Acute mental stress drives vascular inflammation and promotes plaque destabilization in mouse atherosclerosis

Julia Hinterdobler, Simin S. Schott, Hong Jin, Almut Meesmann, Anna Lena Steinsiek, Anna Sophia Zimmermann, Jana Wobst, Philipp Müller, Carina Mauersberger, Baiba Vilne, Alexandra Baecklund, Chien Sin Chen, Aldo Moggio, Quinte Braster, Michael Molitor, Markus Krane, Wolfgang E. Kempf, Karl Heinz Ladwig, Michael Hristov, Maarten HulsmansIngo Hilgendorf, Christian Weber, Philip Wenzel, Christoph Scheiermann, Lars Maegdefessel, Oliver Soehnlein, Peter Libby, Matthias Nahrendorf, Heribert Schunkert, Thorsten Kessler, Hendrik B. Sager (Coresponding Author)

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)
7 Downloads (Pure)


Aims: Mental stress substantially contributes to the initiation and progression of human disease, including cardiovascular conditions. We aim to investigate the underlying mechanisms of these contributions since they remain largely unclear. Methods and results: Here, we show in humans and mice that leucocytes deplete rapidly from the blood after a single episode of acute mental stress. Using cell-tracking experiments in animal models of acute mental stress, we found that stress exposure leads to prompt uptake of inflammatory leucocytes from the blood to distinct tissues including heart, lung, skin, and, if present, atherosclerotic plaques. Mechanistically, we found that acute stress enhances leucocyte influx into mouse atherosclerotic plaques by modulating endothelial cells. Specifically, acute stress increases adhesion molecule expression and chemokine release through locally derived norepinephrine. Either chemical or surgical disruption of norepinephrine signalling diminished stress-induced leucocyte migration into mouse atherosclerotic plaques. Conclusion: Our data show that acute mental stress rapidly amplifies inflammatory leucocyte expansion inside mouse atherosclerotic lesions and promotes plaque vulnerability.

Original languageEnglish
Pages (from-to)4077-4088
Number of pages12
JournalEuropean Heart Journal
Issue number39
Publication statusPublished - 14 Oct 2021


  • Acute mental stress
  • Atherosclerosis
  • Leucocyte recruitment
  • Neuroimmune interaction
  • Sympathetic nervous system
  • Vascular inflammation

Field of Science*

  • 3.2 Clinical medicine
  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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