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DOI: 10.2337/dc08-s247
© 2008 by the American Diabetes Association
Section II: Diabetes Complications and Hypertension-Novel Insights into Pathophysiology and Management |
NADPH Oxidases, Reactive Oxygen Species, and Hypertension
Clinical implications and therapeutic possibilities
Kidney Research Centre, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
Address correspondence and reprint requests to Rhian M. Touyz, MD, PhD, Canada Research Chair in Hypertension, Kidney Research Centre, OHRI/University of Ottawa, 451 Smyth Rd., Ottawa, K1H 8M5, Ontario, Canada. E-mail: rtouyz{at}uottawa.ca
Reactive oxygen species (ROS) influence many physiological processes including host defense, hormone biosynthesis, fertilization, and cellular signaling. Increased ROS production (termed "oxidative stress") has been implicated in various pathologies, including hypertension, atherosclerosis, diabetes, and chronic kidney disease. A major source for vascular and renal ROS is a family of nonphagocytic NAD(P)H oxidases, including the prototypic Nox2 homolog-based NAD(P)H oxidase, as well as other NAD(P)H oxidases, such as Nox1 and Nox4. Other possible sources include mitochondrial electron transport enzymes, xanthine oxidase, cyclooxygenase, lipoxygenase, and uncoupled nitric oxide synthase. NAD(P)H oxidase-derived ROS plays a physiological role in the regulation of endothelial function and vascular tone and a pathophysiological role in endothelial dysfunction, inflammation, hypertrophy, apoptosis, migration, fibrosis, angiogenesis, and rarefaction, important processes underlying cardiovascular and renal remodeling in hypertension and diabetes. These findings have evoked considerable interest because of the possibilities that therapies against nonphagocytic NAD(P)H oxidase to decrease ROS generation and/or strategies to increase nitric oxide (NO) availability and antioxidants may be useful in minimizing vascular injury and renal dysfunction and thereby prevent or regress target organ damage associated with hypertension and diabetes. Here we highlight current developments in the field of reactive oxygen species and cardiovascular disease, focusing specifically on the recently identified novel Nox family of NAD(P)H oxidases in hypertension. We also discuss the potential role of targeting ROS as a therapeutic possibility in the management of hypertension and cardiovascular disease.
Abbreviations: NOS, nitric oxide synthase • ROS, reactive oxygen species • SHR, spontaneously hypertensive rat • SOD, superoxide dismutase
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