title: Stress-induced release of matrix metalloproteinase-9 in patients with coronary artery disease: The possible influence of cortisol.
abstract: Stress and inflammation are both important risk factors for coronary artery disease (CAD). However, the susceptibility to stress-induced inflammation and its determinants have been little explored in patients with CAD. Here, our aim was to study the stress-induced inflammatory response, more precisely the early release of matrix metalloproteinase (MMP)-9, and its association with cortisol response in patients with CAD. Sixty-four patients underwent a standardized laboratory stress test. The stress-induced release of MMP-9 was closely associated with the release of other neutrophil-associated proteins, MMP-8 and myeloperoxidase (MPO). It also showed a large variation among patients, as did cortisol. Twenty minutes after stress, a negative association between changes in MMP-9 and cortisol was seen (p<0.01). In vitro, dexamethasone reduced the IL-8-mediated release of MMP-9 from neutrophils, indicating that glucocorticoids may exert rapid effects on neutrophil activation. Further characterization of patients revealed that stress-induced release of MMP-9 was related to leukocyte telomere shortening and increased ultrasound-assessed plaque occurrence in the carotid arteries, but not to other characteristics such as age, gender or psychological background factors. The susceptibility to stress-induced release of MMP-9 may thus have impact on disease phenotype. Stress tests can be useful to identify CAD patients in need of novel prevention and treatment strategies.
authors: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Anna K
authors: AK
authors: Lundberg
authors: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Simon
authors: S
authors: Jönsson
authors: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Jonathan
authors: J
authors: Stenmark
authors: Division of Community Medicine, Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Sweden.
authors: Margareta
authors: M
authors: Kristenson
authors: Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Electronic address: lena.jonasson@liu.se.
authors: Lena
authors: L
authors: Jonasson
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007249:Inflammation / Q000209:etiology / Q000378:metabolism*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism*
chemical_list: C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9; D006854:Hydrocortisone
keywords: Coronary artery disease; Cortisol; Inflammation; Matrix metalloproteinase; Neutrophil; Stress