Leukotrienes in the atherosclerotic cardiovascular diseases — a systematic review

Introduction: The role of inflammation in the pathogenesis of atherosclerotic diseases is strongly suggested.There are multiple studies indicating the possibility of a pathophysiological connection between atheroscleroticchanges and leukotrienes (LTs) — the products of arachidonic acid metabolism. The goal of this systematicreview, performed in line with the PRISMA statement, was to investigate the potential role of LTs in the pathophysiologyof atherosclerotic cardiovascular diseases (CVD). Material and methods: The MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews weresearched to identify the potentially eligible studies. Publications that contained information on any type of LTsidentified in blood or urine were included in the review. A database search identified 2082 records. Reliable LTsidentification in patients with CVD was used in 30 publications. Results: Stable and acute forms of coronary artery disease are characterized by the overproduction of differenttypes of LTs. The level of LTB4 and LTC4 in the blood is elevated in patients with cerebral ischemia. Patients withacute and chronic peripheral artery disease have elevated levels of LTE4 in urine. Conclusions: The findings of this systematic review show that there is a clear tendency to indicate the associationof cardiovascular atherosclerotic diseases with increased production of LTs. This dependency detailedcharacteristic remains unclear and the question on the impact of elevated leukotrienes on clinical atheroscleroticdisease manifestations is still open

Stimulation of the vascular endothelium and angiogenesis by blood-flow-restricted exercise

Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved 35 young healthy adults. They conducted a 21-min low-resistant exercise with blood flow restricted by pressure cuffs placed on arms and tights. They also did the same training but without blood flow restriction. Endothelial parameters and angiogenesis biomarkers were evaluated before and up to 20 min after exercise. Both types of exercise increased Flow-Mediated Dilatation (FMD) but elevation after BFRE was more significant compared to the controls. The stiffness index decreased only after BFRE, while the reflection index decreased significantly after both types of exercise but was higher after BFRE. Platelet endothelial cell adhesion molecule (PECAM-1) and vascular endothelial growth factor receptor 2 (VEGFR-2) concentrations were increased by both exercise types but elevations were higher after BFRE compared to the controls. Only BFRE elevated the mean serum CD34 protein concentration. Based on these results, we can assume that low-resistance BFR exercise stimulates angiogenesis and improves endothelial functions more significantly compared to the same training performed without blood flow restriction