Xanthine oxidoreductase: A leading actor in cardiovascular disease drama

Area of Science:

• Biochemistry
• Cardiology
• Pathophysiology

Background:

• Cardiovascular diseases (CVD) are a leading global cause of death, primarily driven by atherosclerosis.
• Oxidative stress and inflammation are key contributors to endothelial dysfunction and atherosclerotic plaque formation.
• Xanthine oxidoreductase (XOR) and its products play a significant role in these pathological processes.

Purpose of the Study:

• To review the role of xanthine oxidoreductase (XOR) and its products in chronic inflammation and oxidative stress.
• To examine the link between XOR activity, hyperuricemia, hypertension, and cardiovascular disease (CVD).
• To evaluate the efficacy of urate-lowering therapies in managing cardiovascular risk.

Main Methods:

• Literature review focusing on the impact of XOR products on inflammation and oxidative stress.
• Analysis of evidence linking hyperuricemia and XOR activity to CVD pathogenesis.
• Examination of clinical studies on urate-lowering therapies for cardiovascular patients.

Main Results:

• Excessive XOR products are associated with increased inflammation, plaque development, and cardiovascular risk factors.
• A confirmed relationship exists between hyperuricemia, hypertension, and XOR activity in CVD.
• Clinical trial results for urate-lowering therapies remain uncertain, with XOR inhibition showing potential but also risks.

Conclusions:

• XOR inhibition may be more beneficial than simply controlling uricemia for preventing cardiovascular events by reducing oxidative stress.
• However, XOR inhibition's impact on nitric oxide availability necessitates caution, limiting its recommendation to hyperuricemic patients.
• Further research is needed to clarify the therapeutic role of XOR modulation in cardiovascular disease management.