Therapeutic Potential of Quercetin as an Antiatherosclerotic Agent in Atherosclerotic Cardiovascular Disease: A Review

Table 1

Summary of the main effects of quercetin on antiatherosclerosis in vivo.

Effect	Subjects	Possible mechanism	Reference
Animals
Endothelial protection	Wistar rats	Neutralize ROS, protect mitochondrial membrane, reduce LPO, and increase GSH levels through the increased catalase activity	[109]
	ApoE^−/− mice	Regulate NADPH oxidase subunits expression	[16]
	Sprague-Dawley rats	Increase GSH, erythrocyte CAT, and MDA levels	[50]
	Wistar rats	Decrease serum LDL, TC, MDA, and ROS to improve the vascular structure and prevent from the plaque formation	[101]
Anti-inflammation	ApoE^−/− mice	Decrease serum TNF-α and IL-6 levels and increase levels	[110]
	ApoE^−/− mice	Inhibit phenotypic and functional maturation of DCs	[111]
	Balb/c mice	Mediate HDL function and lipid-glucose state in the circulation by improving biological activity (quality) and the activity of bound to PON1	[112]
Antiapoptosis	Nude mice	Activate ERK and the ERK signaling pathway to promote autophagy	[113]
	ApoE^−/− mice	Enhance autophagy and downregulate mTOR, P53 and P21 protein expression levels to alleviate AS lesions and reduce lipid accumulation and increase ratio of LC3 II/I	[83]
Regulate lipid metabolism and reduce the atherosclerotic plaque area	ApoE^−/− mice	Increase ABCA1 and LXRα expression and downregulate PCSK9 protein expression	[110]
	Wistar rats	Elevate activity of hepatic CYP7A1, LXRα, and ABCG1 to promote cholesterol-to-bile acid conversion and cholesterol efflux	[114]
	C57BL/6J mice	Upregulate LDLR and CYP7A1 gene expression to facilitate the removal of cholesterol via fecal excretion	[115]
	Wistar rats	Promote conversion of cholesterol to bile acids and cholesterol efflux by increasing hepatic CYP7A1 activity and hepatic LXRα, ABCG1, and LDLR protein expressions	[116]
	ApoE^−/− mice	Elevate cholesterol accepting ability of HDL and increase ABCA1/G1 expression levels of proteins related to RCT	[117]
	Sprague-Dawley rats	Influence gene and protein expression of SREBP1c and HMGR to lower lipid	[118]
	Sprague-Dawley rats	Upregulate hepatic gene expression CYP7A1, LXRα, ABCA1, and ABCG1 to promote cholesterol efflux	[119]
	Zucker rats	Lower the level of HDL cholesterol and increase phosphorus level by increasing the ratio of ASAT/ALAT activity induced by leptin	[56]
	ApoE^−/− mice	Regulate expressions of ABCA1, LXRα, and PCSK9	[26]
	ApoE^−/− mice	Downregulate PCSK9 and CD36 protein expression and upregulate PPAR γ, LXRα, and ABCA1 protein expression levels in both the aortic and liver tissues	[65]
Alter the gut microbiota	ApoE^−/− mice	Regulate primary bile acid biosynthesis	[95]
	C57BL/6J mice	Improve composition and functionality of gut microbiome and production of short chain fatty acids	[120]
	Wistar rats	Stimulate bacterial enzymatic activity and increase enzymatic activity of the intestinal microbiota	[121]
	Ldlr^−/− mice	Reduce MDA, cholesterol, and LPC 18 : 1 and increase IL-6 and coprostanol levels	[98]
Humans
Anti-inflammation	Healthy nonsmokers	Inhibit production of IL-1β, TNF-α, IL-6, and IL-8 in Lipopolysaccharide-stimulated	[122]
	CVD patients	Decrease transcriptional activity of NF-kB	[74]
Endothelial protection	CVD individuals	Enhance NO bioavailability, possibly by stimulating eNOS activity	[123]