Raloxifene is a better antioxidant of low-density lipoprotein than estradiol or tamoxifen in postmenopausal women in vitro

Objective: The oxidation of low-density lipoprotein (LDL) is an important factor in the development of atherosclerosis. The antioxidant activity of some compounds buffers the free radicals generated either endogenously or exogenously, thus decreasing the potential damage mediated by oxidation. Estrogens are potent antioxidants of LDL, in vitro and in vivo, a mechanism that could probably influence the cardioprotection associated with hormone replacement therapy in postmenopause. We conducted an in vitro study of the antioxidant effect on LDL of two selective estrogen receptor modulators, raloxifene (RLX) and tamoxifen (TMX), comparing them with the known antioxidant effect of estradiol (E-2). Design: LDL was isolated by ultracentrifugation from plasma obtained from 12 healthy, untreated, postmenopausal women. Aliquots containing 0.5 mg of LDL protein were incubated for 4 h with CuSO4 (15 muM) to induce oxidative stress and with one of the three compounds studied: RLX, TMX, or E-2 at doses of 0, 1, 2, 3, 5, 15, 50, and 500 muM, and I and 2 mM. Malonaldehyde (MDA, nmol/mg protein) was measured as a marker of LDL oxidation. Results: E-2 induced a dose-dependent decrease in MDA concentration. MDA values decreased significantly, as compared with baseline, starting at a concentration of 2 muM for RLX and 3 muM for both, TMX, or E-2. The dose necessary to reduce the generation of MDA by 50% was significantly lower for RLX (3.3 muM, P < 0.001) than for E-2 (24.6 muM) or TMX (35.3 muM). The area under the curve also showed a higher antioxidant activity for RLX compared with TMX or E-2 (P < 0.001). Conclusions: The in vitro antioxidant activity of RLX is substantially more potent than TMX or E-2. This finding, added to the other beneficial effects of the drug in the cardiovascular system, could imply some cardioprotector effect.