Opposing effects of HNP1 (α-defensin-1) on plasma cholesterol and atherogenesis

PLoS One. 2020 Apr 17;15(4):e0231582. doi: 10.1371/journal.pone.0231582. eCollection 2020.


Atherosclerosis, the predominant cause of death in well-resourced countries, may develop in the presence of plasma lipid levels within the normal range. Inflammation may contribute to lesion development in these individuals, but the underlying mechanisms are not well understood. Transgenic mice expressing α-def-1 released from activated neutrophils develop larger lipid and macrophage-rich lesions in the proximal aortae notwithstanding hypocholesterolemia caused by accelerated clearance of α-def-1/low-density lipoprotein (LDL) complexes from the plasma. The phenotype does not develop when the release of α-def-1 is prevented with colchicine. However, ApoE-/- mice crossed with α-def-1 mice or given exogenous α-def-1 develop smaller aortic lesions associated with reduced plasma cholesterol, suggesting a protective effect of accelerated LDL clearance. Experiments were performed to address this seeming paradox and to determine if α-def-1 might provide a means to lower cholesterol and thereby attenuate atherogenesis. We confirmed that exposing ApoE-/- mice to α-def-1 lowers total plasma cholesterol and decreases lesion size. However, lesion size was larger than in mice with total plasma cholesterol lowered to the same extent by inhibiting its adsorption or by ingesting a low-fat diet. Furthermore, α-def-1 levels correlated independently with lesion size in ApoE-/- mice. These studies show that α-def-1 has competing effects on atherogenesis. Although α-def-1 accelerates LDL clearance from plasma, it also stimulates deposition and retention of LDL in the vasculature, which may contribute to development of atherosclerosis in individuals with normal or even low plasma levels of cholesterol. Inhibiting α-def-1 may attenuate the impact of chronic inflammation on atherosclerotic vascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anticholesteremic Agents / administration & dosage
  • Aorta / pathology*
  • Atherosclerosis / blood
  • Atherosclerosis / etiology
  • Atherosclerosis / metabolism
  • Atherosclerosis / pathology*
  • Cholesterol / blood*
  • Cholesterol / metabolism
  • Cholestyramine Resin / administration & dosage
  • Colchicine / administration & dosage
  • Diet, High-Fat / adverse effects
  • Disease Models, Animal
  • Female
  • Humans
  • Lipid Metabolism / drug effects
  • Lipoproteins, LDL / blood
  • Lipoproteins, LDL / metabolism
  • Mice
  • Mice, Knockout, ApoE
  • Mice, Transgenic
  • Neutrophils / drug effects
  • Neutrophils / metabolism
  • alpha-Defensins / genetics
  • alpha-Defensins / metabolism*


  • Anticholesteremic Agents
  • Lipoproteins, LDL
  • alpha-Defensins
  • human neutrophil peptide 1
  • Cholestyramine Resin
  • Cholesterol
  • Colchicine

Grant support

This work was supported by HL123912 (AAH), HL139448 (DBC) and a grant from the Israeli Science Foundation (AAH).