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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1387.)
© 2001 American Heart Association, Inc.

Editorials

Absence of EC-SOD Does Not Promote Atherogenesis in Mice

Have We Lost Yet Another Player?

Jan Nilsson

From the Department of Medicine, Malmö University Hospital, University of Lund, Malmö, Sweden.

Correspondence to Jan Nilsson, Department of Medicine, Malmö University Hospital, 205 02 Malmö, Sweden. E-mail jan.nilsson@medforsk.mas.lu.se

A convincing body of cell culture, animal, and epidemiological studies have provided support and plausible biological mechanisms of a role for lipid oxidation in atherogenesis.^1,2 Oxidized structures associated with lipoproteins, primarily LDL, have been shown to be abundant in atherosclerotic plaques.³ The observation that cultured macrophages take up oxidized LDL through a family of scavenger receptors, receptors that appear to be part of a more general "cleaning up" function of the immune system, provides a good explanation for the formation of foam cells in plaques. The generation of cytotoxic and immunogenic structures associated with oxidation of lipoprotein lipids offers an apparent cause of the inflammatory activity in the arterial intima that characterizes almost all stages of atherosclerosis.⁴ A large majority of experimental animal studies show that antioxidants inhibit the development of atherosclerosis.⁵ Epidemiological data suggest that a low intake of antioxidant vitamins is associated with an increased risk of developing cardiovascular disease.⁶ With all this knowledge at hand, it is frustrating to admit that we still have yet to identify how lipoproteins become oxidized in vivo and how we can prevent it.

See p 1477

Assuming that the lipid oxidation hypothesis is correct, it would be expected that antioxidant vitamins such as vitamins E and C and ß-carotene should be able to prevent cardiovascular disease. However, the results of the clinical intervention trials, including the recent HOPE and GISSI trials, have been largely disappointing. Even if these studies do not exclude a role for antioxidative vitamins in the protection against . . . [Full Text of this Article]