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Tchernychev B, Nitschke Y, Chu D, Sullivan C, Flaman L, O’Brien K, Howe J, Cheng Z, Thompson D, Ortiz D, Rutsch F, Sabbagh Y. Inhibition of Vascular Smooth Muscle Cell Proliferation by ENPP1: The Role of CD73 and the Adenosine Signaling Axis. Cells 2024; 13:1128. [PMID: 38994980 PMCID: PMC11240470 DOI: 10.3390/cells13131128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024] Open
Abstract
The Ectonucleotide Pyrophosphatase/Phosphodiesterase 1 (ENPP1) ectoenzyme regulates vascular intimal proliferation and mineralization of bone and soft tissues. ENPP1 variants cause Generalized Arterial Calcification of Infancy (GACI), a rare genetic disorder characterized by ectopic calcification, intimal proliferation, and stenosis of large- and medium-sized arteries. ENPP1 hydrolyzes extracellular ATP to pyrophosphate (PPi) and AMP. AMP is the precursor of adenosine, which has been implicated in the control of neointimal formation. Herein, we demonstrate that an ENPP1-Fc recombinant therapeutic inhibits proliferation of vascular smooth muscle cells (VSMCs) in vitro and in vivo. Addition of ENPP1 and ATP to cultured VSMCs generated AMP, which was metabolized to adenosine. It also significantly decreased cell proliferation. AMP or adenosine alone inhibited VSMC growth. Inhibition of ecto-5'-nucleotidase CD73 decreased adenosine accumulation and suppressed the anti-proliferative effects of ENPP1/ATP. Addition of AMP increased cAMP synthesis and phosphorylation of VASP at Ser157. This AMP-mediated cAMP increase was abrogated by CD73 inhibitors or by A2aR and A2bR antagonists. Ligation of the carotid artery promoted neointimal hyperplasia in wild-type mice, which was exacerbated in ENPP1-deficient ttw/ttw mice. Prophylactic or therapeutic treatments with ENPP1 significantly reduced intimal hyperplasia not only in ttw/ttw but also in wild-type mice. These findings provide the first insight into the mechanism of the anti-proliferative effect of ENPP1 and broaden its potential therapeutic applications beyond enzyme replacement therapy.
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Affiliation(s)
- Boris Tchernychev
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Yvonne Nitschke
- Department of General Pediatrics, Münster University Children’s Hospital, 48149 Münster, Germany;
- INTEC Network of Ectopic Calcification, Center for Medical Genetics Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Di Chu
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Caitlin Sullivan
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Lisa Flaman
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Kevin O’Brien
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Jennifer Howe
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Zhiliang Cheng
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - David Thompson
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Daniel Ortiz
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
| | - Frank Rutsch
- Department of General Pediatrics, Münster University Children’s Hospital, 48149 Münster, Germany;
- INTEC Network of Ectopic Calcification, Center for Medical Genetics Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Yves Sabbagh
- Research and Development, Inozyme Pharma, 321 Summer St, Suite 400, Boston, MA 02201, USA; (B.T.); (D.C.); (C.S.); (L.F.); (K.O.); (J.H.); (Z.C.); (D.T.); (D.O.); (Y.S.)
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Furmanik M, van Gorp R, Whitehead M, Ahmad S, Bordoloi J, Kapustin A, Schurgers LJ, Shanahan CM. Endoplasmic Reticulum Stress Mediates Vascular Smooth Muscle Cell Calcification via Increased Release of Grp78 (Glucose-Regulated Protein, 78 kDa)-Loaded Extracellular Vesicles. Arterioscler Thromb Vasc Biol 2021; 41:898-914. [PMID: 33297752 PMCID: PMC7837691 DOI: 10.1161/atvbaha.120.315506] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/25/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Vascular calcification is common among aging populations and mediated by vascular smooth muscle cells (VSMCs). The endoplasmic reticulum (ER) is involved in protein folding and ER stress has been implicated in bone mineralization. The role of ER stress in VSMC-mediated calcification is less clear. Approach and Results: mRNA expression of the ER stress markers PERK (PKR (protein kinase RNA)-like ER kinase), ATF (activating transcription factor) 4, ATF6, and Grp78 (glucose-regulated protein, 78 kDa) was detectable in human vessels with levels of PERK decreased in calcified plaques compared to healthy vessels. Protein deposition of Grp78/Grp94 was increased in the matrix of calcified arteries. Induction of ER stress accelerated human primary VSMC-mediated calcification, elevated expression of some osteogenic markers (Runx2 [RUNX family transcription factor 2], OSX [Osterix], ALP [alkaline phosphatse], BSP [bone sialoprotein], and OPG [osteoprotegerin]), and decreased expression of SMC markers. ER stress potentiated extracellular vesicle (EV) release via SMPD3 (sphingomyelin phosphodiesterase 3). EVs from ER stress-treated VSMCs showed increased Grp78 levels and calcification. Electron microscopy confirmed the presence of Grp78/Grp94 in EVs. siRNA (short interfering RNA) knock-down of Grp78 decreased calcification. Warfarin-induced Grp78 and ATF4 expression in rat aortas and VSMCs and increased calcification in an ER stress-dependent manner via increased EV release. CONCLUSIONS ER stress induces vascular calcification by increasing release of Grp78-loaded EVs. Our results reveal a novel mechanism of action of warfarin, involving increased EV release via the PERK-ATF4 pathway, contributing to calcification. This study is the first to show that warfarin induces ER stress and to link ER stress to cargo loading of EVs.
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MESH Headings
- Activating Transcription Factor 4/genetics
- Activating Transcription Factor 4/metabolism
- Adolescent
- Adult
- Aged
- Animals
- Cells, Cultured
- Disease Models, Animal
- Endoplasmic Reticulum Chaperone BiP
- Endoplasmic Reticulum Stress/drug effects
- Extracellular Vesicles/drug effects
- Extracellular Vesicles/metabolism
- Extracellular Vesicles/pathology
- Female
- Gene Expression Regulation
- Heat-Shock Proteins/genetics
- Heat-Shock Proteins/metabolism
- Humans
- Male
- Middle Aged
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Rats, Sprague-Dawley
- Signal Transduction
- Vascular Calcification/chemically induced
- Vascular Calcification/genetics
- Vascular Calcification/metabolism
- Vascular Calcification/pathology
- Warfarin/toxicity
- Young Adult
- eIF-2 Kinase/genetics
- eIF-2 Kinase/metabolism
- Rats
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Affiliation(s)
- Malgorzata Furmanik
- Department of Biochemistry, Cardiovascular Research Institute Maastricht CARIM, Maastricht University, the Netherlands (M.F., R.v.G., L.J.S.)
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
| | - Rick van Gorp
- Department of Biochemistry, Cardiovascular Research Institute Maastricht CARIM, Maastricht University, the Netherlands (M.F., R.v.G., L.J.S.)
| | - Meredith Whitehead
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
| | - Sadia Ahmad
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
| | - Jayanta Bordoloi
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
| | - Alexander Kapustin
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
| | - Leon J. Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht CARIM, Maastricht University, the Netherlands (M.F., R.v.G., L.J.S.)
| | - Catherine M. Shanahan
- BHF Centre of Research Excellence, School of Cardiovascular Medicine and Sciences, James Black Centre, King’s College London, United Kingdom (M.F., M.W., S.A., J.B., A.K., C.M.S.)
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Nitschke Y, Yan Y, Buers I, Kintziger K, Askew K, Rutsch F. ENPP1-Fc prevents neointima formation in generalized arterial calcification of infancy through the generation of AMP. Exp Mol Med 2018; 50:1-12. [PMID: 30369595 PMCID: PMC6204430 DOI: 10.1038/s12276-018-0163-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/08/2018] [Accepted: 07/12/2018] [Indexed: 12/12/2022] Open
Abstract
Generalized arterial calcification of infancy (GACI) is associated with widespread arterial calcification and stenoses and is caused by mutations in ENPP1. ENPP1 encodes for ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), which cleaves ATP to generate inorganic pyrophosphate (PPi) and adenosine monophosphate (AMP) extracellularly. The current study was designed to define the prevalence of arterial stenoses in GACI individuals and to identify the mechanism through which ENPP1 deficiency causes intimal proliferation. Furthermore, we aimed to effectively prevent and treat neointima formation in an animal model of GACI through the systemic administration of recombinant human (rh)ENPP1-Fc protein. Based on a literature review, we report that arterial stenoses are present in at least 72.4% of GACI cases. We evaluated the effect of rhENPP1-Fc on ENPP1-silenced human vascular smooth muscle cells (VSMCs) and on induced intimal proliferation in Enpp1-deficient ttw/ttw mice treated with carotid ligation. We demonstrate that silencing ENPP1 in VSMCs resulted in a tenfold increase in proliferation relative to that of cells transfected with negative control siRNA. The addition of rhENPP1-Fc, AMP or adenosine restored the silenced ENPP1-associated proliferation. In contrast, neither PPi nor etidronate, a current off-label treatment for GACI, had an effect on VSMC proliferation. Furthermore, subcutaneous rhENPP1-Fc protein replacement was effective in preventing and treating intimal hyperplasia induced by carotid ligation in an animal model of GACI. We conclude that ENPP1 inhibits neointima formation by generating AMP. RhENPP1-Fc may serve as an approach for the effective prevention and treatment of arterial stenoses in GACI. A protein replacement therapy may prove useful in tackling calcification and narrowing of the arteries in babies with a severe genetic disorder. Generalized Arterial Calcification of Infancy (GACI) is a rare condition in which infants’ arteries become calcified and their blood vessels internally scarred. It often leads to congestive heart failure. The ENPP1 gene encodes a protein that is crucial to preventing excess calcium build-up in the body. Mutations in the ENPP1 gene lead to GACI, but no therapies for the condition exist. Now, Frank Rutsch at Muenster University Children’s Hospital in Germany and co-workers have shown that administering a protein replacement can inhibit blood vessel scarring and arterial clogging in GACI mice models and in human stem cell cultures. The protein replacement boosts production of a key metabolic molecule called adenosine monophosphate.
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Affiliation(s)
- Yvonne Nitschke
- Department of General Pediatrics, Münster University Children's Hospital, Albert-Schweitzer-Campus 1, D-48149, Münster, Germany.,Cells in Motion Cluster of Excellence, Münster University, Münster, Germany
| | - Yan Yan
- Alexion Pharmaceuticals, 100 College St, New Haven, CT, USA
| | - Insa Buers
- Department of General Pediatrics, Münster University Children's Hospital, Albert-Schweitzer-Campus 1, D-48149, Münster, Germany.,Cells in Motion Cluster of Excellence, Münster University, Münster, Germany
| | - Kristina Kintziger
- Department of General Pediatrics, Münster University Children's Hospital, Albert-Schweitzer-Campus 1, D-48149, Münster, Germany
| | - Kim Askew
- Alexion Pharmaceuticals, 100 College St, New Haven, CT, USA
| | - Frank Rutsch
- Department of General Pediatrics, Münster University Children's Hospital, Albert-Schweitzer-Campus 1, D-48149, Münster, Germany. .,Cells in Motion Cluster of Excellence, Münster University, Münster, Germany.
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Jin Y, Cong Q, Gvozdenovic-Jeremic J, Hu J, Zhang Y, Terkeltaub R, Yang Y. Enpp1 inhibits ectopic joint calcification and maintains articular chondrocytes by repressing hedgehog signaling. Development 2018; 145:dev.164830. [PMID: 30111653 DOI: 10.1242/dev.164830] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/12/2018] [Indexed: 01/15/2023]
Abstract
The differentiated phenotype of articular chondrocytes of synovial joints needs to be maintained throughout life. Disruption of the articular cartilage, frequently associated with chondrocyte hypertrophy and calcification, is a central feature in osteoarthritis (OA). However, the molecular mechanisms whereby phenotypes of articular chondrocytes are maintained and pathological calcification is inhibited remain poorly understood. Recently, the ecto-enzyme Enpp1, a suppressor of pathological calcification, was reported to be decreased in joint cartilage with OA in both human and mouse, and Enpp1 deficiency causes joint calcification. Here, we found that hedgehog (Hh) signaling activation contributes to ectopic joint calcification in the Enpp1-/- mice. In the Enpp1-/- joints, Hh signaling was upregulated. Further activation of Hh signaling by removing the patched 1 gene in the Enpp1-/- mice enhanced ectopic joint calcification, whereas removing Gli2 partially rescued the ectopic calcification phenotype. In addition, reduction of Gαs in the Enpp1-/- mice enhanced joint calcification, suggesting that Enpp1 inhibits Hh signaling and chondrocyte hypertrophy by activating Gαs-PKA signaling. Our findings provide new insights into the mechanisms underlying Enpp1 regulation of joint integrity.
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Affiliation(s)
- Yunyun Jin
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Stem Cell Institute, Boston, MA 02115, USA.,Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai 200241, China
| | - Qian Cong
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Stem Cell Institute, Boston, MA 02115, USA
| | | | - Jiajie Hu
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Stem Cell Institute, Boston, MA 02115, USA
| | - Yiqun Zhang
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Stem Cell Institute, Boston, MA 02115, USA
| | - Robert Terkeltaub
- Department of Medicine, Veterans Affairs Healthcare System, University of California San Diego, 111K, 3350 La Jolla Village Dr., San Diego, CA 92161, USA
| | - Yingzi Yang
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Stem Cell Institute, Boston, MA 02115, USA
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Abhishek A, Neogi T, Choi H, Doherty M, Rosenthal AK, Terkeltaub R. Review: Unmet Needs and the Path Forward in Joint Disease Associated With Calcium Pyrophosphate Crystal Deposition. Arthritis Rheumatol 2018; 70:1182-1191. [PMID: 29609209 DOI: 10.1002/art.40517] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/27/2018] [Indexed: 12/17/2022]
Abstract
Calcium pyrophosphate (CPP) crystal deposition (CPPD) is prevalent and can be associated with synovitis and joint damage. The population of elderly persons predominantly affected by CPPD is growing rapidly. Since shortfalls exist in many aspects of CPPD, we conducted an anonymous survey of CPPD unmet needs, prioritized by experts from the Gout, Hyperuricemia and Crystal-Associated Disease Network. We provide our perspectives on the survey results, and we propose several CPPD basic and clinical translational research pathways. Chondrocyte and cartilage culture systems for generating CPP crystals in vitro and transgenic small animal CPPD models are needed to better define CPPD mechanism paradigms and help guide new therapies. CPPD recognition, clinical research, and care would be improved by international consensus on CPPD nomenclature and disease phenotype classification, better exploitation of advanced imaging, and pragmatic new point-of-care crystal analytic approaches for detecting CPP crystals. Clinical impacts of CPP crystals in osteoarthritis and in asymptomatic joints in elderly persons remain major unanswered questions that are rendered more difficult by current inability to therapeutically limit or dissolve the crystal deposits and assess the consequent clinical outcome. Going forward, CPPD clinical research studies should define clinical settings in which articular CPPD does substantial harm and should include analyses of diverse clinical phenotypes and populations. Clinical trials should identify the best therapeutic targets to limit CPP crystal deposition and associated inflammation and should include assessment of intraarticular agents. Our perspective is that such advances in basic and clinical science in CPPD are now within reach and can lead to better treatments for this disorder.
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Affiliation(s)
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | - Hyon Choi
- Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Robert Terkeltaub
- Veterans Affairs, University of California at San Diego, San Diego, California
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Kwon DH, Kim YK, Kook H. New Aspects of Vascular Calcification: Histone Deacetylases and Beyond. J Korean Med Sci 2017; 32:1738-1748. [PMID: 28960024 PMCID: PMC5639052 DOI: 10.3346/jkms.2017.32.11.1738] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 08/19/2017] [Indexed: 11/20/2022] Open
Abstract
Vascular calcification is a pathologic phenomenon in which calcium phosphate is ectopically deposited in the arteries. Previously, calcification was considered to be a passive process in response to metabolic diseases, vascular or valvular diseases, or even aging. However, now calcification is recognized as a highly-regulated consequence, like bone formation, and many clinical trials have been carried out to elucidate the correlation between vascular calcification and cardiovascular events and mortality. As a result, vascular calcification has been implicated as an independent risk factor in cardiovascular diseases. Many molecules are now known to be actively associated with this process. Recently, our laboratory found that posttranslational modification of histone deacetylase (HDAC) 1 is actively involved in the development of vascular calcification. In addition, we found that modulation of the activity of HDAC as well as its protein stability by MDM2, an HDAC1-E3 ligase, may be a therapeutic target in vascular calcification. In the present review, we overview the pathomechanism of vascular calcification and the involvement of posttranslational modification of epigenetic regulators.
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Affiliation(s)
- Duk Hwa Kwon
- Department of Pharmacology, Chonnam National University Medical School, Gwangju, Korea
- Basic Research Laboratory for Cardiac Remodeling, Chonnam National University Medical School, Gwangju, Korea
| | - Young Kook Kim
- Basic Research Laboratory for Cardiac Remodeling, Chonnam National University Medical School, Gwangju, Korea
- Center for Creative Biomedical Scientists at Chonnam National University, Gwangju, Korea
- Department of Biochemistry, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun Kook
- Department of Pharmacology, Chonnam National University Medical School, Gwangju, Korea
- Basic Research Laboratory for Cardiac Remodeling, Chonnam National University Medical School, Gwangju, Korea.
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Shanahan CM, Furmanik M. Endoplasmic Reticulum Stress in Arterial Smooth Muscle Cells: A Novel Regulator of Vascular Disease. Curr Cardiol Rev 2017; 13:94-105. [PMID: 27758694 PMCID: PMC5440785 DOI: 10.2174/1573403x12666161014094738] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/24/2016] [Accepted: 10/06/2016] [Indexed: 01/27/2023] Open
Abstract
Cardiovascular disease continues to be the leading cause of death in industrialised societies. The idea that the arterial smooth muscle cell (ASMC) plays a key role in regulating many vascular pathologies has been gaining importance, as has the realisation that not enough is known about the pathological cellular mechanisms regulating ASMC function in vascular remodelling. In the past decade endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) have been recognised as a stress response underlying many physiological and pathological processes in various vascular cell types. Here we summarise what is known about how ER stress signalling regulates phenotypic switching, trans/dedifferentiation and apoptosis of ASMCs and contributes to atherosclerosis, hypertension, aneurysms and vascular calcification.
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Affiliation(s)
- Catherine M Shanahan
- British Heart Foundation Centre of Research Excellence, Cardiovascular Division, James Black Centre, King's College London, 125 Coldharbour Lane, London, SE5 9NU, United Kingdom
| | - Malgorzata Furmanik
- British Heart Foundation Centre of Research Excellence, Cardiovascular Division, James Black Centre, King's College London, 125 Coldharbour Lane, London, SE5 9NU, United Kingdom
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