β-Hydroxybutyrate Attenuates Cigarette Smoke-Induced Aortic Injury and Improves Endothelial Function in Wistar Rats

Background: Cigarette smoking is a major risk factor for cardiovascular disease. Oxidative stress plays a central role in endothelial dysfunction and atherosclerosis. β-hydroxybutyrate (β-OHB), a ketone body, has been proposed to exert antioxidant and vascular protective effects. This study aimed to evaluate the effects of β-OHB on aortic histopathology and von Willebrand Factor (vWF) levels in Wistar rats exposed to cigarette smoke. Methods: This experimental randomized controlled animal study included 25 male Wistar rats divided into five groups: negative control (K−), positive control (K+; cigarette smoke exposure), and three treatment groups receiving β-hydroxybutyrate-(R)-1,3-butanediol monoester (DeltaG®, TDeltaS Global Inc., Orlando, FL, USA) at doses of 1.5 g/kg/day (P1), 3 g/kg/day (P2), and 6 g/kg/ day (P3). Rats were exposed to 40 cigarettes/day for 28 days. Aortic tissues were collected after euthanasia on day 28 for histopathological analysis and vWF measurement using ELISA. Data were analyzed using ANOVA with Fisher’s LSD post-hoc test. Results: β-OHB significantly reduced aortic histopathological alterations compared to the smoke-exposed control group (degeneration p