Abstract:
Medial vascular calcification, the deposition of calcium-phosphate in the media of the vasculature, is considered as an active and highly regulated process. This is believed to be controlled by osteo/chondrogenic transformation of vascular smooth muscle cells. Until now, the underlying mechanisms are incompletely understood. The calcification of arterial tissue is closely associated with cardiovascular mortality, but due to the incomplete understanding about the mechanisms of vascular calcification, no therapeutic treatment exists. This work studied new signaling pathways in vascular smooth muscle cell calcification. A putative therapeutic strategy may be magnesium supplementation, which counteracts vascular calcification. Therefore, possible signaling pathways to mediate the effects of magnesium were investigated in vascular smooth muscle cells. The phosphate-induced calcification and the mRNA expression of the osteogenic markers core-binding factor α1, msh homeobox 2, and tissue-nonspecific alkaline phosphatase in human aortic smooth muscle cells were ameliorated by additional treatment with magnesium. The presence of magnesium chloride enhanced mRNA expression of the calcium-sensing receptor in human aortic smooth muscle cells. Most importantly, the blunting effects of magnesium on calcification and osteogenic markers mRNA expression were reproduced by the calcium-sensing receptors activator gadolinium. Furthermore, the anti-calcific effects of Magnesium were abolished by silencing of the calcium-sensing receptor or addition of its antagonist NPS-2143. Furthermore, cholecalciferol overload in mice led to vascular calcification and upregulated aortic osteogenic markers core-binding factor α1, msh homeobox 2, tissue-nonspecific alkaline phosphatase and collagen type I, collagen type III and fibronectin mRNA expression in mice. These effects were ameliorated by supplementary treatment with magnesium chloride. Further studies investigated a contribution of the Glycogen synthase kinase 3 (GSK-3) during vascular calcification. The calcification and upregulated expression of osteogenic markers msh homeobox 2, core-binding factor α1 and tissue-nonspecific alkaline phosphatase as well as mRNA expression of type III sodium-dependent phosphate transporter and plasminogen activator inhibitor 1 following cholecalciferol overload in mice was blunted in Gsk-3α/β double knock-in mice, which lack the functional AKT/SGK phosphorylation sites. In addition, phosphate exposure induced calcification and osteogenic markers expression in aortic ring explants from GSK-3 wild type mice, effects blunted in aortic ring explants from GSK-3 knock-in mice. The current observations thus shed new light on the signaling pathways of vascular smooth muscle cell calcification. The anti-calcific effects of magnesium are at least in part mediated via the calcium-sensing receptor. Furthermore, the GSK3 is apparently involved in the pro-calcifying signaling cascades. These observations extend the current knowledge on the mechanisms of calcification, an understanding that may ultimately lead to development of a therapeutic approach.