Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Nov 20, 2015; 5(4): 218-224
Published online Nov 20, 2015. doi: 10.5493/wjem.v5.i4.218
Enzymatic antioxidant system in vascular inflammation and coronary artery disease
Valter Lubrano, Silvana Balzan
Valter Lubrano, Department of Laboratory Medicine, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
Silvana Balzan, Institute of Clinical Phisiology, CNR, 56124 Pisa, Italy
Author contributions: Lubrano V drafted of the text; Balzan S contributed to review and literature search.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors that contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Valter Lubrano, PhD, Department of Laboratory Medicine, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi n° 1, 56124 Pisa, Italy.
Telephone: +39-50-3152199 Fax: +39-50-3153454
Received: June 16, 2015
Peer-review started: June 20, 2015
First decision: July 27, 2015
Revised: October 12, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: November 20, 2015

In biological systems there is a balance between the production and neutralization of reactive oxygen species (ROS). This balance is maintained by the presence of natural antioxidants and antioxidant enzymes such as superoxide dismutase (SOD), catalase and glutathione peroxidase. The enhancement of lipid peroxidation or the decrease of antioxidant protection present in metabolic diseases or bad lifestyle can induce endothelial dysfunction and atherosclerosis. Clinical studies have shown that oxidative stress can increase ROS reducing the formation of antioxidant defences, especially in subjects with coronary artery disease (CAD). Some observation indicated that in the early stages of the disease there is a homeostatic up-regulation of the antioxidant enzyme system in response to increased free radicals to prevent vascular damage. As soon as free radicals get to chronically elevated levels, this compensation ceases. Therefore, SOD and the other enzymes may represent a good therapeutic target against ROS, but they are not useful markers for the diagnosis of CAD. In conclusion antioxidant enzymes are reduced in presence of metabolic disease and CAD. However the existence of genes that promote their enzymatic activity could contribute to create new drugs for the treatment of damage caused by metabolic diseases or lifestyle that increases the plasma ROS levels.

Keywords: Superoxide dismutase, Catalase, Glutathione peroxidase, Antioxidant enzyme, Coronary artery disease, Reactive oxygen species, Vascular inflammation

Core tip: This review shows that antioxidant enzymes are very important factors for the prevention and treatment of atherosclerotic disease, but more studies are required to understand whether they can be used as markers for diagnosis of coronary artery disease. The presence of polymorphic genes that increases the activity and expression of these enzymes can be considered important for the development of new therapeutic strategies. In our opinion further efforts should be directed especially on this last point, in order to find new therapies to increase the function of antioxidant enzymes in metabolic disease or other risk factors.