Oxidative stress and endothelial function: therapeutic interventions.
Oxidative stress and endothelial function: therapeutic interventions.
复制标题
DOI：
10.2174/157489011795933819
复制
发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
D. Tousoulis;A. Briasoulis;N. Papageorgiou;C. Tsioufis;E. Tsiamis;K. Toutouzas;C. Stefanadis
中科院分区：
文献类型：
--
作者：
D. Tousoulis;A. Briasoulis;N. Papageorgiou;C. Tsioufis;E. Tsiamis;K. Toutouzas;C. Stefanadis
心血管危险因素，如高血压、高胆固醇血症、糖尿病或慢性吸烟，刺激血管壁中活性氧（ROS）的产生。冠状动脉和外周循环中的氧化应激和内皮功能障碍对随后的心血管事件具有重要的预后意义。氧化应激的病理生理原因可能涉及许多不同酶系统的变化。活性氧（ROS）由多种氧化酶产生，包括烟酰胺腺嘌呤二核苷酸磷酸（NADPH）氧化酶、黄嘌呤氧化酶、解偶联内皮NO合酶（eNOS）、环氧合酶、葡萄糖氧化酶和脂氧合酶以及线粒体电子传递。由于eNOS的表达和活性的变化而导致的NO产生的减少以及通过与超氧化物反应而导致的NO降解的增加导致内皮依赖性血管舒张的减少。近年来，各种抗氧化剂在预防和治疗动脉粥样硬化的临床试验中得到了广泛的研究。在小型临床研究中，维生素C和E都可以改善高危患者的内皮功能。然而，更大规模的干预性试验一直存在争议，这表明在某些高危人群中存在潜在危害。抗高血压和降血脂药物具有良好的抗氧化作用，并改善内皮功能。然而，最近的专利与新的抗氧化剂策略的讨论需要澄清的作用，抗氧化剂干预血管疾病。
Cardiovascular risk factors, such as hypertension, hypercholesterolemia, diabetes mellitus, or chronic smoking, stimulate the production of reactive oxygen species (ROS) in the vascular wall. Oxidative stress and endothelial dysfunction in the coronary and peripheral circulation have important prognostic implications for subsequent cardiovascular events. The pathophysiologic causes of oxidative stress are likely to involve changes in a number of different enzyme systems. Reactive oxygen species (ROS) are produced by various oxidase enzymes, including nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase, xanthine oxidase, uncoupled endothelial NO synthase (eNOS), cyclooxygenase, glucose oxidase, and lipooxygenase, and mitochondrial electron transport. Decreased NO production due to changes in the expression and activity of eNOS and increased degradation of NO, by reaction with superoxide account for the reduction in endothelium-dependent vascular relaxation. Recently, a variety of antioxidants have been extensively studied in clinical trials for the prevention and treatment of atherosclerosis. In small clinical studies both vitamins C and E may improve endothelial function in high-risk patients. However, larger interventional trials have been controversial, suggesting potential harm in certain high-risk populations. Antihypertensive and hypolipidemic medications exhibit well-documented antioxidant effects and improve endothelial function. However, the discussion of recent patents with the novel antioxidant strategies are required to clarify the role of antioxidant intervention in vascular diseases.