Toll-Like Receptor 4 Polymorphism Is Associated With Coronary Stenosis But Not With The Occurrence Of Acute Or Old Myocardial Infarctions

Objective. Atherosclerosis is considered to be a chronic inflammatory disease. Toll-like receptor 4 (TLR-4), a key mediator in activating inflammatory cascade, has an A-to-G functional polymorphism that changes aspartic acid to glycine at position 299. TLR-4 is activated by, for example, lipopolysaccharides. The purpose of this study was to investigate the role of a common Asp299Gly polymorphism of the TLR-4 gene in atherosclerosis. Material and methods. The study comprised autopsy material from 657 men ( the Helsinki Sudden Death Study; mean age 53, range 33-70 years). Results. Fewer G-allele carriers had 3-vessel coronary artery disease compared with AA homozygotes ( OR 0.32; 95% CI, 0.12-0.88, p = 0.027), and they also had a lower mean value for maximal coronary stenosis (p = 0.019). TLR-4 polymorphism was not significantly associated with the occurrence of acute or old myocardial infarction (MI). Conclusions. The G allele of the TLR-4 gene, which is associated with a lower inflammation response, was associated with a lower risk of coronary stenosis but not with the occurrence of MI and hence is not a major factor in the development of coronary atherosclerosis.