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ROS react with cellular macromolecules. The most common form of DNA oxidative
damage is the formation of hydroxylated bases. 8-hydroxy-2’-deoxyguanosine (8-OHdG) is
generally used an index of oxidative DNA damage. ROS react with lipids to produce lipid peroxyl
radicals and lipid hydroperoxides. Lipid peroxyl can subsequently form malondialdehyde
(MDA), which is commonly used as an index of oxidative lipid damage. Lipid radicals can diffuse
through membrane leading to protein oxidation and formation of DNA-MDA adduct. Oxidative
lipid damages affect the structure and function of cell membrane. ROS attack proteins directly
and indirectly. Protein carbonyl is a form of protein oxidative damage. Changes in protein
structure lead to alteration in enzymatic activities, particularly, damage to membrane transport
proteins leads to ionic imbalance such as intracellular concentrations of calcium and potassium.
Oxidative stress could also cause changes in regulation of transcription factors in cells, e.g., the
Nrf2 antioxidant pathway.