Extracellular vesicles in atherosclerosis and vascular calcification: the versatile non-coding RNAs from endothelial cells and vascular smooth muscle cells

The Involvement of miR-221/222 in Vascular Pathophysiology: Implications for Stenting

MicroRNAs (miRNAs) are pivotal regulatory molecules involved in numerous cellular processes, including apoptosis, differentiation, proliferation, and migration. Recent research highlights specific miRNAs, such as the miR-221/222 cluster, which modulate key signaling pathways related to vascular smooth muscle cell (VSMC) proliferation, inflammation, and endothelial function. This function of miR-221/222 is accompanied by influencing the expression of certain proteins implicated in VSMCs and endothelial cells regulatory processes. miRNAs have been increasingly recognized for their roles in cardiovascular diseases, particularly in the mechanisms underlying in-stent restenosis and stent thrombosis. Elevated levels of miR-221/222 have been reported to be associated with severe adverse events following stenting and affect VSMC behavior and inflammatory responses. This image makes them promising candidates for new therapeutic strategies to address the most complex inferences of stenting, in-stent restenosis/stent thrombosis. Therefore, a discussion over the involvement of miR-221/222 in vascular pathophysiology could lead to finding possible signaling pathways and better stent designing for improving outcomes in patients undergoing stenting. Emerging therapeutic approaches, such as anti-miR oligonucleotides, offer the potential for translating these findings into clinical practice. This review article systematically investigates the biogenesis and functions of the miR-221/222 cluster along with its contributions to angiogenesis, vascular calcification, and neointimal formation. It aims to provide readers and researchers with insights into the signaling pathways that underpin vascular pathology linked to the miR-221 and miR-222 involvement.

Pathogenesis and Mechanism of Uremic Vascular Calcification

This review elucidates the modeling and mechanistic studies of vascular calcification in chronic kidney disease - mineral and bone disorder. In patients with chronic kidney disease, metabolic abnormalities in uremic toxins, including phosphate and indole sulfate, are closely associated with vascular calcification. Vitamin K, vascular circadian clock, and autophagy are also key factors involved in vascular calcification. Furthermore, communication between endothelial cells and smooth muscle cells also plays a pivotal role in the regulation of this process. Together, these factors accelerate vascular calcification progression and increase the risk of cardiovascular events. Therefore, timely intervention for vascular calcification is essential for patients with chronic kidney disease.

Reactive Carbonyl Species and Protein Lipoxidation in Atherogenesis

Atherosclerosis is a multifactorial disease of medium and large arteries, characterized by the presence of lipid-rich plaques lining the intima over time. It is the main cause of cardiovascular diseases and death worldwide. Redox imbalance and lipid peroxidation could play key roles in atherosclerosis by promoting a bundle of responses, including endothelial activation, inflammation, and foam cell formation. The oxidation of polyunsaturated fatty acids generates various lipid oxidation products such as reactive carbonyl species (RCS), including 4-hydroxy alkenals, malondialdehyde, and acrolein. RCS covalently bind to nucleophilic groups of nucleic acids, phospholipids, and proteins, modifying their structure and activity and leading to their progressive dysfunction. Protein lipoxidation is the non-enzymatic post-translational modification of proteins by RCS. Low-density lipoprotein (LDL) oxidation and apolipoprotein B (apoB) modification by RCS play a major role in foam cell formation. Moreover, oxidized LDLs are a source of RCS, which form adducts on a huge number of proteins, depending on oxidative stress intensity, the nature of targets, and the availability of detoxifying systems. Many systems are affected by lipoxidation, including extracellular matrix components, membranes, cytoplasmic and cytoskeletal proteins, transcription factors, and other components. The mechanisms involved in lipoxidation-induced vascular dysfunction are not fully elucidated. In this review, we focus on protein lipoxidation during atherogenesis.

Extracellular Vesicles in Atherosclerosis: State of the Art

Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation in the arteries, leading to narrowing and thrombosis that causes mortality. Emerging evidence has confirmed that atherosclerosis affects younger people and is involved in the majority of deaths worldwide. EVs are associated with critical steps in atherosclerosis, cholesterol metabolism, immune response, endothelial dysfunction, vascular inflammation, and remodeling. Endothelial cell-derived EVs can interact with platelets and monocytes, thereby influencing endothelial dysfunction, atherosclerotic plaque destabilization, and the formation of thrombus. EVs are potential diagnostic and prognostic biomarkers in atherosclerosis (AS) and cardiovascular disease (CVD). Importantly, EVs derived from stem/progenitor cells are essential mediators of cardiogenesis and cardioprotection and may be used in regenerative medicine and tissue engineering.