The aetiological role of maternal vitamin-B6 deficiency in the development of atherosclerosis.

Lysyl oxidase is the copper-dependent enzyme responsible for the normal cross-linking of both collagen and elastin which is necessary for their functional integrity. There is now strong evidence that this enzyme is vitamin-B6-dependent. The earliest visible lesion of atherosclerosis, commonly found in human neonatal coronary arteries and probably indicative of the location of future atherosclerotic plaques, is a focal splitting of the internal elastic lamina, the cause of which has hitherto remained unexplained. It is suggested that this lesion is the result of imperfect cross-linking of arterial elastin as well as collagen, and is caused by a maternal deficiency of vitamin B6 which is commonly found in pregnancy and which could thus impair the function of lysyl oxidase. Prophylactic supplementation of maternal diet with adequate vitamin B6 is therefore suggested.