NHLBI Orloff Award 2018: Nehal N. Mehta

NHLBI Orloff Award 2018: Nehal N. Mehta


I saw a 36-year-old with psoriasis and not the severe form. It was elbows and knees and we had a coronary scan done on him and he had heart artery plaque that looked like he was 60 years of age. And that’s when I said,
I gotta figure this out. My name is Nehal Mehta and I am the Head of
the Lab of Inflammation and Cardiometabolic Diseases at the National Heart,
Lung, and Blood Institute. Our observation is the
first in human discovery that treatment of remote
inflammation in the body can reduce the plaque
that is prone to rupture to cause heart attack. Classically, a heart attack is caused by one of five risk factors, diabetes, hypertension, high cholesterol, family history, or smoking, but now, we have evidence
that there’s a sixth factor, and that factor is inflammation and it is critical to
not only the development, but the progression of
atherosclerosis to heart attack. We started studying psoriasis which was associated with overactive immune cells in the skin, and what we found was that when we looked at the
skin cells in the body, they were the same cells
that we were finding in the heart arteries. And we started making a
connection between the first part of inflammation leading
to heart artery disease. So going in, we asked is
the immune system associated with heart artery plaque buildup? That was the first question,
and the second question is, if you treat the skin disease which is driving the
immune system overactive, can you reduce the heart artery disease? Our lab has discovered that
there is a disease state that leads to heart disease
and that’s psoriasis. Our discovery has been demonstrating that there is an accelerated
lipid-rich plaque, or a soft plaque in the heart, that ruptures and causes
myocardial infarction in inflammatory diseases. The second discovery was, when we treated their skin disease, their heart arteries
actually lost that age. So treating the skin disease actually reversed the immune response which in turn reversed
the heart artery disease. It’s astonishing. In the study that we have completed, we saw no effect on lipids, glucose, or cardiovascular risk factors. Their blood pressures didn’t change. This was purely anti-inflammatory, and I think that’s what’s important here, is that in the absence of
getting the risk factors better, we still got their heart arteries better, and the only thing that
changed was their inflammation. So I think that the
incremental value here is is we’re changing the natural history of that coronary plaque. That’s so cool. We’ve never been able to change the natural history of
that coronary plaque, but now we have real evidence that treating remote
inflammation in the body, actually can reduce heart artery disease. Inflammation thought of as a risk factor can be something we treat and target to potentially save the
lives of millions of people from developing heart
attack and heart disease.

Leave a Reply

Your email address will not be published. Required fields are marked *