慢性抗氧化治疗不能改善高血压:背后的潜在机制。

Olga Pechanova, Fedor Simko
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引用次数: 48

摘要

与氧化应激相关的高血压是心血管疾病文献中讨论最多的话题。人们普遍认为活性氧(ROS)的产生升高在高血压中起重要作用,但慢性抗氧化治疗高血压的临床研究未能证实这一假设。这种差异可能部分是由抗氧化剂或清除剂短期和长期治疗的不同效果决定的。高血压患者ROS生成升高不仅是有害的。它还可能刺激抗氧化防御系统的活性,改善一氧化氮(NO)/环3′,5′-鸟苷单磷酸途径,从而在增强的氧化负荷和受刺激的NO途径之间建立新的平衡,从而保持足够的NO生物利用度。已有研究表明,抗氧化处理可能在短时间内是有益的,直到增加的NO生成超过ROS生成。抗氧化剂进一步削弱ROS的形成可能减弱核因子κ B的激活,导致内皮NO合成酶的表达和活性降低。因此,长期抗氧化治疗可能会减弱ROS的有益调节作用,导致NO生成减少,并重新建立有害力和保护力之间的不良比例。因此,长期抗氧化治疗人类高血压可能无法提供预期的临床收益。
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Chronic antioxidant therapy fails to ameliorate hypertension: potential mechanisms behind.

Hypertension in association with oxidative stress belongs to the most discussed topics within the literature on cardiovascular diseases. It is generally believed that elevated production of reactive oxygen species (ROS) plays an important role in hypertension, but clinical studies on chronic antioxidant therapy of hypertension fail to confirm this hypothesis. This discrepancy may be partly determined by the different effects of short and long-lasting treatment with antioxidants or scavengers. Elevated ROS production in hypertension need not be only harmful. It may also stimulate the activity of the antioxidant defence system and improve the nitric oxide (NO)/cyclic 3', 5'-guanosine monophosphate pathway, resulting in the establishment of a new equilibrium between enhanced oxidative load and the stimulated NO pathway, thus maintaining sufficient NO bioavailability. It has been suggested that antioxidant treatment might be beneficial for a short time, until increased NO generation predominates over ROS production. Further weakening of ROS formation by antioxidants may attenuate nuclear factor kappa B activation resulting in decreased endothelial NO synthase expression and activity. Prolonged antioxidant therapy may thus attenuate the beneficial regulatory effect of ROS, leading to decreased NO generation and the re-establishment of the undesirable disproportion between deleterious and protective forces. As a consequence prolonged antioxidant treatment in human hypertension may fail to provide the expected clinical profit.

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