Oksidatif Stres, Ateroskleroz ve Diyet Önerileri

Abstract

ÖZ Ateroskleroz, arterlerin içerisinde plak birikimiyle birlikte damar endotelinde kalınlaşma ve sertleşmeyi ifade eden kronik inflamatuar bir hastalıktır. Hastalığın patogenezinde oksidatif stres sonucunda lipoproteinlerin oksidasyonuyla okside LDL (ox-LDL) oluşumu ilk aşama olarak görülmektedir. Oksidatif stres, reaktif oksijen türlerinin (ROS) artması ve/veya vücudun antioksidan savunma sistemlerinin azalması yönünde dengesizlik olarak tanımlanmaktadır. Oksidatif stres sonucunda oluşan ox-LDL, endotel fonksiyonunda bozulma, Intracellular Adhesion Molecule-1 (ICAM-1), Vascular Cell Adhesion Molecule-1 (VCAM-1) gibi çeşitli adezyon moleküllerinin çoğalması, nitrik oksidin (NO) azalmasına sebep olmaktadır. Artmış adezyon molekülleri sonucunda monositler damar intimasına girmekte ve burada ox-LDL’ler ile makrofajlara dönüşmektedirler. Sonraki aşamada düz kas hücrelerinin göçü ve köpük hücre oluşumu görülmektedir. Köpük hücrelerin kan damarlarında çökmesiyle plak oluşumu gerçekleşmektedir. Tüm bu ateroskleroz sürecini başlatan oksidatif stres vücutta doğal olarak metabolizma sonucunda oluştuğu gibi çeşitli hastalıklar ve çevresel etkenler bu durumu daha da arttırabilmektedir. Oksidatif stres ve ateroskleroz gelişimde rol oynayan diyet, sigara, alkol gibi çevresel etkenler içerisinden en önemlilerinden biri diyettir. Oksidatif stres ve ateroskleroz gelişiminin önlenmesinde Akdeniz diyeti içeriğindeki besinlerden gelen polifenoller, antioksidanlar, diyet posası ve sağlıklı yağlar ile yarar sağlayacaktır. Anahtar Sözcükler: Oksidatif Stres; Ateroskleroz; Antioksidan; Beslenme

Keywords

• Oksidatif Stres; Ateroskleroz; Antioksidan; Beslenme

Oxidative Stress, Atherosclerosis and Dietary Recommendations

Abstract

ABSTRACT Atherosclerosis, a chronic inflammatory disease, refers to the thickening and hardening of the vascular endothelium with plaque accumulation in the arteries. In the disease pathogenesis, the formation of oxidized LDL (ox-LDL) by oxidation of lipoproteins due to oxidative stress is seen as the first stage. Oxidative stress is defined as an imbalance in the direction of the increase in reactive oxygen species (ROS) and / or the decrease in the antioxidant defense systems of the body. Ox-LDL which is occur as a result of oxidative stress, causes to deterioration in endothelial function, proliferation of adhesion molecules such as Intracellular Adhesion Molecule-1 (ICAM-1), Vascular Cell Adhesion Molecule 1 (VCAM-1) causes a decrease in nitric oxide (NO). Increased adhesion molecules, monocytes enter the vascular intima and turn into macrophages with ox-LDLs. The next stage is the migration of smooth muscle cells and foam cell formation. Plaque formation occurs as foam cells collapse in blood vessels. Oxidative stress that initiates all this atherosclerosis process occurs naturally due to metabolism in the body, and various diseases and environmental factors can further escalate this situation. Diet is one of the most important environmental factors such as diet, smoking and alcohol that play a role in the development of oxidative stress and atherosclerosis. In the prevention of oxidative stress and atherosclerosis, it will be beneficial with the polyphenols, antioxidants, dietary fiber and healthy fats coming from the foods in the Mediterranean diet. Key Words: Oxidative Stress; Atherosclerosis; Antioxidant; Nutrition

Keywords

• Oxidative Stress
• Atherosclerosis
• Antioxidant
• Nutrition

References

1. 1. Tanrıverdi B, Savaş Ş. Aterosklerozun Patofizyolojisi ve Risk Faktörleri. Marmara Pharmaceutical Journal 2017; 1:1-9.
2. 2. Khosravi M, Poursaleh A, Ghasempour G, Farhad S, Najafi M. The effects of oxidative stress on the development of atherosclerosis. Biological Chemistry 2018; 1-44.
3. 3. İlerigelen B. Ateroskleroz ve Obezite. Obezite Dergisi 2014; 2:6-8.
4. 4. Alphan E. Kardiyovasküler Hastalıklar ve Beslenme Tedavisi. Hastalıklarda Tıbbi Beslenme Tedavisi. 5.Baskı. Ankara: Hatipoğlu Yayınevi, 2020:375-380.
5. 5. Kattor AJ, Pothineni NVK, Palagiri D, Mehta JL. Oxidative Stress in Atherosclerosis. Curr Atheroscler Rep 2017; 19:42. 6. Pelusoa I, Morabitob G, Urbana L, Ioannonea F, Serafinia M. Oxidative Stress in Atherosclerosis Development: The Central Role of LDL and Oxidative Burst. Endocrine, Metabolic & Immune Disorders - Drug Targets 2012; 12:351-360.
6. 7. Macit S, Akbulut G. Diabetes Mellitus ve Oksidatif Stres. Beslenme ve Diyet Dergisi 2015; 43(1):59-65.
7. 8. Förstermann U, Xia N, Li H. Roles of vascular oxidative stress and nitric oxide in the pathogenesis of atherosclerosis. Circulation research 2017; 120(4):713-735.
8. 9. Mahan LK, Raymond JL. Kardiyovasküler Hastalıklarda Tıbbi Beslenme Tedavisi. Krause Besin ve Beslenme Bakım Süreci. 14.Baskı. Ankara: Nobel Tıp Kitabevleri 2017; 646-658.

9. 10. Manea A, Simionescu M. Nox enzymes and oxidative stress in atherosclerosis. Frontiers in Bioscience 2012; 4:651-670.
10. 11. Perrotta I, Aquila S. The role of oxidative stress and autophagy in atherosclerosis. Oxidative Medicine and Cellular Longevity, 2015.
11. 12. Konukoğlu D. Sorularla Konu Anlatımlı Tıbbi Biyokimya. 1.Baskı. Ankara: Nobel Tıp Kitabevleri; 2016.
12. 13. Özcan O, Erdal H, Çakırca G, Yönden Z. Oksidatif stres ve hücre içi lipit, protein ve DNA yapıları üzerine etkileri. 2015.
13. 14. Sies H, Berndt C, Jones D. Oxidative Stress. Annu. Rev. Biochem 2017; 86:715-748.
14. 15. Di Pietro M, Filardo S, Falasca F, Turriziani O, Sessa R. Infectious agents in atherosclerotic cardiovascular diseases through oxidative stress. International journal of molecular sciences 2017; 18(11):2459.
15. 16. Drummond GR, Selemidis S, Griendling KK, Sobey CG. Combating oxidative stress in vascular disease: NADPH oxidases as therapeutic targets. Nat Rev Drug Discov 2011; 10(6):453–71.
16. 17. Matthews AT, Ross MK. Oxyradical stress, endocannabinoids, and atherosclerosis. Toxics 2015; 3(4):481-498.
17. 18. Yuan T, Yang T, Chen H, Fu D, Hu Y, Wang J, Xie X. New insights into oxidative stress and inflammation during diabetes mellitus-accelerated atherosclerosis. Redox biology 2019; 20:247-260.
18. 19. Kasikara C, Doran AC, Cai B, Tabas I. The role of non-resolving inflammation in atherosclerosis. The Journal of clinical investigation 2018; 128(7):2713-2723.
19. 20. Malekmohammad K, Sewell RD, Rafieian-Kopaei M. Antioxidants and atherosclerosis: Mechanistic aspects. Biomolecules 2019; 9(8):301.
20. 21. López-Domènech S, Martínez-Herrera M, Abad-Jiménez Z, Morillas C, Escribano-López I, Díaz-Morales N, Bañuls C, Víctor MV, Rocha M. Dietary weight loss intervention improves subclinical atherosclerosis and oxidative stress markers in leukocytes of obese humans. International Journal of Obesity 2019; 43(11):2200-2209.
21. 22. Marchio P, Guerra-Ojeda S, Vila JM, Aldasoro M, Victor VM, Mauricio MD. Targeting early atherosclerosis: A focus on oxidative stress and inflammation. Oxidative medicine and cellular longevity. 2019.
22. 23. Tousoulis D, Psaltopoulou T, Androulakis E, Papageorgiou N, Papaioannou S, Oikonomou E, Synetos A, Stefanadis C. Oxidative stress and early atherosclerosis: novel antioxidant treatment. Cardiovascular Drugs and Therapy 2015; 29(1):75-88.
23. 24. Tousoulis D, Kampoli AM, Tentolouris Nikolaos Papageorgiou C, Stefanadis C. The role of nitric oxide on endothelial function. Current vascular pharmacology 2012; 10(1):4-18.
24. 25. Ferrier D. Pentoz Fosfat Yolu ve Nikotinamid Adenin Dinükleotid Fosfat. Lippincott Görsel Anlatımlı Çalışma Kitapları: Biyokimya. 7.Baskı. İstanbul: Nobel Tıp Kitabevleri; 2019. p.150-151.
25. 26. Cheng YC, Sheen JM, Hu WL, Hung YC. Polyphenols and oxidative stress in atherosclerosis-related ischemic heart disease and stroke. Oxidative Medicine and Cellular Longevity. 2017.
26. 27. Pignatelli P, Menichelli D, Pastori D, Violi F. Oxidative stress and cardiovascular disease: new insights. Kardiol Pol 2018; 76(4):713-722.
27. 28. Torres N, Guevara-Cruz M, Velázquez-Villegas LA, Tovar AR. Nutrition and atherosclerosis. Archives of Medical Research 2015; 46(5):408-426.
28. 29. Yang X, Li Y, Ren X, Zhang X, Hu D, Shang H. Oxidative stress-mediated atherosclerosis: mechanisms and therapies. Frontiers in Physiology 2017; 8:600.
29. 30. Salvayre R, Negre-Salvayre A, Camaré C. Oxidative theory of atherosclerosis and antioxidants. Biochimie. 2016;125:281-296.
30. 31. Lönn ME, Dennis JM, Stocker R. Actions of “antioxidants” in the protection against atherosclerosis. Free Radical Biology and Medicine 2012; 53(4):863-884.
31. 32. Gimbrone Jr MA, García-Cardeña G. Endothelial cell dysfunction and the pathobiology of atherosclerosis. Circulation research 2016; 118(4):620-636.
32. 33. Zheng S, Du Y, Peng Q, Fan X, Li J, Chen M. Trimetazidine protects against atherosclerosis by changing energy charge and oxidative stress. Medical science monitor: international medical journal of experimental and clinical research 2018; 24:8459.
33. 34. Chistiakov DA, Melnichenko AA, Myasoedova VA, Grechko AV, Orekhov AN. Mechanisms of foam cell formation in atherosclerosis. Journal of Molecular Medicine 2017; 95(11):1153-1165.
34. 35. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med 2013; 368:2004-2013.
35. 36. Casas R, Castro-Barquero S, Estruch R, Sacanella E. Nutrition and cardiovascular health. International journal of molecular sciences 2018; 19(12):3988.
36. 37. Goszcz K, Deakin SJ, Duthie GG, Stewart D, Leslie SJ, Megson IL. Antioxidants in cardiovascular therapy: panacea or false hope?. Frontiers in cardiovascular medicine 2015; 2:29.
37. 38. Çaylak E. Hayvan ve bitkilerde oksidatif stres ile antioksidanlar. Tıp Araştırmaları Dergisi 2011; 9(1):73-83.
38. 39. Cheng F, Torzewski M, Degreif A, Rossmann H, Canisius A, Lackner KJ. Impact of glutathione peroxidase-1 deficiency on macrophage foam cell formation and proliferation: implications for atherogenesis. PLoS One 2013; 8(8):72063.
39. 40. Kirsch J, Schneider H, Pagel J, Rehberg M, Singer M, Hellfritsch J, Chillo O, Schubert KM, Qiu J, Pogoda K, Kameritsch P, Uhl B, Pircher J, Deindl E, Müller S, Kirchner T, Pohl U, Conrad M, Beck H. Endothelial dysfunction, and a Prothrombotic, Proinflammatory phenotype is caused by loss of mitochondrial Thioredoxin reductase in endothelium. Arterioscler Thromb Vasc Biol 2016; 36(9):1891–9.
40. 41. Chen B, Wang W, Shen T, Qi R. Thioredoxin 1 downregulates oxidized low-density lipoprotein-induced adhesion molecule expression via Smad 3 protein. PLoS One 2013; 8(9):76226.
41. 42. Moss JW, Ramji DP. Nutraceutical therapies for atherosclerosis. Nature Reviews Cardiology 2016; 13(9):513.
42. 43. Kang SJ, Lee C, Kruzliak P. Effects of serum bilirubin on atherosclerotic processes. Annals of medicine 2014; 46(3):138-147.
43. 44. Gagliardi AC, Miname MH, Santos RD. Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 2009; 202(1):11-17.
44. 45. Kimura Y, Yanagida T, Onda A, Tsukui D, Hosoyamada M, Kono H. Soluble uric acid promotes atherosclerosis via AMPK (AMP-Activated Protein Kinase)-mediated inflammation. Arteriosclerosis, Thrombosis, and Vascular Biology 2020; 40(3):570-582.
45. 46. Shay KP, Moreau RF, Smith EJ, Smith AR, Hagen TM. Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochimica et Biophysica Acta (BBA)-General Subjects 2009; 1790(10):1149-1160.
46. 47. Siti HN, Kamisah Y, Kamsiah J. The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review). Vascular pharmacology 2015; 71:40-56.
47. 48. Meydani M, Kwan P, Band M, Knight A, Guo W, Goutis J, Ordovas J. Long-term vitamin E supplementation reduces atherosclerosis and mortality in Ldlr −/− mice, but not when fed Western style diet. Atherosclerosis 2014; 233(1):196-205.
48. 49. May JM, Harrison FE. Role of vitamin C in the function of the vascular endothelium. Antioxidants & redox signaling 2013; 19(17):2068-2083.
49. 50. Choe H, Hwang JY, Yun JA, Kim JM, Song TJ, Chang N, Kim YJ, Kim Y. Intake of antioxidants and B vitamins is inversely associated with ischemic stroke and cerebral atherosclerosis. Nutrition research and practice 2016; 10(5):516-523.
50. 51. Mahmoudi MJ, Saboor-Yaraghi AA., Zabetian-Targhi F, Siassi F, Zarnani AH, Eshraghian MR, Shokri F, Rezaei N, Kalikias Y, Mahmoudi M. Vitamin A decreases cytotoxicity of oxidized low-density lipoprotein in patients with atherosclerosis. Immunological investigations 2016; 45(1):52-62.
51. 52. Storniolo CE, Roselló-Catafau J, Pintó X, Mitjavila MT, Moreno JJ. Polyphenol fraction of extra virgin olive oil protects against endothelial dysfunction induced by high glucose and free fatty acids through modulation of nitric oxide and endothelin-1. Redox Biology 2014; 2: 971-977.
52. 53. Estruch R, Ros E, Jordi S-S, Covas M-I, Corella D, Aros F, Enrique G-G, Ruiz-Gutierrez V, Fiol M, Lapetra J, Rosa M, Raventos L, Lluís S-M, Xavier P, Basora J, Munoz MA, Sorli JV, Martinez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N. Engl. J. Med 2018; 378, e34.
53. 54. Alphan E, Güleç GS. Akdeniz Diyeti. Diyetler ve Gerçekler. 2. Baskı. Ankara: Hatipoğlu Yayınevi, 2019:123-133.
54. 55. Torres-Peña JD, Rangel-Zuñiga OA, Alcala-Diaz JF, Lopez-Miranda J, Delgado-Lista J. Mediterranean diet and endothelial function: a review of its effects at different vascular bed levels. Nutrients 2020; 12(8):2212.
55. 56. Stromsnes K, Mas-Bargues C, Gambini J, Gimeno-Mallench L. Protective effects of polyphenols present in mediterranean diet on endothelial dysfunction. Oxidative Medicine and Cellular Longevity. 2020.
56. 57. Gardener H, Wright CB, Cabral D, Scarmeas N, Gu Y, Cheung K, Elkind MS, Sacco RL, Rundek T. Mediterranean diet and carotid atherosclerosis in the Northern Manhattan Study. Atherosclerosis 2014; 234:303–310.
57. 58. Murie-Fernandez M, Irimia P, Toledo E, Martínez-Vila E, Buil-Cosiales P, Serrano-Martínez M, Ruíz-Gutierrez V, Ros E, Estruch R, Martínez-González MÁ. Carotid intima-media thickness changes with Mediterranean diet: A randomized trial (PREDIMED-Navarra). Atherosclerosis 2011; 219:158–162.
58. 59. Tuttolomondo A, Simonetta I, Daidone M, Mogavero A, Ortello A, Pinto A. Metabolic and vascular effect of the Mediterranean diet. International journal of molecular sciences 2019; 20(19):4716.