Nrf2-Mediated Dichotomy in the Vascular System: Mechanistic and Therapeutic Perspective
Open accessAbstract
Nuclear factor-erythroid 2-related factor 2 (Nrf2), a transcription factor, controls the expression of more than 1000 genes that can be clustered into different categories with distinct functions ranging from redox balance and metabolism to protein quality control in the cell. The biological consequence of Nrf2 activation can be either protective or detrimental in a context-dependent manner. In the cardiovascular system, most studies have focused on the protective properties of Nrf2, mainly as a key transcription factor of antioxidant defense. However, emerging evidence revealed an unexpected role of Nrf2 in mediating cardiovascular maladaptive remodeling and dysfunction in certain disease settings. Herein we review the role of Nrf2 in cardiovascular diseases with a focus on vascular disease. We discuss the negative effect of Nrf2 on the vasculature as well as the potential underlying mechanisms. We also discuss the clinical relevance of targeting Nrf2 pathways for the treatment of cardiovascular and other diseases.
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Most cancers show elevated levels of ROS and oxidative stress, which can cause DNA damage, impair protein function, and alter mechanisms of cellular proliferation to promote tumorigenesis.
“Most cancers show elevated levels of ROS and oxidative stress, which can cause DNA damage, impair protein function, and alter mechanisms of cellular proliferation to promote tumorigenesis [154].”
From Nrf2 and Oxidative Stress: A General Overview of Mechanisms and Implications in Human Disease (2022) · cites this paper as [154]
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Nrf2 and Oxidative Stress: A General Overview of Mechanisms and Implications in Human Disease
Ngo, V., & Duennwald, M. L. (2022) · Antioxidants · doi:10.3390/antiox11122345 · Cited by 1,130 · see citing works
Redox Imbalance in Inflammation: The Interplay of Oxidative and Reductive Stress
Bellanti, F., Coda, A. R. D., Trecca, M. I., Buglio, A. L., Serviddio, G., & Vendemiale, G. (2025) · Antioxidants · doi:10.3390/antiox14060656 · Cited by 212 · see citing works
The Nrf2 Pathway in Depressive Disorders: A Systematic Review of Animal and Human Studies
Sani, G., Margoni, S., Brugnami, A., Ferrara, O. M., Bernardi, E., Simonetti, A., Monti, L., Mazza, M., Janiri, D., Moccia, L., et al. (2023) · Antioxidants · doi:10.3390/antiox12040817 · Cited by 41 · see citing works
Advances in the Model Structure of In Vitro Vascularized Organ-on-a-Chip
Yin, H., Wang, Y., Liu, N., Zhong, S., Li, L., Zhang, Q., Liu, Z., & Yue, T. (2024) · Cyborg and Bionic Systems · doi:10.34133/cbsystems.0107 · Cited by 37 · see citing works
Bioactive lipid regulation of platelet function, hemostasis, and thrombosis
Stanger, L., & Holinstat, M. A. (2023) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2023.108420 · Cited by 34 · see citing works
Acción y efecto del desbalance redox, visto en tiempo real por Capilaroscopía
Garza, V. A. A. (2025) · Ethos Scientific Journal · doi:10.63380/esj.v3n2.2025.198 · Cited by 28 · see citing works
Diabetic neuropathy: A NRF2 disease?
Neagu, M. T., Constantin, C., Surcel, M., Munteanu, A. N., Scheau, C., Săvulescu-Fiedler, I., & Căruntu, C. (2023) · Journal of Diabetes · doi:10.1111/1753-0407.13524 · Cited by 23 · see citing works
Zhao, W., Li, B., Hao, J., Sun, R., He, P., Lv, H., He, M., Shen, J., & Han, Y. (2024) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2024.108652 · Cited by 18 · see citing works
Zhou, D., Yang, Y., Han, R., He, J., Liu, D., Xia, W., Cai, Y., Perek, B., & Xia, Z. (2024) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2510360 · Cited by 15 · see citing works
Irisin: A Potentially Fresh Insight into the Molecular Mechanisms Underlying Vascular Aging
Wang, Y., Wang, M., & Wang, Y. (2023) · Aging and Disease · doi:10.14336/ad.2023.1112 · Cited by 10 · see citing works
Shamsi, M., Mohammadzadeh, G., Hatami, M., Roshanazadeh, M., Noorbehbahani, M., & Rashidi, M. (2024) · Iranian journal of pharmaceutical research · doi:10.5812/ijpr-151428 · Cited by 8 · see citing works
Liu, S., Jing, J., Zhang, Y., Sun, J., & Zhu, C. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1631274 · Cited by 8 · see citing works
Mao, X., Du, Y., Sui, R., Yu, X., Zhu, Y., & Huang, M. (2024) · Nanomedicine Nanotechnology Biology and Medicine · doi:10.1016/j.nano.2024.102763 · Cited by 6 · see citing works
Senaphan, K., Sangartit, W., Kukongviriyapan, V., Boonla, O., Greenwald, S. E., & Kukongviriyapan, U. (2025) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes24017 · Cited by 5 · see citing works
Antonova, V. V., Evseev, A. K., Goroncharovskaya, I. V., Ryzhkov, A. Y., Grebenchikov, O. A., & Курбанович, Ш. А. (2023) · Annals of critical care · doi:10.21320/1818-474x-2023-4-185-196 · Cited by 5 · see citing works
Martinez, A. N., Tortelote, G. G., Pascale, C. L., Ekanem, U.-O. I., Leite, A. P. D. O., McCormack, I. G., & Dumont, A. S. (2024) · Antioxidants · doi:10.3390/antiox13070773 · Cited by 5 · see citing works
Dimethyl fumarate is an inhibitor of pathological angiogenesis
Ng, P. Q., Huang, K., McLellan, F. C., Yang, M., Lennikov, A., Hu, Z., Chaudhary, S., Appiah, A. C., Vuong, M. L., & Shu, D. Y. (2025) · Cellular Signalling · doi:10.1016/j.cellsig.2025.112106 · Cited by 2 · see citing works
State‐of‐the‐Art Nrf2 Inhibitors: Therapeutic Opportunities in Non‐Cancer Diseases
Ayala‐Cosme, E. G., Yang, D. J., Vences, K., Davis, L. O., & Borgini, M. (2024) · ChemMedChem · doi:10.1002/cmdc.202400377 · Cited by 1 · see citing works
Shafi, O., Irfan, S., Ahmed, A., Maheshwari, G., Kumar, R., Raveena, Rajpar, R., & Saeed, A. (2024) · Research Square · doi:10.21203/rs.3.rs-4498525/v1
Research Progress on Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction
吴, 伟. (2025) · Advances in Clinical Medicine · doi:10.12677/acm.2025.15113135
- Authors
- Wu, W., Hendrix, A., Nair, S., & Cui, T.
- Affiliations
- Qingdao University (CN)
- University of South Carolina (US)
- Corresponding author
- Cui, Taixing
- Venue
- Cells
- Publisher
- MDPI AG
- Published
- 2022-09-28
- Volume
- 11
- Issue
- 19
- Pages
- 3042
- ISSN
- 2073-4409 (ISSN-L)
- PMC
- PMC9563590
- OpenAlex
- W4297464420
- Cited by
- 20
- References
- 200
- Citations by year
- 2025: 6 · 2024: 8 · 2023: 5 · 2022: 1
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cells (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Heart, Lung, and Blood Institute of NIH (R01 HL160541, I01 CX002062)
- US Department of Veterans Affairs (R01 HL160541, I01 CX002062)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Genomics, phytochemicals, and oxidative stress
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Heme Oxygenase-1 and Carbon Monoxide
- Keywords
- Nrf2, vascular disease, cardiovascular disease, antioxidant defense, redox homeostasis, protein quality control, cardiovascular remodeling, transcription factors, context sensitivity
- MeSH terms
- Antioxidants, Cells, Cultured, Signal Transduction, Myocytes, Smooth Muscle, NF-E2-Related Factor 2
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