Exploration of Cardiology

Table 1. Key molecular mechanisms of endothelial dysfunction in aging.

Mechanism	Molecular features	Functional consequence	References
Reduced NO bioavailability	↓ eNOS activity, ↑ ADMA, tetrahydrobiopterin deficiency	Impaired vasodilation, pro-thrombotic state	[6, 13–15]
Oxidative stress	↑ NADPH oxidase, mitochondrial ROS, eNOS uncoupling	NO degradation, peroxynitrite formation	[15–17, 31–33]
Inflammation	NF-κB activation, ↑ IL-6, ↑ TNF-α, adhesion molecules	Endothelial activation, leukocyte adhesion	[18, 33, 46]
Senescence	p53/p21, p16/Rb, SASP secretion	Irreversible growth arrest, pro-inflammatory milieu	[17, 18, 29, 30, 40]

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ADMA: asymmetric dimethylarginine; eNOS: endothelial nitric oxide synthase; IL-6: interleukin-6; NF-κB: nuclear factor kappa-light-chain-enhancer of activated B cells; NO: nitric oxide; ROS: reactive oxygen species; SASP: senescence-associated secretory phenotype; TNF-α: tumor necrosis factor-alpha.

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Acknowledgments

During the preparation of this work, the authors used ChatGPT (OpenAI) to assist with composing and refining the figures. After using the tool, authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Author contributions

MCÇ: Conceptualization, Investigation, Writing—original draft. MK: Conceptualization, Writing—review & editing. AB: Conceptualization, Investigation, Writing—original draft. MY: Writing—review & editing. LB: Supervision, Validation. YK: Supervision, Validation. All of the authors contributed to planning, conducting, and reporting of the work. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

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