3-deoxy-D-manno-octulosonic acid (Kdo2-Lipid A) is the essential component of lipopolysaccharide in most Gram-negative bacteria and the minimal structural component to sustain bacterial viability. It serves as the active component of lipopolysaccharide to stimulate potent host immune responses through the complex of Toll-like-receptor 4 (TLR4) and myeloid differentiation protein 2 (MD2). Therefore, Kdo2-lipid A is an important stimulator for studying the mechanism of the innate immune system and for developing bacterial vaccine adjuvants. Kdo2 Lipid A/TLR4 antagonists can also be applied in anti-inflammatory interventions. Kdo2-lipid A, induces de novo sphingolipid biosynthesis in RAW264.7 macrophages, which is essential for induction of autophagy. Kdo2-Lipid A has been used in animal atherosclerosis model.