Background: Chronic psychosocial and environmental stress (PSES) impairs endothelial function and accelerates cardiovascular disease (CVD); however, underlying signaling pathways are less understood. Studies have independently shown that chronic PSES increases catecholamine levels (e.g. epinephrine) and induces a low-grade chronic inflammation by cytokines (e.g. tumor necrosis factor α - TNFα). The potential impact of a combination of increased levels of epinephrine and TNFα on the endothelium has not been fully investigated. We sought to elucidate if epinephrine and TNFα synergistically impair endothelial function and which signaling pathways might underlie this phenomenon. Methods: Human aortic endothelial cells (HAoEC) were treated with 10μM epinephrine (E), 10ng/ml TNFα (T), or their combination (E+T). Endothelial monolayer integrity was measured in a transwell filter setup and visualized by immunofluorescence. Signaling pathway analysis was performed by western blotting and PCR. Various pathway inhibitors were deployed to identify key pathways for the observed effects. Results: The addition of epinephrine exacerbated the observed TNFα-induced loss of the adherens junction protein VE-cadherin accompanied with accelerated intercellular gap formation and loss of endothelial barrier integrity. Signaling pathway analysis revealed that E+T induced delayed and prolonged Stat3 activation lasting up to 24h of treatment, which could not be observed in the individual E or T treatments. Inhibition of the Stat3 pathway using Tofacetinib, an inhibitor of JAK/Stat signaling, prevented the E+T-induced activation of Stat3, loss in VE-cadherin, E+T-induced gap formation and loss in barrier integrity, indicating the crucial importance of JAK/Stat signaling in the E+T-induced effects on the endothelium. Conclusion: These data indicate long-term PSES-induced CVD might in part be mediated by a combined effect of epinephrine and TNFα that can induce endothelial dysfunction dependent on a JAK/Stat3 pathway. Understanding pathways involved in PSES-related CVD is crucial to elucidate the biology of adversity in CVD health disparities, or mechanisms by which populations most impacted by PSES are disproportionately susceptible to CVD.
Read full abstract