Vitamin E and Atherosclerosis

Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5

Vitamin E was advocated as an effective treatment for heart disease by Dr. Even Shute of London, Ontario more than 50 years ago. His pioneering claims, which were unacceptable to the medical community at large, have been confirmed by recent findings from epidemiologic studies and clinical trials. This review integrates our current knowledge of atherogenesis with the biological functions of vitamin E. The response-to-injury hypothesis explains atherosclerosis as a chronic inflammatory response to injury of the endothelium, which leads to complex cellular and molecular interactions among cells derived from the endothelium, smooth muscle and several blood cell components. Inflammatory and other stimuli trigger an overproduction of free radicals, which promote peroxidation of lipids in LDL trapped in the subendothelial space. Products of LDL oxidation are bioactive, and they induce endothelial expression and secretion of cytokines, growth factors and several cell surface adhesion molecules. The last-mentioned are capable of recruiting circulating monocytes and T lymphocytes into the intima where monocytes are differentiated into macrophages, the precursor of foam cells. In response to the growth factors and cytokines, smooth muscle cells proliferate in the intima, resulting in the narrowing of the lumen. Oxidized LDL can also inhibit endothelial production of prostacyclin and nitric oxide, two potent autacoids that are vasodilators and inhibitors of platelet aggregation. Evidence is presented that vitamin E is protective against the development of atherosclerosis. Vitamin E enrichment has been shown to retard LDL oxidation, inhibit the proliferation of smooth muscle cells, inhibit platelet adhesion and aggregation, inhibit the expression and function of adhesion molecules, attenuate the synthesis of leukotrienes and potentiate the release of prostacyclin through up-regulating the expression of cytosolic phospholipase A₂ and cyclooxygenase. Collectively, these biological functions of vitamin E may account for its protection against the development of atherosclerosis.

The Journal of Nutrition Vol. 128 No. 10 October 1998, pp. 1593-1596
Copyright ©1998 by the American Society for Nutritional Sciences

This article has been cited by other articles:

				B. B. Dokken The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids Diabetes Spectr, July 1, 2008; 21(3): 160 - 165. [Abstract] [Full Text] [PDF]

				R. Siekmeier, C. Steffen, and W. Marz Role of Oxidants and Antioxidants in Atherosclerosis: Results of In Vitro and In Vivo Investigations Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2007; 12(4): 265 - 282. [Abstract] [PDF]

				M. Charlson and M. McFerren Garlic: What We Know and What We Don't Know Arch Intern Med, February 26, 2007; 167(4): 325 - 326. [Full Text] [PDF]

				B. H. S. Lau Suppression of LDL Oxidation by Garlic Compounds Is a Possible Mechanism of Cardiovascular Health Benefit J. Nutr., March 1, 2006; 136(3): 765S - 768S. [Abstract] [Full Text] [PDF]

				S. Devaraj, I. Hugou, and I. Jialal {{alpha}}-Tocopherol decreases CD36 expression in human monocyte-derived macrophages J. Lipid Res., April 1, 2001; 42(4): 521 - 527. [Abstract] [Full Text]

				B. H. S. Lau Suppression of LDL Oxidation by Garlic J. Nutr., March 1, 2001; 131(3): 985S - 988. [Abstract] [Full Text]

				Y. Terasawa, Z. Ladha, S. W. Leonard, J. D. Morrow, D. Newland, D. Sanan, L. Packer, M. G. Traber, and R. V. Farese Jr. Increased atherosclerosis in hyperlipidemic mice deficient in alpha -tocopherol transfer protein and vitamin E PNAS, November 22, 2000; (2000) 240462697. [Abstract] [Full Text]

				R. Ricciarelli, J.-M. Zingg, and A. Azzi Vitamin E Reduces the Uptake of Oxidized LDL by Inhibiting CD36 Scavenger Receptor Expression in Cultured Aortic Smooth Muscle Cells Circulation, July 4, 2000; 102(1): 82 - 87. [Abstract] [Full Text] [PDF]

				G. T Vatassery, T. Bauer, and M. Dysken High doses of vitamin E in the treatment of disorders of the central nervous system in the aged Am. J. Clinical Nutrition, November 1, 1999; 70(5): 793 - 801. [Abstract] [Full Text] [PDF]

				R. BRIGELIUS-FLOHÉ and M. G. TRABER Vitamin E: function and metabolism FASEB J, July 1, 1999; 13(10): 1145 - 1155. [Abstract] [Full Text]

				Y. Terasawa, Z. Ladha, S. W. Leonard, J. D. Morrow, D. Newland, D. Sanan, L. Packer, M. G. Traber, and R. V. Farese Jr. Increased atherosclerosis in hyperlipidemic mice deficient in alpha -tocopherol transfer protein and vitamin E PNAS, December 5, 2000; 97(25): 13830 - 13834. [Abstract] [Full Text] [PDF]