Notopterol attenuates atherosclerosis by promoting macrophage cholesterol efflux via targeting KEAP1/NRF2 interaction

• NOT reduces atherosclerotic plaque in apoE - / - mice: decreases lipid accumulation and lesion area, improves plasma lipids. • NOT enhances cholesterol efflux in macrophages: boosts ABCA1/G1 expression and efflux, reducing cholesterol in foam cells. • Nrf2-HO-1 pathway mediates NOT effects: involved in ABCA1/G1 expression and atherosclerosis protection. • NOT disrupts Keap1-Nrf2 complex: binds Keap1, inhibits complex formation, activating Nrf2-HO-1 pathway. • Study offers new insights: NOT's atherosclerotic protection suggests therapeutic potential for prevention.