title: Clinical aspects of reactive oxygen and nitrogen species.
abstract: Endothelial dysfunction in the setting of cardiovascular risk factors, such as hypercholesterolaemia, hypertension, diabetes mellitus and chronic smoking, as well as in the setting of heart failure, has been shown to be at least partly dependent on the production of reactive oxygen species in endothelial and/or smooth muscle cells and the adventitia, and the subsequent decrease in vascular bioavailability of NO. Superoxide-producing enzymes involved in increased oxidative stress within vascular tissue include NAD(P)H-oxidase, xanthine oxidase and endothelial nitric oxide synthase in an uncoupled state. Recent studies indicate that endothelial dysfunction of peripheral and coronary resistance and conductance vessels represents a strong and independent risk factor for future cardiovascular events. Ways to reduce endothelial dysfunction include risk-factor modification and treatment with substances that have been shown to reduce oxidative stress and, simultaneously, to stimulate endothelial NO production, such as inhibitors of angiotensin-converting enzyme or the statins. In contrast, in conditions where increased production of reactive oxygen species, such as superoxide, in vascular tissue is established, treatment with NO, e.g. via administration of nitroglycerin, results in a rapid development of endothelial dysfunction, which may worsen the prognosis in patients with established coronary artery disease.
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik III, Martinistr. 52, D-20246 Hamburg, Germany.
authors.forename: Ascan
authors.initials: A
authors.lastname: Warnholtz
authors.forename: Maria
authors.initials: M
authors.lastname: Wendt
authors.forename: Michael
authors.initials: M
authors.lastname: August
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
mesh_terms: D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D018384:Oxidative Stress / Q000502:physiology*; D026361:Reactive Nitrogen Species / Q000378:metabolism*; D017382:Reactive Oxygen Species / Q000378:metabolism*; D012307:Risk Factors
chemical_list: D026361:Reactive Nitrogen Species; D017382:Reactive Oxygen Species