Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2006 Feb;22 Suppl B(Suppl B):61B-65B.
doi: 10.1016/s0828-282x(06)70988-6.

Antioxidants: the good, the bad and the ugly

Jean-Claude Tardif  1
Affiliations
Review

Antioxidants: the good, the bad and the ugly

Jean-Claude Tardif. Can J Cardiol. 2006 Feb.

Abstract
in English, French

Inflammation has a fundamental role in mediating all stages of atherosclerotic disease. The key role of oxidation in linking lipids and inflammation to atherosclerosis is compelling and is supported by experimental evidence. However, the relevance of the antioxidant hypothesis for the treatment of patients with atherosclerosis has not been definitively proven. Results of randomized trials with 'antioxidant' vitamins have been disappointing, and there are potentially important problems associated with their use, including their potential pro-oxidant effects. Probucol has reduced postpercutaneous coronary intervention (PCI)-restenosis and progression of carotid atherosclerosis in clinical trials. The antioxidant vascular protectant AGI-1067 has also been effective at preventing atherosclerosis in all tested animal models. The nonintervened reference coronary segments of the PCI vessel demonstrated improvements with AGI-1067 in the Canadian Antioxidant Restenosis Trial-1 (CART-1), evidence supportive of a clinical effect on slowing atherosclerosis progression. Two trials test the antioxidant/anti-inflammatory hypothesis with AGI-1067; CART-2 assesses its value for the reduction of both atherosclerosis progression and post-PCI restenosis, and Aggressive Reduction of Inflammation Stops Events (ARISE), which is evaluating its effects on hard cardiovascular outcomes.

L’inflammation joue un rôle fondamental de médiation à tous les stades de l’athérosclérose. Le rôle central de l’oxydation dans les phénomènes qui relient les lipides et l’inflammation à l’athérosclérose n’est plus à démontrer et s’appuie sur des preuves expérimentales. Par contre, la pertinence de l’hypothèse antioxydante pour le traitement des patients qui souffrent d’athérosclérose n’a pas encore été prouvée hors de tout doute. Les résultats d’essais randomisés menés sur des vitamines « antioxydantes » ont donné des résultats décevants et leur utilisation est associée à des problèmes potentiellement importants, notamment à un risque d’effets pro-oxydants. Le probucol a réduit la resténose consécutive aux angioplasties coronariennes percutanées (ACP) et a ralenti la progression de l’athérosclérose carotidienne lors d’essais cliniques. L’AGI 1067, un antioxydant vasoprotecteur, s’est également révélé efficace à prévenir l’athérosclérose dans tous les modèles animaux testés. Les segments coronariens de référence sur lesquels les chercheurs ne sont pas intervenus lors d’ACP ont montré des signes d’amélioration avec l’AGI-1067 dans le cadre de l’étude CART-1 (pour Canadian Antioxidant Restenosis Trial-1); ces signes en confirment l’effet clinique sur le ralentissement de l’athérosclérose. Deux essais vérifient par ailleurs l’hypothèse de l’effet antioxydant/anti-inflammatoire de l’AGI 1067 : l’essai CART-2 évalue son utilité dans le ralentissement de la progression de l’athérosclérose et la réduction de la resténose post-ACP et l’essai ARISE (pour Aggressive Reduction of Inflammation Stops Events) mesure ses effets sur les paramètres cardiovasculaires définitifs.

PubMed Disclaimer

Figures

Figure 1)
Figure 1)
Primary end point results in the Canadian Antioxidant Restenosis Trial-1 (CART-1). IVUS Intravascular ultrasound; PCI Percutaneous coronary intervention
Figure 2)
Figure 2)
Study design of the Aggressive Reduction of Inflammation Stops Events (ARISE) multinational, multicentre trial. CAD Coronary artery disease; MI Myocardial infarction; UA Unstable angina
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ross R. Atherosclerosis – An inflammatory disease. N Engl J Med. 1999;340:115–26. - PubMed
    1. Kunsch C, Medford RM. Oxidative stress as a regulator of gene expression in the vasculature. Circ Res. 1999;85:753–66. - PubMed
    1. Cushing SD, Berliner JA, Valente AJ, et al. Minimally modified low density lipoprotein induces monocyte chemotactic protein 1 in human endothelial cells and smooth muscle cells. Proc Natl Acad Sci USA. 1990;87:5134–8. - PMC - PubMed
    1. Marui N, Offermann MK, Swerlick R, et al. Vascular cell adhesion molecule-1 (VCAM-1) gene transcription and expression are regulated through an antioxidant-sensitive mechanism in human vascular endothelial cells. J Clin Invest. 1993;92:1866–74. - PMC - PubMed
    1. Rajavashisth TB, Andalibi A, Territo MC, et al. Induction of endothelial cell expression of granulocyte and macrophage colony-stimulating factors by modified low-density lipoproteins. Nature. 1990;344:254–7. - PubMed

Publication types

MeSH terms