Oxidative theory of atherosclerosis and antioxidants

How is your doctor going to use this to stop and reverse your atherosclerosis?
http://www.sciencedirect.com/science/article/pii/S0300908415004289

Dedicated to the memory of L. Douste-Blazy (MD, DrSc, Professor of Biochemistry, Faculty of Medicine, University of Toulouse, France).

• R. Salvayre^{a, b, c, ,} ,
• Negre -Salvayre^a, ,
• C. Camaré^{a, b, c}

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doi:10.1016/j.biochi.2015.12.014

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Highlights

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Atherosclerosis is a universal process in humans. Brief picture of Atherogenesis.

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The 'Lipid theory of atherosclerosis'. From early discoveries to modern era: cholesterol, LDL receptor and scavenger receptor pathways.

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The 'oxidative theory of atherosclerosis'. Free radicals, Reactive oxygen species, LDL oxidation, biological properties and potential role of oxidized LDLs in atherogenesis.

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Antioxidants are effective to prevent LDL oxidation and delay atherogenesis in animal models, but do not prevent myocardial infarction and coronary heart disease death in humans.

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The 'Mediterranean diet' seems to be protective against cardiovascular events and death.

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Abstract

Atherosclerosis is a multifactorial process that begins early in infancy and affects all the humans. Early steps of atherogenesis and the evolution towards complex atherosclerotic plaques are briefly described. After a brief history of the 'Lipid theory of atherosclerosis', we report the most prominent discoveries on lipoproteins, their receptors and metabolism, and their role in atherogenesis. The main focus is the 'oxidative theory of atherosclerosis', with emphasis on free radicals and reactive oxygen species, lipid peroxidation and LDL oxidation, biological properties of oxidized LDL and their potential role in atherogenesis. Then, we report the properties of antioxidants and antioxidant systems and their effects in vitro, on cultured cells, in animal models and in humans. The surprising discrepancy between the efficacy of antioxidants in vitro and in animal model of atherosclerosis and the lack of protective effect against cardiovascular events and death in epidemiological study and clinical trials are discussed. In contrast, epidemiological studies seem to indicate that the Mediterranean diet may protect (in part) against atherosclerosis complications (myocardial infarction and cardiovascular death).

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