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Abstract
Plaque calcification develops by the inflammation-dependent mechanisms involved in progression and regression of atherosclerosis. Macrophages can undergo two distinct polarization states, that is, pro-inflammatory M1 phenotype in progression and anti-inflammatory M2 phenotype in regression. In plaque progression, predominant M1 macrophages promote the initial calcium deposition within the necrotic core of the lesions, called as microcalcification, through not only vesicle-mediated mineralization as the result of apoptosis of macrophages and vascular smooth muscle cells (VSMCs), but also VSMC differentiation into early phase osteoblasts. On the other hand, in plaque regression M2 macrophages are engaged in the healing response to plaque inflammation. In association with the resolution of chronic inflammation, M2 macrophages may facilitate macroscopic calcium deposition, called as macrocalcification, through induction of osteoblastic differentiation and maturation of VSMCs. Oncostatin M, which has been shown to promote osteoblast differentiation in bone, may play a pivotal role in the development of plaque calcification. Clinically, two types of plaque calcification have distinct implications. Macrocalcification leads to plaque stability, while microcalcification is more likely to be associated with plaque rupture. Statin therapy, which reduces cardiovascular mortality, has been shown to exert its dual actions on plaque morphology, that is, regression of atheroma and increment of macroscopic calcium deposits. Statins may facilitate the healing process against plaque inflammation by enhancing M2 polarization of macrophages. Vascular calcification has pleiotropic properties as pro-inflammatory “microcalcification” and anti-inflammatory “macrocalcification”. The molecular mechanisms of this process in relation with plaque progression as well as plaque regression should be intensively elucidated.
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Affiliation(s)
- Atsushi Shioi
- Department of Vascular Medicine, Osaka City University Graduate School of Medicine.,Vascular Science Center for Translational Research, Osaka City University Graduate School of Medicine
| | - Yuji Ikari
- Department of Cardiovascular Medicine, Tokai University School of Medicine
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202
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Harper E, Rochfort KD, Forde H, Davenport C, Smith D, Cummins PM. TRAIL attenuates RANKL-mediated osteoblastic signalling in vascular cell mono-culture and co-culture models. PLoS One 2017; 12:e0188192. [PMID: 29145460 PMCID: PMC5690591 DOI: 10.1371/journal.pone.0188192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/02/2017] [Indexed: 02/05/2023] Open
Abstract
Background and objectives Vascular calcification (VC) is a major risk factor for elevated cardiovascular morbidity/mortality. Underlying this process is osteoblastic signalling within the vessel wall involving complex and interlinked roles for receptor-activator of nuclear factor-κB ligand (RANKL), osteoprotegerin (OPG), and tumour necrosis factor-related apoptosis-inducing ligand (TRAIL). RANKL promotes vascular cell osteoblastic differentiation, whilst OPG acts as a neutralizing decoy receptor for RANKL (and TRAIL). With respect to TRAIL, much recent evidence points to a vasoprotective role for this ligand, albeit via unknown mechanisms. In order to shed more light on TRAILs vasoprotective role therefore, we employed in vitro cell models to test the hypothesis that TRAIL can counteract the RANKL-mediated signalling that occurs between the vascular cells that comprise the vessel wall. Methods and results Human aortic endothelial and smooth muscle cell mono-cultures (HAECs, HASMCs) were treated with RANKL (0–25 ng/mL ± 5 ng/mL TRAIL) for 72 hr. Furthermore, to better recapitulate the paracrine signalling that exists between endothelial and smooth muscle cells within the vessel wall, non-contact transwell HAEC:HASMC co-cultures were also employed and involved RANKL treatment of HAECs (±TRAIL), subsequently followed by analysis of pro-calcific markers in the underlying subluminal HASMCs. RANKL elicited robust osteoblastic signalling across both mono- and co-culture models (e.g. increased BMP-2, alkaline phosphatase/ALP, Runx2, and Sox9, in conjunction with decreased OPG). Importantly, several RANKL actions (e.g. increased BMP-2 release from mono-cultured HAECs or increased ALP/Sox9 levels in co-cultured HASMCs) could be strongly blocked by co-incubation with TRAIL. In summary, this paper clearly demonstrates that RANKL can elicit pro-osteoblastic signalling in HAECs and HASMCs both directly and across paracrine signalling axes. Moreover, within these contexts we present clear evidence that TRAIL can block several key signalling actions of RANKL in vascular cells, providing further evidence of its vasoprotective potential.
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Affiliation(s)
- Emma Harper
- School of Biotechnology, Dublin City University, Dublin, Ireland
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Keith D. Rochfort
- School of Biotechnology, Dublin City University, Dublin, Ireland
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Hannah Forde
- School of Biotechnology, Dublin City University, Dublin, Ireland
- Department of Academic Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Colin Davenport
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Diarmuid Smith
- Department of Academic Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Philip M. Cummins
- School of Biotechnology, Dublin City University, Dublin, Ireland
- National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland
- * E-mail:
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203
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Keiler J, Schulze M, Sombetzki M, Heller T, Tischer T, Grabow N, Wree A, Bänsch D. Neointimal fibrotic lead encapsulation - Clinical challenges and demands for implantable cardiac electronic devices. J Cardiol 2017; 70:7-17. [PMID: 28583688 DOI: 10.1016/j.jjcc.2017.01.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/16/2017] [Indexed: 01/09/2023]
Abstract
Every tenth patient with a cardiac pacemaker or implantable cardioverter-defibrillator implanted is expected to have at least one lead problem in his lifetime. However, transvenous leads are often difficult to remove due to thrombotic obstruction or extensive neointimal fibrotic ingrowth. Despite its clinical significance, knowledge on lead-induced vascular fibrosis and neointimal lead encapsulation is sparse. Although leadless pacemakers are already available, their clinical operating range is limited. Therefore, lead/tissue interactions must be further improved in order to improve lead removals in particular. The published data on the coherences and issues related to lead associated vascular fibrosis and neointimal lead encapsulation are reviewed and discussed in this paper.
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Affiliation(s)
- Jonas Keiler
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany.
| | - Marko Schulze
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Martina Sombetzki
- Department for Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Rostock, Germany
| | - Thomas Heller
- Institute of Diagnostic and Interventional Radiology, Rostock University Medical Center, Rostock, Germany
| | - Tina Tischer
- Heart Center Rostock, Department of Internal Medicine, Divisions of Cardiology, Rostock University Medical Center, Rostock, Germany
| | - Niels Grabow
- Institute for Biomedical Engineering, Rostock University Medical Center, Rostock, Germany
| | - Andreas Wree
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany
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204
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Nishimura M. A New Factor for Vascular Calcification in Chronic Kidney Disease: Computed Tomography-Based Renal Parenchymal Volume. J Atheroscler Thromb 2017; 24:1085-1087. [PMID: 28701626 PMCID: PMC5684472 DOI: 10.5551/jat.ed081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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205
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Schousboe JT, Lewis JR, Kiel DP. Abdominal aortic calcification on dual-energy X-ray absorptiometry: Methods of assessment and clinical significance. Bone 2017; 104:91-100. [PMID: 28119178 DOI: 10.1016/j.bone.2017.01.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/20/2017] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
Abdominal aortic calcification (AAC) can be accurately recognized on lateral spine images intended for vertebral fracture assessment, that are obtained with dual-energy X-ray absorptiometry (DXA). Greater amounts of AAC are common in the older population for whom DXA is routinely done, and have been consistently associated with incident atherosclerotic cardiovascular disease (ASCVD) events. AAC has also been associated with incident fractures in some prospective studies, but not in others. However, further research is needed to quantify the extent to which measurement of AAC improves prediction of ASCVD events and its impact on physician and patient ASCVD risk management. Additionally, research to develop better, more precise, automated, quantitative methods of AAC assessment on lateral spine densitometric images will hopefully lead to better prediction of clinical outcomes. In conclusion, although the prime indication for densitometric lateral spine imaging remains vertebral fracture assessment, AAC that is found incidentally on lateral spine images should be reported, so that patients and their health care providers are aware of its presence.
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Affiliation(s)
- John T Schousboe
- Park Nicollet Clinic and HealthPartners Institute, HealthPartners Inc., Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
| | - Joshua R Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew Senior Life, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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206
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Chen X, Zhang Y, Chen Q, Li Q, Li Y, Ling W. Lower Plasma Fetuin-A Levels Are Associated With a Higher Mortality Risk in Patients With Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2017; 37:2213-2219. [DOI: 10.1161/atvbaha.117.309700] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/29/2017] [Indexed: 12/31/2022]
Abstract
Objective—
The present study was designed to evaluate the association of circulating fetuin-A with cardiovascular disease (CVD) and all-cause mortality.
Approach and Results—
We measured plasma fetuin-A in 1620 patients using an enzyme-linked immunosorbent assay kit. The patients were members of the Guangdong coronary artery disease cohort and were recruited between October 2008 and December 2011. Cox regression models were used to estimate the association between plasma fetuin-A and the risk of mortality. A total of 206 deaths were recorded during a median follow-up of 5.9 years, 146 of whom died from CVD. The hazard ratios for the second and third tertiles of the fetuin-A levels (using the first tertile as a reference) were 0.65 (95% confidence interval, 0.44–0.96) and 0.51 (95% confidence interval, 0.33–0.78) for CVD mortality (
P
=0.005) and 0.65 (95% confidence interval, 0.47–0.91) and 0.48 (95% confidence interval, 0.33–0.70) for all-cause mortality (
P
<0.001), respectively.
Conclusions—
Lower plasma fetuin-A levels were associated with an increased risk of all-cause and CVD mortality in patients with coronary artery disease independently of traditional CVD risk factors.
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Affiliation(s)
- Xuechen Chen
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
| | - Yuan Zhang
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
| | - Qian Chen
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
| | - Qing Li
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
| | - Yanping Li
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
| | - Wenhua Ling
- From the Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China (X.C., Q.C., Y.L., W.L.); Department of Cardiology, General Hospital of Guangzhou Military Command of People’s Liberation Army, China (Y.Z.); and Department of Epidemiology, School of Public Health, Guilin Medical
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207
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Joner M, Xhepa E. Consequences of Vascular Calcification. JACC Cardiovasc Imaging 2017; 10:1162-1164. [DOI: 10.1016/j.jcmg.2016.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 11/26/2022]
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208
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Panh L, Lairez O, Ruidavets JB, Galinier M, Carrié D, Ferrières J. Coronary artery calcification: From crystal to plaque rupture. Arch Cardiovasc Dis 2017; 110:550-561. [DOI: 10.1016/j.acvd.2017.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/14/2017] [Accepted: 04/18/2017] [Indexed: 12/31/2022]
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209
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Bischetti S, Scimeca M, Bonanno E, Federici M, Anemona L, Menghini R, Casella S, Cardellini M, Ippoliti A, Mauriello A. Carotid plaque instability is not related to quantity but to elemental composition of calcification. Nutr Metab Cardiovasc Dis 2017; 27:768-774. [PMID: 28739184 DOI: 10.1016/j.numecd.2017.05.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/10/2017] [Accepted: 05/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Recent studies highlighted the role of calcification processes in the clinical progression of chronic cardiovascular diseases. In this study we investigated the relationship between the chemical composition of calcification and atherosclerotic plaque stability in carotid arteries. METHODS AND RESULTS To this end, we characterized the calcification on 229 carotid plaques, by morphology, immunohistochemistry, transmission electron microscopy and energy dispersive X-ray microanalysis. Plaques were classified into two categories: unstable and stable. No significant differences were found in the incidence of the various risk factors between patients with and without carotid calcification, with the exception of diabetes. The energy dispersive X-ray microanalysis allowed us to identify two types of calcium salts in the atheromatous plaques, hydroxyapatite (HA) and calcium oxalate (CO). Our results showed that calcification is a common finding in carotid plaques, being present in 77.3% of cases, and the amount of calcium is not a factor of vulnerability. Noteworthy, we observed an association between HA calcification and unstable plaques. On the contrary, CO calcifications were mainly detected in stable plaques. CONCLUSIONS The presence of different types of calcification in atheromatous plaques may open new perspectives in understanding the molecular mechanisms of atheroma formation and plaque instability.
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Affiliation(s)
- S Bischetti
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Scimeca
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy; OrchideaLab S.r.l., Via del Grecale 6, Morlupo, Rome, Italy; IRCCS San Raffaele Pisana, 00166 Rome, Italy.
| | - E Bonanno
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Federici
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - L Anemona
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - R Menghini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - S Casella
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
| | - M Cardellini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Center for Atherosclerosis, Department of Medicine, Policlinico Tor Vergata, 00133 Rome, Italy.
| | - A Ippoliti
- Vascular Surgery, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - A Mauriello
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
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210
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Patil PV, Patil MG, Patil AM. Isolated intrasplenic vascular calcifications in a child with type 1 diabetes mellitus---A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:438-440. [PMID: 27813102 DOI: 10.1002/jcu.22418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/04/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
We report a case of vascular calcifications in the spleen of a 7-year-old girl who was diagnosed with type 1 diabetes mellitus (DM). The possible etiology for vascular calcifications might be medial sclerosis associated with DM. To the best of our knowledge, this finding has not yet been reported in the literature. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:438-440, 2017.
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Affiliation(s)
- Parag V Patil
- Department of Radiology, Lifecare Hospital, Musaffah, Box 133500, Abu Dhabi, United Arab Emirates
| | - Manojkumar G Patil
- Department of Pediatrics, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, India, 411018
| | - Abhijit M Patil
- Department of Radiology, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, India, 411018
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211
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Shi L, Ji Y, Liu D, Liu Y, Xu Y, Cao Y, Jiang X, Xu C. Sitagliptin attenuates high glucose-induced alterations in migration, proliferation, calcification and apoptosis of vascular smooth muscle cells through ERK1/2 signal pathway. Oncotarget 2017; 8:77168-77180. [PMID: 29100378 PMCID: PMC5652771 DOI: 10.18632/oncotarget.20417] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/05/2017] [Indexed: 12/11/2022] Open
Abstract
Background/Aims This study investigated the effects of sitagliptin on migration, proliferation, calcification and apoptosis of vascular smooth muscle cells (VSMCs) under high glucose (HG) conditions. Methods VSMCs were isolated from the thoracic aorta of Sprague Dawley rats. The cultured VSMCs were subjected to control medium, mannitol medium, HG medium (25 mM), pretreatment with 200 nM sitagliptin in control or HG medium, or the ERK1/2 inhibitor PD98059 in HG medium. Cell proliferation, migration, apoptosis and calcification were determined. Results HG conditions promoted the proliferation, migration, calcification and impairment of apoptosis in VSMCs compared with controls (P<0.05). Pretreatment with sitagliptin effectively attenuated proliferation, migration, calcification of cells and increased apoptosis of HG-cultured VSMCs as compared with the HG group (P<0.05). Culture with HG resulted in the up-regulation of p-ERK1/2 in VSMCs, whereas sitagliptin pretreatment could inhibit HG-induced p-ERK1/2 expression. In addition, the ERK1/2 inhibitor PD98059, inhibited proliferation, migration, calcification and promoted the apoptosis of HG-cultured VSMCs compared with the HG group (P<0.05). Conclusion The effects of sitagliptin on VSMC under high glucose condition were achieved through ERK1/2 signaling pathways.
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Affiliation(s)
- Lili Shi
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Ye Ji
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Dandan Liu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Ying Liu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Ying Xu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Yang Cao
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Xiaoyan Jiang
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Changqing Xu
- Department of Pathophysiology, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
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212
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Oestrogen Inhibits Arterial Calcification by Promoting Autophagy. Sci Rep 2017; 7:3549. [PMID: 28615727 PMCID: PMC5471178 DOI: 10.1038/s41598-017-03801-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 05/04/2017] [Indexed: 01/08/2023] Open
Abstract
Arterial calcification is a major complication of cardiovascular disease. Oestrogen replacement therapy in postmenopausal women is associated with lower levels of coronary artery calcification, but its mechanism of action remains unclear. Here, we show that oestrogen inhibits the osteoblastic differentiation of vascular smooth muscle cells (VSMCs) in vitro and arterial calcification in vivo by promoting autophagy. Through electron microscopy, GFP–LC3 redistribution, and immunofluorescence analyses as well as measurement of the expression of the autophagosome marker light-chain I/II (LC3I/II) and autophagy protein 5 (Atg5), we show that autophagy is increased in VSMCs by oestrogen in vitro and in vivo. The inhibitory effect of oestrogen on arterial calcification was counteracted by 3-methyladenine (3MA) or knockdown of Atg5 and was increased by rapamycin. Furthermore, the inhibitory effect of oestrogen on arterial calcification and the degree of autophagy induced by oestrogen were blocked by a nonselective oestrogen receptor (ER) antagonist (ICI 182780), a selective oestrogen receptor alpha (ERα) antagonist (MPP), and ERα-specific siRNA. Our data indicate that oestrogen inhibits the osteoblastic differentiation of VSMCs by promoting autophagy through the ERα signalling pathway in vitro and arterial calcification in vivo by increasing autophagy. Our findings provide new insights into the mechanism by which oestrogen contributes to vascular calcification in vitro and in vivo.
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213
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Lin R, Chen S, Liu G, Xue Y, Zhao X. Association Between Carotid Atherosclerotic Plaque Calcification and Intraplaque Hemorrhage. Arterioscler Thromb Vasc Biol 2017; 37:1228-1233. [PMID: 28450297 DOI: 10.1161/atvbaha.116.308360] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/17/2017] [Indexed: 11/16/2022]
Abstract
Objective—
Carotid intraplaque hemorrhage (IPH) is associated with cardiovascular events. Calcification, which frequently accompanies IPH, may play a role in IPH occurrence. In this study, we aimed to investigate the associations between calcification characteristics and IPH in carotid plaques.
Approach and results—
One hundred seventeen patients with cerebrovascular symptoms and carotid plaques detected by ultrasound were recruited and underwent multicontrast magnetic resonance imaging. Advanced carotid plaques with composition measured by magnetic resonance imaging were included in the analysis. Carotid calcifications were divided into the following categories: surface, mixed, and deep calcification. They were also classified into single and multiple calcifications according to quantity. Logistic regression models utilizing generalized estimating equations were performed to evaluate the relationship between calcification and IPH. Of 117 subjects, 85 with 142 plaques were included in the final analysis, whereas 32 were excluded because of lack of plaque compositions. Of the 142 plaques, 40 (28.2%) had IPH. Plaques with IPH showed greater prevalence of calcification than those without (87.5% versus 55.9%;
P
=0.005). After adjusting for age, low-density lipoprotein, maximum wall thickness, and maximum soft plaque thickness, multiple calcifications (odd ratio, 10.1; 95% confidence interval, 3.3–30.4), surface calcification (odd ratio, 29.4; 95% confidence interval, 4.1–210.8), and mixed calcifications (odd ratio, 27.9; 95% confidence interval, 7.3–107.1) were found to be strongly associated with the presence of IPH (all
P
<0.05).
Conclusions—
Surface calcification and multiple calcifications in carotid atherosclerotic plaques are independently associated with the presence of IPH, suggesting that both quantity and location of calcification may play important roles in the occurrence of IPH. These findings may provide novel insights for understanding mechanisms of IPH.
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Affiliation(s)
- Ruolan Lin
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (R.L., Y.X.); Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (S.C., X.Z.); and Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (G.L.)
| | - Shuo Chen
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (R.L., Y.X.); Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (S.C., X.Z.); and Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (G.L.)
| | - Gaifen Liu
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (R.L., Y.X.); Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (S.C., X.Z.); and Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (G.L.)
| | - Yunjing Xue
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (R.L., Y.X.); Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (S.C., X.Z.); and Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (G.L.).
| | - Xihai Zhao
- From the Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China (R.L., Y.X.); Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (S.C., X.Z.); and Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (G.L.).
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Onuma OK, Pencina K, Qazi S, Massaro JM, D'Agostino RB, Chuang ML, Fox CS, Hoffmann U, O'Donnell CJ. Relation of Risk Factors and Abdominal Aortic Calcium to Progression of Coronary Artery Calcium (from the Framingham Heart Study). Am J Cardiol 2017; 119:1584-1589. [PMID: 28442125 DOI: 10.1016/j.amjcard.2017.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 12/21/2022]
Abstract
Coronary artery calcium (CAC) and abdominal aortic calcium (AAC) on multidetector computed tomography (MDCT) permit assessment of the presence and burden of coronary and systemic atherosclerosis. Risk factors for progression of CAC and AAC and the association of AAC with CAC progression have not been well characterized in a community-dwelling cohort. We studied 1,959 asymptomatic participants from the Framingham Heart Study who underwent serial MDCT scans with a median interval of 6.1 years. Primary outcomes were (a) the incidence of CAC and AAC (CAC >0 and AAC >0 with baseline CAC = 0 and AAC = 0) and (b) absolute progression of CAC (CAC > baseline CAC and AAC > baseline AAC). Covariates were collected at adjacent cycle examinations and included age, gender, use of antihypertensive therapy, use of lipid-lowering therapy, cigarette smoking, and total and high-density lipoprotein cholesterol. Predictors for CAC and AAC progression included baseline CAC, baseline AAC, lipid-lowering therapy, diabetes, high-density lipoprotein cholesterol, BMI, and serum creatinine. Multivariable stepwise logistic and linear regression models were used to test the association of these risk factors with CAC and AAC. Those who developed incident CAC on follow-up scanning comprised 18.8% of 1,124 participants, and 84.9% of 780 participants, with detectable baseline CAC, had further progression. Baseline AAC was a predictor of both CAC incidence and progression, independent of other risk factors. In stepwise models, addition of baseline AAC slightly improved the area under the curve from 0.72 (0.68 to 0.76) to 0.74 (0.70 to 0.78). In conclusion, standard cardiovascular disease risk factors are associated with incidence and progression of CAC and AAC, and AAC augments CAC incidence and progression above cardiovascular disease risk factors.
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Affiliation(s)
- Oyere K Onuma
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Karol Pencina
- Department of Mathematics, Boston University, Boston, Massachusetts
| | - Saadia Qazi
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts; Cardiology Section, Department of Medicine, Boston Veteran's Administration Healthcare, Boston, Massachusetts
| | - Joseph M Massaro
- Department of Mathematics, Boston University, Boston, Massachusetts
| | | | - Michael L Chuang
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts
| | - Caroline S Fox
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts
| | - Udo Hoffmann
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher J O'Donnell
- The National Heart, Lung, and Blood Institute's the Framingham Heart Study, Framingham, Massachusetts; Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Cardiology Section, Department of Medicine, Boston Veteran's Administration Healthcare, Boston, Massachusetts.
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215
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Zhan Y, Zhang Y, Hou J, Lin G, Yu B. Relation Between Superficial Calcifications and Plaque Rupture: An Optical Coherence Tomography Study. Can J Cardiol 2017; 33:991-997. [PMID: 28754399 DOI: 10.1016/j.cjca.2017.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There are several forms of calcium deposition, which play different roles in the stability of the coronary artery. It remains unknown whether certain calcification morphological characteristics determine rupture of lipid-rich lesions in the same plaque in acute coronary syndrome (ACS). METHODS We retrospectively analyzed 550 patients with ACS between May 2008 and October 2014, who had undergone preintervention optical coherence tomography (OCT) imaging examination. A total of 78 patients with 78 culprit lipid-rich lesions having superficial calcifications on OCT images were included in this study, among which 45 were ruptured lesions with calcium and 33 were nonruptured lipid-rich lesion with calcium. The smallest depth of calcium (CAL-DEP) was determined, and the morphology of the calcifications and plaques was analyzed during preintervention OCT imaging. RESULTS The CAL-DEP was significantly thinner in ruptured lesions with calcium than in nonruptured lipid-rich lesion with calcium (median, 50 [interquartile range (IQR), 33-63] μm vs 110 [73-208] μm; P < 0.001) and in myocardial infarction than in unstable angina pectoris patients (median, 57 [IQR, 36-78] μm vs median, 85 [IQR, 43-140] μm; P = 0.045). For lipid-rich calcified plaques, when CAL-DEP was < 63 μm, the lipid-rich lesion was most vulnerable and prone to rupture (sensitivity = 77.8%; specificity = 81.8%; area under the curve: 0.804; P < 0.0001). CONCLUSIONS Small CAL-DEP in lipid-rich calcified plaques is a morphological characteristic of a vulnerable plaque phenotype. A CAL-DEP ≤ 63 μm is the critical depth of calcification for lipid-rich calcified plaque rupture in patients with ACS.
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Affiliation(s)
- Yefei Zhan
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Intensive Care Unit, Ningbo No 2 Hospital, Ningbo, China
| | - Yingying Zhang
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Jingbo Hou
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Guochang Lin
- Center for Composite Materials, Harbin Institute of Technology, Harbin, China
| | - Bo Yu
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
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216
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Seidel R, Blumer M, Zaslansky P, Knötel D, Huber DR, Weaver JC, Fratzl P, Omelon S, Bertinetti L, Dean MN. Ultrastructural, material and crystallographic description of endophytic masses – A possible damage response in shark and ray tessellated calcified cartilage. J Struct Biol 2017; 198:5-18. [DOI: 10.1016/j.jsb.2017.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 12/23/2022]
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217
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Okafor ON, Farrington K, Gorog DA. Allopurinol as a therapeutic option in cardiovascular disease. Pharmacol Ther 2017; 172:139-150. [DOI: 10.1016/j.pharmthera.2016.12.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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218
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Singh GD, Armstrong EJ, Waldo SW, Alvandi B, Brinza E, Hildebrand J, Amsterdam EA, Humphries MD, Laird JR. Non-compressible ABIs are associated with an increased risk of major amputation and major adverse cardiovascular events in patients with critical limb ischemia. Vasc Med 2017; 22:210-217. [PMID: 28466753 DOI: 10.1177/1358863x16689831] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI. Consecutive patients undergoing endovascular evaluation for CLI between 2006 and 2013 were included in a single center cohort. Major adverse cardiovascular events (MACE) were then compared between the two groups. Among 284 patients with CLI, 68 (24%) had ncABIs. These patients were more likely to have coronary artery disease ( p=0.003), diabetes ( p<0.001), end-stage renal disease ( p<0.001) and tissue loss ( p=0.01) when compared to patients with cABI. Rates of infrapopliteal disease were similar between the two groups ( p=0.10), though patients with ncABI had lower rates of iliac ( p=0.004) or femoropopliteal stenosis ( p=0.003). Infrapopliteal vessels had smaller diameters ( p=0.01) with longer lesions ( p=0.05) among patients with ncABIs. After 3 years of follow-up, ncABIs were associated with increased rates of mortality (HR 1.75, 95% CI: 1.12-2.78), MACE (HR 2.04, 95% CI: 1.35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI.
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Affiliation(s)
- Gagan D Singh
- 1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Ehrin J Armstrong
- 2 Division of Cardiology, University of Colorado, Denver, CO, USA.,3 VA Eastern Colorado Healthcare System, Denver, CO, USA
| | - Stephen W Waldo
- 2 Division of Cardiology, University of Colorado, Denver, CO, USA.,3 VA Eastern Colorado Healthcare System, Denver, CO, USA
| | - Bejan Alvandi
- 1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Ellen Brinza
- 2 Division of Cardiology, University of Colorado, Denver, CO, USA.,3 VA Eastern Colorado Healthcare System, Denver, CO, USA
| | - Justin Hildebrand
- 1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Ezra A Amsterdam
- 1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Misty D Humphries
- 4 Division of Vascular and Endovascular Surgery and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - John R Laird
- 1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA
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219
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Abbas AE, Zacharias SK, Goldstein JA, Hanson ID, Safian RD. Invasive characterization of atherosclerotic plaque in patients with peripheral arterial disease using near-infrared spectroscopy intravascular ultrasound. Catheter Cardiovasc Interv 2017; 90:461-470. [PMID: 28303659 DOI: 10.1002/ccd.27023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/11/2017] [Accepted: 02/15/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We describe the characteristics of atherosclerotic plaque in patients with peripheral arterial disease (PAD) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) BACKGROUND: Imaging and autopsy studies have described atherosclerotic plaque in different vascular beds, including varying degrees of lipid, fibrosis, and calcification. Recently, NIRS has been validated as an accurate method for detecting lipid-core plaque (LCP) in the coronary circulation. Invasive evaluation of plaque composition using NIRS-IVUS has not been reported in different peripheral arterial circulations. METHODS We performed invasive angiography and NIRS-IVUS in consecutive PAD patients prior to percutaneous revascularization. Imaging evaluation included parameters from angiography, IVUS, and NIRS. NIRS-IVUS findings were compared among different vascular beds with regard to the presence and extent of calcification and LCP. RESULTS One hundred and forty-nine lesions in 126 PAD patients were enrolled, including the internal carotid (n = 10), subclavian/axillary (n = 9), renal (n = 14), iliac (n = 35), femoropopliteal (n = 69), and infrapopliteal (n = 12) arteries. Plaque morphology was calcified in 132 lesions (89%) and fibrous in 17 lesions (11%). Calcification varied from 100% of renal artery stenoses to 55% of subclavian/axillary artery stenoses. LCP was present in 48 lesions (32%) and prevalence varied from 60% in carotid artery stenoses to 0% in renal artery stenoses (P < 0.005). LCP was only observed in fibrocalcific plaque, and was longitudinally and circumferentially surrounded by a more extensive degree of calcium. CONCLUSIONS NIRS-IVUS in stable PAD patients demonstrates a high frequency of calcific plaque and statistically significant differences in the frequency of LCP in different arterial beds. LCP, when present in the peripheral circulation, is always associated with calcified plaque. The strong co-localization of calcified plaque and LCP in severe PAD lesions may provide plaque-stabilizing effects; further studies are needed. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Amr E Abbas
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Sibin K Zacharias
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - James A Goldstein
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Ivan D Hanson
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
| | - Robert D Safian
- Department of Cardiovascular Medicine, Center for Innovation and Research in Cardiovascular Diseases, Beaumont Health, Royal Oak, Michigan.,Oakland University William Beaumont School of Medicine, Oakland County, Michigan
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220
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Nicoll R, Henein M. Arterial calcification: A new perspective? Int J Cardiol 2017; 228:11-22. [DOI: 10.1016/j.ijcard.2016.11.099] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/06/2016] [Indexed: 12/19/2022]
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221
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Sun M, Chang Q, Xin M, Wang Q, Li H, Qian J. Endogenous bone morphogenetic protein 2 plays a role in vascular smooth muscle cell calcification induced by interleukin 6 in vitro. Int J Immunopathol Pharmacol 2017; 30:227-237. [PMID: 28134597 PMCID: PMC5815263 DOI: 10.1177/0394632016689571] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Systemic inflammation is involved in vascular calcification and cardiovascular disease which is the leading cause of mortality in rheumatoid arthritis (RA). A high level of serum interleukin (IL)-6 plays a key role in local and systemic inflammation in RA. However, the underlying mechanisms remain unclear. We established a human umbilical artery smooth muscle cell (HUASMC) culturing method to investigate the possible role of IL-6 on vascular calcification. HUASMCs were obtained from umbilical arteries of healthy neonates. To detect calcification effects, HUASMCs were treated with (experimental group) or without (control group) recombinant human (rh) IL-6. The calcium deposition stain and calcium concentrations were measured, as well as the mRNA and protein levels of the regulating factor of osteogenic differentiation-bone morphogenetic protein (BMP) 2 and those calcifying related molecules including bone-specific alkaline phosphatase (BAP), osteoprotegerin (OPG), and osteopontin (OPN). Our study showed that rhIL-6 induced calcification of HUASMCs in a time- and dose-dependent manner, and upregulated expressions of BMP2, BAP, OPG, and OPN of HUASMCs. We then used the anti-BMP2 siRNA to knockdown the expression of endogenous BMP2 to confirm its role. HUASMCs were transfected with negative siRNA (control group) or the valid anti-BMP2 siRNA (experimental group) before they were treated with rhIL-6. Cells transfected with negative siRNA without IL-6 stimulating served as the blank group. The results showed that anti-BMP2 siRNA markedly decreased expressions of BMP2, BAP, OPG, and OPN, and also partly reduced the calcification of HUASMCs induced by rhIL-6. Collectively, according to our study, rhIL-6 could induce the extracellular calcification and osteogenic differentiation of human artery smooth muscle cells through upregulating endogenous BMP2 in vitro. This may be one of the underlying mechanisms of the overwhelming vascular calcification in RA.
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Affiliation(s)
- Mingshu Sun
- 1 Department of Rheumatology and Clinical Immunology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qing Chang
- 2 Department of Cardiac surgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Miaomiao Xin
- 1 Department of Rheumatology and Clinical Immunology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qian Wang
- 1 Department of Rheumatology and Clinical Immunology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hua Li
- 1 Department of Rheumatology and Clinical Immunology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jiaqi Qian
- 3 Department of Nephrology, Renji Hospital, Shanghai Jiaotong University Medical College, Shanghai, China
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222
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Martín Giménez VM, Ruiz-Roso MB, Camargo AB, Kassuha D, Manucha W. Nanotechnology, a new paradigm in atherosclerosis treatment. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2016; 29:224-230. [PMID: 27914728 DOI: 10.1016/j.arteri.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
Abstract
Atherosclerosis, a known and prevalent disease, causes progressive deterioration of affected vessels, inducing a blood flow reduction with different complications, and its symptoms usually manifest in advanced stages of the disease. Therefore, the classic therapeutic alternatives are insufficient because the damages are many times irreversible. For this reason, there is a need to implement intelligent forms of drug administration and develop new therapeutic targets that reduce the progression of atherosclerotic lesion. The implementation of new tools for prevention, diagnosis and treatment of this cardiovascular disease is of special interest, focusing our attention on achieving a more effective control of the immune system. Finally, this review highlights the latest knowledge about nanotechnology as a powerful, modern, and promising therapeutic alternative applied to atherosclerotic disease, as well as warning of the potential complications with their use.
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Affiliation(s)
- Virna M Martín Giménez
- Instituto de Investigación en Ciencias Químicas, Facultad de Ciencias de la Alimentación, Bioquímicas y Farmacéuticas, Universidad Católica de Cuyo, San Juan, San Juan, Argentina
| | - María Belén Ruiz-Roso
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Alejandra Beatriz Camargo
- IBAM, UNCuyo, CONICET, Facultad de Ciencias Agrarias, Chacras de Coria, Luján, Mendoza, Argentina; Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Diego Kassuha
- Instituto de Investigación en Ciencias Químicas, Facultad de Ciencias de la Alimentación, Bioquímicas y Farmacéuticas, Universidad Católica de Cuyo, San Juan, San Juan, Argentina
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de Cuyo, Consejo Nacional de Investigación Científica y Tecnológica (IMBECU-CONICET), Argentina; Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina.
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223
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Cross-Sectional Imaging to Evaluate the Risk of Rupture in Abdominal Aortic Aneurysms: Review article based on a dissertation submitted to fulfill the academic grade of doctor in medical sciences (….), entitled: Imaging the mechanisms involved in abdominal aortic aneurysms rupture; a step towards patient-specific risk assessment. J Belg Soc Radiol 2016; 100:91. [PMID: 30151486 PMCID: PMC6100636 DOI: 10.5334/jbr-btr.1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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224
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Plaque surface irregularity and calcification length within carotid plaque predict secondary events in patients with coronary artery disease. Atherosclerosis 2016; 256:29-34. [PMID: 27998824 DOI: 10.1016/j.atherosclerosis.2016.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/13/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Although comprehensive risk factor modification is recommended, a uniform management strategy does not necessarily prevent secondary events in patients with coronary artery disease (CAD). Therefore, identification of high-risk patients who may benefit from more intensive interventions may improve prognosis. Carotid ultrasound can reliably identify systemic atherosclerosis, and carotid plaque and intima-media thickness (IMT) are known independent risk factors for CAD. However, it is unclear whether findings on carotid ultrasound can improve prediction of secondary CAD events. METHODS The study population comprised 146 consecutive patients with CAD (mean age, 66 ± 9 years; 126 with angina pectoris, 20 with acute myocardial infarction). IMT, plaque score, plaque area, plaque surface irregularity, and calcification length (calculated by summing the calcified lesions within each plaque accompanied by acoustic shadow) were measured at baseline. Patients were followed for 10 years to ascertain secondary CAD events defined as hard major adverse cardiovascular events (MACE; cardiac death and acute myocardial infarction) and as total MACE (hard MACE and angina pectoris with coronary revascularization). RESULTS Multiple regression analysis demonstrated that calcification length (p < 0.05) and plaque surface irregularity (p < 0.01) remained independently associated with total MACE after adjustment for age, sex, diabetes mellitus, dyslipidemia, hypertension, chronic kidney disease, smoking, and multivessel CAD. CONCLUSIONS These findings suggest that the combination of calcification length and plaque surface irregularity has additional value beyond traditional risk classification. Intensive intervention for these high-risk patients may avoid or delay progression of atherosclerosis towards secondary CAD events.
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225
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Cunnane EM, Mulvihill JJE, Barrett HE, Hennessy MM, Kavanagh EG, Walsh MT. Mechanical properties and composition of carotid and femoral atherosclerotic plaques: A comparative study. J Biomech 2016; 49:3697-3704. [PMID: 27776741 DOI: 10.1016/j.jbiomech.2016.09.036] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 01/25/2023]
Abstract
This study compares the mechanical properties of excised carotid and femoral human plaques and also develops a predictor of these properties based on plaque composition. Circumferential planar tension tests were performed on 24 carotid and 16 femoral plaque samples. Composition was characterised using Fourier Transform Infrared spectroscopy. Stretch at failure, strength, and stiffness are significantly higher in the carotid group (P=.012, P<.001 and P=.002, respectively). The ratio of calcified to lipid plaque content demonstrates the strongest correlation with the stretch at failure and strength (R2=.285, P<.001 and R2=.347, P<.001). No composition based parameter correlates significantly with stiffness. The significantly different mechanical properties of the two groups aids in explaining the varying endovascular treatment outcomes clinically observed in these vessels. Furthermore, determining the ratio of calcified to lipid plaque content may be useful in predicting individual plaque mechanical response to endovascular treatment.
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Affiliation(s)
- Eoghan M Cunnane
- School of Engineering, Bernal Institute, and the Health Research Institute, University of Limerick, Ireland
| | - John J E Mulvihill
- School of Engineering, Bernal Institute, and the Health Research Institute, University of Limerick, Ireland
| | - Hilary E Barrett
- School of Engineering, Bernal Institute, and the Health Research Institute, University of Limerick, Ireland
| | - Mairead M Hennessy
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - Eamon G Kavanagh
- Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland
| | - Michael T Walsh
- School of Engineering, Bernal Institute, and the Health Research Institute, University of Limerick, Ireland.
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226
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Barrett HE, Cunnane EM, Kavanagh EG, Walsh MT. Towards the characterisation of carotid plaque tissue toughness: Linking mechanical properties to plaque composition. Acta Biomater 2016; 43:88-100. [PMID: 27475529 DOI: 10.1016/j.actbio.2016.07.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/06/2016] [Accepted: 07/26/2016] [Indexed: 01/20/2023]
Abstract
UNLABELLED The morphological manifestation of calcification within an atherosclerotic plaque is diverse and the response to cutting balloon angioplasty remains an elusive target to predict in the presence of extensive calcification. This study examines the resistance of plaque tissue to blade penetration by characterising the underlying toughness properties and stratifying the upper and lower scale toughness limits based on the strong mechanical influence of calcification. Mechanical toughness properties of the common, bifurcation and internal carotid artery (n=62) were determined using guillotine-cutting tests measuring the energy required to pass a surgical blade through a unit length of plaque tissue. The corresponding structural composition of the dissected plaque segments was characterised using Fourier transform infrared analysis, electron microscopy and energy dispersive x-ray spectroscopy. Mechanical results reveal a clear distinction in toughness properties within each region of the carotid vessel with significantly tougher properties localised in the bifurcation (p=0.004) and internal region (p=0.0003) compared to the common. The severity of the intra-plaque variance is highest in plaques with high toughness localised in the bifurcation region (p<0.05). Structural examination reveals that the diverse mechanical influence of the level of calcification present is characteristic of specific regions within the carotid plaque. The energy required to overcome the calcific resistance and propagate a controlled cut in the calcified tissue at each region varies further with the degree of plaque progression. The identification of the localised calcification characteristics is a key determinant in achieving successful dissection of the severely toughened plaque segments during cutting balloon angioplasty. STATEMENT OF SIGNIFICANCE Calcification plays a fundamental role in plaque tissue mechanics and demonstrates a diverse range of material moduli properties. This work addresses the characterisation of the toughness properties in human carotid plaque tissue using a fracture mechanics approach. Toughness determines the energy required to propagate a controlled cut in the plaque material. This parameter is crucial for predicting the cutting forces required during endovascular cutting balloon angioplasty intervention. Results demonstrate that a strong relationship exists between the structural calcification configurations, fracture mechanisms and associated toughness properties that are characteristic of specific regions within the carotid artery plaque. The identification of the morphological characteristics of localised calcification may serve as a valuable quantitative measure for cutting balloon angioplasty treatment.
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Affiliation(s)
- H E Barrett
- Centre for Applied Biomedical Engineering Research (CABER), Health Research Institute (HRI), School of Engineering, Bernal Institute, University of Limerick, Ireland
| | - E M Cunnane
- Centre for Applied Biomedical Engineering Research (CABER), Health Research Institute (HRI), School of Engineering, Bernal Institute, University of Limerick, Ireland
| | - E G Kavanagh
- Department of Vascular Surgery, University Hospital Limerick, Ireland
| | - M T Walsh
- Centre for Applied Biomedical Engineering Research (CABER), Health Research Institute (HRI), School of Engineering, Bernal Institute, University of Limerick, Ireland.
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227
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Zhu L, Liu J, Gao C, Zhao W, Que J, Wang X, Qi D, Liu J, Xiao W, Yan J, Li W, Zhang Y, Yang H. Comparison of coronary plaque, coronary artery calcification and major adverse cardiac events in Chinese outpatients with and without type 2 diabetes. SPRINGERPLUS 2016; 5:1678. [PMID: 27733980 PMCID: PMC5042911 DOI: 10.1186/s40064-016-3373-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 09/23/2016] [Indexed: 01/15/2023]
Abstract
Objective Diabetes substantially increases the risk of cardiovascular disease (CAD) and is associated with an increased risk of CAD mortality. The purpose of this study was to investigate the differences in coronary artery plaque, coronary artery calcification (CAC) measured in outpatients with and without type 2 diabetes, and the occurrence rate of a major adverse cardiac event (MACE) throughout follow-up with the same patients. Methods Five hundred eighty-eight outpatients with suspected CAD comprising 208 diabetic and 380 non-diabetic patients were enrolled in this study. Coronary artery plaque and CAC scores were detected and measured by dual-source computed tomography. The major MACE during the follow-up period (4.0–20 months) was recorded and its relationship to type 2 diabetes and CAC was investigated. Results The diabetes group had higher CAC scores in the left anterior descending, left circumflex, and right coronary arteries and total CAC burden than the group without diabetes. The diabetes group had more diseased coronary segments and more obstructed vessels than the non-diabetes group. Logistic regression analysis demonstrated that diabetes is positively associated with mixed coronary plaque and non-calcified plaque. All patients in the diabetes group and all patients with higher CACs in both groups had a higher incidence rate of MACEs. Conclusion Patients with type 2 diabetes have a higher prevalence of obstructive CAD, higher CAC scores, and a higher incidence rate of MACEs than those without diabetes. Diabetes and higher CAC scores were the important predictors of the occurrence of MACEs throughout follow-up with patients.
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Affiliation(s)
- Lijie Zhu
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Jingjing Liu
- Cardio-Pulmonary Function Department, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Chuanyu Gao
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China ; Henan Institute of Cardiovascular Epidemiology, Zhengzhou, China
| | - Wenli Zhao
- Cardiac Catheterization Room, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jing Que
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Xianpei Wang
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Datun Qi
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Jun Liu
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Wentao Xiao
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Juanjuan Yan
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - Wentao Li
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
| | - You Zhang
- Henan Institute of Cardiovascular Epidemiology, Zhengzhou, China
| | - Honghui Yang
- Department of Cardiology, Zhengzhou University People's Hospital, 7 Wei Wu Road, Zhengzhou, 450003 China
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Kern J, Kern S, Blennow K, Zetterberg H, Waern M, Guo X, Börjesson-Hanson A, Skoog I, Östling S. Calcium supplementation and risk of dementia in women with cerebrovascular disease. Neurology 2016; 87:1674-1680. [PMID: 27534711 DOI: 10.1212/wnl.0000000000003111] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/05/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine whether calcium supplementation is associated with the development of dementia in women after a 5-year follow-up. METHODS This was a longitudinal population-based study. The sample was derived from the Prospective Population Study of Women and H70 Birth Cohort Study in Gothenburg, Sweden, and included 700 dementia-free women aged 70-92 years. At baseline in 2000-2001, and at follow-up in 2005-2006, the women underwent comprehensive neuropsychiatric and somatic examinations. A CT scan was performed in 447 participants at baseline. Information on the use and dosage of calcium supplements was collected. Dementia was diagnosed according to DSM-III-R criteria. RESULTS Women treated with calcium supplements (n = 98) were at a higher risk of developing dementia (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.01-4.37, p = 0.046) and the subtype stroke-related dementia (vascular dementia and mixed dementia) (OR 4.40, 95% CI 1.54-12.61, p = 0.006) than women not given supplementation (n = 602). In stratified analyses, calcium supplementation was associated with the development of dementia in groups with a history of stroke (OR 6.77, 95% CI 1.36-33.75, p = 0.020) or presence of white matter lesions (OR 2.99, 95% CI 1.28-6.96, p = 0.011), but not in groups without these conditions. CONCLUSIONS Calcium supplementation may increase the risk of developing dementia in elderly women with cerebrovascular disease. Because our sample was relatively small and the study was observational, these findings need to be confirmed.
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Affiliation(s)
- Jürgen Kern
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Silke Kern
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK.
| | - Kaj Blennow
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Henrik Zetterberg
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Margda Waern
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Xinxin Guo
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Anne Börjesson-Hanson
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Ingmar Skoog
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
| | - Svante Östling
- From the Department of Neuropsychiatric Epidemiology (J.K., S.K., M.W., X.G., A.B.-H., I.S., S.O.) and Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology (S.K., K.B., H.Z.), Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and UCL Institute of Neurology (H.Z.), London, UK
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Mokas S, Larivière R, Lamalice L, Gobeil S, Cornfield DN, Agharazii M, Richard DE. Hypoxia-inducible factor-1 plays a role in phosphate-induced vascular smooth muscle cell calcification. Kidney Int 2016; 90:598-609. [PMID: 27470678 DOI: 10.1016/j.kint.2016.05.020] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 05/12/2016] [Accepted: 05/19/2016] [Indexed: 12/21/2022]
Abstract
Medial vascular calcification is a common complication of chronic kidney disease (CKD). Although elevated inorganic phosphate stimulates vascular smooth muscle cell (VSMC) osteogenic transdifferentiation and calcification, the mechanisms involved in their calcification during CKD are not fully defined. Because hypoxic gene activation is linked to CKD and stimulates bone cell osteogenic differentiation, we used in vivo and in vitro rodent models to define the role of hypoxic signaling during elevated inorganic phosphate-induced VSMC calcification. Cell mineralization studies showed that elevated inorganic phosphate rapidly induced VSMC calcification. Hypoxia strongly enhanced elevated inorganic phosphate-induced VSMC calcification and osteogenic transdifferentiation, as seen by osteogenic marker expression. Hypoxia-inducible factor-1 (HIF-1), the key hypoxic transcription factor, was essential for enhanced VSMC calcification. Targeting HIF-1 expression in murine VSMC blocked calcification in hypoxia with elevated inorganic phosphate while HIF-1 activators, including clinically used FG-4592/Roxadustat, recreated a procalcifying environment. Elevated inorganic phosphate rapidly activated HIF-1, even in normal oxygenation; an effect mediated by HIF-1α subunit stabilization. Thus, hypoxia synergizes with elevated inorganic phosphate to enhance VSMC osteogenic transdifferentiation. Our work identifies HIF-1 as an early CKD-related pathological event, prospective marker, and potential target against vascular calcification in CKD-relevant conditions.
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Affiliation(s)
- Sophie Mokas
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Richard Larivière
- Department of Medicine, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Laurent Lamalice
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Stéphane Gobeil
- Department of Molecular Medicine, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
| | - David N Cornfield
- Center for Excellence in Pulmonary Biology, Stanford University, Stanford, California, USA
| | - Mohsen Agharazii
- Department of Medicine, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Darren E Richard
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada.
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Carotid and Aortic Stiffness in Patients with Heterozygous Familial Hypercholesterolemia. PLoS One 2016; 11:e0158964. [PMID: 27434535 PMCID: PMC4951005 DOI: 10.1371/journal.pone.0158964] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 06/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background The role of plasma cholesterol in impairing arterial function and elasticity remains unclear. We evaluated arterial stiffness, measured locally in the common carotid artery by high-resolution echo-tracking, and aortic stiffness, using carotid-femoral pulse wave velocity (PWV) (the “gold-standard” measurement of arterial stiffness), in treatment-naive patients with heterozygous familial hypercholesterolemia (FH). Methods The study included 66 patients with FH (10–66 years old) and 57 first-degree relatives without FH (11–61 years old). Carotid-femoral PWV was determined by SphygmoCor (AtCor, Australia). The parameters of carotid stiffness β-index, Peterson elastic modulus and local PWV were assessed with regard to the common carotid artery at a distance of 1cm from the bifurcation (AlokaProsound Alpha7, Japan). Results FH patients showed significantly higher β-index (6.3(4.8–8.2) vs. 5.2(4.2–6.4), p = 0.005), Ep (78(53–111) kPa vs. 62(48–79) kPa, p = 0.006), local PWV (5.4(4.5–6.4) m/c vs. 4.7(4.2–5.4) m/c, p = 0.005), but comparable values of carotid-femoral PWV (6.76(7.0–7.92) m/c vs. 6.48(6.16–7.12) m/c, p = 0.138). Carotid arteries and the aorta stiffened with age in patients with FH, but after 30 years, carotid arteries stiffened more significantly than the aorta. Conclusions Our study demonstrated that treatment-naive patients with FH had stiffer carotid arteries than their relatives, but showed no difference in aortic stiffness. We also found out that the rate of reduction of elasticity of the aorta and carotid arteries in FH patients varies: it is observed earlier in carotid arteries than in the aorta.
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231
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Hsu JJ, Lim J, Tintut Y, Demer LL. Cell-matrix mechanics and pattern formation in inflammatory cardiovascular calcification. Heart 2016; 102:1710-1715. [PMID: 27406839 DOI: 10.1136/heartjnl-2016-309667] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/20/2016] [Indexed: 12/24/2022] Open
Abstract
Calcific diseases of the cardiovascular system, such as atherosclerotic calcification and calcific aortic valve disease, are widespread and clinically significant, causing substantial morbidity and mortality. Vascular cells, like bone cells, interact with their matrix substrate through molecular signals, and through biomechanical signals, such as traction forces transmitted from cytoskeleton to matrix. The interaction of contractile vascular cells with their matrix may be one of the most important factors controlling pathological mineralisation of the artery wall and cardiac valves. In many respects, the matricrine and matrix mechanical changes in calcific vasculopathy and valvulopathy resemble those occurring in embryonic bone development and normal bone mineralisation. The matrix proteins provide a microenvironment for propagation of crystal growth and provide mechanical cues to the cells that direct differentiation. Small contractions of the cytoskeleton may tug on integrin links to sites on matrix proteins, and thereby sense the stiffness, possibly through deformation of binding proteins causing release of differentiation factors such as products of the members of the transforming growth factor-β superfamily. Inflammation and matrix characteristics are intertwined: inflammation alters the matrix such as through matrix metalloproteinases, while matrix mechanical properties affect cellular sensitivity to inflammatory cytokines. The adhesive properties of the matrix also regulate self-organisation of vascular cells into patterns through reaction-diffusion phenomena and left-right chirality. In this review, we summarise the roles of extracellular matrix proteins and biomechanics in the development of inflammatory cardiovascular calcification.
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Affiliation(s)
- Jeffrey J Hsu
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Jina Lim
- Department of Pediatrics, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Yin Tintut
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Linda L Demer
- Department of Medicine, Division of Cardiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Bioengineering, University of California, Los Angeles (UCLA), Los Angeles, California, USA
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232
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Dorsomorphin homologue 1, a highly selective small-molecule bone morphogenetic protein inhibitor, suppresses medial artery calcification. J Vasc Surg 2016; 66:586-593. [PMID: 27374065 DOI: 10.1016/j.jvs.2016.03.462] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/26/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Medial artery calcification develops in diabetes, chronic kidney disease, and as part of the aging process. It is associated with increased morbidity and mortality in vascular patients. Bone morphogenetic proteins (BMPs) have previously been implicated in the initiation and progression of vascular calcification. We thus evaluated whether dorsomorphin homologue 1 (DMH1), a highly selective BMP inhibitor, could attenuate vascular calcification in vitro and in an organ culture model of medial calcification. METHODS Confluent human aortic smooth muscle cells (SMCs) were cultured in calcification medium containing 3.0 mM inorganic phosphate (Pi) for 7 days with or without DMH1. Medial calcification was assessed using an aortic organ culture model. Calcification was visualized by alizarin red S staining, and calcium concentration was assessed by an o-cresolphthalein complexone calcium assay. Osteogenic cell and vascular SMC markers were determined by Western blot, quantitative reverse transcription polymerase chain reaction, and immunohistochemical staining. RESULTS DMH1 reduced Pi-induced calcium deposition in human SMCs. It also antagonized human recombinant BMP2-induced calcium accumulation. Western blot further revealed that DMH1 was able to block Pi-mediated upregulation of the osteoblast markers osterix and alkaline phosphatase and downregulation of the SMC markers smooth muscle myosin heavy chain and SM22α as well as p-Smad1/5/8, suggesting that DMH1 may regulate SMC osteogenic differentiation through the BMP/Smad1/5/8 signaling pathway. Finally, using an ex vivo aortic ring organ culture model, we observed that DMH1 reduces Pi-induced aortic medial calcification. CONCLUSIONS The selective BMP inhibitor DMH1 can inhibit calcium accumulation in vascular SMCs and arterial segments exposed to elevated phosphate levels. Such small molecules may have clinical utility in reducing medial artery calcification in our population of vascular patients.
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Coronary artery calcification score is an independent predictor of the no-reflow phenomenon after reperfusion therapy in acute myocardial infarction. Coron Artery Dis 2016; 26:562-6. [PMID: 26010531 DOI: 10.1097/mca.0000000000000269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM/BACKGROUND Abundant evidence shows that coronary artery calcification (CAC) is a strong marker of structural and functional changes within the artery wall. Thus far, the implications of CAC in patients with acute coronary syndromes remain unclear. We aimed to investigate whether the CAC score is associated with impaired reperfusion during the acute phase of ST-elevation myocardial infarction (STEMI). METHODS We enrolled 60 consecutive STEMI patients to undergo cardiac computed tomography for assessment of the CAC score within 1 week after STEMI. Coronary thrombus burden, coronary blood flow (TIMI flow), and myocardial blush grade (MBG) were evaluated systematically. Patients with maximal TIMI flow and MBG were grouped as optimal reperfusion (n=27) and their counterparts as no-reflow (NR, n=33). RESULTS There were no differences in the clinical characteristics between groups. Patients in the NR group had higher heart rate, coronary angiographic severity, and CAC score. CAC score greater than 100 was associated independently with the presence of NR (odds ratio 4.4, 95% confidence interval 1.17-16.3). The CAC score of nonculprit coronary arteries was higher in NR individuals than in their counterparts (P=0.04). In addition, the CAC score of the isnfarct-related artery correlated negatively with the TIMI-flow rate (r=-0.54, P<0.001) and with the MBG (r=-0.32, P=0.04). CONCLUSION The CAC score is associated with the presence of the NR phenomenon in STEMI patients.
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Davenport C, Harper E, Forde H, Rochfort KD, Murphy RP, Smith D, Cummins PM. RANKL promotes osteoblastic activity in vascular smooth muscle cells by upregulating endothelial BMP-2 release. Int J Biochem Cell Biol 2016; 77:171-180. [PMID: 27339040 DOI: 10.1016/j.biocel.2016.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 05/18/2016] [Accepted: 06/19/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Receptor activator of nuclear factor kappa beta-ligand (RANKL) is thought to promote vascular calcification (VC) by inducing osteoblastic behaviour in vascular smooth muscle cells (VSMC) in an ill-defined process. The present study assessed whether RANKL affects pro-osteoblastic paracrine signalling between human aortic endothelial cells (HAEC) and human aortic smooth muscle cells (HASMC) using both conditioned media transfer and cell co-culture experimental approaches. METHODS AND RESULTS For initial experiments (6-well format), HAEC-conditioned media was harvested following 72h exposure to RANKL, and transferred to reporter HASMCs with/without noggin, an inhibitor of pro-osteoblastic bone morphogenetic protein (BMP) paracrine signalling. In further experiments, HAECs and HASMCs were co-cultured within the CellMax(®) Duo, a perfusing bioreactor unit that mimics the flow-mediated co-interaction of these cells within the arterial wall, and RANKL was added to the perfusing media for 72h. At the conclusion of each experiment markers of osteoblastic activity were measured in HASMCs, including alkaline phosphatase (ALP) activity, mRNA levels of ALP and Runx2, as well as BMP-2 and BMP-4 concentrations. RANKL increased BMP-2 release from HAECs, while exposure of HASMCs to RANKL-treated HAEC-conditioned media induced osteoblastic behaviour in HASMCs, an effect prevented by noggin. Within the CellMax(®) Duo bioreactor, the addition of RANKL to the intraluminal HAECs also produced an increase in BMP-2 and increased osteoblastic behaviour within the co-cultured HASMC population. CONCLUSIONS RANKL promotes VC by inducing BMP-2 release from HAECs, which in turn appears to act in a paracrine fashion on the adjacent HASMC population to increase osteoblastic activity.
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Affiliation(s)
- Colin Davenport
- School of Biotechnology, Dublin City University, Dublin, Ireland.
| | - Emma Harper
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Hannah Forde
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | | | - Ronan P Murphy
- School of Health and Human Performance, Dublin City University, Dublin, Ireland; Centre for Preventive Medicine, Dublin City University, Dublin, Ireland
| | - Diarmuid Smith
- Department of Academic Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Philip M Cummins
- School of Biotechnology, Dublin City University, Dublin, Ireland; Centre for Preventive Medicine, Dublin City University, Dublin, Ireland
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Cai Z, Ding Y, Zhang M, Lu Q, Wu S, Zhu H, Song P, Zou MH. Ablation of Adenosine Monophosphate-Activated Protein Kinase α1 in Vascular Smooth Muscle Cells Promotes Diet-Induced Atherosclerotic Calcification In Vivo. Circ Res 2016; 119:422-33. [PMID: 27256105 DOI: 10.1161/circresaha.116.308301] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/02/2016] [Indexed: 12/27/2022]
Abstract
RATIONALE Atherosclerotic calcification is highly linked with plaque rapture. How calcification is regulated is poorly characterized. OBJECTIVE We sought to determine the contributions of AMP-activated protein kinase (AMPK) in atherosclerotic calcification. METHODS AND RESULTS Aortic calcification was evaluated in aortic roots and brachiocephalic arteries of atherosclerotic prone ApoE(-/-) mice or in mice with dual deficiencies of ApoE and AMPKα isoforms in whole body (ApoE(-/-)/AMPKα1(-/-) and ApoE(-/-)/AMPKα2(-/-)) or vascular smooth muscle cell (VSMC)-specific or macrophage-specific knockout of AMPKα1 fed with Western diet for 24 weeks. Genetic deficiency of AMPKα1 but not of AMPKα2 promoted atherosclerotic calcification and the expression of Runx2 (Runt-related transcription factor). Conversely, chronic administration of metformin, which activated AMPK, markedly reduced atherosclerotic calcification and Runx2 expression in ApoE(-/-) mice but had less effects in ApoE(-/-)/AMPKα1(-/-) mice. Furthermore, VSMC-specific but not macrophage-specific ablation of AMPKα1 promoted aortic calcification in vivo. Ablation of AMPKα1 in VSMC prevented Runx2 from proteasome degradation in parallel with aberrant osteoblastic differentiation of VSMC, whereas AMPK activation promoted Runx2 post-translational modification by small ubiquitin-like modifier (SUMO, SUMOylation), which is associated with its instability. Mechanically, we found that AMPKα1 directly phosphorylated protein inhibitor of activated STAT-1 (PIAS1), the SUMO E3-ligase of Runx2, at serine 510, to promote its SUMO E3-ligase activity. Finally, mutation of protein inhibitor of activated STAT-1 at serine 510 suppressed metformin-induced Runx2 SUMOylation and subsequently prevented metformin's effect on reducing oxidized low-density lipoprotein-triggered Runx2 expression in VSMC. CONCLUSIONS AMPKα1 phosphorylated protein inhibitor of activated STAT-1 to promote Runx2 SUMOylation and subsequently lead to its instability. AMPKα1 deficiency in VSMC increased Runx2 expression and promoted atherosclerotic calcification in vivo.
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Affiliation(s)
- Zhejun Cai
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Ye Ding
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Miao Zhang
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Qiulun Lu
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Shengnan Wu
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Huaiping Zhu
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Ping Song
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.)
| | - Ming-Hui Zou
- From the Center for Molecular and Translational Medicine, Georgia State University, Atlanta (Z.C., Y.D., Q.L., S.W., H.Z., P.S., M.-H.Z.); Department of Cardiology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China (Z.C.); and Department of Medicine, University of Oklahoma Health Sciences Center (M.Z.).
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Li N, Song J, Zhu G, Shi X, Wang Y. Alendronate conjugated nanoparticles for calcification targeting. Colloids Surf B Biointerfaces 2016; 142:344-350. [DOI: 10.1016/j.colsurfb.2016.03.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 11/28/2022]
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237
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Cui L, Houston DA, Farquharson C, MacRae VE. Characterisation of matrix vesicles in skeletal and soft tissue mineralisation. Bone 2016; 87:147-58. [PMID: 27072517 DOI: 10.1016/j.bone.2016.04.007] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/25/2016] [Accepted: 04/06/2016] [Indexed: 12/16/2022]
Abstract
The importance of matrix vesicles (MVs) has been repeatedly highlighted in the formation of cartilage, bone, and dentin since their discovery in 1967. These nano-vesicular structures, which are found in the extracellular matrix, are believed to be one of the sites of mineral nucleation that occurs in the organic matrix of the skeletal tissues. In the more recent years, there have been numerous reports on the observation of MV-like particles in calcified vascular tissues that could be playing a similar role. Therefore, here, we review the characteristics MVs possess that enable them to participate in mineral deposition. Additionally, we outline the content of skeletal tissue- and soft tissue-derived MVs, and discuss their key mineralisation mediators that could be targeted for future therapeutic use.
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Affiliation(s)
- L Cui
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK.
| | - D A Houston
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
| | - C Farquharson
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
| | - V E MacRae
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
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238
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Wu XH, Chen XY, Wang LJ, Wong KS. Intracranial Artery Calcification and Its Clinical Significance. J Clin Neurol 2016; 12:253-61. [PMID: 27165425 PMCID: PMC4960208 DOI: 10.3988/jcn.2016.12.3.253] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/20/2015] [Accepted: 12/21/2015] [Indexed: 01/19/2023] Open
Abstract
Intracranial arterial calcification (IAC) is an easily identifiable entity on plain head computed tomography scans. Recent studies have found high prevalence rates for IAC worldwide, and this may be associated with ischemic stroke and cognitive decline. Aging, traditional cardiovascular risk factors, and chronic kidney disease have been found to be associated with IAC. The severity of IAC can be assessed using different visual grading scales or various quantitative methods (by measuring volume or intensity). An objective method for assessing IAC using consistent criteria is urgently required to facilitate comparisons between multiple studies involving diverse populations. There is accumulating evidence from clinical studies that IAC could be utilized as an indicator of intracranial atherosclerosis. However, the pathophysiology underlying the potential correlation between IAC and ischemic stroke-through direct arterial stenosis or plaque stability-remains to be determined. More well-designed clinical studies are needed to explore the predictive values of IAC in vascular events and the underlying pathophysiological mechanisms.
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Affiliation(s)
- Xiao Hong Wu
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiang Yan Chen
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Li Juan Wang
- Department of Neurology, The First Hospital of Jilin University, Jilin, China
| | - Ka Sing Wong
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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239
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Zhang Y, Feng B. Systematic review and meta-analysis for the association of bone mineral density and osteoporosis/osteopenia with vascular calcification in women. Int J Rheum Dis 2016; 20:154-160. [PMID: 27153243 DOI: 10.1111/1756-185x.12842] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM The relationships of osteoporosis/osteopenia and bone mineral density (BMD) with vascular calcification (VC) remain controversial. Thus, we performed this systematic review and meta-analysis to evaluate the association between BMD, osteoporosis/osteopenia risk and VC. METHODS PubMed, Embase and Springer databases were searched from inception to March, 2015 for studies involving the association of vascular calcification with BMD and osteopenia/osteoporosis in women. A manual search of the references cited in the publications was also employed for more relevant studies. The heterogeneity was assessed using Cochran's Q statistic and I2 test. Weighted mean difference (WMD) or odds ratio (OR) and 95% confidence interval (CI) in the VC group and control group were appropriately pooled. RESULTS Four studies were enrolled in the meta-analysis. The pooled effects indicated that the spine BMD (WMD = -0.08, 95% CI: -0.11 to -0.06) and hip BMD (WMD = -0.06, 95% CI: -0.10 to -0.07) in VC group were significantly lower than those in control group, respectively. Moreover, patients with VC were prone to develop osteoporosis (OR = 4.39, 95% CI: 2.82-6.83) and osteopenia (OR = 1.72, 95% CI: 1.14-2.60). CONCLUSION The results suggest that patients with VC have lower lumbar spine and hip BMD levels and increased risk for developing osteoporosis/osteopenia. Thus, VC patients should be evaluated for the presence of osteoporosis/osteopenia, as well as susceptibility to fractures.
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Affiliation(s)
- Yiyun Zhang
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Bo Feng
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
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240
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Li F, Wang X. Bilateral symmetry of human carotid artery atherosclerosis: a multi-contrast weighted MR study. Int J Cardiovasc Imaging 2016; 32:1219-26. [DOI: 10.1007/s10554-016-0890-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/02/2016] [Indexed: 02/05/2023]
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Ong DS, Lee JS, Soeda T, Higuma T, Minami Y, Wang Z, Lee H, Yokoyama H, Yokota T, Okumura K, Jang IK. Coronary Calcification and Plaque Vulnerability: An Optical Coherence Tomographic Study. Circ Cardiovasc Imaging 2016; 9:CIRCIMAGING.115.003929. [PMID: 26743463 DOI: 10.1161/circimaging.115.003929] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Spotty superficial calcium deposits have been implicated in plaque vulnerability based on previous intravascular imaging studies. Biomechanical models suggest that microcalcifications between 5 and 65 µm in diameter can intensify fibrous cap stress, promoting plaque rupture. However, the 100- to 200-µm resolution of intravascular ultrasound limits its ability to discriminate single calcium deposits from clusters of smaller deposits, and a previous optical coherence tomographic investigation evaluated calcifications within a long segment of artery, which may not truly reflect the mechanics involved in potentiating focal plaque rupture. METHODS AND RESULTS Detailed optical coherence tomographic assessment of coronary calcification at the culprit plaque (10-mm length) was performed in 53 patients with acute ST-segment-elevation myocardial infarction mediated by plaque rupture and 55 patients with stable angina pectoris. The number and longitudinal length of individual calcium deposits were recorded. Cross-sectional images were analyzed every 1 mm for calcium arc and depth, and these quantitative parameters were used to define individual deposits as spotty, large, and superficial. There was no significant difference between ST-segment-elevation myocardial infarction mediated by plaque rupture and stable angina pectoris groups in the number of total (P=0.58), spotty (P=0.87), or large calcium deposits (P=0.27). Minimum calcium depth was similar between groups (P=0.27), as was the number of superficial deposits (P=0.35 using a 65-µm depth threshold and P=0.84 using a 100-µm depth threshold). CONCLUSIONS The number and pattern of culprit plaque calcifications did not differ between patients presenting with ST-segment-elevation myocardial infarction mediated by plaque rupture versus stable angina pectoris. The optical coherence tomographic assessment of coronary calcification may not be a useful marker of local plaque vulnerability as previously suspected. REGISTRATION INFORMATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01110538.
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Affiliation(s)
- Daniel S Ong
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Jay S Lee
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Tsunenari Soeda
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Takumi Higuma
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Yoshiyasu Minami
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Zhao Wang
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Hang Lee
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Hiroaki Yokoyama
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Takashi Yokota
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Ken Okumura
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.)
| | - Ik-Kyung Jang
- From the Division of Cardiology (D.S.O., J.S.L., T.S., Y.M., Z.W., I.-K.J.) and Biostatistics Center (H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan (T.H., H.Y., T.Y, K.O.); and Division of Cardiology, Kyung Hee University, Seoul, South Korea (I.-K.J.).
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242
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Aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:218-25. [PMID: 27103916 PMCID: PMC4826891 DOI: 10.11909/j.issn.1671-5411.2016.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background The coronary artery calcium (CAC) and aortic arch calcification (AoAC) are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardiac death, stroke, myocardial infarction, or repeated revascularization. The extent of AoAC on chest X-ray was graded on a scale from 0 to 3. Results During the four years of follow-up, 620 patients were treated by coronary stenting and 153 (7%) adverse events occurred. A higher grade of AoAC was associated with a higher CAC score. Cox regression showed that the CAC score, but not AoAC, were associated with adverse events. In patients with CAC score < 400, AoAC showed an additive predictive value in detecting significant coronary artery disease (CAD). A gradual increases in the risk of adverse events were noted if AoAC was present in patients with similar CAC score. Conclusions As AoAC is strongly correlated with the CAC score regardless of age or gender, careful evaluation of CAD would be required in patients with AoAC on conventional chest X-rays.
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243
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Higgins CL, Isbilir S, Basto P, Chen IY, Vaduganathan M, Vaduganathan P, Reardon MJ, Lawrie G, Peterson L, Morrisett JD. Distribution of alkaline phosphatase, osteopontin, RANK ligand and osteoprotegerin in calcified human carotid atheroma. Protein J 2016; 34:315-28. [PMID: 26307009 DOI: 10.1007/s10930-015-9620-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Ectopic vascular calcification is a significant component of atherosclerotic disease. Osteopontin (OPN), Osteoprotegerin (OPG), Receptor Activator of NFκB Ligand (RANKL), and alkaline phosphatase (ALP) are each thought to play central roles in the calcification or demineralization of atherosclerotic lesions. Abnormalities in the balance of these proteins may lead to perturbations in bone remodeling and arterial calcification. The purpose of this study was to measure the distribution of these proteins in human carotid lesions and to elucidate possible mechanism(s) whereby they control the deposition or depletion of arterial calcification. Thirty-three patients who had undergone carotid endarterectomy (CEA) within the previous 18 months and 11 control patients were enrolled. CEA specimens were analyzed by EBCT for calcification content in terms of Agatston (AGAT) and Volume scores. CEA specimens were then cut into 5 mm segments which were homogenized and extracted. Extracts were analyzed for tissue levels of calcium, phosphorus, ALP, OPN, RANKL, and OPG. Fasting blood samples were analyzed for the same components. In CEA tissue segments, the calcification levels (CHA AGAT) were inversely associated with the levels of OPG (r = -0.432/-0.579, p < 0.05) and positively associated with the levels of RANKL (r = 0.332/0.415, p < 0.05). In turn, the tissue levels of OPG were associated with homologous serum levels of OPG (r = 0.820/0.389, p < 0.001), and the tissue levels of RANKL were associated with the serum levels of homologous RANKL (r = 0.739/0.666, p < 0.0001). This study suggests that serum levels of OPG and RANKL may be useful biomarkers for estimating the degree of calcification in carotid atherosclerotic lesions.
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Affiliation(s)
| | - Salim Isbilir
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Pamela Basto
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Iou Yih Chen
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Muthiah Vaduganathan
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, A601, 6565 Fannin St., Houston, TX, 77030, USA
| | - Periyanan Vaduganathan
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, A601, 6565 Fannin St., Houston, TX, 77030, USA
| | - Michael J Reardon
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, A601, 6565 Fannin St., Houston, TX, 77030, USA
| | - Gerald Lawrie
- Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, A601, 6565 Fannin St., Houston, TX, 77030, USA
| | - Leif Peterson
- Department of Public Health, The Methodist Hospital Research Institute, Houston, TX, USA
| | - Joel D Morrisett
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA. .,Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, A601, 6565 Fannin St., Houston, TX, 77030, USA.
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Forde H, Harper E, Davenport C, Rochfort KD, Wallace R, Murphy RP, Smith D, Cummins PM. The beneficial pleiotropic effects of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) within the vasculature: A review of the evidence. Atherosclerosis 2016; 247:87-96. [DOI: 10.1016/j.atherosclerosis.2016.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/27/2016] [Accepted: 02/02/2016] [Indexed: 01/19/2023]
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245
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Tsang HG, Rashdan NA, Whitelaw CBA, Corcoran BM, Summers KM, MacRae VE. Large animal models of cardiovascular disease. Cell Biochem Funct 2016; 34:113-32. [PMID: 26914991 PMCID: PMC4834612 DOI: 10.1002/cbf.3173] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 12/12/2022]
Abstract
The human cardiovascular system is a complex arrangement of specialized structures with distinct functions. The molecular landscape, including the genome, transcriptome and proteome, is pivotal to the biological complexity of both normal and abnormal mammalian processes. Despite our advancing knowledge and understanding of cardiovascular disease (CVD) through the principal use of rodent models, this continues to be an increasing issue in today's world. For instance, as the ageing population increases, so does the incidence of heart valve dysfunction. This may be because of changes in molecular composition and structure of the extracellular matrix, or from the pathological process of vascular calcification in which bone-formation related factors cause ectopic mineralization. However, significant differences between mice and men exist in terms of cardiovascular anatomy, physiology and pathology. In contrast, large animal models can show considerably greater similarity to humans. Furthermore, precise and efficient genome editing techniques enable the generation of tailored models for translational research. These novel systems provide a huge potential for large animal models to investigate the regulatory factors and molecular pathways that contribute to CVD in vivo. In turn, this will help bridge the gap between basic science and clinical applications by facilitating the refinement of therapies for cardiovascular disease.
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Affiliation(s)
- H G Tsang
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - N A Rashdan
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - C B A Whitelaw
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - B M Corcoran
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - K M Summers
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
| | - V E MacRae
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush, Midlothian, SCT, UK
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Bondonno NP, Lewis JR, Prince RL, Lim WH, Wong G, Schousboe JT, Woodman RJ, Kiel DP, Bondonno CP, Ward NC, Croft KD, Hodgson JM. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study. Nutrients 2016; 8:159. [PMID: 26978394 PMCID: PMC4808887 DOI: 10.3390/nu8030159] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/22/2016] [Accepted: 02/25/2016] [Indexed: 01/06/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC), a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana) intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05), but not with pear, orange or banana intakes (p > 0.25). In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day) increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5) (odd ratio OR): 0.76 (0.62, 0.93), p = 0.009). Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women.
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Affiliation(s)
- Nicola P Bondonno
- Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth 6000, Western Australia, Australia.
| | - Joshua R Lewis
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney 2145, New South Wales, Australia.
- School of Public Health, Sydney Medical School, University of Sydney, Sydney 2006, New South Wales, Australia.
- Sir Charles Gairdner Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth 6009, Western Australia, Australia.
| | - Richard L Prince
- Sir Charles Gairdner Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth 6009, Western Australia, Australia.
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth 6009, Western Australia, Australia.
| | - Wai H Lim
- Sir Charles Gairdner Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth 6009, Western Australia, Australia.
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth 6009, Western Australia, Australia.
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney 2145, New South Wales, Australia.
- School of Public Health, Sydney Medical School, University of Sydney, Sydney 2006, New South Wales, Australia.
| | - John T Schousboe
- Park Nicollet Osteoporosis Centre and HealthPartners Institute, HealthPartners, Minneapolis, MN 55416, USA.
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Richard J Woodman
- Centre for Epidemiology and Biostatistics, School of Public Health, Flinders University of South Australia, Adelaide 5042, South Australia, Australia.
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew Senior Life, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA 02215, USA.
| | - Catherine P Bondonno
- Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth 6000, Western Australia, Australia.
| | - Natalie C Ward
- Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth 6000, Western Australia, Australia.
- School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University Western Australia, Perth 6102, Australia.
| | - Kevin D Croft
- Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth 6000, Western Australia, Australia.
| | - Jonathan M Hodgson
- Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth 6000, Western Australia, Australia.
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Cenizo Revuelta N, González-Fajardo J, Bratos Pérez M, Álvarez Gago T, Aguirre Gervás B, Vaquero Puerta C. Nanopartículas calcificantes como factor etiológico del desarrollo de hiperplasia y calcificación vascular. ANGIOLOGIA 2016. [DOI: 10.1016/j.angio.2015.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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248
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Yang B, Campbell PT, Gapstur SM, Jacobs EJ, Bostick RM, Fedirko V, Flanders WD, McCullough ML. Calcium intake and mortality from all causes, cancer, and cardiovascular disease: the Cancer Prevention Study II Nutrition Cohort. Am J Clin Nutr 2016; 103:886-94. [PMID: 26864361 DOI: 10.3945/ajcn.115.117994] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/29/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Calcium intake may be important for bone health, but its effects on other outcomes, including cardiovascular disease (CVD) and cancer, remain unclear. Recent reports of adverse cardiovascular effects of supplemental calcium have raised concerns. OBJECTIVE We investigated associations of supplemental, dietary, and total calcium intakes with all-cause, CVD-specific, and cancer-specific mortality in a large, prospective cohort. DESIGN A total of 132,823 participants in the Cancer Prevention Study II Nutrition Cohort, who were followed from baseline (1992 or 1993) through 2012 for mortality outcomes, were included in the analysis. Dietary and supplemental calcium information was first collected at baseline and updated in 1999 and 2003. Multivariable-adjusted Cox proportional hazards models with cumulative updating of exposures were used to calculate RRs and 95% CIs for associations between calcium intake and mortality. RESULTS During a mean follow-up of 17.5 y, 43,186 deaths occurred. For men, supplemental calcium intake was overall not associated with mortality outcomes (P-trend > 0.05 for all), but men who were taking ≥1000 mg supplemental calcium/d had a higher risk of all-cause mortality (RR: 1.17; 95% CI: 1.03, 1.33), which was primarily attributed to borderline statistically significant higher risk of CVD-specific mortality (RR: 1.22; 95% CI: 0.99, 1.51). For women, supplemental calcium was inversely associated with mortality from all causes [RR (95% CI): 0.90 (0.87, 0.94), 0.84 (0.80, 0.88), and 0.93 (0.87, 0.99) for intakes of 0.1 to <500, 500 to <1000, and ≥1000 mg/d, respectively; P-trend < 0.01]. Total calcium intake was inversely associated with mortality in women (P-trend < 0.01) but not in men; dietary calcium was not associated with all-cause mortality in either sex. CONCLUSIONS In this cohort, associations of calcium intake and mortality varied by sex. For women, total and supplemental calcium intakes are associated with lower mortality, whereas for men, supplemental calcium intake ≥1000 mg/d may be associated with higher all-cause and CVD-specific mortality.
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Affiliation(s)
- Baiyu Yang
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, and
| | - Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | - Eric J Jacobs
- Epidemiology Research Program, American Cancer Society, Atlanta, GA; and
| | - Roberd M Bostick
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
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Hydrogen Sulfide Improves Vascular Calcification in Rats by Inhibiting Endoplasmic Reticulum Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:9095242. [PMID: 27022436 PMCID: PMC4789052 DOI: 10.1155/2016/9095242] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/21/2016] [Accepted: 02/01/2016] [Indexed: 01/20/2023]
Abstract
In this study, the vitamin D3 plus nicotine (VDN) model of rats was used to prove that H2S alleviates vascular calcification (VC) and phenotype transformation of vascular smooth muscle cells (VSMC). Besides, H2S can also inhibit endoplasmic reticulum stress (ERS) of calcified aortic tissues. The effect of H2S on alleviating VC and phenotype transformation of VSMC can be blocked by TM, while PBA also alleviated VC and phenotype transformation of VSMC that was similar to the effect of H2S. These results suggest that H2S may alleviate rat aorta VC by inhibiting ERS, providing new target and perspective for prevention and treatment of VC.
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250
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Role of UBIAD1 in Intracellular Cholesterol Metabolism and Vascular Cell Calcification. PLoS One 2016; 11:e0149639. [PMID: 26890002 PMCID: PMC4758632 DOI: 10.1371/journal.pone.0149639] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/03/2016] [Indexed: 01/04/2023] Open
Abstract
Vascular calcification is an important risk factor associated with mortality among patients with chronic kidney disease. Intracellular cholesterol metabolism is involved in the process of vascular cell calcification. In this study, we investigated the role of UbiA prenyltransferase domain containing 1 (UBIAD1) in intracellular cholesterol metabolism and vascular cell calcification, and identified its subcellular location. Primary human umbilical vein smooth muscle cells (HUVSMCs) were incubated with either growth medium (1.4 mmol/L Pi) or calcification medium (CM) (3.0 mmol/L Pi). Under treatment with CM, HUVSMCs were further incubated with exogenous cholesterol, or menaquinone-4, a product of UBIAD1. The plasmid and small interfering RNA were transfected in HUVSMCs to alter the expression of UBIAD1. Matrix calcium quantitation, alkaline phosphatase activity, intracellular cholesterol level and menaquinone-4 level were measured. The expression of several genes involved in cholesterol metabolism were analyzed. Using an anti-UBIAD1 antibody, an endoplasmic reticulum marker and a Golgi marker, the subcellular location of UBIAD1 in HUVSMCs was analyzed. CM increased matrix calcium, alkaline phosphatase activity and intracellular cholesterol level, and reduced UBIAD1 expression and menaquinone-4 level. Addition of cholesterol contributed to increased matrix calcification and alkaline phosphatase activity in a dose-dependent manner. Elevated expression of UBIAD1 or menaquinone-4 in HUVSMCs treated with CM significantly reduced intracellular cholesterol level, matrix calcification and alkaline phosphatase activity, but increased menaquinone-4 level. Elevated expression of UBIAD1 or menaquinone-4 reduced the gene expression of sterol regulatory element-binding protein-2, and increased gene expression of ATP binding cassette transporters A1, which are in charge of cholesterol synthesis and efflux. UBIAD1 co-localized with the endoplasmic reticulum marker and the Golgi marker in HUVSMCs. In conclusion, high intracellular cholesterol content contributes to phosphate-induced vascular cell differentiation and calcification. UBIAD1 or menaquinone-4 could decrease vascular cell differentiation and calcification, probably via its potent role of inversely modulating cellular cholesterol.
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