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Brief Reviews |
From Emory University Division of Cardiology, Department of Medicine and the Atlanta Veterans Administration Hospital, Atlanta, Ga.
Correspondence to David G. Harrison, Division of Cardiology, Emory University, 1639 Pierce Drive, WMRB 319, Atlanta, GA 30322. E-mail dharr02{at}emory.edu
Series Editor: Kathy K. Griendling
| Abstract |
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Reactive oxygen species have been implicated in the pathogenesis of virtually every stage of vascular lesion formation, hypertension, and other vascular diseases. Upcoming series of articles in Arteriosclerosis, Thrombosis, and Vascular Biology help elucidate how reactive oxygen species are produced by vascular cells and their role in vascular homeostasis.
Key Words: NADPH oxidase superoxide nitric oxide synthase xanthine oxidase mitochondria
| Introduction |
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See cover
It has been, only in the past decade, widely accepted that vascular cells could produce ROS, and we are still learning a great deal about the role of the various potential enzymes, how they are regulated, and the role of oxidative stress in vascular disease. A technical problem has been that vessels do not produce ROS at levels equivalent to neutrophils; therefore, the methods commonly used for neutrophils, such as cytochrome c reduction, yield values that are only slightly above the limit of detection. This problem was overcome by the use of chemiluminescence techniques, such as lucigenin-enhanced chemiluminescence, and this entire area of research was dramatically advanced by the use of such methods. In the late 1990s, several articles appeared in which the authors showed that lucigenin-enhanced chemiluminescence could artifactually produce superoxide; however, these "test tube" experiments did not reflect the assay as used in intact vessels.14 Subsequently, numerous methods including electron spin resonance, dihydroethidium oxidation, other chemiluminescence methods, and even cytochrome c reduction have been used to confirm the results observed with lucigenin-enhanced chemiluminescence. Further, assays of hydrogen peroxide often provide results that mirror these measures of superoxide production in diseased vessels. All of these have confirmed an increased ROS production by vessels in the setting of disorders like hypercholesterolemia, diabetes, and hypertension.1517
| Sources of ROS in Vascular Cells |
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| NADPH Oxidases |
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| Xanthine Oxidase |
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and hydrogen peroxide. The ratio of XO to XDH in the cell is therefore critical to determine the amount of ROS produced by these enzymes. Conversion of XDH to XO is stimulated by inflammatory cytokines, like tumor necrosis factor-
, and also by oxidation of critical cysteine residues by oxidants, such as peroxynitrite.33,34 Recently, we have shown in bovine and mouse aortic endothelial cells that the relative levels of these is markedly altered by the presence of a functioning NADPH oxidase, such that in cells with an absence of the NADPH oxidase, the levels of XO are extremely low.35,36 In more recent studies, we have found that this is mediated by hydrogen peroxide released from the NADPH oxidase. Thus, this regulation represents a second situation in which cellular production of ROS from the NADPH oxidase further begets ROS production. There is substantial debate as to whether XDH is expressed. Immunohistochemical studies of normal human tissues have failed to demonstrate XDH in endothelial cells or other cardiovascular tissues.36 In contrast, there is evidence that XO can produce ROS and affect endothelial function in humans in the setting of pathology,15,3739 possibly caused by stimulation of XO expression by inflammatory cytokines or other stimuli in these conditions. For example, Sohn et al have shown that hypoxia induces XO activity in human umbilical vein endothelial cells.40 There is substantial interest in the concept that the XO present in endothelial cells originates from other organs and that the enzyme is probably taken-up via heparin binding sites.15,41,42 Whatever the source of XO, its vascular activity correlates inversely with endothelial function in patients with heart failure and in subjects with atherosclerosis.15,43 Dr Margaret Tarpey discusses these concepts in greater depth in her upcoming review of xanthine oxidoreductase.
| Uncoupled Endothelial Nitric Oxide Synthase |
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formation.44 Uncoupling of eNOS has been demonstrated in various pathophysiological conditions including diabetes,17 hypercholesterolemia,45 and hypertension.46 In DOCA-salt hypertension, oxidation of BH4 occurs as a result of ROS (particularly peroxynitrite) produced by the NADPH oxidase. Oral treatment of mice that have DOCA-salt hypertension with BH4"re-couples" eNOS, leading to increased vascular NO production, decreased
production, and lowering of blood pressure.46 Thus, uncoupling of eNOS caused by oxidation of BH4 represents a third mechanism whereby ROS produced by the NADPH oxidase can stimulate another enzyme to produce additional ROS in a self-perpetuating fashion.
Related to this situation, eNOS is subject to regulation by H2O2, which acutely activates the enzyme and, over the longer-term, increases its expression. Thus, increased expression of eNOS in the setting of oxidant stress can lead to a situation in which high levels of the uncoupled enzyme can generate even greater amounts of
. It should be stressed that not all eNOS becomes uncoupled, such that some of the enzyme continues to produce NO, leading to a condition favoring production of peroxynitrite. Dr Thomas Münzel discusses NOS uncoupling in much greater detail in his upcoming review.
| Mitochondrial Electron Transport |
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and consequently H2O2. It has been estimated that between 1% and 4% of the oxygen reacting with the respiratory chain is incompletely reduced to
. Defects in mitochondria DNA can be inherited or can develop as a result of disease, and have been proposed to augment ROS production by these organelles.47,48 Interestingly, exposure of endothelial or vascular smooth muscle cells to exogenous peroxynitrite or H2O2 leads to mitochondrial DNA damage.49 This represents yet another mechanism whereby oxidant stress could beget further oxidant stress. In the vessel wall, the precise contribution of mitochondria to the total ROS production, however, remains unclear. Part of this problem relates to the fact that specific antagonists are not well-characterized. For example, rotenone is often used to inhibit mitochondrial radical production50,51 but, in fact, is capable of having the opposite effect.31,52 Furthermore, inhibition of mitochondrial function can dramatically alter many other aspects of cell metabolism, making results from such interventions difficult to interpret. Nevertheless, there is ample evidence that mitochondria play an important role in vascular ROS production. Stimuli such as high glucose, cyclic strain, leptin, and cigarette smoking have been shown to damage aortic mitochondrial DNA and alter mitochondrial enzyme activity. Dr Paul Schumackers review examines the role of mitochondria in vascular oxidant stress further.
| Diverse Properties of ROS |
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the hydroxyl radical (HO), peroxy-radicals (ROO·), and NO have unpaired electrons in their outer orbital. Others, such as H2O2 and peroxynitrite, do not have unpaired electrons but are oxidants. These can have very different roles. Superoxide reacts with NO in a diffusion limited fashion, leading to formation of peroxynitrite and loss of the beneficial actions of NO. This phenomenon is thought to be responsible for reduced endothelium-dependent vasodilatation in many conditions, and likely contributes to hypertension by removing the vasodilator effect of NO. Peroxynitrite is a very potent oxidant and can oxidize lipids and thiols and react with iron sulfur centers in a variety of enzymes. Whereas scavenging
improves endothelium-dependent vasodilatation, it might not reduce atherosclerosis, because
scavenging does not eliminate other ROS and, in fact, can enhance production of H2O2 (Scheme 1).53
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Scheme 1 is important because there is increasing evidence that H2O2 plays an important role in atherosclerosis. As an example, Tribble et al showed that lesion formation was not diminished in mice overexpressing Cu/Zn SOD and, in fact, was increased in direct relation to aortic Cu/Zn SOD activity.54
Another aspect of ROS is that they are not uniformly deleterious and can have important signaling properties within the vessel wall.55 Hydrogen peroxide, in particular, is relatively stable and uncharged so that it can easily diffuse between cells. Recently, it has become clear that endogenously produced H2O2 can act as an endogenous hyperpolarizing factor in both human and mouse resistance vessels.56,57 Dr Gutterman discusses this further in his upcoming review. Hydrogen peroxide has been shown to inhibit phosphatases, and activate guanylate cyclase, and to stimulate NO production and alter gene expression. The mechanisms involved in these signaling events are varied. An important reaction is oxidation of critical cysteines to sulfenic acids, which in turn can serve as precursors to sulfonic acid and/or disulfide formation. These modifications can alter function of a number of enzymes, including phosphatases, glyceraldehyde-3-phosphate dehydrogenase, and peroxiredoxin.5860 Recent evidence suggests that interactions between H2O2 and peroxidases, especially myeloperoxidase, lead to formation of oxidizing and nitrosating species that are particularly atherogenic. Importantly, modification of proteins by these radicals alters their enzymatic function. Nitration of apolipoprotein A1 dramatically impairs its ability to participate in reverse cholesterol transport from lipid-laden macrophages, and thus reduces atheroprotective properties of high-density lipoprotein.61 Dr Hazen discusses this in detail in his review of myeloperoxidase.
Finally, it is essential that we develop a greater understanding of all the compensatory responses to prolonged oxidant stress. Recent studies from our groups have supported the concept that increased ROS production has minimal effects on vascular function and hemodynamics at baseline but can augment the response pathogenic stimuli. We have produced mice with smooth muscle-targeted overexpression of the NADPH oxidase subunit p22phox. Overexpression of this subunit resulted in a concomitant increase in expression of Nox1 and enhanced vascular
and H2O2 production.62 At baseline, these mice were normotensive and had normal vascular reactivity and histology. In response to angiotensin II, however, augmented hypertension and increased thickness of the vascular media develop in these animals.63 In addition, vascular injury enhances atheroma formation in these animals.64 Further characterization of these mice indicated that they have increased endothelial NO synthase expression, NO production, and expression of the extracellular superoxide dismutase, which likely compensate for their enhanced vascular ROS production. We have concluded from these studies that increased vascular ROS production has minimal effects in the absence of stimuli such as angiotensin II or mechanical injury, but the presence of such stimuli markedly augments pathological responses. In this regard, the compensatory responses to oxidative stress are likely critically important, and disease probably does not occur until these mechanisms fail. It remains a challenge to understand all of these compensatory mechanisms, why they fail, and what can be done to preserve their function.
Received September 27, 2004; accepted October 20, 2004.
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T. M. Paravicini and R. M. Touyz NADPH Oxidases, Reactive Oxygen Species, and Hypertension: Clinical implications and therapeutic possibilities Diabetes Care, February 1, 2008; 31(Supplement_2): S170 - S180. [Abstract] [Full Text] [PDF] |
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E. Yamamoto, K. Kataoka, H. Shintaku, T. Yamashita, Y. Tokutomi, Y.-F. Dong, S. Matsuba, H. Ichijo, H. Ogawa, and S. Kim-Mitsuyama Novel Mechanism and Role of Angiotensin II Induced Vascular Endothelial Injury in Hypertensive Diastolic Heart Failure Arterioscler Thromb Vasc Biol, December 1, 2007; 27(12): 2569 - 2575. [Abstract] [Full Text] [PDF] |
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C. Wadham, A. Parker, L. Wang, and P. Xia High Glucose Attenuates Protein S-Nitrosylation in Endothelial Cells: Role of Oxidative Stress Diabetes, November 1, 2007; 56(11): 2715 - 2721. [Abstract] [Full Text] [PDF] |
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T. Nakamura, E. Yamamoto, K. Kataoka, T. Yamashita, Y. Tokutomi, Y.-F. Dong, S. Matsuba, H. Ogawa, and S. Kim-Mitsuyama Pioglitazone Exerts Protective Effects Against Stroke in Stroke-Prone Spontaneously Hypertensive Rats, Independently of Blood Pressure Stroke, November 1, 2007; 38(11): 3016 - 3022. [Abstract] [Full Text] [PDF] |
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T. Yamashita, E. Yamamoto, K. Kataoka, T. Nakamura, S. Matsuba, Y. Tokutomi, Y.-F. Dong, H. Ichijo, H. Ogawa, and S. Kim-Mitsuyama Apoptosis Signal-Regulating Kinase-1 Is Involved in Vascular Endothelial and Cardiac Remodeling Caused by Nitric Oxide Deficiency Hypertension, September 1, 2007; 50(3): 519 - 524. [Abstract] [Full Text] [PDF] |
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S. Selemidis, G. J. Dusting, H. Peshavariya, B. K. Kemp-Harper, and G. R. Drummond Nitric oxide suppresses NADPH oxidase-dependent superoxide production by S-nitrosylation in human endothelial cells Cardiovasc Res, July 15, 2007; 75(2): 349 - 358. [Abstract] [Full Text] [PDF] |
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H.-J. Sung, A. Yee, S. G. Eskin, and L. V. McIntire Cyclic strain and motion control produce opposite oxidative responses in two human endothelial cell types Am J Physiol Cell Physiol, July 1, 2007; 293(1): C87 - C94. [Abstract] [Full Text] [PDF] |
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A. Fukatsu, T. Hayashi, A. Miyazaki-Akita, H. Matsui-Hirai, Y. Furutate, A. Ishitsuka, Y. Hattori, and A. Iguchi Possible usefulness of apocynin, an NADPH oxidase inhibitor, for nitrate tolerance: prevention of NO donor-induced endothelial cell abnormalities Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H790 - H797. [Abstract] [Full Text] [PDF] |
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G. Gavazzi, C. Deffert, C. Trocme, M. Schappi, F. R. Herrmann, and K.-H. Krause NOX1 Deficiency Protects From Aortic Dissection in Response to Angiotensin II Hypertension, July 1, 2007; 50(1): 189 - 196. [Abstract] [Full Text] [PDF] |
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D. X. Zhang and D. D. Gutterman Mitochondrial reactive oxygen species-mediated signaling in endothelial cells Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2023 - H2031. [Abstract] [Full Text] [PDF] |
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E. Yamamoto, T. Yamashita, T. Tanaka, K. Kataoka, Y. Tokutomi, Z.-F. Lai, Y.-F. Dong, S. Matsuba, H. Ogawa, and S. Kim-Mitsuyama Pravastatin Enhances Beneficial Effects of Olmesartan on Vascular Injury of Salt-Sensitive Hypertensive Rats, via Pleiotropic Effects Arterioscler Thromb Vasc Biol, March 1, 2007; 27(3): 556 - 563. [Abstract] [Full Text] [PDF] |
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I. Papparella, G. Ceolotto, L. Berto, M. Cavalli, S. Bova, G. Cargnelli, E. Ruga, O. Milanesi, L. Franco, M. Mazzoni, et al. Vitamin C prevents zidovudine-induced NAD(P)H oxidase activation and hypertension in the rat Cardiovasc Res, January 15, 2007; 73(2): 432 - 438. [Abstract] [Full Text] [PDF] |
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T. Szasz, K. Thakali, G. D. Fink, and S. W. Watts A Comparison of Arteries and Veins in Oxidative Stress: Producers, Destroyers, Function, and Disease Experimental Biology and Medicine, January 1, 2007; 232(1): 27 - 37. [Abstract] [Full Text] [PDF] |
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K. Bedard and K.-H. Krause The NOX Family of ROS-Generating NADPH Oxidases: Physiology and Pathophysiology Physiol Rev, January 1, 2007; 87(1): 245 - 313. [Abstract] [Full Text] [PDF] |
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I. Chinen, M. Shimabukuro, K. Yamakawa, N. Higa, T. Matsuzaki, K. Noguchi, S. Ueda, M. Sakanashi, and N. Takasu Vascular Lipotoxicity: Endothelial Dysfunction via Fatty-Acid-Induced Reactive Oxygen Species Overproduction in Obese Zucker Diabetic Fatty Rats Endocrinology, January 1, 2007; 148(1): 160 - 165. [Abstract] [Full Text] [PDF] |
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R. M. Weiss, M. Ohashi, J. D. Miller, S. G. Young, and D. D. Heistad Calcific Aortic Valve Stenosis in Old Hypercholesterolemic Mice Circulation, November 7, 2006; 114(19): 2065 - 2069. [Abstract] [Full Text] [PDF] |
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S. Dayal, K. M. Wilson, L. Leo, E. Arning, T. Bottiglieri, and S. R. Lentz Enhanced susceptibility to arterial thrombosis in a murine model of hyperhomocysteinemia Blood, October 1, 2006; 108(7): 2237 - 2243. [Abstract] [Full Text] [PDF] |
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F. M. Faraci Hydrogen peroxide: watery fuel for change in vascular biology. Arterioscler Thromb Vasc Biol, September 1, 2006; 26(9): 1931 - 1933. [Full Text] [PDF] |
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A. Kontush and M. J. Chapman Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis Pharmacol. Rev., September 1, 2006; 58(3): 342 - 374. [Abstract] [Full Text] [PDF] |
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H. Li, K. Witte, M. August, I. Brausch, U. Godtel-Armbrust, A. Habermeier, E. I. Closs, M. Oelze, T. Munzel, and U. Forstermann Reversal of Endothelial Nitric Oxide Synthase Uncoupling and Up-Regulation of Endothelial Nitric Oxide Synthase Expression Lowers Blood Pressure in Hypertensive Rats J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2536 - 2544. [Abstract] [Full Text] [PDF] |
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F. M. Faraci, M. L. Modrick, C. M. Lynch, L. A. Didion, P. E. Fegan, and S. P. Didion Selective cerebral vascular dysfunction in Mn-SOD-deficient mice J Appl Physiol, June 1, 2006; 100(6): 2089 - 2093. [Abstract] [Full Text] [PDF] |
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S Moncada Adventures in vascular biology: a tale of two mediators Phil Trans R Soc B, May 29, 2006; 361(1469): 735 - 759. [Abstract] [Full Text] [PDF] |
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D. D. Heistad Oxidative Stress and Vascular Disease: 2005 Duff Lecture Arterioscler Thromb Vasc Biol, April 1, 2006; 26(4): 689 - 695. [Abstract] [Full Text] [PDF] |
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S. M. Bode-Boger, F. Scalera, J. T. Kielstein, J. Martens-Lobenhoffer, G. Breithardt, M. Fobker, and H. Reinecke Symmetrical Dimethylarginine: A New Combined Parameter for Renal Function and Extent of Coronary Artery Disease J. Am. Soc. Nephrol., April 1, 2006; 17(4): 1128 - 1134. [Abstract] [Full Text] [PDF] |
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F. M. Faraci Reactive oxygen species: influence on cerebral vascular tone J Appl Physiol, February 1, 2006; 100(2): 739 - 743. [Abstract] [Full Text] [PDF] |
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R. W. Alexander Leukocyte and Endothelial Angiotensin II Type 1 Receptors and Microvascular Thrombotic and Inflammatory Responses to Hypercholesterolemia Arterioscler Thromb Vasc Biol, February 1, 2006; 26(2): 240 - 241. [Full Text] [PDF] |
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O. A. Hatoum, M. F. Otterson, D. Kopelman, H. Miura, I. Sukhotnik, B. T. Larsen, R. M. Selle, J. E. Moulder, and D. D. Gutterman Radiation Induces Endothelial Dysfunction in Murine Intestinal Arterioles via Enhanced Production of Reactive Oxygen Species Arterioscler Thromb Vasc Biol, February 1, 2006; 26(2): 287 - 294. [Abstract] [Full Text] [PDF] |
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P. Sjogren, S. Basu, M. Rosell, A. Silveira, U. de Faire, B. Vessby, A. Hamsten, M.-L. Hellenius, and R. M. Fisher Measures of Oxidized Low-Density Lipoprotein and Oxidative Stress Are Not Related and Not Elevated in Otherwise Healthy Men With the Metabolic Syndrome Arterioscler Thromb Vasc Biol, December 1, 2005; 25(12): 2580 - 2586. [Abstract] [Full Text] [PDF] |
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M. S. Wolin Loss of Vascular Regulation by Soluble Guanylate Cyclase Is Emerging as a Key Target of the Hypertensive Disease Process Hypertension, June 1, 2005; 45(6): 1068 - 1069. [Full Text] [PDF] |
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