Lim Soo, Barter Philip
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine.
J Atheroscler Thromb. 2014;21(10):997-1010. doi: 10.5551/jat.24398. Epub 2014 Aug 15.
Redox systems are key players in vascular health. A shift in redox homeostasis-that results in an imbalance between reactive oxygen species (ROS) generation and endogenous antioxidant defenses has the potential to create a state of oxidative stress that subsequently plays a role in the pathogenesis of a number of diseases, including those of the cardiovascular and metabolic system. Statins, which are primarily used to reduce the concentration of low-density lipoprotein cholesterol, have also been shown to reduce oxidative stress by modulating redox systems. Studies conducted both in vitro and in vivo support the role of oxidative stress in the development of atherosclerosis and cardiovascular diseases. Oxidative stress may also be responsible for various diabetic complications and the development of fatty liver. Statins reduce oxidative stress by blocking the generation of ROS and reducing the NAD+/NADH ratio. These drugs also have effects on nitric oxide synthase, lipid peroxidation and the adiponectin levels. It is possible that the antioxidant properties of statins contribute to their protective cardiovascular effects, independent of the lipid-lowering actions of these agents. However, possible adverse effects of statins on glucose homeostasis may be related to the redox system. Therefore, studies investigating the modulation of redox signaling by statins are warranted.
氧化还原系统是血管健康的关键因素。氧化还原稳态的改变——即活性氧(ROS)生成与内源性抗氧化防御之间的失衡——有可能导致氧化应激状态,进而在包括心血管和代谢系统疾病在内的多种疾病的发病机制中发挥作用。他汀类药物主要用于降低低密度脂蛋白胆固醇浓度,也已证明可通过调节氧化还原系统来减轻氧化应激。体外和体内研究均支持氧化应激在动脉粥样硬化和心血管疾病发展中的作用。氧化应激也可能是各种糖尿病并发症和脂肪肝发展的原因。他汀类药物通过阻断ROS的生成和降低NAD+/NADH比值来减轻氧化应激。这些药物还对一氧化氮合酶、脂质过氧化和脂联素水平有影响。他汀类药物的抗氧化特性可能有助于其对心血管的保护作用,而与这些药物的降脂作用无关。然而,他汀类药物对葡萄糖稳态可能的不良影响可能与氧化还原系统有关。因此,有必要开展研究来探究他汀类药物对氧化还原信号的调节作用。