AUTHOR=Zhang Li , Yao Jiayi , Yao Yucheng , Boström Kristina I. 

TITLE=Contributions of the Endothelium to Vascular Calcification

JOURNAL=Frontiers in Cell and Developmental Biology

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2021.620882

DOI=10.3389/fcell.2021.620882

ISSN=2296-634X

ABSTRACT=Vascular calcification increases morbidity and mortality and constitutes a significant obstacle during percutaneous interventions and surgeries. On a cellular and molecular level, vascular calcification is a highly regulated process that involves abnormal cell transitions and osteogenic differentiation, re-purposing of signaling pathways normally used in bone, and even formation of osteoclast-like cells.  Endothelial cells have been shown to contribute to vascular calcification through a variety of means.  This includes direct contributions of osteoprogenitor cells generated through endothelial-mesenchymal transitions in activated endothelium, with subsequent migration into the vessel wall. The endothelium also secretes pro-osteogenic growth factors, such as bone morphogenetic proteins and inflammatory mediators and cytokines, in conditions like hyperlipidemia, diabetes, and renal failure. Furthermore, an activated endothelium expresses proteases that are instrumental in breaking down the internal elastic lamina that serves, among other things, as a stabilizer of the endothelium. Appropriate bone mineralization is highly dependent on active angiogenesis, but it is unclear whether the same relationship exists in areas of vascular calcification. Through its location facing the vascular lumen, the endothelium is the first to encounter circulating factor and bone marrow-derived cells that might contribute to osteoclast-like versus osteoblast-like cells in the vascular wall. In the same way, the endothelium may be the easiest target to reach with treatments aimed at limiting calcification.  This review provides a brief summary of the contributions of the endothelium to vascular calcification as we currently know them.