Abstract: Objective To investigate the pathologies of aortic root atherosclerotic lesion in uremic apoE-/- mice and explore the
effect of serum from patients with chronic renal insufficiency (CRI) and the uremic toxin, indoxyl sulfate (IS), on the
expression of cholesterol transporting receptors and lipid accumulation in macrophages in vitro. Methods The uremic apoE-/-
mouse model was established by surgical operation. Frozen sections of the aortic root were collected from uremic apoE-/- mice,
sham-operated apoE-/- mice and C57BL/6J mice and stained with oil red O to calculate the relative area of atherosclerotic
plaque. Murine macrophage RAW264.7 cell line was treated for 12 h with different concentrations of IS or serum samples from
CRI patients and healthy individuals, and the mRNA expressions of cholesterol transporting receptors (SR-A1, CD36, ABCA1,
ABCG1 and SR-B1) were detected. After treatment for 24 h, the cells were induced into foam cells to determine lipid contents
using oil red O staining. Results The relative area of the atherosclerotic plaques in the aortic root increased significantly in
uremic apoE-/- mice compared with that in sham-operated apoE-/- mice. CRI serum (5%) and IS (250 μmol/L) obviously
increased the mRNA expression of CD36 and lipid accumulation in the macrophages, but did not affect the mRNA expression
of other cholesterol transporting receptors. Conclusion CRI can accelerate the progression of atherosclerosis through the
mechanism that IS in CRI serum promotes lipid accumulation in macrophages by enhancing the mRNA expression of CD36,
which contributes to the formation of foam cells.