Reactive Oxygen Species and the Cardiovascular System

Figure 5

Different pathways leading to cell injury after ischemia. Ischemia due to atherosclerotic obstruction leads to an inflammatory process which provides the starting point of many other pathways of cellular injury via ROS production. Three main paths distinguished, being endothelial derived nitric oxide synthase (eNOS) uncoupling, mitochondrial electron transport, and proinflammatory signal molecules. Further, the produced ROS interact leading to DNA breaking and thus protein modification, with further cellular injury and dysfunction. Mit e⁻.t.c.: mitochondrial electron transport chain; ATP: adenosine triphosphate; NAD(P)H: nicotinamide adenine dinucleotide phosphate oxidase; PARP: poly-ADP-ribosylated proteins; O₂^•−: superoxide; H₂O₂: hydrogen peroxide.