Deficiency of B vitamins leads to cholesterol-independent atherogenic transformation of the aorta

Gunter Almer, Peter Opriessnig, Heimo Wolinski, Gerhard Sommer, Clemens Diwoky, Margarete Lechleitner, Dagmar Kolb, Vladimir Bubalo, Markus S. Brunner, Andreas N. Schwarz, Gerd Leitinger, Gabriele Schoiswohl, Gunther Marsche, Tobias Niedrist, Silvia Schauer, Wolfgang Oswald, Andrea Groselj-Strele, Margret Paar, Gerhard Cvirn, Gerald HoeflerGerald N. Rechberger, Markus Herrmann, Saša Frank, Gerhard A. Holzapfel, Dagmar Kratky, Harald Mangge, Gerd Hörl*, Oksana Tehlivets

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Atherosclerosis, the leading cause of cardiovascular disease responsible for the majority of deaths worldwide, cannot be sufficiently explained by established risk factors, including hypercholesterolemia. Elevated plasma homocysteine is an independent risk factor for atherosclerosis and is strongly linked to cardiovascular mortality. However, the role of homocysteine in atherosclerosis is still insufficiently understood. Previous research in this area has been also hampered by the lack of reproducible in vivo models of atherosclerosis that resemble the human situation. Here, we have developed and applied an automated system for vessel wall injury that leads to more homogenous damage and more pronounced atherosclerotic plaque development, even at low balloon pressure. Our automated system helped to glean vital details of cholesterol-independent changes in the aortic wall of balloon-injured rabbits. We show that deficiency of B vitamins, which are required for homocysteine degradation, leads to atherogenic transformation of the aorta resulting in accumulation of macrophages and lipids, impairment of its biomechanical properties and disorganization of aortic collagen/elastin in the absence of hypercholesterolemia. A combination of B vitamin deficiency and hypercholesterolemia leads to thickening of the aorta, decreased aortic water diffusion, increased LDL-cholesterol and impaired vascular reactivity compared to any single condition. Our findings suggest that deficiency of B vitamins leads to atherogenic transformation of the aorta even in the absence of hypercholesterolemia and aggravates atherosclerosis development in its presence.

Original languageEnglish
Article number113640
JournalBiomedicine and Pharmacotherapy
Publication statusPublished - Oct 2022


  • Atherosclerosis
  • B vitamins
  • Balloon injury
  • Homocysteine
  • Rabbits

ASJC Scopus subject areas

  • Pharmacology


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