Cardioprotection with alcohol: role of both alcohol and polyphenolic antioxidants

Both epidemiological and experimental studies indicate that mild-to-moderate alcohol consumption is associated with a reduced incidence of mortality and morbidity from coronary heart disease. The consumption of wine, particularly red wine, imparts a greater benefit in the prevention of coronary heart disease than the consumption of other alcoholic beverages. The cardioprotective effects of red wine have been attributed to several polyphenolic antioxidants including resveratrol and proanthocyanidins. The results of our study documented that the polyphenolic antioxidants present in red wine, for example, resveratrol and proanthocyanidins, provide cardioprotection by their ability to function as in vivo antioxidants while its alcoholic component or alcohol by itself imparts cardioprotection by adapting the hearts to oxidative stress. Moderate alcohol consumption induced significant amount of oxidative stress to the hearts which was then translated into the induction of the expression of several cardioprotective oxidative stress-inducible proteins including heat shock protein (HSP) 70. Feeding the rats with red wine extract or its polyphenolic antioxidants as well as alcohol resulted in the improvement of postischemic ventricular function. Additionally, both wine and alcohol triggered a signal transduction cascade by reducing proapoptotic transcription factors and genes such as JNK-1 and c-Jun thereby potentiating an anti-death signal. This resulted in the reduction of myocardial infarct size and cardiomyocyte apoptosis. The results, thus, indicate that although both wine and alcohol alone reduce myocardial ischemic reperfusion injury, the mechanisms of cardioprotection differ from each other.