Kattoor Ajoe John, Pothineni Naga Venkata K, Palagiri Deepak, Mehta Jawahar L
Cardiovascular Division, Central Arkansas Veterans Healthcare System and the University of Arkansas for Medical Sciences, Little Rock, AR, 72212, USA.
Curr Atheroscler Rep. 2017 Sep 18;19(11):42. doi: 10.1007/s11883-017-0678-6.
Atherosclerosis is now considered a chronic inflammatory disease. Oxidative stress induced by generation of excess reactive oxygen species has emerged as a critical, final common mechanism in atherosclerosis. Reactive oxygen species (ROS) are a group of small reactive molecules that play critical roles in the regulation of various cell functions and biological processes. Although essential for vascular homeostasis, uncontrolled production of ROS is implicated in vascular injury. Endogenous anti-oxidants function as checkpoints to avoid these untoward consequences of ROS, and an imbalance in the oxidant/anti-oxidant mechanisms leads to a state of oxidative stress. In this review, we discuss the role of ROS and anti-oxidant mechanisms in the development and progression of atherosclerosis, the role of oxidized low-density lipoprotein cholesterol, and highlight potential anti-oxidant therapeutic strategies relevant to atherosclerosis.
There is growing evidence on how traditional risk factors translate into oxidative stress and contribute to atherosclerosis. Clinical trials evaluating anti-oxidant supplements had failed to improve atherosclerosis. Current studies focus on newer ROS scavengers that specifically target mitochondrial ROS, newer nanotechnology-based drug delivery systems, gene therapies, and anti-miRNAs. Synthetic LOX-1 modulators that inhibit the effects of Ox-LDL are currently in development. Research over the past few decades has led to identification of multiple ROS generating systems that could potentially be modulated in atherosclerosis. Therapeutic approaches currently being used for atheroslcerotic vascular disease such as aspirin, statins, and renin-angiotensin system inhibitors exert a pleiotropic antioxidative effects. There is ongoing research to identify novel therapeutic modalities to selectively target oxidative stress in atherosclerosis.
动脉粥样硬化现被视为一种慢性炎症性疾病。由过量活性氧生成所诱导的氧化应激已成为动脉粥样硬化中一个关键的、最终的共同机制。活性氧(ROS)是一组小的活性分子,在各种细胞功能和生物学过程的调节中发挥关键作用。尽管ROS对于血管稳态至关重要,但不受控制的ROS产生与血管损伤有关。内源性抗氧化剂起到检查点的作用,以避免ROS的这些不良后果,而氧化/抗氧化机制的失衡会导致氧化应激状态。在本综述中,我们讨论了ROS和抗氧化机制在动脉粥样硬化发生发展中的作用、氧化型低密度脂蛋白胆固醇的作用,并强调了与动脉粥样硬化相关的潜在抗氧化治疗策略。
关于传统危险因素如何转化为氧化应激并促成动脉粥样硬化,证据越来越多。评估抗氧化补充剂的临床试验未能改善动脉粥样硬化。当前的研究集中在专门针对线粒体ROS的新型ROS清除剂、基于纳米技术的新型药物递送系统、基因疗法和抗miRNA。目前正在研发抑制氧化型低密度脂蛋白(Ox-LDL)作用的合成LOX-1调节剂。过去几十年的研究已导致识别出多个可能在动脉粥样硬化中被调节的ROS生成系统。目前用于动脉粥样硬化性血管疾病的治疗方法,如阿司匹林、他汀类药物和肾素-血管紧张素系统抑制剂,具有多效性抗氧化作用。正在进行研究以确定在动脉粥样硬化中选择性靶向氧化应激的新型治疗方式。