Abstract
Atherosclerosis is a chronic inflammatory disease which is a major cause of coronary heart disease and stroke in humans. It is characterized by intimal plaques and cholesterol accumulation in arterial walls. The side effects of currently prescribed synthetic drugs and their high cost in the treatment of atherosclerosis has prompted the use of alternative herbal medicines, dietary supplements, and antioxidants associated with fewer adverse effects for the treatment of atherosclerosis. This article aims to present the activity mechanisms of antioxidants on atherosclerosis along with a review of the most prevalent medicinal plants employed against this multifactorial disease. The wide-ranging information in this review article was obtained from scientific databases including PubMed, Web of Science, Scopus, Science Direct and Google Scholar. Natural and synthetic antioxidants have a crucial role in the prevention and treatment of atherosclerosis through different mechanisms. These include: The inhibition of low density lipoprotein (LDL) oxidation, the reduction of reactive oxygen species (ROS) generation, the inhibition of cytokine secretion, the prevention of atherosclerotic plaque formation and platelet aggregation, the preclusion of mononuclear cell infiltration, the improvement of endothelial dysfunction and vasodilation, the augmentation of nitric oxide (NO) bioavailability, the modulation of the expression of adhesion molecules such as vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) on endothelial cells, and the suppression of foam cell formation.
Highlights
Atherosclerosis is a chronic inflammatory disease which is a major cause of coronary heart disease and stroke in humans [1]
Oxidizing enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, xanthine oxidase (XO), lipoxygenase (LOX), cyclooxygenase (COX), myeloperoxidase (MPO), nitric oxide synthase (NOS), and uncoupled endothelial nitric oxide synthetase occur in macrophages, vascular smooth muscle cells, and endothelial cells. These enzymes are involved in smooth muscle cell proliferation, the production of reactive oxygen species (ROS)/reactive nitrogen species (RNS), and low density lipoprotein (LDL)
ROS can damage the cellular functions of biomolecules such as lipids, proteins, and carbohydrates and may be initiated, for instance, postprandially, by hyperglycemia, and/or hyperglyceridemia, resulting in lipid peroxidation and LDL oxidation [19,20]
Summary
Atherosclerosis is a chronic inflammatory disease which is a major cause of coronary heart disease and stroke in humans [1]. It is characterized by intimal plaques and cholesterol accumulation in the arterial walls [2]. Atherosis—characterized by fat accumulation along with macrophages—and the term sclerosis, characterized by a fibrotic layer including smooth muscle cells, connective tissue, and leukocytes [3]. Oxidative stress, which is exemplified by the overproduction of reactive oxygen species (ROS). An imbalance between radical production (reactive oxygen and/or nitrogen species formation) and radical scavenging systems (the antioxidant defense system) is the main cause of oxidative stress [4]. Important risk factors including hypertension, diabetes mellitus, insulin resistance, obesity hypercholesterolemia, dyslipidemia, a high level of Biomolecules 2019, 9, 301; doi:10.3390/biom9080301 www.mdpi.com/journal/biomolecules
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