In 1912, Anichkov moved to Freiburg to work under German pathologist L. Aschoff. The latter was interested in Anichkov's experimental work done in Russia. In Germany he became the first to describe
cholesterinesterphagozyten, German for 'cholesteryl ester phagocytes', which derive from
macrophages and today are known as
foam cells. By histologically analyzing the development of atherosclerotic plaque, Anichkov identified the cell types involved in the atherosclerotic process:
smooth muscle cells, macrophages, and
lymphocytes. He discovered the leading role of cholesterol in atherosclerosis development ("There is no atherosclerosis without cholesterol"). Anichkov worked in Aschoff's laboratory up to the time World War I broke out in August 1914. He joined the
Russian Army Medical Corps and, from 1914 to 1917, was a physician-in-charge. In 1920, Anichkov was appointed Professor of the Department of Pathological physiology of the Military Medical Academy, a position that he held until 1939. He presented updates on atherosclerosis research at the Congresses in Berlin, Freiburg, Würzburg and Wiesbaden, and at meetings of the Swedish Society of Pathologists, and the International Society of Geographic Pathology. In 1930, after the Congress in Osaka, he went to Tokyo, Niigata, and Kyoto, to deliver a lecture "On experimental atherosclerosis of the coronary arteries of the heart". He wrote a chapter in E.V. Cowdry's
Arteriosclerosis: A Survey of the Problem in 1933. In 1939-46, the lieutenant-general of Medical Corps Anichkov headed the Military Medical Academy's Department of Pathological anatomy. In 1942, Anichkov and A. I. Abrikosov received a State award for their textbook
Pathological Anatomy of the Heart and Vessels, in which they gave a detailed account of the development of atherosclerosis and
ischemic heart disease. In their 1998 book titled ''Medicine's 10 Greatest Discoveries'', M. Friedman and M. Friedland included the Anichkov's cholesterol theory in a list of great discoveries in medicine. During Anichkov's work as President of the Academy of Medical Sciences (1946–53) he participated in the foundation of a number of research institutes and research journals. In this period and later he created a research team in Russian pathology that consisted of 30 professors and many doctors. ==Family==