Leukocyte-endothelial cell interactions are mediated by adhesion molecules, expression of which is modulated by cytokines and chemical mediators in the early phase of inflammatory and immunologic reactions, including the development of atherosclerosis. Vitamin E is a lipid-soluble antioxidant that is present in all cell membranes at a low concentration and is reported to be an anti-atherogenic agent. Recently, it was reported that vitamin E inhibits the activation of protein kinase C and nuclear factor-kappa B (NF-kappa B). We demonstrated that vitamin E can prevent leukocyte-endothelial cell adhesion by inhibiting signal transduction involved in the surface expression of adhesion molecules by leukocytes and endothelial cells. These results suggest that vitamin E may have a protective effect against the progression of inflammation and atherosclerosis.