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Fig. 7 Schematic representation of the link between stiffness and SPTBN1 expression, and its effects in endothelial cells. SPTBN1 levels are reduced upon higher local tissue stiffness. Lower levels of SPTBN1 in turn lead to (1) reduced cell adhesion, spreading, and migration, which may lead to less developed plaque microvessels, and (2) altered endothelial junctions, more stress fibers, and more focal adhesions, which in turn enhance leukocyte transmigration and local vascular permeability. Together, this will lead to an increased local inflammatory response, as well as a higher occurrence of vascular leakage and intraplaque hemorrhage