Redox Homeostasis and Molecular Biomarkers in Precision Therapy for Cardiovascular Diseases

Abstract

Precision medicine is envisioned as the future of cardiovascular healthcare, offering a more tailored and effective method for managing cardiovascular diseases compared to the traditional one-size-fits-all approaches. The complex role of oxidative stress in chronic diseases within the framework of precision medicine was carefully explored, delving into the cellular redox status and its critical involvement in the pathophysiological complexity of cardiovascular diseases (CVDs). The review outlines the mechanisms of reactive oxygen species generation and the function of antioxidants in maintaining redox balance. It emphasizes the elevated reactive oxygen species concentrations observed in heart failure and their detrimental impact on cardiovascular health. Various sources of ROS within the cardiovascular system are examined, including mitochondrial dysfunction, which contributes to oxidative stress and mitochondrial DNA degradation. The article also addresses oxidative stress's role in myocardial remodeling, a process pivotal to the progression of heart diseases. By integrating these aspects, the review underscores the importance of redox homeostasis and identifies molecular biomarkers that can enhance precision therapy for CVDs. The insights provided aim to pave the way for targeted therapeutic strategies that mitigate oxidative stress, thereby improving patient outcomes in cardiovascular medicine.

Keywords: cardiovascular system; heart failure; mitochondrial dysfunction; oxidative stress; precision medicine; redox homeostasis.

Figure 2

The body’s antioxidant defense mechanism entails a synergistic interaction between enzymatic and non-enzymatic antioxidant systems to collectively protect cells and organ systems from damage caused by free radicals. ROS (reactive oxygen species), SOD (superoxide dismutase), GSH (reduced glutathione), GSSG (oxidized glutathione), GSH-Px (glutathione peroxidase), GSH-Red (glutathione reductase) [72].

Figure 1

General overview of reactive oxygen species (ROS) generation pathways and antioxidant systems in the cardiac tissue. ROS generation and the corresponding antioxidant defense mechanisms in the heart are schematically illustrated. At physiological levels, ROS are believed to be vital for physiological cardiac signaling, adaptive growth responses, and extracellular matrix remodeling. However, elevated ROS levels are implicated in pathological cardiac remodeling, apoptosis, and chamber dysfunction. Key antioxidant systems include superoxide dismutase (SOD), glutathione peroxidase (GPX), thioredoxin (TRX), and catalase (CAT) [37].

Figure 3

Mitochondrial electron transport chain, a major physiological source of pro-oxidant species and the compensatory mechanisms of neutralization [37].