Bernhard D, Wang X L
Cardiac Surgery Research Laboratory, Department of Cardiac Surgery, Innsbruck Medical University, Innrain 66, 6020 Innsbruck, Austria.
Curr Med Chem. 2007;14(16):1703-12. doi: 10.2174/092986707781058959.
Oxidative reactions caused by cigarette smoke (CS) chemicals have been shown to initiate crucial events in atherogenesis. However, physicians and scientists are confronted with the paradoxical situation that an antioxidative treatment of smokers improves acute smoking effects but hardly has any impact on long term outcome of cardiovascular diseases (CVD). In this review we make an attempt to explain this paradox. First, smoke-derived free radicals and oxidants are part of CS causing a pro-oxidative state in the circulatory system. Further, smoke chemicals down-regulate antioxidant defence enzymes that would counteract the oxidative burden by cigarette smoke. With the prolonged exposure to smoke, oxidation catalysing metals accumulate in the vessel wall and mediate local oxidation reactions. Therefore, pharmacological intervention relying on non-selective antioxidants often appears to be ineffective. Consequently a novel strategy for the prevention and treatment of CVD caused by smoking is suggest, relying on a combined application of antioxidants, substitution of factors important for physiological oxidant defence, and metal-detoxifying agents.
香烟烟雾（CS）中的化学物质所引发的氧化反应已被证明会引发动脉粥样硬化形成中的关键事件。然而，医生和科学家面临着一种矛盾的情况，即对吸烟者进行抗氧化治疗可改善急性吸烟效应，但对心血管疾病（CVD）的长期预后几乎没有任何影响。在这篇综述中，我们试图解释这一矛盾。首先，烟雾衍生的自由基和氧化剂是CS的一部分，会在循环系统中导致促氧化状态。此外，烟雾中的化学物质会下调抗氧化防御酶，而这些酶原本可以抵消香烟烟雾造成的氧化负担。随着长期接触烟雾，催化氧化的金属在血管壁中积累并介导局部氧化反应。因此，依靠非选择性抗氧化剂的药物干预往往似乎无效。因此，提出了一种预防和治疗吸烟所致CVD的新策略，该策略依赖于抗氧化剂的联合应用、对生理抗氧化防御重要因素的替代以及金属解毒剂。
