Demer and Yin Tintut. Vascular Calcification: Pathobiology of a Multifaceted Disease

Division of Cardiology, University of California at Los Angeles, School of Medicine, Los Angeles, CA 90095-1679, USA.
Circulation (Impact Factor: 14.43). 06/2008; 117(22):2938-48. DOI: 10.1161/CIRCULATIONAHA.107.743161
Source: PubMed


Clinically, vascular calcification is now accepted as a valuable predictor of coronary heart disease. Achieving control over this process requires understanding mechanisms in the context of a tightly controlled regulatory network, with multiple, nested feedback loops and cross talk between organ systems, in the realm of control theory. Thus, treatments for osteoporosis such as calcitriol, estradiol, bisphosphonates, calcium supplements, and intermittent PTH are likely to affect vascular calcification, and, conversely, many treatments for cardiovascular disease such as statins, antioxidants, hormone replacement therapy, angiotensin-converting enzyme inhibitors, fish oils, and calcium channel blockers may affect bone health. As we develop and use treatments for cardiovascular and skeletal diseases, we must give serious consideration to the implications for the organ at the other end of the bone-vascular axis.

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    • "Among those, BMP-7, osteoprotegerin , osteopontin, and inorganic pyrophosphate, an inhibitor of hydroxyapatite crystal growth, probably counteract detrimental vascular and soft-tissue calcification in CKD [27] [28] [29], while BMP-2, RANKL, and leptin have been found to promote arterial calcification [30] [31] [32]. Second, the death or " damage " of VSMCs can provide phospholipid-rich membranous debris and apoptotic bodies that may serve as initiation sites for apatite crystallisation [33], particularly in diseases where necrosis and apoptosis are prevalent, such as atherosclerosis [34] [35]. Third, we and others have provided evidence that AC is a process reflecting the transformation of the VSMCs from contractile to secretory phenotype [11, 36– 38]. "
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    ABSTRACT: Arterial calcification is highly prevalent and correlated with cardiovascular mortality, especially in patients with ESRD or diabetes. The pathogenesis of arterial calcification is multifactorial, with both genetic and environmental factors being implicated. In recent years, several mechanisms contributing to arterial calcification have been proposed. However, these can only explain a small proportion of the variability in arterial calcification, which is a major obstacle for its prevention and management. Epigenetics has emerged as one of the most promising areas that may fill in some of the gaps in our current knowledge of the interaction between the environmental insults with gene regulation in the development of diseases. Epigenetics refers to heritable and acquired changes in gene transcription that occur independently of the DNA sequence. Well-known components of epigenetic regulation include DNA methylation, histone modifications, and microRNAs. Epigenetics research in the regulation of arterial calcification has only recently been elucidated. In this review, we will summarise recent progress in epigenetic pathways involved in arterial calcification and discuss potential therapeutic interventions based on epigenetic mechanisms.
    07/2015; 2015(1):320849. DOI:10.1155/2015/320849
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    • "Medial artery calcification is now recognized as a highly regulated process which is similar in many ways to bone mineralization. Osteoblast-like phenotypes transformation of vascular smooth muscular cells (VSMCs), the predominant cells in the tunica media of arteries, is currently considered responsible for the formation of medial artery calcification [4] [5] [6]. However, the specific mechanism governing this process is still elusive. "
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    ABSTRACT: We previously reported that Runx2/miR-3960/miR-2861 regulatory feedback loop stimulates osteoblast differentiation. However, the effect of this feedback loop on the osteogenic transdifferentiation of vascular smooth muscle cells (VSMCs) remains unclear. Our recent study showed that miR-2861 and miR-3960 expression increases significantly during β -glycerophosphate-induced osteogenic transdifferentiation of VSMCs. Overexpression of miR-2861 or miR-3960 in VSMCs enhances β -glycerophosphate-induced osteoblastogenesis, whereas inhibition of miR-2861 or miR-3960 expression attenuates it. MiR-2861 or miR-3960 promotes osteogenic transdifferentiation of VSMCs by targeting histone deacetylase 5 or Homeobox A2, respectively, resulting in increased runt-related transcription factor 2 (Runx2) protein production. Furthermore, overexpression of Runx2 induces miR-2861 and miR-3960 transcription, and knockdown of Runx2 attenuates β -glycerophosphate-induced miR-2861 and miR-3960 transcription in VSMCs. Thus, our data show that Runx2/miR-3960/miR-2861 positive feedback loop plays an important role in osteogenic transdifferentiation of VSMCs and contributes to vascular calcification.
    07/2015; 2015(37):624037. DOI:10.1155/2015/624037
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    • "Traditionally, cardiovascular calcification has been considered to be passive phenomenon associated with aging. However, it is currently viewed as an actively regulated disease process, and increasing evidence suggests that the underlying mechanisms of cardiovascular calcification are similar to embryonic bone formation (Demer and Tintut 2008; Otto 2008; Towler and Demer 2011). AVC is considered as similar to osteogenesis. "
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    ABSTRACT: Aortic valve calcification (AVC), which used to be recognized as a passive and irreversible process, is now widely accepted as an active and regulated process characterized by osteoblastic differentiation of aortic valve interstitial cells (AVICs). Apelin, the endogenous ligand for G-protein-coupled receptor APJ, was found to have protective cardiovascular effects in several studies. However, the effects and mechanisms of apelin on osteoblastic differentiation of AVICs have not been elucidated. Using a pro-calcific medium, we devised a method to produce calcific human AVICs. These cells were used to study the relationship between apelin and the osteoblastic calcification of AVICs and the involved signaling pathways. Alkaline phosphatase (ALP) activity/expression and runt-related transcription factor 2 (Runx2) expression were examined as hallmark proteins in this research. The involved signaling pathways were studied using the extracellular signal-regulated kinase (ERK) inhibitor, PD98059, and the phosphatidylinositol 3-kinase (PI3-K) inhibitor, LY294002. The results indicate that apelin attenuates the expression and activity of ALP, the expression of Runx2, and the formation of mineralized nodules. This protective effect was dependent on the dose of apelin, reaching the maximum at 100 pM, and was connected to activity of ERK and Akt (a downstream effector of PI3-K). The activation of ERK and PI3-K initiated the effects of apelin on ALP activity/expression and Runx2, but PD98059 and LY294002 abolished the effect. These results demonstrate that apelin attenuates the osteoblastic differentiation of AVICs via the ERK and PI3-K/Akt pathway.
    Amino Acids 07/2015; DOI:10.1007/s00726-015-2020-3 · 3.29 Impact Factor
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