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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1102.)
© 2001 American Heart Association, Inc.

Editorial

Gene-Environment Interaction in the Expression of Antioxidant Status

A Role for Genes in the Relationship Between Smoking and Coronary Disease

John E. Hokanson

From the Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver.

Correspondence to John E. Hokanson, PhD, Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver CO 80262. E-mail john.hokanson@UCHSC.edu

Key Words: genetics • antioxidants • smoking

Both environmental determinants and underlying genetic susceptibility are undoubtedly involved in complex diseases such as atherosclerosis. However, determining the relative contributions of environmental and genetic factors of complex diseases is difficult. Adding to the difficulty is the possibility of gene-environment interaction in the expression of these traits. That is, the genetic contribution to a disease may vary by a person’s level of environmental exposure, and conversely, environmental exposure may have different effects depending on one’s genetic background. Valuable insights into the causation of complex diseases will come as we learn to dissect these complicated gene-environment relationships.

Over the past decade, the role of oxidative stress in atherosclerosis has been extensively studied. It is now well established that LDL oxidation is important in foam cell formation, a crucial step in the early atherosclerotic process. Animal models have shown the importance of oxidative stress on plaque formation. It has been more difficult to show a direct link between oxidative stress and atherosclerosis in humans. Nonetheless, evidence is now accumulating to support a role for oxidation in coronary heart disease, including recent studies showing that antibodies to oxidative epitopes are associated with an increase in coronary disease.^{1 2}

A number of environmental factors that modify oxidative potential have been identified. Dietary factors such as -tocopherol, ascorbate, and ß-carotene are associated with an increase in antioxidant status in humans. Clinical trials, however, have not convincingly shown a benefit on coronary disease events associated with these antioxidants. Smoking is one potent stimulus of the oxidative process. . . . [Full Text of this Article]