Role of oxidative stress in pathogenesis of atherosclerosis.

Atherosclerotic disease remains a major cause of death. Documented cases of atherosclerosis in Georgia (Caucasus) have increased by up to 40% and, moreover, the disease is occurring with increased frequency and greater severity in younger adults. Prevention of atherosclerosis as well as detection at early stages of the disease is reviewed. The authors argue that known indicators (serum cholesterol and triglycerides, blood pressure, life style factors) show up too late in the disease when damage is already extensive, still controllable to some extent, but irreversible. Imbalances in the redox status in which excess oxidation occurs or reducing power cannot be maintained (e.g. in inflammation, age, smoking, high lipid content and oxidation) creates a state in which molecular and tissue modifications progress rapidly, leading to development of lesions and full-blown atherogenesis. Oxidative stress do not replace the recognized role of lipids and cholesterol in atherosclerosis, but rather underline that role. Indeed, quantifying redox processes may well elucidate some molecular mechanisms by which lipids mediate atherogenesis.