TitleIncreased LL37 in psoriasis and other inflammatory disorders promotes LDL uptake and atherosclerosis.
Publication TypeJournal Article
Year of Publication2024
AuthorsNakamura Y, Kulkarni NN, Takahashi T, Alimohamadi H, Dokoshi T, Liu E, Shia M, Numata T, Luo EWc, Gombart AF, Yang X, Secrest P, Gordts PLsm, Tsimikas S, Wong GCl, Gallo RL
JournalJ Clin Invest
Date Published2024 Mar 01
KeywordsAnimals, Atherosclerosis, Cardiovascular Diseases, Cholesterol, Humans, Mice, Mice, Knockout, ApoE, Psoriasis, Rabbits

Patients with chronic inflammatory disorders such as psoriasis have an increased risk of cardiovascular disease and elevated levels of LL37, a cathelicidin host defense peptide that has both antimicrobial and proinflammatory properties. To explore whether LL37 could contribute to the risk of heart disease, we examined its effects on lipoprotein metabolism and show that LL37 enhanced LDL uptake in macrophages through the LDL receptor (LDLR), scavenger receptor class B member 1 (SR-B1), and CD36. This interaction led to increased cytosolic cholesterol in macrophages and changes in expression of lipid metabolism genes consistent with increased cholesterol uptake. Structure-function analysis and synchrotron small-angle x-ray scattering showed structural determinants of the LL37-LDL complex that underlie its ability to bind its receptors and promote uptake. This function of LDL uptake is unique to cathelicidins from humans and some primates and was not observed with cathelicidins from mice or rabbits. Notably, Apoe-/- mice expressing LL37 developed larger atheroma plaques than did control mice, and a positive correlation between plasma LL37 and oxidized phospholipid on apolipoprotein B (OxPL-apoB) levels was observed in individuals with cardiovascular disease. These findings provide evidence that LDL uptake can be increased via interaction with LL37 and may explain the increased risk of cardiovascular disease associated with chronic inflammatory disorders.

Alternate JournalJ Clin Invest
PubMed ID38194294
PubMed Central IDPMC10904043
Grant ListR37 AI052453 / AI / NIAID NIH HHS / United States
R01 AR076082 / AR / NIAMS NIH HHS / United States
R01 DK126848 / DK / NIDDK NIH HHS / United States
R01 HL159156 / HL / NHLBI NIH HHS / United States
R01 AI153185 / AI / NIAID NIH HHS / United States
T32 HL069766 / HL / NHLBI NIH HHS / United States
P50 AR080594 / AR / NIAMS NIH HHS / United States