Biomarkers of Oxidative Stress in Cardiovascular Diseases

Worldwide, cardiovascular diseases (CVDs) are the primary cause of mortality (1). They involve a variety of underlying mechanisms, with increased oxidative stress being one of the key contributing factors.

Behavioral risk factors like poor diet, lack of physical activity, and tobacco use are connected to CVDs. Conditions that heighten the risk include obesity, high blood sugar, hypertension, increased low-density lipoprotein (LDL) cholesterol, and oxidative stress (1).

Understanding oxidative stress

 

Oxidative stress occurs when there is an imbalance between the production of free radicals (reactive oxygen species – ROS) and the body’s antioxidant defenses (endogenous antioxidant capacity) (2). ROS are by-products of cellular metabolism and can be triggered by various factors such as pollutants, heavy metals, tobacco, drugs, and others. It is believed that oxidative stress plays a role in the development and progression of numerous diseases, including cancer (3), diabetes (4), metabolic syndrome (5), Alzheimer´s disease (6), atherosclerosis (7), and cardiovascular conditions (8).

Biomarkers of Oxidative Stress in Cardiovascular Diseases

Oxidized LDL (oxLDL) and Autoantibodies Against Oxidized LDL

Atherosclerosis is a disease characterized by the accumulation of lipids, fibrous tissue, and calcification in large arteries. The process starts with endothelial activation, followed by a series of events that result in vessel narrowing and the activation of inflammatory pathways, leading to the formation of atheromatous plaques. These mechanisms collectively contribute to cardiovascular complications (9).

Oxidized LDL (OxLDL) and anti-OxLDL antibodies are closely linked and play crucial roles in the development of atherosclerosis, contributing to plaque formation, inflammation, and rupture. While OxLDL encourages foam cell development, anti-OxLDL antibodies, may provide a protective effect against coronary artery disease (CAD). Both are promising candidates as diagnostic biomarkers and targets for imaging in assessing cardiovascular risk (10).

Autoantibodies targeting oxidatively modified LDL (anti-oxLDL Ab) have been identified in both patients with atherosclerosis and healthy individuals. It is proposed that these antibodies reflect ongoing oxidation processes occurring within the body.

Anti-oxLDL Ab levels can be quantified in human blood samples using a standard ELISA assay . Several studies suggest that autoantibodies to oxLDL may enhance cardiovascular risk assessment and stratification (11).

 

Methods for Measuring Oxidative Status and Oxidative Stress

    1. MEASUREMENT OF ANTI-OXIDIZED LDL AUTOANTIBODIES (anti-oxLDL antibodies)

ELISA for the detection of Anti-oxidized LDL Autoantibodies (oLAB ) | BI-20032

• Sample type – serum
• Sample volume –  50µl/well
• Incubation time –  1.5 h / 30 min / 15 min
• Detection range – 0 – 1200 mU / ml
• Sensitivity – 48 mU / ml
• Precision-  In-between-run (n=5): ≤ 8 % CV, Within-run (n=8): ≤ 4 % CV
• Use – Research use only
• Widely cited in over 70 publications

Protocol booklet and MSDS

 

2. MEASUREMENT OF BIOLOGICAL PEROXIDES 

Oxidative Stress Test – OXYSTAT Assay | BI-5007

Quick and easy assay to measure total peroxides in biological fluids.

• Method – colorimetric assay, 96 wells
• Sample type – serum, plasma, biological fluids
• Sample volume – 10µl/well
• Assay time – 15 min
• Detection range – 0 – 660 µmol/l
• Sensitivity – 7 µmol/l
• Use – Research use only
• Widely cited in over 60 publications

 Protocol booklet and MSDS

Results indicate a direct relationship between free radicals and circulating biological peroxides, enabling the assessment of oxidative status in biological samples.

 

Literature

1. Cardiovascular diseases (CVDs). World Health Organization; 2025.
2. Free radicals and oxidative stress: Mechanisms and therapeutic targets. Hassan HA, Ahmed HS, Hassan DF. Hum Antibodies. 2024;32(4):151-167. doi: 10.3233/HAB-240011. PMID: 39031349.
3. Interplay of oxidative stress, cellular communication and signaling pathways in cancer. Iqbal MJ, Kabeer A, Abbas Z, Siddiqui HA, Calina D, Sharifi-Rad J, Cho WC. Cell Commun Signal. 2024 Jan 2;22(1):7. doi: 10.1186/s12964-023-01398-5. PMID: 38167159; PMCID: PMC10763046.
4. Oxidative Stress: Pathogenetic Role in Diabetes Mellitus and Its Complications and Therapeutic Approaches to Correction. Darenskaya MA, Kolesnikova LI, Kolesnikov SI. Bull Exp Biol Med. 2021 May;171(2):179-189. doi: 10.1007/s10517-021-05191-7. Epub 2021 Jun 26. PMID: 34173093; PMCID: PMC8233182.
5. Mechanisms of Oxidative Stress in Metabolic Syndrome. Masenga SK, Kabwe LS, Chakulya M, Kirabo A. Int J Mol Sci. 2023 Apr 26;24(9):7898. doi: 10.3390/ijms24097898. PMID: 37175603; PMCID: PMC10178199.
6. Oxidative stress: The core pathogenesis and mechanism of Alzheimer’s disease. Bai R, Guo J, Ye XY, Xie Y, Xie T. Ageing Res Rev. 2022 May;77:101619. doi: 10.1016/j.arr.2022.101619. Epub 2022 Apr 5. PMID: 35395415.
7. The Role of Oxidative Stress in Atherosclerosis. Batty M, Bennett MR, Yu E. Cells. 2022 Nov 30;11(23):3843. doi: 10.3390/cells11233843. PMID: 36497101; PMCID: PMC9735601.
8. Oxidative Stress in Cardiovascular Diseases. Dubois-Deruy E, Peugnet V, Turkieh A, Pinet F. Antioxidants (Basel). 2020 Sep 14;9(9):864. doi: 10.3390/antiox9090864. PMID: 32937950; PMCID: PMC7554855.
9. Pathophysiology of Atherosclerosis. Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, Olaetxea JR, Alloza I, Vandenbroeck K, Benito-Vicente A, Martín C. Int J Mol Sci. 2022 Mar 20;23(6):3346. doi: 10.3390/ijms23063346. PMID: 35328769; PMCID: PMC8954705.
10. Oxidized LDL and anti-oxidized LDL antibodies in atherosclerosis – Novel insights and future directions in diagnosis and therapy. Hartley A, Haskard D, Khamis R. Trends Cardiovasc Med. 2019 Jan;29(1):22-26. doi: 10.1016/j.tcm.2018.05.010. Epub 2018 Jun 4. PMID: 29934015.

11. Overview of Clinical Relevance of Antibodies Against Oxidized Low-Density Lipoprotein (oLAb) Within Three Decades by ELISA Technology. Antioxidants (Basel). Wonisch W, Tatzber F, Lindschinger M, Falk A, Resch U, Mörkl S, Zarkovic N, Cvirn G 2024 Dec 19;13(12):1560. doi: 10.3390/antiox13121560. PMID: 39765889; PMCID: PMC11672888.