Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Chin Med J (Engl). 2009 Dec 5;122(23):2827-32.
Atherosclerosis is a chronic inflammatory disease. Accumulated evidences suggest a deep involvement of oxidative damage in the development of atherosclerosis, but little is discussed over the relationship between plasma glutathione redox status as the most important intrinsic antioxidant defensive mechanism and the atherosclerosis.
A total of 132 patients suspected with atherosclerosis were assigned to three groups by high frequency ultrasonic examination of the carotid artery. With the thickness of intima of the carotid artery as an index of degree of atherosclerosis progression, 56 were included in plaque-forming group (A), 42 in carotid artery intima-thickening group (B), and 34 in normal carotid artery intima-thickness group (C). All patients were subjected to the measurement of plasma glutathione (GSH) (reduced form GSH and oxidized form GSSG), nicotinamide adenine dinucleotide phosphate (NADP) (reduced form NADPH and oxidized form NADP(+)), oxidized low density lipoprotein (oxLDL), and malondialdehyde (MDA). The GSH/GSSG and NADPH/NADP(+) redox potentials were calculated according to the Nernst equation, and their correlation with intima thickness and oxLDL was analyzed.
With the thickening of artery intima (from group C to A), GSH concentration and the ratio of GSH/GSSG gradually reduced, and GSSG and GSH/GSSG redox potential gradually increased (more positive) (P < 0.05). The NADPH and NADPH/NADP(+) redox status also showed similar but milder changes. The products of oxidative stress oxLDL and MDA increased significantly along with the thickening of artery intima (P < 0.05). The analysis of the relationship between GSH/GSSG redox potential, intima thickness, and oxLDL showed positive correlations (P < 0.05). The plasma GSH/GSSG redox status was positively correlated with the intima thickness of the carotid artery and the oxidized injury of LDL. The redox status shifted to oxidizing direction along with the intima thickening and plaque-forming.
Elevated peroxidative glutathione redox status was deeply implicated in atherosclerosis progressing, and it may be a sensitive and reliable index for monitoring oxidative status in atherosclerosis.
动脉粥样硬化是一种慢性炎症性疾病。越来越多的证据表明，氧化损伤在动脉粥样硬化的发生发展中起着重要作用，但关于血浆谷胱甘肽氧化还原状态（作为最重要的内在抗氧化防御机制）与动脉粥样硬化之间的关系，目前讨论甚少。
通过高频超声检查颈动脉，将 132 例疑似动脉粥样硬化患者分为三组。以颈动脉内膜厚度为动脉粥样硬化进展程度的指标，将 56 例患者纳入斑块形成组（A 组），42 例患者纳入颈动脉内膜增厚组（B 组），34 例患者纳入正常颈动脉内膜厚度组（C 组）。所有患者均进行血浆谷胱甘肽（还原型 GSH 和氧化型 GSSG）、烟酰胺腺嘌呤二核苷酸磷酸（还原型 NADPH 和氧化型 NADP(+)）、氧化型低密度脂蛋白（oxLDL）和丙二醛（MDA）的测定。根据能斯特方程计算 GSH/GSSG 和 NADPH/NADP(+)的氧化还原电位，并分析其与内膜厚度和 oxLDL 的相关性。
随着动脉内膜增厚（从 C 组到 A 组），GSH 浓度和 GSH/GSSG 比值逐渐降低，GSSG 和 GSH/GSSG 氧化还原电位逐渐升高（更正）（P<0.05）。NADPH 和 NADPH/NADP(+)的氧化还原状态也呈现出相似但较温和的变化。随着动脉内膜增厚，氧化应激产物 oxLDL 和 MDA 显著增加（P<0.05）。GSH/GSSG 氧化还原电位与内膜厚度和 oxLDL 之间的关系分析显示呈正相关（P<0.05）。血浆 GSH/GSSG 氧化还原状态与颈动脉内膜厚度和 LDL 氧化损伤呈正相关。随着动脉内膜增厚和斑块形成，氧化还原状态向氧化方向偏移。
升高的过氧化谷胱甘肽氧化还原状态与动脉粥样硬化进展密切相关，可能是监测动脉粥样硬化氧化状态的敏感可靠指标。
