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      Pharmacological induction of ferritin prevents osteoblastic transformation of smooth muscle cells

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          Abstract

          Vascular calcification is a frequent complication of atherosclerosis, diabetes and chronic kidney disease. In the latter group of patients, calcification is commonly seen in tunica media where smooth muscle cells ( SMC) undergo osteoblastic transformation. Risk factors such as elevated phosphorus levels and vitamin D 3 analogues have been identified. In the light of earlier observations by our group and others, we sought to inhibit SMC calcification via induction of ferritin. Human aortic SMC were cultured using β‐glycerophosphate with activated vitamin D 3, or inorganic phosphate with calcium, and induction of alkaline phosphatase ( ALP) and osteocalcin as well as accumulation of calcium were used to monitor osteoblastic transformation. In addition, to examine the role of vitamin D 3 analogues, plasma samples from patients on haemodialysis who had received calcitriol or paricalcitol were tested for their tendency to induce calcification of SMC. Addition of exogenous ferritin mitigates the transformation of SMC into osteoblast‐like cells. Importantly, pharmacological induction of heavy chain ferritin by 3H‐1,2‐Dithiole‐3‐thione was able to inhibit the SMC transition into osteoblast‐like cells and calcification of extracellular matrix. Plasma samples collected from patients after the administration of activated vitamin D 3 caused significantly increased ALP activity in SMC compared to the samples drawn prior to activated vitamin D 3 and here, again induction of ferritin diminished the osteoblastic transformation. Our data suggests that pharmacological induction of ferritin prevents osteoblastic transformation of SMC. Hence, utilization of such agents that will cause enhanced ferritin synthesis may have important clinical applications in prevention of vascular calcification.

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          Clinical epidemiology of cardiovascular disease in chronic renal disease.

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            Phosphate regulation of vascular smooth muscle cell calcification.

            Vascular calcification is a common finding in atherosclerosis and a serious problem in diabetic and uremic patients. Because of the correlation of hyperphosphatemia and vascular calcification, the ability of extracellular inorganic phosphate levels to regulate human aortic smooth muscle cell (HSMC) culture mineralization in vitro was examined. HSMCs cultured in media containing normal physiological levels of inorganic phosphate (1.4 mmol/L) did not mineralize. In contrast, HSMCs cultured in media containing phosphate levels comparable to those seen in hyperphosphatemic individuals (>1.4 mmol/L) showed dose-dependent increases in mineral deposition. Mechanistic studies revealed that elevated phosphate treatment of HSMCs also enhanced the expression of the osteoblastic differentiation markers osteocalcin and Cbfa-1. The effects of elevated phosphate on HSMCs were mediated by a sodium-dependent phosphate cotransporter (NPC), as indicated by the ability of the specific NPC inhibitor phosphonoformic acid, to dose dependently inhibit phosphate-induced calcium deposition as well as osteocalcin and Cbfa-1 gene expression. With the use of polymerase chain reaction and Northern blot analyses, the NPC in HSMCs was identified as Pit-1 (Glvr-1), a member of the novel type III NPCs. These data suggest that elevated phosphate may directly stimulate HSMCs to undergo phenotypic changes that predispose to calcification and offer a novel explanation of the phenomenon of vascular calcification under hyperphosphatemic conditions. The full text of this article is available at http://www.circresaha.org.
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              Vascular calcification: the killer of patients with chronic kidney disease.

              Cardiovascular complications are the leading cause of death in patients with chronic kidney disease (CKD). Vascular calcification is a common complication in CKD, and investigators have demonstrated that the extent and histoanatomic type of vascular calcification are predictors of subsequent vascular mortality. Although research efforts in the past decade have greatly improved our knowledge of the multiple factors and mechanisms involved in vascular calcification in patients with kidney disease, many questions remain unanswered. No longer can we accept the concept that vascular calcification in CKD is a passive process resulting from an elevated calcium-phosphate product. Rather, as a result of the metabolic insults of diabetes, dyslipidemia, oxidative stress, uremia, and hyperphosphatemia, "osteoblast-like" cells form in the vessel wall. These mineralizing cells as well as the recruitment of undifferentiated progenitors to the osteochondrocyte lineage play a critical role in the calcification process. Important transcription factors such as Msx 2, osterix, and RUNX2 are crucial in the programming of osteogenesis. Thus, the simultaneous increase in arterial osteochondrocytic programs and reduction in active cellular defense mechanisms creates the "perfect storm" of vascular calcification seen in ESRD. Innovative clinical studies addressing the combined use of inhibitors that work on vascular calcification through distinct molecular mechanisms, such as fetuin-A, osteopontin, and bone morphogenic protein 7, among others, will be necessary to reduce significantly the accrual of vascular calcifications and cardiovascular mortality in kidney disease. In addition, the roles of oxidative stress and inflammation on the fate of smooth muscle vascular cells and their function deserve further translational investigation.
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                Author and article information

                Journal
                J Cell Mol Med
                J. Cell. Mol. Med
                10.1111/(ISSN)1582-4934
                JCMM
                Journal of Cellular and Molecular Medicine
                John Wiley and Sons Inc. (Hoboken )
                1582-1838
                1582-4934
                26 October 2015
                February 2016
                : 20
                : 2 ( doiID: 10.1111/jcmm.2016.20.issue-2 )
                : 217-230
                Affiliations
                [ 1 ] Faculty of Medicine Division of Nephrology Department of Internal MedicineUniversity of Debrecen DebrecenHungary
                [ 2 ] Division of Nephrology Department of Medicine Nephrology Research and Training Center and Center for Free Radical BiologyUniversity of Alabama at Birmingham Birmingham ALUSA
                [ 3 ] Faculty of Medicine Division of Neonatology Department of PediatricsUniversity of Debrecen DebrecenHungary
                [ 4 ] Molecular Targets Program James Graham Brown Cancer CenterUniversity of Louisville Louisville KYUSA
                [ 5 ] Department of Molecular and Translational MedicineUniversity of Brescia BresciaItaly
                [ 6 ] MTA‐DE Vascular Biology, Thrombosis and Hemostasis Research GroupHungarian Academy of Sciences DebrecenHungary
                Author notes
                [*] [* ] Correspondence to: József BALLA, M.D., Ph.D., D.Sc.

                E‐mail: balla@ 123456belklinika.com

                György Balla, MD, PhD, D.Sc.

                E‐mail: balla@ 123456dote.hu

                [†]

                These authors contributed equally to this work.

                Article
                JCMM12682
                10.1111/jcmm.12682
                4727553
                26499096
                df6a5d72-e069-4488-bf7a-c2efd426889d
                © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 March 2015
                : 14 August 2015
                Page count
                Pages: 14
                Funding
                Funded by: BMC Korea Research Fund
                Award ID: TÁMOP‐4.2.2
                Award ID: A‐11/1/KONV‐2012‐0045
                Funded by: Hungarian Scientific Research Fund
                Award ID: K 112333
                Funded by: Hungarian Academy of Sciences
                Award ID: 11003
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                jcmm12682
                February 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.7.5 mode:remove_FC converted:26.01.2016

                Molecular medicine
                ferritin,ferroxidase activity,β‐glycerophosphate,vascular calcification,vitamin d3

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