Background: Abdominal aortic aneurysm (AAA) is a degenerative disease that causes mortality
in people aged > 65 years. Increased reactive oxygen species (ROS) and oxidative stress seem to
play a pivotal role in AAA pathogenesis. Several sources of ROS have been identified in aortic tissues
using experimental models: inflammation, increased activity of NAD(P)H or NOX, over-expression of
inducible nitric oxide synthase (iNOS), uncoupled endothelial nitric oxide synthase (eNOS), platelets
activation and iron release from hemoglobin.
Objectives: Human studies confirmed that oxidative stress and endothelial dysfunction, an important
source of ROS production, were well associated with AAA development. Reducing oxidative stress by
antioxidants can therefore be a good strategy for limiting AAA development. The objective of the present
study is to review literature data favoring or not such a hypothesis. There is currently no evidence
showing that strategies using classical low molecular weight antioxidants (vitamins C and E, β-
carotene) as target for ROS is effective to reduce human AAA progression. However, recent epidemiological
data have highlighted the positive role of a diet enriched in fruits which contain high amounts
of antioxidant polyphenols. By their ability to restore endothelial function and also their capacity to
stimulate enzymatic antioxidants through activation of the Keap1/Nrf2/ARE pathway, polyphenols
can represent a promising treatment target for reducing human AAA progression.
Conclusion: Clinical studies are therefore urgently necessary to confirm the potential beneficial effect
of polyphenols in preventing or limiting AAA.