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Klotho suppresses high phosphate-induced osteogenic responses in human aortic valve interstitial cells through inhibition of Sox9. J Mol Med (Berl) 2017; 95:739-751. [PMID: 28332126 DOI: 10.1007/s00109-017-1527-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 02/27/2017] [Accepted: 03/08/2017] [Indexed: 12/19/2022]
Abstract
Elevated level of blood phosphate (Pi) associated with chronic kidney disease (CKD) is a risk factor of aortic valve calcification. Aortic valve interstitial cells (AVICs) display osteogenic responses to high Pi although the underlying mechanism is incompletely understood. Sox9 is a pro-chondrogenic factor and may play a role in ectopic tissue calcification. Circulating and kidney levels of Klotho are reduced in patients with CKD. We hypothesized that Sox9 mediates high Pi-induced osteogenic responses in human AVICs and that Klotho inhibits the responses. Treatment of human AVICs with high Pi increased protein levels of Runt-related transcription factor 2 (Runx2) and alkaline phosphatase (ALP), and a prolonged exposure to high Pi caused calcium deposition. High Pi induced Sox9 upregulation through PKD and Akt activation. Knockdown of Sox9 essentially abolished the effect of high Pi on the osteogenic responses. Lower Klotho levels were observed in calcified aortic valve tissues. Interestingly, high Pi decreased Klotho levels in AVICs from normal valves, and treatment with recombinant Klotho markedly reduced the effect of high Pi on the levels of Sox9, Runx2, and ALP and suppressed calcium deposition. We conclude that high Pi induces human AVIC osteogenic responses through Sox9. Human AVICs express Klotho, and its levels in AVICs are modulated by high Pi and valvular calcification. Importantly, Klotho suppresses the pro-osteogenic effect of high Pi on human AVICs. These novel findings indicate that modulation of Klotho may have therapeutic potential for mitigation of valvular calcification associated with CKD. KEY MESSAGES CAVD associated with chronic kidney disease is a significant clinical problem. High phosphate upregulates Sox9 through AKT and PKD in human AVICs. Calcified human aortic valves have lower levels of Klotho. Klotho suppresses Sox9 upregulation and intranuclear translocation. Klotho inhibits high phosphate-induced osteogenic activity in human AVICs.
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102
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Shen W, Zhou J, Wang C, Xu G, Wu Y, Hu Z. High mobility group box 1 induces calcification of aortic valve interstitial cells via toll-like receptor 4. Mol Med Rep 2017; 15:2530-2536. [PMID: 28260034 PMCID: PMC5428883 DOI: 10.3892/mmr.2017.6287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 11/15/2016] [Indexed: 01/10/2023] Open
Abstract
Chronic inflammation and the calcification of aortic valve interstitial cells (AVICs) are the primary etiologies of calcific aortic valve disease (CAVD). However, the underlying mechanism remains to be elucidated. The present study investigated the importance of high mobility group box 1 (HMGB1) via toll-like receptor 4 (TLR4) for the regulation of inflammation and calcification in AVICs. It was determined that the expression levels of HMGB1 and TLR4 were increased in the calcific region of aortic valves with CAVD. In cultured primary AVICs from wild-type mice, HMGB1 treatment demonstrated a dose-dependent increase in mineralization levels and osteogenic gene expression. These effects were significantly reduced in AVICs obtained from TLR4 knockout mice (TLR4−/−). In addition, calcification was inhibited by TLR4-specific antibodies in primary AVICs. HMGB1 induced the activation of p38 and nuclear factor-κB (NF-κB) in TLR4−/− primary AVICs, and inhibited p38 and NF-κB in wild-type AVICs treated with TLR4-specific antibodies. The present study demonstrated that TLR4 may function as an essential mediator of HMGB1-induced calcification and in the activation of p38 and NF-κB.
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Affiliation(s)
- Wenjun Shen
- Ningbo Medical Treatment Center, Lihuili Hospital, Ningbo, Zhejiang 310041, P.R. China
| | - Jianqing Zhou
- Ningbo Medical Treatment Center, Lihuili Hospital, Ningbo, Zhejiang 310041, P.R. China
| | - Chaoyang Wang
- Ningbo Medical Treatment Center, Lihuili Hospital, Ningbo, Zhejiang 310041, P.R. China
| | - Guangze Xu
- Ningbo Medical Treatment Center, Lihuili Hospital, Ningbo, Zhejiang 310041, P.R. China
| | - Ying Wu
- Ningbo Medical Treatment Center, Lihuili Hospital, Ningbo, Zhejiang 310041, P.R. China
| | - Zhaohui Hu
- Department of Cardiovascular Disease, The Affiliated Tongji Hospital, Tongji University, Shanghai 210062, P.R. China
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Zukowska P, Kutryb-Zajac B, Jasztal A, Toczek M, Zabielska M, Borkowski T, Khalpey Z, Smolenski RT, Slominska EM. Deletion of CD73 in mice leads to aortic valve dysfunction. Biochim Biophys Acta Mol Basis Dis 2017; 1863:1464-1472. [PMID: 28192180 DOI: 10.1016/j.bbadis.2017.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 01/11/2023]
Abstract
Aortic stenosis is known to involve inflammation and thrombosis. Changes in activity of extracellular enzyme - ecto-5'-nucleotidase (referred also as CD73) can alter inflammatory and thrombotic responses. This study aimed to evaluate the effect of CD73 deletion in mice on development of aortic valve dysfunction and to compare it to the effect of high-fat diet. Four groups of mice (normal-diet Wild Type (WT), high-fat diet WT, normal diet CD73-/-, high-fat diet CD73-/-) were maintained for 15weeks followed by echocardiographic analysis of aortic valve function, measurement of aortic surface activities of nucleotide catabolism enzymes as well as alkaline phosphatase activity, mineral composition and histology of aortic valve leaflets. CD73-/- knock out led to an increase in peak aortic flow (1.06±0.26m/s) compared to WT (0.79±0.26m/s) indicating obstruction. Highest values of peak aortic flow (1.26±0.31m/s) were observed in high-fat diet CD73-/- mice. Histological analysis showed morphological changes in CD73-/- including thickening and accumulation of dark deposits, proved to be melanin. Concentrations of Ca2+, Mg2+ and PO43- in valve leaflets were elevated in CD73-/- mice. Alkaline phosphatase (ALP) activity was enhanced after ATP treatment and reduced after adenosine treatment in aortas incubated in osteogenic medium. AMP hydrolysis in CD73-/- was below 10% of WT. Activity of ecto-adenosine deaminase (eADA), responsible for adenosine deamination, in the CD73-/- was 40% lower when compared to WT. Deletion of CD73 in mice leads to aortic valve dysfunction similar to that induced by high-fat diet suggesting important role of this surface protein in maintaining heart valve integrity.
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Affiliation(s)
- P Zukowska
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - B Kutryb-Zajac
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - A Jasztal
- Jagiellonian Center for Experimental Therapeutics, Jagiellonian University, Krakow, Poland
| | - M Toczek
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - M Zabielska
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - T Borkowski
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - Z Khalpey
- Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona, College of Medicine, Tuscon, United States
| | - R T Smolenski
- Department of Biochemistry, Medical University of Gdansk, Poland
| | - E M Slominska
- Department of Biochemistry, Medical University of Gdansk, Poland.
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104
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Sádaba JR, Martínez-Martínez E, Arrieta V, Álvarez V, Fernández-Celis A, Ibarrola J, Melero A, Rossignol P, Cachofeiro V, López-Andrés N. Role for Galectin-3 in Calcific Aortic Valve Stenosis. J Am Heart Assoc 2016; 5:JAHA.116.004360. [PMID: 27815266 PMCID: PMC5210369 DOI: 10.1161/jaha.116.004360] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Aortic stenosis (AS) is a chronic inflammatory disease, and calcification plays an important role in the progression of the disease. Galectin‐3 (Gal‐3) is a proinflammatory molecule involved in vascular osteogenesis in atherosclerosis. Therefore, we hypothesized that Gal‐3 could mediate valve calcification in AS. Methods and Results Blood samples and aortic valves (AVs) from 77 patients undergoing AV replacement were analyzed. As controls, noncalcified human AVs were obtained at autopsy (n=11). Gal‐3 was spontaneously expressed in valvular interstitial cells (VICs) from AVs and increased in AS as compared to control AVs. Positive correlations were found between circulating and valvular Gal‐3 levels. Valvular Gal‐3 colocalized with the VICs markers, alpha‐smooth muscle actin and vimentin, and with the osteogenic markers, osteopontin, bone morphogenetic protein 2, runt‐related transcription factor 2, and SRY (sex‐determining region Y)‐box 9. Gal‐3 also colocalized with the inflammatory markers cd68, cd80 and tumor necrosis factor alpha. In vitro, in VICs isolated from AVs, Gal‐3 induced expression of inflammatory, fibrotic, and osteogenic markers through the extracellular signal‐regulated kinase 1 and 2 pathway. Gal‐3 expression was blocked in VICs undergoing osteoblastic differentiation using its pharmacological inhibitor, modified citrus pectin, or the clustered regularly interspaced short palindromic repeats/Cas9 knockout system. Gal‐3 blockade and knockdown decreased the expression of inflammatory, fibrotic, and osteogenic markers in differentiated VICs. Conclusions Gal‐3, which is overexpressed in AVs from AS patients, appears to play a central role in calcification in AS. Gal‐3 could be a new therapeutic approach to delay the progression of AV calcification in AS.
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Affiliation(s)
- J Rafael Sádaba
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ernesto Martínez-Martínez
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Vanessa Arrieta
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Virginia Álvarez
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Amaya Fernández-Celis
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Jaime Ibarrola
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Amaia Melero
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116, CHRU de Nancy, Université de Lorraine French-Clinical Research Infrastructure Network (F-CRIN) INI-CRCT, Nancy, France
| | - Victoria Cachofeiro
- Department of Physiology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain
| | - Natalia López-Andrés
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain .,INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116, CHRU de Nancy, Université de Lorraine French-Clinical Research Infrastructure Network (F-CRIN) INI-CRCT, Nancy, France
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105
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Liu X, Xu Z. Osteogenesis in calcified aortic valve disease: From histopathological observation towards molecular understanding. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2016; 122:156-161. [DOI: 10.1016/j.pbiomolbio.2016.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/23/2016] [Accepted: 02/25/2016] [Indexed: 12/14/2022]
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106
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Kennamer A, Sierad L, Pascal R, Rierson N, Albers C, Harpa M, Cotoi O, Harceaga L, Olah P, Terezia P, Simionescu A, Simionescu D. Bioreactor Conditioning of Valve Scaffolds Seeded Internally with Adult Stem Cells. Tissue Eng Regen Med 2016; 13:507-515. [PMID: 30337944 DOI: 10.1007/s13770-016-9114-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The goal of this study was to test the hypothesis that stem cells, as a response to valve-specific extracellular matrix "niches" and mechanical stimuli, would differentiate into valvular interstitial cells (VICs). Porcine aortic root scaffolds were prepared by decellularization. After verifying that roots exhibited adequate hemodynamics in vitro, we seeded human adipose-derived stem cells (hADSCs) within the interstitium of the cusps and subjected the valves to in vitro pulsatile bioreactor testing in pulmonary pressures and flow conditions. As controls we incubated cell-seeded valves in a rotator device which allowed fluid to flow through the valves ensuring gas and nutrient exchange without subjecting the cusps to significant stress. After 24 days of conditioning, valves were analyzed for cell phenotype using immunohistochemistry for vimentin, alpha-smooth muscle cell actin (SMA) and prolyl-hydroxylase (PHA). Fresh native valves were used as immunohistochemistry controls. Analysis of bioreactor-conditioned valves showed that almost all seeded cells had died and large islands of cell debris were found within each cusp. Remnants of cells were positive for vimentin. Cell seeded controls, which were only rotated slowly to ensure gas and nutrient exchange, maintained about 50% of cells alive; these cells were positive for vimentin and negative for alpha-SMA and PHA, similar to native VICs. These results highlight for the first time the extreme vulnerability of hADSCs to valve-specific mechanical forces and also suggest that careful, progressive mechanical adaptation to valve-specific forces might encourage stem cell differentiation towards the VIC phenotype.
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Affiliation(s)
- Allison Kennamer
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Leslie Sierad
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Richard Pascal
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Nicholas Rierson
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Christopher Albers
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Marius Harpa
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Ovidiu Cotoi
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Lucian Harceaga
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Peter Olah
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Preda Terezia
- Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Agneta Simionescu
- Cardiovascular Tissue Engineering and Regenerative Medicine Laboratory, Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Dan Simionescu
- Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University, Clemson, SC, USA.,Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy, Targu Mures, Romania
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107
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Ayoub S, Ferrari G, Gorman RC, Gorman JH, Schoen FJ, Sacks MS. Heart Valve Biomechanics and Underlying Mechanobiology. Compr Physiol 2016; 6:1743-1780. [PMID: 27783858 PMCID: PMC5537387 DOI: 10.1002/cphy.c150048] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Heart valves control unidirectional blood flow within the heart during the cardiac cycle. They have a remarkable ability to withstand the demanding mechanical environment of the heart, achieving lifetime durability by processes involving the ongoing remodeling of the extracellular matrix. The focus of this review is on heart valve functional physiology, with insights into the link between disease-induced alterations in valve geometry, tissue stress, and the subsequent cell mechanobiological responses and tissue remodeling. We begin with an overview of the fundamentals of heart valve physiology and the characteristics and functions of valve interstitial cells (VICs). We then provide an overview of current experimental and computational approaches that connect VIC mechanobiological response to organ- and tissue-level deformations and improve our understanding of the underlying functional physiology of heart valves. We conclude with a summary of future trends and offer an outlook for the future of heart valve mechanobiology, specifically, multiscale modeling approaches, and the potential directions and possible challenges of research development. © 2016 American Physiological Society. Compr Physiol 6:1743-1780, 2016.
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Affiliation(s)
- Salma Ayoub
- Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, Austin, USA
| | - Giovanni Ferrari
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, USA
| | - Robert C. Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, USA
| | - Joseph H. Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, USA
| | - Frederick J. Schoen
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Michael S. Sacks
- Center for Cardiovascular Simulation, Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, Austin, USA
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108
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Sierad LN, Shaw EL, Bina A, Brazile B, Rierson N, Patnaik SS, Kennamer A, Odum R, Cotoi O, Terezia P, Branzaniuc K, Smallwood H, Deac R, Egyed I, Pavai Z, Szanto A, Harceaga L, Suciu H, Raicea V, Olah P, Simionescu A, Liao J, Movileanu I, Harpa M, Simionescu DT. Functional Heart Valve Scaffolds Obtained by Complete Decellularization of Porcine Aortic Roots in a Novel Differential Pressure Gradient Perfusion System. Tissue Eng Part C Methods 2016; 21:1284-96. [PMID: 26467108 DOI: 10.1089/ten.tec.2015.0170] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
There is a great need for living valve replacements for patients of all ages. Such constructs could be built by tissue engineering, with perspective of the unique structure and biology of the aortic root. The aortic valve root is composed of several different tissues, and careful structural and functional consideration has to be given to each segment and component. Previous work has shown that immersion techniques are inadequate for whole-root decellularization, with the aortic wall segment being particularly resistant to decellularization. The aim of this study was to develop a differential pressure gradient perfusion system capable of being rigorous enough to decellularize the aortic root wall while gentle enough to preserve the integrity of the cusps. Fresh porcine aortic roots have been subjected to various regimens of perfusion decellularization using detergents and enzymes and results compared to immersion decellularized roots. Success criteria for evaluation of each root segment (cusp, muscle, sinus, wall) for decellularization completeness, tissue integrity, and valve functionality were defined using complementary methods of cell analysis (histology with nuclear and matrix stains and DNA analysis), biomechanics (biaxial and bending tests), and physiologic heart valve bioreactor testing (with advanced image analysis of open-close cycles and geometric orifice area measurement). Fully acellular porcine roots treated with the optimized method exhibited preserved macroscopic structures and microscopic matrix components, which translated into conserved anisotropic mechanical properties, including bending and excellent valve functionality when tested in aortic flow and pressure conditions. This study highlighted the importance of (1) adapting decellularization methods to specific target tissues, (2) combining several methods of cell analysis compared to relying solely on histology, (3) developing relevant valve-specific mechanical tests, and (4) in vitro testing of valve functionality.
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Affiliation(s)
- Leslie Neil Sierad
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Eliza Laine Shaw
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Alexander Bina
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Bryn Brazile
- 2 Tissue Bioengineering Laboratory, Department of Agricultural and Biological Engineering, Mississippi State University , Starkville, Mississippi
| | - Nicholas Rierson
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Sourav S Patnaik
- 2 Tissue Bioengineering Laboratory, Department of Agricultural and Biological Engineering, Mississippi State University , Starkville, Mississippi
| | - Allison Kennamer
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Rebekah Odum
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Ovidiu Cotoi
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Preda Terezia
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Klara Branzaniuc
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Harrison Smallwood
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Radu Deac
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Imre Egyed
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Zoltan Pavai
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Annamaria Szanto
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Lucian Harceaga
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Horatiu Suciu
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Victor Raicea
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Peter Olah
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Agneta Simionescu
- 4 Cardiovascular Tissue Engineering and Regenerative Medicine Laboratory, Department of Bioengineering, Clemson University , Clemson, South Carolina
| | - Jun Liao
- 2 Tissue Bioengineering Laboratory, Department of Agricultural and Biological Engineering, Mississippi State University , Starkville, Mississippi
| | - Ionela Movileanu
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Marius Harpa
- 3 Tissue Engineering and Regenerative Medicine Laboratory, Department of Anatomy, University of Medicine and Pharmacy , Targu Mures, Romania
| | - Dan Teodor Simionescu
- 1 Biocompatibility and Tissue Regeneration Laboratories, Department of Bioengineering, Clemson University , Clemson, South Carolina
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Abstract
SIGNIFICANCE Currently, calcific aortic valve disease (CAVD) is only treatable through surgical intervention because the specific mechanisms leading to the disease remain unclear. In this review, we explore the forces and structure of the valve, as well as the mechanosensors and downstream signaling in the valve endothelium known to contribute to inflammation and valve dysfunction. RECENT ADVANCES While the valvular structure enables adaptation to dynamic hemodynamic forces, these are impaired during CAVD, resulting in pathological systemic changes. Mechanosensing mechanisms-proteins, sugars, and membrane structures-at the surface of the valve endothelial cell relay mechanical signals to the nucleus. As a result, a large number of mechanosensitive genes are transcribed to alter cellular phenotype and, ultimately, induce inflammation and CAVD. Transforming growth factor-β signaling and Wnt/β-catenin have been widely studied in this context. Importantly, NADPH oxidase and reactive oxygen species/reactive nitrogen species signaling has increasingly been recognized to play a key role in the cellular response to mechanical stimuli. In addition, a number of valvular microRNAs are mechanosensitive and may regulate the progression of CAVD. CRITICAL ISSUES While numerous pathways have been described in the pathology of CAVD, no treatment options are available to avoid surgery for advanced stenosis and calcification of the aortic valve. More work must be focused on this issue to lead to successful therapies for the disease. FUTURE DIRECTIONS Ultimately, a more complete understanding of the mechanisms within the aortic valve endothelium will lead us to future therapies important for treatment of CAVD without the risks involved with valve replacement or repair. Antioxid. Redox Signal. 25, 401-414.
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Affiliation(s)
- Joan Fernández Esmerats
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology , Atlanta, Georgia
| | - Jack Heath
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology , Atlanta, Georgia
| | - Hanjoong Jo
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology , Atlanta, Georgia
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110
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Lazaros G, Antonopoulos AS, Tousoulis D. The Impact of Interleukin-18 and High-Mobility Group Box 1 Protein Signaling in Aortic Valve Calcification. Cardiology 2016; 135:165-167. [DOI: 10.1159/000446180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 11/19/2022]
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111
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Madhu MN, Aguiar C, Hassan A, Brunt KR. Translating calcified aortic valve disease to the bench - Use of 3D matrices in the development of future treatment strategies. J Mol Cell Cardiol 2016; 98:58-61. [PMID: 27338001 DOI: 10.1016/j.yjmcc.2016.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 06/18/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Malav N Madhu
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Canada; Faculty of Medicine, Dalhousie University, Canada
| | - Christie Aguiar
- Department of Cardiac Surgery, Saint John Regional Hospital, Canada
| | - Ansar Hassan
- Department of Cardiac Surgery, Saint John Regional Hospital, Canada; Faculty of Medicine, Dalhousie University, Canada
| | - Keith R Brunt
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Canada; Faculty of Medicine, Dalhousie University, Canada.
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112
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Sung DC, Bowen CJ, Vaidya KA, Zhou J, Chapurin N, Recknagel A, Zhou B, Chen J, Kotlikoff M, Butcher JT. Cadherin-11 Overexpression Induces Extracellular Matrix Remodeling and Calcification in Mature Aortic Valves. Arterioscler Thromb Vasc Biol 2016; 36:1627-37. [PMID: 27312222 DOI: 10.1161/atvbaha.116.307812] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/06/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Calcific aortic valve (AoV) disease is a significant clinical problem for which the regulatory mechanisms are poorly understood. Enhanced cell-cell adhesion is a common mechanism of cellular aggregation, but its role in calcific lesion formation is not known. Cadherin-11 (Cad-11) has been associated with lesion formation in vitro, but its function during adult valve homeostasis and pathogenesis is not known. This study aims to elucidate the specific functions of Cad-11 and its downstream targets, RhoA and Sox9, in extracellular matrix remodeling and AoV calcification. APPROACH AND RESULTS We conditionally overexpressed Cad-11 in murine heart valves using a novel double-transgenic Nfatc1(Cre);R26-Cad11(TglTg) mouse model. These mice developed hemodynamically significant aortic stenosis with prominent calcific lesions in the AoV leaflets. Cad-11 overexpression upregulated downstream targets, RhoA and Sox9, in the valve interstitial cells, causing calcification and extensive pathogenic extracellular matrix remodeling. AoV interstitial cells overexpressing Cad-11 in an osteogenic environment in vitro rapidly form calcific nodules analogous to in vivo lesions. Molecular analyses revealed upregulation of osteoblastic and myofibroblastic markers. Treatment with a Rho-associated protein kinase inhibitor attenuated nodule formation, further supporting that Cad-11-driven calcification acts through the small GTPase RhoA/Rho-associated protein kinase signaling pathway. CONCLUSIONS This study identifies one of the underlying molecular mechanisms of heart valve calcification and demonstrates that overexpression of Cad-11 upregulates RhoA and Sox9 to induce calcification and extracellular matrix remodeling in adult AoV pathogenesis. The findings provide a potential molecular target for clinical treatment.
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Affiliation(s)
- Derek C Sung
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Caitlin J Bowen
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Kiran A Vaidya
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Jingjing Zhou
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Nikita Chapurin
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Andrew Recknagel
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Bin Zhou
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Jonathan Chen
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Michael Kotlikoff
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.)
| | - Jonathan T Butcher
- From the Meinig School of Biomedical Engineering (D.C.S., C.J.B., K.A.V., J.Z., N.C., A.R., J.T.B.) and Department of Biomedical Sciences (M.K.), Cornell University, Ithaca, NY; Department of Genetics, Pediatrics, and Medicine (Cardiology), Albert Einstein College of Medicine, Montefiore Medical Center, New York (B.Z.); and Department of Pediatric Cardiovascular Surgery, Seattle Children's Hospital, WA (J.C.).
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Active tissue stiffness modulation controls valve interstitial cell phenotype and osteogenic potential in 3D culture. Acta Biomater 2016; 36:42-54. [PMID: 26947381 DOI: 10.1016/j.actbio.2016.03.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/02/2016] [Accepted: 03/02/2016] [Indexed: 12/13/2022]
Abstract
UNLABELLED Calcific aortic valve disease (CAVD) progression is a highly dynamic process whereby normally fibroblastic valve interstitial cells (VIC) undergo osteogenic differentiation, maladaptive extracellular matrix (ECM) composition, structural remodeling, and tissue matrix stiffening. However, how VIC with different phenotypes dynamically affect matrix properties and how the altered matrix further affects VIC phenotypes in response to physiological and pathological conditions have not yet been determined. In this study, we develop 3D hydrogels with tunable matrix stiffness to investigate the dynamic interplay between VIC phenotypes and matrix biomechanics. We find that VIC populated within hydrogels with valve leaflet like stiffness differentiate towards myofibroblasts in osteogenic media, but surprisingly undergo osteogenic differentiation when cultured within lower initial stiffness hydrogels. VIC differentiation progressively stiffens the hydrogel microenvironment, which further upregulates both early and late osteogenic markers. These findings identify a dynamic positive feedback loop that governs acceleration of VIC calcification. Temporal stiffening of pathologically lower stiffness matrix back to normal level, or blocking the mechanosensitive RhoA/ROCK signaling pathway, delays the osteogenic differentiation process. Therefore, direct ECM biomechanical modulation can affect VIC phenotypes towards and against osteogenic differentiation in 3D culture. These findings highlight the importance of the homeostatic maintenance of matrix stiffness to restrict pathological VIC differentiation. STATEMENT OF SIGNIFICANCE We implement 3D hydrogels with tunable matrix stiffness to investigate the dynamic interaction between valve interstitial cells (VIC, major cell population in heart valve) and matrix biomechanics. This work focuses on how human VIC responses to changing 3D culture environments. Our findings identify a dynamic positive feedback loop that governs acceleration of VIC calcification, which is the hallmark of calcific aortic valve disease. Temporal stiffening of pathologically lower stiffness matrix back to normal level, or blocking the mechanosensitive signaling pathway, delays VIC osteogenic differentiation. Our findings provide an improved understanding of VIC-matrix interactions to aid in interpretation of VIC calcification studies in vitro and suggest that ECM disruption resulting in local tissue stiffness decreases may promote calcific aortic valve disease.
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114
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Acute pergolide exposure stiffens engineered valve interstitial cell tissues and reduces contractility in vitro. Cardiovasc Pathol 2016; 25:316-324. [PMID: 27174867 DOI: 10.1016/j.carpath.2016.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/30/2016] [Accepted: 04/20/2016] [Indexed: 01/11/2023] Open
Abstract
Medications based on ergoline-derived dopamine and serotonin agonists are associated with off-target toxicities that include valvular heart disease (VHD). Reports of drug-induced VHD resulted in the withdrawal of appetite suppressants containing fenfluramine and phentermine from the US market in 1997 and pergolide, a Parkinson's disease medication, in 2007. Recent evidence suggests that serotonin receptor activity affected by these medications modulates cardiac valve interstitial cell activation and subsequent valvular remodeling, which can lead to cardiac valve fibrosis and dysfunction similar to that seen in carcinoid heart disease. Failure to identify these risks prior to market and continued use of similar drugs reaffirm the need to improve preclinical evaluation of drug-induced VHD. Here, we present two complimentary assays to measure stiffness and contractile stresses generated by engineered valvular tissues in vitro. As a case study, we measured the effects of acute (24 h) pergolide exposure to engineered porcine aortic valve interstitial cell (AVIC) tissues. Pergolide exposure led to increased tissue stiffness, but it decreased both basal and active contractile tone stresses generated by AVIC tissues. Pergolide exposure also disrupted AVIC tissue organization (i.e., tissue anisotropy), suggesting that the mechanical properties and contractile functionality of these tissues are governed by their ability to maintain their structure. We expect further use of these assays to identify off-target drug effects that alter the phenotypic balance of AVICs, disrupt their ability to maintain mechanical homeostasis, and lead to VHD.
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115
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Abstract
Advances in mass spectrometry technology and bioinformatics using clinical human samples have expanded quantitative proteomics in cardiovascular research. There are two major proteomic strategies: namely, "gel-based" or "gel-free" proteomics coupled with either "top-down" or "bottom-up" mass spectrometry. Both are introduced into the proteomic analysis using plasma or serum sample targeting 'biomarker" searches of aortic aneurysm and tissue samples, such as from the aneurysmal wall, calcific aortic valve, or myocardial tissue, investigating pathophysiological protein interactions and post-translational modifications. We summarize the proteomic studies that analyzed human samples taken during cardiovascular surgery to investigate disease processes, in order to better understand the system-wide changes behind known molecular factors and specific signaling pathways.
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Affiliation(s)
- Teiji Oda
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Ken-ichi Matsumoto
- Department of Biosignaling and Radioisotope Experiment, Interdisciplinary Center for Science Research, Organization for Research, Shimane University, Izumo, Shimane, Japan
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116
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Lee SH, Choi JH. Involvement of Immune Cell Network in Aortic Valve Stenosis: Communication between Valvular Interstitial Cells and Immune Cells. Immune Netw 2016; 16:26-32. [PMID: 26937229 PMCID: PMC4770097 DOI: 10.4110/in.2016.16.1.26] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 01/11/2023] Open
Abstract
Aortic valve stenosis is a heart disease prevalent in the elderly characterized by valvular calcification, fibrosis, and inflammation, but its exact pathogenesis remains unclear. Previously, aortic valve stenosis was thought to be caused by chronic passive and degenerative changes associated with aging. However, recent studies have demonstrated that atherosclerotic processes and inflammation can induce valvular calcification and bone deposition, leading to valvular stenosis. In particular, the most abundant cell type in cardiac valves, valvular interstitial cells, can differentiate into myofibroblasts and osteoblast-like cells, leading to valvular calcification and stenosis. Differentiation of valvular interstitial cells can be trigged by inflammatory stimuli from several immune cell types, including macrophages, dendritic cells, T cells, B cells, and mast cells. This review indicates that crosstalk between immune cells and valvular interstitial cells plays an important role in the development of aortic valve stenosis.
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Affiliation(s)
- Seung Hyun Lee
- Department of Life Science, College of Natural Sciences, Research Institute of Natural Sciences, Hanyang University, Seoul 04763, Korea
| | - Jae-Hoon Choi
- Department of Life Science, College of Natural Sciences, Research Institute of Natural Sciences, Hanyang University, Seoul 04763, Korea
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117
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Zeng YI, Sun R, Li X, Liu M, Chen S, Zhang P. Pathophysiology of valvular heart disease. Exp Ther Med 2016; 11:1184-1188. [PMID: 27073420 PMCID: PMC4812598 DOI: 10.3892/etm.2016.3048] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/05/2016] [Indexed: 01/09/2023] Open
Abstract
Valvular heart disease (VHD) is caused by either damage or defect in one of the four heart valves, aortic, mitral, tricuspid or pulmonary. Defects in these valves can be congenital or acquired. Age, gender, tobacco use, hypercholesterolemia, hypertension, and type II diabetes contribute to the risk of disease. VHD is an escalating health issue with a prevalence of 2.5% in the United States alone. Considering the likely increase of the aging population worldwide, the incidence of acquired VHD is expected to increase. Technological advances are instrumental in identifying congenital heart defects in infants, thereby adding to the growing VHD population. Almost one-third of elderly individuals have echocardiographic or radiological evidence of calcific aortic valve (CAV) sclerosis, an early and subclinical form of CAV disease (CAVD). Of individuals ages >60, ~2% suffer from disease progression to its most severe form, calcific aortic stenosis. Surgical intervention is therefore required in these patients as no effective pharmacotherapies exist. Valvular calcium load and valve biomineralization are orchestrated by the concerted action of diverse cell-dependent mechanisms. Signaling pathways important in skeletal morphogenesis are also involved in the regulation of cardiac valve morphogenesis, CAVD and the pathobiology of cardiovascular calcification. CAVD usually occurs without any obvious symptoms in early stages over a long period of time and symptoms are identified at advanced stages of the disease, leading to a high rate of mortality. Aortic valve replacement is the only primary treatment of choice. Biomarkers such as asymmetric dimethylarginine, fetuin-A, calcium phosphate product, natriuretic peptides and osteopontin have been useful in improving outcomes among various disease states. This review, highlights the current understanding of the biology of VHD, with particular reference to molecular and cellular aspects of its regulation. Current clinical questions and the development of new strategies to treat various forms of VHD medically were addressed.
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Affiliation(s)
- Y I Zeng
- Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, Jiangsu 221009, P.R. China
| | - Rongrong Sun
- Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, Jiangsu 221009, P.R. China
| | - Xianchi Li
- Department of Cardiology, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu 221009, P.R. China
| | - Min Liu
- Department of Cardiology, Xuzhou Clinical School of Xuzhou Medical College, Xuzhou, Jiangsu 221009, P.R. China
| | - Shuang Chen
- Department of Cardiology, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu 221009, P.R. China
| | - Peiying Zhang
- Department of Cardiology, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu 221009, P.R. China
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118
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Jiang M, Wang L, Xuan Q, Shao Y, Kong X, Sun W. Risk Factors Associated with Left-Sided Cardiac Valve Calcification: A Case Control Study. Cardiology 2016; 134:26-33. [PMID: 26841312 DOI: 10.1159/000443203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 12/08/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify risk factors associated with cardiac valve calcification that is easily detectable through routine blood tests in patients who received valve replacement therapy. METHODS Four hundred patients with valvular heart disease who underwent valve replacement surgery between December 2009 and January 2013 were enrolled in this study. Of these, 77 had valve calcification; the other 323 did not. Multivariate logistic regression analysis was used to assess for risk factors associated with valve calcification. RESULTS In our study population, rheumatic valve lesions were the most common reason for valve replacement. Degenerative nonstenotic valve lesion was a protective factor and degenerative stenotic valve lesion was a strong risk factor for valve calcification. Serum levels of gamma-glutamyl transferase (GGT) of between 30 and 46 IU/l and >90 IU/l and total bilirubin (TBIL) of between 15 and 20 μmol/l were positively correlated with valve calcification. Meanwhile, serum calcium (Ca2+) levels of between 2.3 and 2.4 mmol/l were negatively correlated with rheumatic valve calcification. CONCLUSIONS Degenerative stenotic lesion is a risk factor and degenerative nonstenotic lesion a protective factor for cardiac valve calcification. Serum GGT and TBIL levels are positively correlated and serum Ca2+ levels negatively correlated with rheumatic cardiac valve calcification.
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Affiliation(s)
- Minyong Jiang
- Department of Cardiology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin, PR China
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119
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Lowenstine LJ, McManamon R, Terio KA. Comparative Pathology of Aging Great Apes: Bonobos, Chimpanzees, Gorillas, and Orangutans. Vet Pathol 2015; 53:250-76. [PMID: 26721908 DOI: 10.1177/0300985815612154] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The great apes (chimpanzees, bonobos, gorillas, and orangutans) are our closest relatives. Despite the many similarities, there are significant differences in aging among apes, including the human ape. Common to all are dental attrition, periodontitis, tooth loss, osteopenia, and arthritis, although gout is uniquely human and spondyloarthropathy is more prevalent in apes than humans. Humans are more prone to frailty, sarcopenia, osteoporosis, longevity past reproductive senescence, loss of brain volume, and Alzheimer dementia. Cerebral vascular disease occurs in both humans and apes. Cardiovascular disease mortality increases in aging humans and apes, but coronary atherosclerosis is the most significant type in humans. In captive apes, idiopathic myocardial fibrosis and cardiomyopathy predominate, with arteriosclerosis of intramural coronary arteries. Similar cardiac lesions are occasionally seen in wild apes. Vascular changes in heart and kidneys and aortic dissections in gorillas and bonobos suggest that hypertension may be involved in pathogenesis. Chronic kidney disease is common in elderly humans and some aging apes and is linked with cardiovascular disease in orangutans. Neoplasms common to aging humans and apes include uterine leiomyomas in chimpanzees, but other tumors of elderly humans, such as breast, prostate, lung, and colorectal cancers, are uncommon in apes. Among the apes, chimpanzees have been best studied in laboratory settings, and more comparative research is needed into the pathology of geriatric zoo-housed and wild apes. Increasing longevity of humans and apes makes understanding aging processes and diseases imperative for optimizing quality of life in all the ape species.
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Affiliation(s)
- L J Lowenstine
- Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA Mountain Gorilla Veterinary Project-Gorilla Doctors, Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - R McManamon
- Zoo and Exotic Animal Pathology Service, Infectious Diseases Laboratory, Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - K A Terio
- Zoological Pathology Program, University of Illinois College of Veterinary Medicine, Maywood, IL, USA
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Kapelouzou A, Tsourelis L, Kaklamanis L, Degiannis D, Kogerakis N, Cokkinos DV. Serum and tissue biomarkers in aortic stenosis. Glob Cardiol Sci Pract 2015; 2015:49. [PMID: 26779524 PMCID: PMC4710866 DOI: 10.5339/gcsp.2015.49] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 08/27/2015] [Indexed: 12/31/2022] Open
Abstract
Background: Calcific aortic valve stenosis (CAVS) is seen in a large proportion of individuals over 60 years. It is an active process, influenced by lipid accumulation, mechanical stress, inflammation, and abnormal extracellular matrix turnover. Various biomarkers (BMs) are studied, as regards mechanisms, diagnosis and prognosis. Methods: In the calcified valves calcium deposition, elastin fragmentation and disorganization of cellular matrix were assessed, together with expression of OPN, OPG, osteocalcin (OCN) and RL2. We prospectively studied the following serum BMs in 60 patients with CAVS and compared them to 20 healthy controls, free from any cardiac disease: Matrix metalloproteinases (MMP) 2 and 9 and tissue inhibitor of metalloproteinase 1 (TIMP1), which regulate collagen turnover, inflammatory factors, i.e. tumor necrosis factor a (TNFa), interleukin 2 (IL2), transforming growth factor β1 (TGF-β1) which regulates fibrosis, fetuin-A (fet-A), osteopontin (OPN), osteoprotegerin (OPG), sclerostin (SOST), and relaxin-2 (RL2) which positively or negatively regulate calcification. Monocyte chemoattractant protein 1 (MCP-1) which regulates migration and infiltration of monocytes/macrophages was also studied as well as malondialdehyde (MDA) an oxidative marker. Results: Extent of tissue valve calcification (Alizarin Red stain) was negatively correlated with tissue elastin, and RL2, and positively correlated with tissue OCN and serum TIMP1 and MCP-1 and negatively with MMP9. Tissue OCN was positively correlated with OPN and negatively with the elastin. Tissue OPN was negatively correlated with elastin and OPG. Tissue OPN OPG and RL2 were not correlated with serum levels In the serum we found in patients statistically lower TIMP1, fet-A and RL2 levels, while all other BMs were higher compared to the healthy group. Positive correlations between SOST and IL2, OPG and MDA but negative with TNFa and OPN were found; also MMP9 was negatively correlated with TNFa and MCP-1 was negatively correlated with TIMP1. Conclusion: We found that many BMs expressing calcification, collagen breakdown, or formation, and inflammation are increased in the valve tissue and in the serum of patients with CAVS as compared with healthy group. Our findings may give new insights towards diagnosis but also therapy. Thus antisclerostin, and antiflammatory agents could be tried for preventing aortic calcification progression.
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Affiliation(s)
- Alkistis Kapelouzou
- Center of Clinical, Experimental Surgery, & Translation Research. Biomedical Research Foundation Academy of Athens (BRFAA), Soranou Efesiou 4 11527Athens, Greece
| | - Loukas Tsourelis
- Department of Pathology, Onassis Cardiac Surgery Center, Avenue Sygrou 356 17674Athens, Greece
| | - Loukas Kaklamanis
- Department of Pathology, Onassis Cardiac Surgery Center, Avenue Sygrou 356 17674Athens, Greece
| | - Dimitrios Degiannis
- Laboratory of Molecular Immunopathology and Istocompatibility Onassis Cardiac Surgery Center, Avenue Sygrou 356 17674Athens, Greece
| | - Nektarios Kogerakis
- Department of Pathology, Onassis Cardiac Surgery Center, Avenue Sygrou 356 17674Athens, Greece
| | - Dennis V Cokkinos
- Center of Clinical, Experimental Surgery, & Translation Research. Biomedical Research Foundation Academy of Athens (BRFAA), Soranou Efesiou 4 11527Athens, Greece
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Guauque-Olarte S, Messika-Zeitoun D, Droit A, Lamontagne M, Tremblay-Marchand J, Lavoie-Charland E, Gaudreault N, Arsenault BJ, Dubé MP, Tardif JC, Body SC, Seidman JG, Boileau C, Mathieu P, Pibarot P, Bossé Y. Calcium Signaling Pathway Genes RUNX2 and CACNA1C Are Associated With Calcific Aortic Valve Disease. ACTA ACUST UNITED AC 2015; 8:812-22. [PMID: 26553695 DOI: 10.1161/circgenetics.115.001145] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 11/06/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Calcific aortic valve stenosis (AS) is a life-threatening disease with no medical therapy. The genetic architecture of AS remains elusive. This study combines genome-wide association studies, gene expression, and expression quantitative trait loci mapping in human valve tissues to identify susceptibility genes of AS. METHODS AND RESULTS A meta-analysis was performed combining the results of 2 genome-wide association studies in 474 and 486 cases from Quebec City (Canada) and Paris (France), respectively. Corresponding controls consisted of 2988 and 1864 individuals with European ancestry from the database of genotypes and phenotypes. mRNA expression levels were evaluated in 9 calcified and 8 normal aortic valves by RNA sequencing. The results were integrated with valve expression quantitative trait loci data obtained from 22 AS patients. Twenty-five single-nucleotide polymorphisms had P<5×10(-6) in the genome-wide association studies meta-analysis. The calcium signaling pathway was the top gene set enriched for genes mapped to moderately AS-associated single-nucleotide polymorphisms. Genes in this pathway were found differentially expressed in valves with and without AS. Two single-nucleotide polymorphisms located in RUNX2 (runt-related transcription factor 2), encoding an osteogenic transcription factor, demonstrated some association with AS (genome-wide association studies P=5.33×10(-5)). The mRNA expression levels of RUNX2 were upregulated in calcified valves and associated with eQTL-SNPs. CACNA1C encoding a subunit of a voltage-dependent calcium channel was upregulated in calcified valves. The eQTL-SNP with the most significant association with AS located in CACNA1C was associated with higher expression of the gene. CONCLUSIONS This integrative genomic study confirmed the role of RUNX2 as a potential driver of AS and identified a new AS susceptibility gene, CACNA1C, belonging to the calcium signaling pathway.
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Affiliation(s)
- Sandra Guauque-Olarte
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - David Messika-Zeitoun
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Arnaud Droit
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Maxime Lamontagne
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Joël Tremblay-Marchand
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Emilie Lavoie-Charland
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Nathalie Gaudreault
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Benoit J Arsenault
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Marie-Pierre Dubé
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Jean-Claude Tardif
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Simon C Body
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Jonathan G Seidman
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Catherine Boileau
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Patrick Mathieu
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Philippe Pibarot
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.)
| | - Yohan Bossé
- From the Centre de recherche Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada (S.G.-O., M.L., J.T.-M., E.L.-C., N.G., P.M., P.P., Y.B.); Departments of Molecular Medicine (A.D., Y.B.), Surgery (P.M.), and Medicine (P.P.), Laval University, Quebec, Canada; Cardiology Department, AP-HP, Bichat Hospital, Paris, France (D.M.-Z.); INSERM U698, Paris, France (D.M.-Z.); Département de Génétique, Hôpital Bichat, 75018 Paris, France (C.B.); Centre de Recherche du CHUQ, Quebec, Canada (A.D.); Montreal Heart Institute, Department of Medicine (M.-P.D., J.-C.T.), Université de Montréal, Montreal, Canada (B.J.A.); Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA (S.C.B.); and Department of Genetics, Harvard Medical School, Boston, MA (J.G.S.).
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Masuda M, Miyazaki-Anzai S, Keenan AL, Okamura K, Kendrick J, Chonchol M, Offermanns S, Ntambi JM, Kuro-O M, Miyazaki M. Saturated phosphatidic acids mediate saturated fatty acid-induced vascular calcification and lipotoxicity. J Clin Invest 2015; 125:4544-58. [PMID: 26517697 DOI: 10.1172/jci82871] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/10/2015] [Indexed: 01/06/2023] Open
Abstract
Recent evidence indicates that saturated fatty acid-induced (SFA-induced) lipotoxicity contributes to the pathogenesis of cardiovascular and metabolic diseases; however, the molecular mechanisms that underlie SFA-induced lipotoxicity remain unclear. Here, we have shown that repression of stearoyl-CoA desaturase (SCD) enzymes, which regulate the intracellular balance of SFAs and unsaturated FAs, and the subsequent accumulation of SFAs in vascular smooth muscle cells (VSMCs), are characteristic events in the development of vascular calcification. We evaluated whether SMC-specific inhibition of SCD and the resulting SFA accumulation plays a causative role in the pathogenesis of vascular calcification and generated mice with SMC-specific deletion of both Scd1 and Scd2. Mice lacking both SCD1 and SCD2 in SMCs displayed severe vascular calcification with increased ER stress. Moreover, we employed shRNA library screening and radiolabeling approaches, as well as in vitro and in vivo lipidomic analysis, and determined that fully saturated phosphatidic acids such as 1,2-distearoyl-PA (18:0/18:0-PA) mediate SFA-induced lipotoxicity and vascular calcification. Together, these results identify a key lipogenic pathway in SMCs that mediates vascular calcification.
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Chen D, Shen YL, Hu WL, Chen ZP, Li YS. Effects of oxidized low density lipoprotein on transformation of valvular myofibroblasts to osteoblast-like phenotype. ACTA ACUST UNITED AC 2015; 35:362-367. [PMID: 26072074 DOI: 10.1007/s11596-015-1438-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/12/2015] [Indexed: 11/24/2022]
Abstract
In order to investigate the roles of Wnt signal pathway in transformation of cardiac valvular myofibroblasts to the osteoblast-like phenotype, the primary cultured porcine aortic valve myofibroblasts were incubated with oxidized low density lipoprotein (ox-LDL, 50 mg/L), and divided into four groups according to the ox-LDL treatment time: control group, ox-LDL 24-h group, ox-LDL 48-h group, and ox-LDL 72-h group. Wnt signal pathway blocker Dickkopf-1 (DDK-1, 100 μg/L) was added in ox-LDL 72-h group. The expression of a-smooth muscle actin (α-SMA), bone morphogenetic protein 2 (BMP2), alkaline phosphatase (ALP), and osteogenic transcription factor Cbfa-1 was detected by Western blotting, and that of β-catenin, a key mediator of Wnt signal pathway by immunocytochemical staining method. The Wnt/β-catenin was observed and the transformation of myofibroblasts to the osteoblast-like phenotype was examined. The expression of α-SMA, BMP2, ALP and Cbfa-1 proteins in the control group was weaker than in the ox-LDL-treated groups. In ox-LDL-treated groups, the protein expression of a-SMA, BMP2, ALP, and Cbfa-1 was significantly increased in a time-dependent manner as compared with the control group, and there was significant difference among the three ox-LDL-treated groups (P<0.05 for all); β-catenin protein was also up-regulated in the ox-LDL-treated groups in a time-dependent manner as compared with the control group (P<0.05), and its transfer from cytoplasm to nucleus and accumulation in the nucleus were increased in the same fashion (P<0.05). After addition of DKK-1, the expression of α-SMA, bone-related proteins and β-catenin protein was significantly reduced as compared with ox-LDL 72-h group (P<0.05). The Wnt/ β-catenin signaling pathway may play an important role in transformation of valvular myofibroblasts to the osteoblast-like phenotype.
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Affiliation(s)
- Di Chen
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ying-Lian Shen
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Lin Hu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng-Ping Chen
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong-Sheng Li
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Zhan Q, Song R, Zeng Q, Yao Q, Ao L, Xu D, Fullerton DA, Meng X. Activation of TLR3 induces osteogenic responses in human aortic valve interstitial cells through the NF-κB and ERK1/2 pathways. Int J Biol Sci 2015; 11:482-93. [PMID: 25798067 PMCID: PMC4366646 DOI: 10.7150/ijbs.10905] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 12/12/2014] [Indexed: 12/22/2022] Open
Abstract
Calcific aortic valve disease (CAVD) is characterized by chronic inflammation and progressive calcification in valve leaflets. Aortic valve interstitial cells (AVICs) play a critical role in the pathogenesis of CAVD. Previous studies show that stimulation of Toll-like receptor (TLR) 2 or TLR4 in AVICs in vitro up-regulates the expression of osteogenic mediators. Double-stranded RNA (dsRNA) can activate pro-inflammatory signaling through TLR3, the NLRP3 inflammasome and RIG-I-like receptors. The objective of this study is to determine the effect of dsRNA on AVIC osteogenic activities and the mechanism of its action. Methods and results: AVICs isolated from normal human valves were exposed to polyinosinic-polycytidylic acid [poly(I:C)], a mimic of dsRNA. Treatment with poly(I:C) increased the production of bone morphogenetic protein-2 (BMP-2), transforming growth factor beta-1 (TGF-β1) and alkaline phosphatase (ALP), and resulted in calcium deposit formation. Poly(I:C) induced the phosphorylation of NF-κB and ERK1/2. Knockdown of TLR3 essentially abrogated NF-κB and ERK1/2 phosphorylation, and markedly reduced the effect of poly(I:C) on the production of BMP-2, TGF-β1 and ALP. Further, inhibition of either NF-κB or ERK1/2 markedly reduced the levels of BMP-2, TGF-β1 and ALP in cells exposed to poly(I:C). Conclusion: Poly(I:C) up-regulates the production of BMP-2, TGF-β1 and ALP, and promotes calcium deposit formation in human AVICs. The pro-osteogenic effect of poly(I:C) is mediated primarily by TLR3 and the NF-κB and ERK1/2 pathways. These findings suggest that dsRNA, when present in aortic valve tissue, may promote CAVD progression through up-regulation of AVIC osteogenic activities.
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Affiliation(s)
- Qiong Zhan
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA. ; 2. Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Rui Song
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA. ; 3. Departments of Pathophysiology, Southern Medical University, Guangzhou 510515, China
| | - Qingchun Zeng
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA. ; 2. Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Qingzhou Yao
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA. ; 4. Medical Research Center of Guangdong General Hospital, Southern Medical University. Guangzhou 510080, China
| | - Lihua Ao
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA
| | - Dingli Xu
- 2. Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - David A Fullerton
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA
| | - Xianzhong Meng
- 1. Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA
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Motovska Z, Vichova T, Doktorova M, Labos M, Maly M, Widimsky P. Serum Dickkopf-1 signaling and calcium deposition in aortic valve are significantly related to the presence of concomitant coronary atherosclerosis in patients with symptomatic calcified aortic stenosis. J Transl Med 2015; 13:63. [PMID: 25889943 PMCID: PMC4336498 DOI: 10.1186/s12967-015-0423-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 01/29/2015] [Indexed: 11/17/2022] Open
Abstract
Background The study aimed to assess serum RANKL:OPG ratio, Dkk-1 and deposition of calcium in aortic valve in relation to the presence of concomitant coronary atherosclerosis in patients with symptomatic calcified aortic stenosis (CAS). Methods OPG, soluble RANKL and Dkk-1 were measured in 218 consecutive patients who were undergoing cardiac catheterization because of symptomatic CAS. Values of studied compounds were compared between patients without (Group A) and with (Group B) coronary atherosclerosis. Computed tomography derived Agatston score was assessed by using 256-slice CT. Results Presence of coronary atherosclerosis was related to significantly (p = 0.007) higher OPG and to significantly (p = 0.004) lower Dkk-1. Coronary atherosclerosis was also associated with a trend towards a decrease of RANKL. RANKL/OPG Ratios (mean (95% C.I.)) were: 20.04 (16.58; 24.23) in Group A and 12.69 (9.96; 16.17) in Group B, resp., p = 0.018). After adjustment, the difference in RANKL:OPG ratios was no longer significant. Multivariable regression underscored the significance of difference in Dkk-1 (pafter adjustement = 0.020). Group A patients had significantly higher Dkk-1, significantly higher deposition of calcium in aortic valve and were symptomatic in significantly younger age (p < 0.001) as compared to group B patients: Agatston score (mean (95% C.I.)) 4069.9 (3211.8; 5134.5) and 2413.5 (1821.3; 3198.1), p = 0.007. Conclusions Dkk-1 and deposition of calcium in aortic valve differ significantly in relation to the presence/absence of coronary atherosclerosis in patients with symptomatic CAS. A positive association was found between Dkk-1 and calcium load in aortic valve in patients with symptomatic CAS and angiographically normal coronary arteries.
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Affiliation(s)
- Zuzana Motovska
- Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Teodora Vichova
- Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Magdalena Doktorova
- Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Marek Labos
- Department, of Radiology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Marek Maly
- National Institute of Public Health, Prague, Czech Republic.
| | - Petr Widimsky
- Cardiocentre, Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
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Bowler MA, Merryman WD. In vitro models of aortic valve calcification: solidifying a system. Cardiovasc Pathol 2015; 24:1-10. [PMID: 25249188 PMCID: PMC4268061 DOI: 10.1016/j.carpath.2014.08.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/21/2014] [Accepted: 08/07/2014] [Indexed: 12/21/2022] Open
Abstract
Calcific aortic valve disease (CAVD) affects 25% of people over 65, and the late-stage stenotic state can only be treated with total valve replacement, requiring 85,000 surgeries annually in the US alone (University of Maryland Medical Center, 2013, http://umm.edu/programs/services/heart-center-programs/cardiothoracic-surgery/valve-surgery/facts). As CAVD is an age-related disease, many of the affected patients are unable to undergo the open-chest surgery that is its only current cure. This challenge motivates the elucidation of the mechanisms involved in calcification, with the eventual goal of alternative preventative and therapeutic strategies. There is no sufficient animal model of CAVD, so we turn to potential in vitro models. In general, in vitro models have the advantages of shortened experiment time and better control over multiple variables compared to in vivo models. As with all models, the hypothesis being tested dictates the most important characteristics of the in vivo physiology to recapitulate. Here, we collate the relevant pieces of designing and evaluating aortic valve calcification so that investigators can more effectively draw significant conclusions from their results.
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Affiliation(s)
- Meghan A Bowler
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212
| | - W David Merryman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37212.
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Review of Molecular and Mechanical Interactions in the Aortic Valve and Aorta: Implications for the Shared Pathogenesis of Aortic Valve Disease and Aortopathy. J Cardiovasc Transl Res 2014; 7:823-46. [DOI: 10.1007/s12265-014-9602-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/30/2014] [Indexed: 01/08/2023]
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Rattazzi M, Bertacco E, Iop L, D'Andrea S, Puato M, Buso G, Causin V, Gerosa G, Faggin E, Pauletto P. Extracellular pyrophosphate is reduced in aortic interstitial valve cells acquiring a calcifying profile: implications for aortic valve calcification. Atherosclerosis 2014; 237:568-76. [PMID: 25463090 DOI: 10.1016/j.atherosclerosis.2014.10.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 10/17/2014] [Accepted: 10/19/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Pyrophosphate (PPi) is a potent inhibitor of ectopic mineralization but its role during aortic valve calcification is not known. METHODS Anti-calcific effect of PPi was investigated by using an in vitro model of serum-driven calcification of collagen sponges and decellularized porcine aortic valve leaflets. Bovine interstitial valve cells (VIC), seeded either within the collagen matrices or in transwell chambers, were used to test cellular ability to inhibit serum-induced calcification. PPi metabolism was investigated in clonal VIC harboring different calcifying potential. RESULTS In a cell-free system, high serum levels induced a dose-dependent calcification of type I collagen matrices which was prevented by PPi and ATP supplementation. Blockade of serum-driven calcification by PPi and ATP was also observed when using decellularized porcine aortic valve leaflets. A similar anti-calcific effect was also seen for bovine VIC, either statically seeded into the collagen matrices or co-cultured by using a transwell system. However, when we performed co-culture experiments by using clonal VIC harboring different calcifying potential, we observed that the subset of cells acquiring a pro-calcific profile lost the ability to protect the collagen from serum-driven calcification. Pro-calcific differentiation of the clonal VIC was accompanied by increase in ALP along with significant reduction in NPP activity and ATP/PPi extracellular accumulation. These changes were not observed in the clonal subtype with lower propensity towards calcification. CONCLUSIONS We showed that PPi and ATP are potent inhibitors of serum-driven calcification of collagen matrix and that their extracellular accumulation is reduced in calcifying VIC.
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Affiliation(s)
- Marcello Rattazzi
- Department of Medicine, University of Padova, Italy; Medicina Interna Iˆ, Ca' Foncello Hospital, Treviso, Italy.
| | | | - Laura Iop
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | | | | | - Giacomo Buso
- Department of Medicine, University of Padova, Italy
| | - Valerio Causin
- Department of Chemical Sciences, University of Padova, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | | | - Paolo Pauletto
- Department of Medicine, University of Padova, Italy; Medicina Interna Iˆ, Ca' Foncello Hospital, Treviso, Italy
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130
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Deng XS, Meng X, Zeng Q, Fullerton D, Mitchell M, Jaggers J. Adult aortic valve interstitial cells have greater responses to toll-like receptor 4 stimulation. Ann Thorac Surg 2014; 99:62-71. [PMID: 25442996 DOI: 10.1016/j.athoracsur.2014.07.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/07/2014] [Accepted: 07/09/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Aortic valve interstitial cells (AVICs) have been implicated in the pathogenesis of calcific aortic valve disease. Signal transducer and activator of transcription 3 (Stat3) possesses antiinflammatory effects. Given that calcification occurs in adult valves, we hypothesized that AVICs from adult valves more likely undergo a proosteogenic phenotypic change than those from pediatric valves and that may be related to different Stat3 activation in the response of those two age groups to toll-like receptor 4 (TLR4). METHODS AVICs from healthy human aortic valve tissues were treated with TLR4 agonist lipopolysaccharide. Cellular levels of TLR4, intercellular adhesion molecule 1, bone morphogenetic protein 2, and alkaline phosphatase, as well as phosphorylation of p-38 mitogen-activated protein kinase (MAPK), nuclear factor-κβ (NF-κβ), and Stat3, were analyzed. RESULTS Toll-like receptor 4 protein levels were comparable between adult and pediatric AVICs. Adult cells produce markedly higher levels of the above markers after TLR4 stimulation, which is negatively associated with phosphorylation of Stat3. Inhibition of Stat3 enhanced p-38 MAPK and NF-κβ phosphorylation and exaggerated the expression of the above markers in pediatric AVICs after TLR4 stimulation. CONCLUSIONS Adult AVICs exhibit greater inflammatory and osteogenic responses to TLR4 stimulation. The enhanced responses in adult AVICs are at least partly due to lower levels of Stat3 activation in response to TLR4 stimulation relative to pediatric cells. Stat3 functions as a negative regulator of the TLR4 responses in human AVICs. The results suggest that Stat3 activation (tyrosine phosphorylation) may be protective and that TLR4 inhibition could be targeted pharmacologically to treat calcific aortic valve disease.
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Affiliation(s)
- Xin-Sheng Deng
- Cardiothoracic Surgery, University of Colorado, Children's Hospital Colorado, Aurora, Colorado; Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Xianzhong Meng
- Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - QingChun Zeng
- Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David Fullerton
- Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Max Mitchell
- Cardiothoracic Surgery, University of Colorado, Children's Hospital Colorado, Aurora, Colorado
| | - James Jaggers
- Cardiothoracic Surgery, University of Colorado, Children's Hospital Colorado, Aurora, Colorado; Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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131
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Affiliation(s)
- Catherine M Otto
- From the Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle (C.M.O.); and the Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom (B.P.)
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Poggio P, Branchetti E, Grau JB, Lai EK, Gorman RC, Gorman JH, Sacks MS, Bavaria JE, Ferrari G. Osteopontin-CD44v6 interaction mediates calcium deposition via phospho-Akt in valve interstitial cells from patients with noncalcified aortic valve sclerosis. Arterioscler Thromb Vasc Biol 2014; 34:2086-94. [PMID: 25060796 DOI: 10.1161/atvbaha.113.303017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The activation of valve interstitial cells (VICs) toward an osteogenic phenotype characterizes aortic valve sclerosis, the early asymptomatic phase of calcific aortic valve disease. Osteopontin is a phosphorylated acidic glycoprotein that accumulates within the aortic leaflets and labels VIC activation even in noncalcified asymptomatic patients. Despite this, osteopontin protects VICs against in vitro calcification. Here, we hypothesize that the specific interaction of osteopontin with CD44v6, and the related intracellular pathway, prevents calcium deposition in human-derived VICs from patients with aortic valve sclerosis. APPROACH AND RESULTS On informed consent, 23 patients and 4 controls were enrolled through the cardiac surgery and heart transplant programs. Human aortic valves and VICs were tested for osteogenic transdifferentiation, ex vivo and in vitro. Osteopontin-CD44 interaction was analyzed using proximity ligation assay and the signaling pathways investigated. A murine model based on angiotensin II infusion was used to mimic early pathological remodeling of the aortic valves. We report osteopontin-CD44 functional interaction as a hallmark of early stages of calcific aortic valve disease. We demonstrated that osteopontin-CD44 interaction mediates calcium deposition via phospho-Akt in VICs from patients with noncalcified aortic valve sclerosis. Finally, microdissection analysis of murine valves shows increased cusp thickness in angiotensin II-treated mice versus saline infused along with colocalization of osteopontin and CD44 as seen in human lesions. CONCLUSIONS Here, we unveil a specific protein-protein association and intracellular signaling mechanisms of osteopontin. Understanding the molecular mechanisms of early VIC activation and calcium deposition in asymptomatic stage of calcific aortic valve disease could open new prospective for diagnosis and therapeutic intervention.
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Affiliation(s)
- Paolo Poggio
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Emanuela Branchetti
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Juan B Grau
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Eric K Lai
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Robert C Gorman
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Joseph H Gorman
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Michael S Sacks
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Joseph E Bavaria
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.)
| | - Giovanni Ferrari
- From the Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia (P.P., E.B., J.B.G., E.K.L., R.C.G., J.H.G., J.E.B., G.F.); Centro Cardiologico Monzino IRCCS, Milan, Italy (P.P.); Columbia University-Valley Heart Center, Ridgewood, NJ (J.B.G.); and Department of Biomedical Engineering, University of Texas at Austin (M.S.S.).
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Lu KC, Wu CC, Yen JF, Liu WC. Vascular calcification and renal bone disorders. ScientificWorldJournal 2014; 2014:637065. [PMID: 25136676 PMCID: PMC4127293 DOI: 10.1155/2014/637065] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 06/15/2014] [Accepted: 06/28/2014] [Indexed: 12/11/2022] Open
Abstract
At the early stage of chronic kidney disease (CKD), the systemic mineral metabolism and bone composition start to change. This alteration is known as chronic kidney disease-mineral bone disorder (CKD-MBD). It is well known that the bone turnover disorder is the most common complication of CKD-MBD. Besides, CKD patients usually suffer from vascular calcification (VC), which is highly associated with mortality. Many factors regulate the VC mechanism, which include imbalances in serum calcium and phosphate, systemic inflammation, RANK/RANKL/OPG triad, aldosterone, microRNAs, osteogenic transdifferentiation, and effects of vitamins. These factors have roles in both promoting and inhibiting VC. Patients with CKD usually have bone turnover problems. Patients with high bone turnover have increase of calcium and phosphate release from the bone. By contrast, when bone turnover is low, serum calcium and phosphate levels are frequently maintained at high levels because the reservoir functions of bone decrease. Both of these conditions will increase the possibility of VC. In addition, the calcified vessel may secrete FGF23 and Wnt inhibitors such as sclerostin, DKK-1, and secreted frizzled-related protein to prevent further VC. However, all of them may fight back the inhibition of bone formation resulting in fragile bone. There are several ways to treat VC depending on the bone turnover status of the individual. The main goals of therapy are to maintain normal bone turnover and protect against VC.
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Affiliation(s)
- Kuo-Cheng Lu
- Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City 23148, Taiwan
| | - Chia-Chao Wu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Jen-Fen Yen
- Division of Nephrology, Department of Internal Medicine, Yonghe Cardinal Tien Hospital, 80 Zhongxing Street, Yonghe District, New Taipei City 23445, Taiwan
| | - Wen-Chih Liu
- Division of Nephrology, Department of Internal Medicine, Yonghe Cardinal Tien Hospital, 80 Zhongxing Street, Yonghe District, New Taipei City 23445, Taiwan
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134
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Wang W, Vootukuri S, Meyer A, Ahamed J, Coller BS. Association between shear stress and platelet-derived transforming growth factor-β1 release and activation in animal models of aortic valve stenosis. Arterioscler Thromb Vasc Biol 2014; 34:1924-32. [PMID: 24903096 DOI: 10.1161/atvbaha.114.303852] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Aortic valve stenosis (AS) is characterized by fibrosis and calcification of valves leading to aortic valve narrowing, resulting in high wall shear stress across the valves. We previously demonstrated that high shear stress can activate platelet-derived transforming growth factor-β1 (TGF-β1), a cytokine that induces fibrosis and calcification. The aim of this study was to investigate the role of shear-induced platelet release of TGF-β1 and its activation in AS. APPROACH AND RESULTS We studied hypercholesterolemic Ldlr(-/-)Apob(100/100)/Mttp(fl/fl)/Mx1Cre(+/+) (Reversa) mice that develop AS on Western diet and a surgical ascending aortic constriction mouse model that acutely simulates the hemodynamics of AS to study shear-induced platelet TGF-β1 release and activation. Reversa mice on Western diet for 6 months had thickening of the aortic valves, increased wall shear stress, and increased plasma TGF-β1 levels. There were weak and moderate correlations between wall shear stress and TGF-β1 levels in the progression and reversed Reversa groups and a stronger correlation in the ascending aortic constriction model in wild-type mice but not in mice with a targeted deletion of megakaryocyte and platelet TGF-β1 (Tgfb1(flox)). Plasma total TGF-β1 levels correlated with collagen deposition in the stenotic valves in Reversa mice. Although active TGF-β1 levels were too low to be measured directly, we found (1) canonical TGF-β1 (phosphorylated small mothers against decapentaplegic 2/3) signaling in the leukocytes and canonical and noncanonical (phosphorylated extracellular signal-regulated kinases 1/2) TGF-β1 signaling in aortic valves of Reversa mice on a Western diet, and (2) TGF-β1 signaling of both pathways in the ascending aortic constriction stenotic area in wild-type but not Tgfb1(flox) mice. CONCLUSIONS Shear-induced, platelet-derived TGF-β1 activation may contribute to AS.
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Affiliation(s)
- Wei Wang
- From the Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY
| | - Spandana Vootukuri
- From the Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY
| | - Alexander Meyer
- From the Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY
| | - Jasimuddin Ahamed
- From the Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY
| | - Barry S Coller
- From the Allen and Frances Adler Laboratory of Blood and Vascular Biology, Rockefeller University, New York, NY.
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135
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Printz BF. The 30-year road of noninvasive imaging for congenital aortic stenosis: new insights from cardiac magnetic resonance imaging. J Am Coll Cardiol 2014; 63:1786-7. [PMID: 24632277 DOI: 10.1016/j.jacc.2013.12.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 12/17/2013] [Accepted: 12/23/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Beth Feller Printz
- Division of Cardiology, Rady Children's Hospital San Diego, and the Department of Pediatrics, University of California San Diego, San Diego, California.
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136
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Aggarwal A, Ferrari G, Joyce E, Daniels MJ, Sainger R, Gorman JH, Gorman R, Sacks MS. Architectural trends in the human normal and bicuspid aortic valve leaflet and its relevance to valve disease. Ann Biomed Eng 2014; 42:986-98. [PMID: 24488233 PMCID: PMC4364391 DOI: 10.1007/s10439-014-0973-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/09/2014] [Indexed: 12/20/2022]
Abstract
The bicuspid aortic valve (AV) is the most common cardiac congenital anomaly and has been found to be a significant risk factor for developing calcific AV disease. However, the mechanisms of disease development remain unclear. In this study we quantified the structure of human normal and bicuspid leaflets in the early disease stage. From these individual leaflet maps average fiber structure maps were generated using a novel spline based technique. Interestingly, we found statistically different and consistent regional structures between the normal and bicuspid valves. The regularity in the observed microstructure was a surprising finding, especially for the pathological BAV leaflets and is an essential cornerstone of any predictive mathematical models of valve disease. In contrast, we determined that isolated valve interstitial cells from BAV leaflets show the same in vitro calcification pathways as those from the normal AV leaflets. This result suggests the VICs are not intrinsically different when isolated, and that external features, such as abnormal microstructure and altered flow may be the primary contributors in the accelerated calcification experienced by BAV patients.
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Affiliation(s)
- Ankush Aggarwal
- Center for Cardiovascular Simulation, Institute for Computational Engineering Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, ACES 5.438, One University Station, C0200, Austin, TX 78712-0027, USA
| | - Giovanni Ferrari
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA, USA
| | - Erin Joyce
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael J. Daniels
- Division of Statistics & Scientific Computation and Department of Integrative Biology, University of Texas at Austin, Austin, TX, USA
| | - Rachana Sainger
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph H. Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Gorman
- Gorman Cardiovascular Research Group, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael S. Sacks
- Center for Cardiovascular Simulation, Institute for Computational Engineering Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, ACES 5.438, One University Station, C0200, Austin, TX 78712-0027, USA
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Abstract
Calcific aortic valve disease (CAVD) is a major contributor to cardiovascular morbidity and mortality and, given its association with age, the prevalence of CAVD is expected to continue to rise as global life expectancy increases. No drug strategies currently exist to prevent or treat CAVD. Given that valve replacement is the only available clinical option, patients often cope with a deteriorating quality of life until diminished valve function demands intervention. The recognition that CAVD results from active cellular mechanisms suggests that the underlying pathways might be targeted to treat the condition. However, no such therapeutic strategy has been successfully developed to date. One hope was that drugs already used to treat vascular complications might also improve CAVD outcomes, but the mechanisms of CAVD progression and the desired therapeutic outcomes are often different from those of vascular diseases. Therefore, we discuss the benchmarks that must be met by a CAVD treatment approach, and highlight advances in the understanding of CAVD mechanisms to identify potential novel therapeutic targets.
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Affiliation(s)
- Joshua D Hutcheson
- Center for Interdisciplinary Cardiovascular Sciences, 3 Blackfan Circle, 17th Floor, Center for Life Sciences Boston, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Elena Aikawa
- Center for Excellence in Vascular Biology, 3 Blackfan Circle, 17th Floor, Center for Life Sciences Boston, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - W David Merryman
- Department of Biomedical Engineering, 2213 Garland Avenue, Vanderbilt University, Nashville, TN 37212, USA
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Molenaar FM, van Reekum FE, Rookmaaker MB, Abrahams AC, van Jaarsveld BC. Extraosseous calcification in end-stage renal disease: from visceral organs to vasculature. Semin Dial 2014; 27:477-87. [PMID: 24438042 DOI: 10.1111/sdi.12177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In earlier days, periarticular accumulations of calcium phosphate causing tumor-like depositions were considered the result of passive precipitation and referred to as metastatic calcifications. From sophisticated computer tomographic studies and growing insight, we have learned that calcifications in the cardiovascular system are far more threatening and in fact one of the most important sequela of end-stage renal disease. The histologic characteristic of uremia-related calcification is arteriosclerosis of the media. In addition, there is atherosclerosis of the intima, due to the high prevalence of classic cardiovascular risk factors in renal disease. The two vascular features can frequently exist at different sites in the vasculature. Novel diagnostic techniques are helping to elucidate the pathogenetic mechanisms of active conversion of vascular smooth muscle cells to osteochondritic cells. Through this process, extensive calcification of the central and peripheral vasculature ensues, influenced by different promotors and inhibitors. Calciphylaxis is a special form of extraosseous calcification leading to skin necrosis. The factors that trigger the development of calciphylaxis are not completely understood, but this syndrome shares part of the pathophysiologic basis of extraosseous calcification in general. However, the therapeutic approach must be prompt and aggressive, because of the poor prognosis. Frequently, a fatal outcome cannot be avoided in calciphylaxis.
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139
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Affiliation(s)
- Donald D Heistad
- Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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