Mechanism of cardioprotection by resveratrol, a phenolic antioxidant present in red wine (Review)

Coronary heart disease (CHD) has been and remains a major contributor to mo rbidity and mortality in developed countries. The most common form of CHD i n the western world is atherosclerosis (AS), especially of the major corona ry arteries. Failure to maintain an intact endothelium, as a result of epis odic and/or persistent injury and perturbation of the vascular endothelium, promotes formation of fatty streaks which are considered initiation events of AS. Cellular constituents contributing to endothelial injury include en dothelial cells, monocytes, platelets, and smooth muscle cells. Individuals diagnosed with AS face complex, enduring clinical complications and enormo us medical costs. Simple and easily compliant prevention and treatment meas ures are therefore strategic considerations in the management of this vascu lar disease. Based on known risk factors for CHD, priorities in AS preventi on should include smoking cessation, blood pressure control, and diet modif ication. In recent years, the possible benefits of low to moderate consumpt ion of alcoholic beverages, particularly of red wine, in the prevention of heart disease has received increasing attention and debate in the popular m edia as well as in the scientific community. Such attention has been prompt ed by research findings supporting a relationship between red wine consumpt ion and the French paradox. This phenomenon refers to people residing in ce rtain parts of France where red wine is customarily consumed during meals h aving a low CHD mortality, despite living a lifestyle considered to have co mparably high CHD risks, as those in the US and many other developed countr ies. Studies have reported that the cardioprotective effects of red wine ar e greater than those attributed solely to ethanol and other types of alcoho lic beverages. The mechanism(s) underlying the greater CHD protective benef its of red wine have not been elucidated. Recently the polyphenol resveratr ol (3,5,4'-trihydroxy-trans-stilbene), known to be abundantly present: in r ed wine, compared to white wine, beer, or spirits, has been demonstrated to elicit a broad spectrum of biological responses in in vitro and in animal studies, including effects that are compatible with the cardioprotective ro les proposed for red wine. These recently described effects of resveratrol will be reviewed in this article. We will first summarize published data sh owing an inverse association between consumption of alcoholic beverages/red wine and risk of CHD. A review of biosynthesis of resveratrol and its pres ence in food groups and wines will follow. Recent studies relating exposure to wine/resveratrol with reduction in myocardial damage during ischemia-re perfusion, modulation of vascular cell functions, inhibition of LDL oxidati on, and suppression of platelet aggregation will be presented. The last sec tion of this review will focus on a discussion of mechanism(s) by which res veratrol acts as a potential cardioprotective agent.