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The Redox-Inflammation Axis in Atherosclerosis and Ischemic Stroke: Mechanisms, Biomarkers, and Translational

Cezary Gaczyński1, Aleksandra Polikowska1, Małgorzata Goszka1

  • 1Department of Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland.

International Journal of Molecular Sciences
|August 13, 2026
PubMed

Insights

Cardiovascular diseases are linked by oxidative stress and inflammation. Future treatments require precision redox modulation using advanced profiling and AI for better risk stratification and personalized therapy.

Area of Science:

  • Cardiovascular Medicine
  • Redox Biology
  • Inflammation Research

Background:

  • Cardiovascular diseases (CVDs) are the leading global cause of death, driven by oxidative stress and inflammation.
  • The integrated mechanistic framework and biomarker-guided precision medicine for the redox-inflammation axis in CVDs are underexplored.
  • Reactive oxygen and nitrogen species (ROS/RNS) significantly contribute to vascular inflammation and injury through various pathways.

Purpose of the Study:

  • To review the redox-inflammation axis in atherosclerosis and acute ischemic stroke from mechanistic, biomarker, and translational viewpoints.
  • To critically evaluate oxidative and inflammatory biomarkers for CVDs.
  • To highlight challenges and emerging therapeutic opportunities in precision cardiovascular medicine.

Main Methods:

  • Narrative review integrating mechanistic, biomarker, and translational perspectives.
  • Evaluation of established and emerging biomarkers for oxidative stress and inflammation.
  • Discussion of challenges in biomarker validation and therapeutic strategies.

Main Results:

  • ROS/RNS activate redox-sensitive pathways (e.g., NF-κB, Nrf2/Keap1, JAK/STAT, NLRP3 inflammasome), promoting endothelial dysfunction and vascular inflammation.
  • Biomarkers like hs-CRP, IL-6, MPO, MDA, F2-isoprostanes, oxLDL, and antioxidant enzyme activity show prognostic potential but require further validation.
  • Most oxidative stress biomarkers lack routine clinical validation due to variability, specificity issues, and standardization challenges.

Conclusions:

  • Precision cardiovascular medicine necessitates a shift from non-specific antioxidant supplementation to precision redox modulation.
  • Integrating multimarker profiling, systems biology, multi-omics, and AI/machine learning is crucial for improved risk stratification and personalized CVD therapy.
  • Understanding the dual roles of ROS in physiology and pathology is key for effective therapeutic interventions.

Keywords:
NLRP3 inflammasomeNrf2acute ischemic strokeatherosclerosisbiomarkersinflammationoxidative stressprecision cardiovascular medicinereactive oxygen speciesredox signaling

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