Oxidative stress is a key feature in atherogenesis, since reactive oxygen species (ROS) are involved in all stages of the disease,
from endothelial dysfunction to atheromatic plaque formation and rupture. It is therefore important to identify reliable biomarkers
allowing us to monitor vascular oxidative stress status. These may lead to improved understanding of disease pathogenesis and
development of new therapeutic strategies.
Measurement of circulating biomarkers of oxidative stress is challenging, since circulation usually behaves as a separate compartment to
the individual structures of the vascular wall. However, measurement of stable products released by the reaction of ROS and
vascular/circulating molecular structures is a particularly popular approach. Serum lipid hydroperoxides, plasma malondialdehyde or
urine F2-isoprostanes are widely used and have a prognostic value in cardiovascular disease.
Quantification of oxidative stress at a tissue level is much more accurate. Various chemiluminescence and high performance liquid
chromatography assays have been developed over the last few years, and some of them are extremely accurate and specific. Electron spin
resonance spectroscopy and micro-electrode assays able to detect ROS directly are also widely used.
In conclusion, measurement of circulating biomarkers of oxidative stress is valuable, and some of them appear to have predictive value in
cardiovascular disease. However, these biomarkers do not necessarily reflect intravascular oxidative stress and therefore cannot be used
as therapeutic targets or markers to monitor pharmacological treatments in clinical settings. Measurement of vascular oxidative stress
status is still the only reliable way to evaluate the involvement of oxidative stress in atherogenesis.