Exploring the Impact of NRF2 Signaling on Atherosclerosis: Insights Into Hydrogen Sulfide, NLRP3 Inflammasome, microRNAs, and HO-1.

Atherosclerosis (AS) is a chronic cardiovascular disorder characterized by lipid accumulation and the formation of atherosclerotic plaques on the arterial walls, leading to arterial stenosis and serving as a principal pathological feature. This condition significantly contributes to elevated mortality and disability rates globally. The NRF2 pathway plays a pivotal role in the pathogenesis of AS. It governs a variety of physiological and pathophysiological processes including lipid homeostasis, foam cell formation, macrophage polarization, redox balance and inflammation, which are integral to the progression of the disease. This review highlights the influence of NRF2 on AS by discussing its upstream regulator hydrogen sulfide (H₂S) and key downstream effectors such as the NLRP3 inflammasome, microRNAs, and heme oxygenase-1.