Cimellaro A, Perticone M, Fiorentino T V, Sciacqua A, Hribal M L
Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy.
Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy.
Nutr Metab Cardiovasc Dis. 2016 Oct;26(10):863-71. doi: 10.1016/j.numecd.2016.05.008. Epub 2016 May 28.
Endoplasmic reticulum (ER) stress is implicated in the pathogenesis of several human disorders, including cardiovascular disease (CVD). CVD recognizes endothelial dysfunction (ED) as its pathogenetic primum movens; interestingly a large body of evidence has identified the unchecked ER stress response as a main actor in vascular damage elicited by various cardio-metabolic risk factors. In the present Review, we summarize findings from experimental studies on the ER stress-related ED, focusing on the mechanisms underlying this association.
Different noxious agents, such as hyperhomocysteinemia, hyperlipidemia, hyperglycemia and chronic inflammation, induce ED promoting an amplified ER stress response as demonstrated by several studies in animal models, as well as in human primary and immortalized endothelial cells. ER stress represents therefore a key mediator of vascular damage, operating in a setting of increased inflammatory burden and oxidative stress, thus contributing to foster a vicious pathogenic cycle.
Experimental studies summarized in this Review strongly suggest that an unchecked ER stress response plays a central role in the pathogenesis of ED and, consequently, CVD. Counteracting ER stress may thus represent a promising, even if largely unexplored as-yet, therapeutic approach aimed to prevent vascular damage, slowing the progression from ED to cardiovascular events.
内质网(ER)应激与包括心血管疾病(CVD)在内的多种人类疾病的发病机制有关。CVD将内皮功能障碍(ED)视为其发病的首要动因;有趣的是,大量证据已确定不受控制的ER应激反应是各种心脏代谢危险因素引发血管损伤的主要因素。在本综述中,我们总结了关于ER应激相关ED的实验研究结果,重点关注这种关联背后的机制。
不同的有害因素,如高同型半胱氨酸血症、高脂血症、高血糖和慢性炎症,会诱导ED,促进ER应激反应增强,动物模型以及人类原代和永生化内皮细胞的多项研究均证明了这一点。因此,ER应激是血管损伤的关键介质,在炎症负担和氧化应激增加的情况下发挥作用,从而促成一个恶性循环。
本综述中总结的实验研究强烈表明,不受控制的ER应激反应在ED以及因此在CVD的发病机制中起核心作用。因此,对抗ER应激可能是一种有前景的治疗方法,尽管目前尚未充分探索,旨在预防血管损伤,减缓从ED到心血管事件的进展。