Lipid-filled macrophages (foam cells) are a defining feature of atherosclerotic plaques. Foam cells contain lipid dro plet- associated proteins that in other cell types regulate lipid turnover. In foam cell such proteins may directly affect lipid droplet formation and lipid efflux. Differentiated primary human monocytes or THP-1 cells were lipid loaded by incubation with aggregated low density lipoproteins (AgLDL) or VLDL resulting in macrophage foam cells with predominantly cholesterol ester or triglyceride-rich lipid droplets, respectively. Lipid droplets were isolated and major proteins identified by mass spectrometry, among them the apolipoprotein B-48 receptor that has not previously been recognized in this context. Expression of two proteins, perilipin and adipophilin, was quantified by Western blots of cell lysates. Perilipin content decreased and adipophilin increased with lipoprotein lipid loading regardless of intracellular neutral lipid composition. This protein expression pattern may hinder lipid turnover in macrophage foam cells, thereby increasing lipid content of atherosclerotic plaques. (C) 2007 Elsevier Inc. All rights reserved.