α-Defensin: Link between inflammation and atherosclerosis

Background: Several markers of inflammation predict the risk of thrombotic cardiovascular events in patients with atherosclerosis. However, the mechanism by which vascular inflammation promotes atherothrombotic disease is incompletely understood. Human neutrophil peptides 1-3, also known as α-defensins, are found in human atherosclerotic arteries, inhibit LDL metabolism and fibrinolysis and promote Lp(a) binding. We asked, therefore, if α-defensins are risk factors for the presence and severity of atherosclerosis. Methods: α-Defensin was measured in skin biopsies taken from 53 male patients (age 58.7 ± 11.3 years, mean ± S.D.) immediately prior to coronary artery catheterization. Other established risk factors were measured concurrently. The correlation between α-defensin deposition in the skin and the severity of the coronary artery disease (CAD) was examined. Results: A statistically significant correlation was observed between the amount of α-defensin in skin and the severity of CAD (R = 0.40, p = 0.003). Multiple regression analysis showed that skin α-defensin is an independent predictor for CAD severity (F = 4.68, p = 0.035). Logistic regression analysis confirmed that skin α-defensin independently predicted the likelihood for CAD (p = 0.016, odds estimate 5.97, 95% CL 1.4-24.2). Conclusions: The deposition of α-defensin in the skin is a strong independent predictor of CAD in men. These results suggest a link between neutrophil activation and progression of atherosclerosis and provide a novel approach to assessment of risk factors for CAD.