cholesterol ester hydrolysis and cholesterol efflux. This review summarizes recent findings on these three biologic processes and natural products with demonstrated potential to target such processes. Discussed also are potential future directions for studying the mechanisms of foam cell formation and the development of foam cell-targeted therapeutic strategies.