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Circulation. 2002;105:1429-1435
Published online before print March 4, 2002, doi: 10.1161/01.CIR.0000012917.74432.66
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(Circulation. 2002;105:1429.)
© 2002 American Heart Association, Inc.

Superoxide Production and Expression of Nox Family Proteins in Human Atherosclerosis

Dan Sorescu, MD; Daiana Weiss, MD; Bernard Lassègue, PhD; Roza E. Clempus, MD; Katalin Szöcs, MD; George P. Sorescu, MD; Liisa Valppu, BS; Mark T. Quinn, PhD; J. David Lambeth, MD; J. David Vega, MD; W. Robert Taylor, MD PhD; Kathy K. Griendling, PhD

From the Department of Medicine (D.S., D.W., B.L., R.E.C., K.S., G.P.S., L.V., W.R.T., K.K.G.), Division of Cardiology, Department of Pathology and Laboratory Medicine (J.D.L.), and Department of Surgery (J.D.V.), Emory University, Atlanta, Ga, and the Department of Veterinary Molecular Biology (M.T.Q.), Montana State University, Bozeman, Mont.

Correspondence to Dr Kathy K. Griendling, Emory University, Division of Cardiology, 319 WMB, 1639 Pierce Dr, Atlanta, GA 30322. E-mail kgriend{at}emory.edu

Background NAD(P)H oxidases are important sources of superoxide in the vasculature, the activity of which is associated with risk factors for human atherosclerosis. This study was designed to investigate the localization of superoxide production and the expression of the Nox family of NAD(P)H oxidase proteins (gp91phox, Nox1, and Nox4) in nonatherosclerotic and atherosclerotic human coronary arteries.

Methods and Results In coronary artery segments from explanted human hearts, we examined intracellular superoxide production with dihydroethidium. In nonatherosclerotic coronary arteries, superoxide was present homogenously throughout the intima, media, and adventitia. In atherosclerotic arteries, there was an additional intense area of superoxide in the plaque shoulder, which is rich in macrophages and {alpha}-actin–positive cells. p22phox colocalized with gp91phox mainly in macrophages, whereas Nox4 was found only in nonphagocytic vascular cells. Expression of gp91phox and p22phox mRNA was associated with the severity of atherosclerosis. gp91phox correlated with the plaque macrophage content, whereas Nox4 correlated with the content of {alpha}-actin–positive cells. Nox1 expression was low both in human coronary arteries and isolated vascular cells.

Conclusions Several Nox proteins, including gp91phox and Nox4, may contribute to increased intracellular oxidative stress in human coronary atherosclerosis in a cell-specific manner and thus may be involved in the genesis and progression of human coronary atherosclerotic disease.


Key Words: enzymes • coronary disease • arteries • atherosclerosis




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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
D. E. Ferrara, D. Weiss, P. H. Carnell, R. P. Vito, D. Vega, X. Gao, S. Nie, and W. R. Taylor
Quantitative 3D fluorescence technique for the analysis of en face preparations of arterial walls using quantum dot nanocrystals and two-photon excitation laser scanning microscopy
Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2006; 290(1): R114 - R123.
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HypertensionHome page
M.-S. Zhou, I. H. Schulman, P. J. Pagano, E. A. Jaimes, and L. Raij
Reduced NAD(P)H Oxidase in Low Renin Hypertension: Link Among Angiotensin II, Atherogenesis, and Blood Pressure
Hypertension, January 1, 2006; 47(1): 81 - 86.
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J. Leukoc. Biol.Home page
F. R. Sheppard, M. R. Kelher, E. E. Moore, N. J. D. McLaughlin, A. Banerjee, and C. C. Silliman
Structural organization of the neutrophil NADPH oxidase: phosphorylation and translocation during priming and activation
J. Leukoc. Biol., November 1, 2005; 78(5): 1025 - 1042.
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J. Leukoc. Biol.Home page
I. Sethy-Coraci, L. W. Crock, and S. C. Silverstein
PAF-receptor antagonists, lovastatin, and the PTK inhibitor genistein inhibit H2O2 secretion by macrophages cultured on oxidized-LDL matrices
J. Leukoc. Biol., November 1, 2005; 78(5): 1166 - 1174.
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Am. J. Physiol. Gastrointest. Liver Physiol.Home page
L. Cheng, W. Cao, C. Fiocchi, J. Behar, P. Biancani, and K. M. Harnett
In vitro model of acute esophagitis in the cat
Am J Physiol Gastrointest Liver Physiol, November 1, 2005; 289(5): G860 - G869.
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Circ. Res.Home page
I. Cucoranu, R. Clempus, A. Dikalova, P. J. Phelan, S. Ariyan, S. Dikalov, and D. Sorescu
NAD(P)H Oxidase 4 Mediates Transforming Growth Factor-{beta}1-Induced Differentiation of Cardiac Fibroblasts Into Myofibroblasts
Circ. Res., October 28, 2005; 97(9): 900 - 907.
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CirculationHome page
J. F. Keaney Jr
Oxidative Stress and the Vascular Wall: NADPH Oxidases Take Center Stage
Circulation, October 25, 2005; 112(17): 2585 - 2588.
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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
C. S. Wilcox
Oxidative stress and nitric oxide deficiency in the kidney: a critical link to hypertension?
Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2005; 289(4): R913 - R935.
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Circ. Res.Home page
Y. M. Kim, T. J. Guzik, Y. H. Zhang, M. H. Zhang, H. Kattach, C. Ratnatunga, R. Pillai, K. M. Channon, and B. Casadei
A Myocardial Nox2 Containing NAD(P)H Oxidase Contributes to Oxidative Stress in Human Atrial Fibrillation
Circ. Res., September 30, 2005; 97(7): 629 - 636.
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StrokeHome page
C. Espinola-Klein, S. Blankenberg, and T. Munzel
Editorial Comment--Is Heme Oxygenase-1 a Causal Player for Plaque Stability?
Stroke, September 1, 2005; 36(9): 1901 - 1903.
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Cardiovasc ResHome page
H. Sato, M. Sato, H. Kanai, T. Uchiyama, T. Iso, Y. Ohyama, H. Sakamoto, J. Tamura, R. Nagai, and M. Kurabayashi
Mitochondrial reactive oxygen species and c-Src play a critical role in hypoxic response in vascular smooth muscle cells
Cardiovasc Res, September 1, 2005; 67(4): 714 - 722.
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Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
M. S. Wolin, M. Ahmad, and S. A. Gupte
Oxidant and redox signaling in vascular oxygen sensing mechanisms: basic concepts, current controversies, and potential importance of cytosolic NADPH
Am J Physiol Lung Cell Mol Physiol, August 1, 2005; 289(2): L159 - L173.
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Arterioscler. Thromb. Vasc. Bio.Home page
T. Munzel, A. Daiber, V. Ullrich, and A. Mulsch
Vascular Consequences of Endothelial Nitric Oxide Synthase Uncoupling for the Activity and Expression of the Soluble Guanylyl Cyclase and the cGMP-Dependent Protein Kinase
Arterioscler Thromb Vasc Biol, August 1, 2005; 25(8): 1551 - 1557.
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Am. J. Physiol. Heart Circ. Physiol.Home page
S. Kinugawa, J. Zhang, E. Messina, E. Walsh, H. Huang, P. M. Kaminski, M. S. Wolin, and T. H. Hintze
gp91phox-containing NAD(P)H oxidase mediates attenuation of nitric oxide-dependent control of myocardial oxygen consumption by ANG II
Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H862 - H867.
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Arterioscler. Thromb. Vasc. Bio.Home page
G. Zalba, O. Beloqui, G. S. Jose, M. U. Moreno, A. Fortuno, and J. Diez
NADPH Oxidase-Dependent Superoxide Production Is Associated With Carotid Intima-Media Thickness in Subjects Free of Clinical Atherosclerotic Disease
Arterioscler Thromb Vasc Biol, July 1, 2005; 25(7): 1452 - 1457.
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HypertensionHome page
M. Akishita, K. Nagai, H. Xi, W. Yu, N. Sudoh, T. Watanabe, M. Ohara-Imaizumi, S. Nagamatsu, K. Kozaki, M. Horiuchi, et al.
Renin-Angiotensin System Modulates Oxidative Stress-Induced Endothelial Cell Apoptosis in Rats
Hypertension, June 1, 2005; 45(6): 1188 - 1193.
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J Am Coll CardiolHome page
F. Krotz, B. Engelbrecht, M. A. Buerkle, F. Bassermann, H. Bridell, T. Gloe, J. Duyster, U. Pohl, and H.-Y. Sohn
The Tyrosine Phosphatase, SHP-1, Is a Negative Regulator of Endothelial Superoxide Formation
J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1700 - 1706.
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Proc. Natl. Acad. Sci. USAHome page
H. Zhao, J. Joseph, H. M. Fales, E. A. Sokoloski, R. L. Levine, J. Vasquez-Vivar, and B. Kalyanaraman
Detection and characterization of the product of hydroethidine and intracellular superoxide by HPLC and limitations of fluorescence
PNAS, April 19, 2005; 102(16): 5727 - 5732.
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Am. J. Physiol. Gastrointest. Liver Physiol.Home page
L. Cheng, W. Cao, J. Behar, P. Biancani, and K. M. Harnett
Inflammation induced changes in arachidonic acid metabolism in cat LES circular muscle
Am J Physiol Gastrointest Liver Physiol, April 1, 2005; 288(4): G787 - G797.
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Am. J. Physiol. Cell Physiol.Home page
J. Hwang, D. J. Kleinhenz, B. Lassegue, K. K. Griendling, S. Dikalov, and C. M. Hart
Peroxisome proliferator-activated receptor-{gamma} ligands regulate endothelial membrane superoxide production
Am J Physiol Cell Physiol, April 1, 2005; 288(4): C899 - C905.
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CirculationHome page
V. Adams, A. Linke, N. Krankel, S. Erbs, S. Gielen, S. Mobius-Winkler, J. F. Gummert, F. W. Mohr, G. Schuler, and R. Hambrecht
Impact of Regular Physical Activity on the NAD(P)H Oxidase and Angiotensin Receptor System in Patients With Coronary Artery Disease
Circulation, February 8, 2005; 111(5): 555 - 562.
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Am. J. Physiol. Cell Physiol.Home page
T. Kawahara, M. Kohjima, Y. Kuwano, H. Mino, S. Teshima-Kondo, R. Takeya, S. Tsunawaki, A. Wada, H. Sumimoto, and K. Rokutan
Helicobacter pylori lipopolysaccharide activates Rac1 and transcription of NADPH oxidase Nox1 and its organizer NOXO1 in guinea pig gastric mucosal cells
Am J Physiol Cell Physiol, February 1, 2005; 288(2): C450 - C457.
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Cardiovasc ResHome page
S. H.M. Ellmark, G. J. Dusting, M. Ng Tang Fui, N. Guzzo-Pernell, and G. R. Drummond
The contribution of Nox4 to NADPH oxidase activity in mouse vascular smooth muscle
Cardiovasc Res, February 1, 2005; 65(2): 495 - 504.
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Am. J. Physiol. Heart Circ. Physiol.Home page
K. Laude, H. Cai, B. Fink, N. Hoch, D. S. Weber, L. McCann, G. Kojda, T. Fukai, H. H. H. W. Schmidt, S. Dikalov, et al.
Hemodynamic and biochemical adaptations to vascular smooth muscle overexpression of p22phox in mice
Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H7 - H12.
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Am. J. Physiol. Heart Circ. Physiol.Home page
S. A. Gupte, P. M. Kaminski, B. Floyd, R. Agarwal, N. Ali, M. Ahmad, J. Edwards, and M. S. Wolin
Cytosolic NADPH may regulate differences in basal Nox oxidase-derived superoxide generation in bovine coronary and pulmonary arteries
Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H13 - H21.
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Cardiovasc ResHome page
R. P. Brandes and J. Kreuzer
Vascular NADPH oxidases: molecular mechanisms of activation
Cardiovasc Res, January 1, 2005; 65(1): 16 - 27.
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Mol. Cell. Biol.Home page
E. Pedruzzi, C. Guichard, V. Ollivier, F. Driss, M. Fay, C. Prunet, J.-C. Marie, C. Pouzet, M. Samadi, C. Elbim, et al.
NAD(P)H Oxidase Nox-4 Mediates 7-Ketocholesterol-Induced Endoplasmic Reticulum Stress and Apoptosis in Human Aortic Smooth Muscle Cells
Mol. Cell. Biol., December 15, 2004; 24(24): 10703 - 10717.
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Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
J.-M. Li and A. M Shah
Endothelial cell superoxide generation: regulation and relevance for cardiovascular pathophysiology
Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2004; 287(5): R1014 - R1030.
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Circ. Res.Home page
G. P. Sorescu, H. Song, S. L. Tressel, J. Hwang, S. Dikalov, D. A. Smith, N. L. Boyd, M. O. Platt, B. Lassegue, K. K. Griendling, et al.
Bone Morphogenic Protein 4 Produced in Endothelial Cells by Oscillatory Shear Stress Induces Monocyte Adhesion by Stimulating Reactive Oxygen Species Production From a Nox1-Based NADPH Oxidase
Circ. Res., October 15, 2004; 95(8): 773 - 779.
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Physiol. Rev.Home page
R. Stocker and J. F. Keaney Jr.
Role of Oxidative Modifications in Atherosclerosis
Physiol Rev, October 1, 2004; 84(4): 1381 - 1478.
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J. Leukoc. Biol.Home page
M. T. Quinn and K. A. Gauss
Structure and regulation of the neutrophil respiratory burst oxidase: comparison with nonphagocyte oxidases
J. Leukoc. Biol., October 1, 2004; 76(4): 760 - 781.
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HypertensionHome page
S. Wassmann, K. Wassmann, and G. Nickenig
Modulation of Oxidant and Antioxidant Enzyme Expression and Function in Vascular Cells
Hypertension, October 1, 2004; 44(4): 381 - 386.
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Arterioscler. Thromb. Vasc. Bio.Home page
M. Yokoyama and N. Inoue
How Vascular NAD(P)H Oxidase Activity and Nox Isoform Expression are Regulated
Arterioscler Thromb Vasc Biol, September 1, 2004; 24(9): 1540 - 1541.
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Arterioscler. Thromb. Vasc. Bio.Home page
T. J. Guzik, J. Sadowski, B. Kapelak, A. Jopek, P. Rudzinski, R. Pillai, R. Korbut, and K. M. Channon
Systemic Regulation of Vascular NAD(P)H Oxidase Activity and Nox Isoform Expression in Human Arteries and Veins
Arterioscler Thromb Vasc Biol, September 1, 2004; 24(9): 1614 - 1620.
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Proc. Natl. Acad. Sci. USAHome page
Z. Chen, J. F. Keaney Jr., E. Schulz, B. Levison, L. Shan, M. Sakuma, X. Zhang, C. Shi, S. L. Hazen, and D. I. Simon
Decreased neointimal formation in Nox2-deficient mice reveals a direct role for NADPH oxidase in the response to arterial injury
PNAS, August 31, 2004; 101(35): 13014 - 13019.
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