Hsu H H, Camacho N P
Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City 66160-7410, USA.
Atherosclerosis. 1999 Apr;143(2):353-62. doi: 10.1016/s0021-9150(98)00322-0.
Advanced mineralization can cause brittleness of aortic walls with decreased elasticity thereby causing the wall to rupture. Although the precise mechanisms of dystrophic calcification remain unknown, morphological evidence reveals the presence of mineral-associated vesicles in the lesions and defective bioprosthetic valves. In an attempt to demonstrate the calcifiability of the vesicles, small segments of human atherosclerotic aortas with calcified lesions were removed at autopsy and then digested in a crude collagenase solution to release vesicles. A differential centrifugation was then used to isolate calcifiable vesicles, which was precipitated at 300,000 x g for 20 min. An exposure of the vesicles to a calcifying medium containing physiologic levels of Ca2+, Pi, and 1 mM ATP caused Ca deposition in a vesicle protein-concentration dependent manner. The calcifiability of the vesicles was further demonstrated by electron microscopy. Fourier transform spectroscopic analysis of the deposited mineral revealed the presence of a hydroxyapatite phase, closely resembling the native form of mineral in atherosclerotic plaques. In addition, calcifiable vesicles were enriched in ATP-hydrolyzing enzymes including Mg2+ or Ca2+-ATPase and NTP pyrophosphohydrolase that may be involved in normal and pathological calcification. Triton X-100 at 0.01% abolished 80% of both ATPase activity and ATP-initiated calcification. A comparison of vesicles isolated from non-atherosclerotic and atherosclerotic aortas indicated that atherosclerotic vesicles tended to have higher calcifiability. These observations suggest that the calcifiable vesicles play a part in dystrophic calcification of aortas in atherosclerosis.
晚期矿化可导致主动脉壁脆性增加、弹性降低,从而致使血管壁破裂。尽管营养不良性钙化的确切机制尚不清楚,但形态学证据显示病变部位及生物人工瓣膜中有与矿物质相关的囊泡存在。为了证明这些囊泡具有钙化能力,在尸检时切除了带有钙化病变的人动脉粥样硬化主动脉的小段组织,然后将其在粗制胶原酶溶液中消化以释放囊泡。接着采用差速离心法分离可钙化囊泡,该囊泡在300,000×g条件下沉淀20分钟。将这些囊泡暴露于含有生理水平的Ca2+、Pi和1 mM ATP的钙化培养基中,会导致Ca以囊泡蛋白浓度依赖性方式沉积。电子显微镜进一步证明了这些囊泡的钙化能力。对沉积矿物质的傅里叶变换光谱分析显示存在羟基磷灰石相,与动脉粥样硬化斑块中的天然矿物质形式极为相似。此外,可钙化囊泡富含ATP水解酶,包括Mg2+或Ca2+-ATP酶以及NTP焦磷酸水解酶,这些酶可能参与正常和病理性钙化过程。0.01%的 Triton X-100可消除80%的ATP酶活性和ATP引发的钙化。对从非动脉粥样硬化主动脉和动脉粥样硬化主动脉中分离出的囊泡进行比较表明,动脉粥样硬化囊泡往往具有更高的钙化能力。这些观察结果表明,可钙化囊泡在动脉粥样硬化中主动脉的营养不良性钙化过程中发挥作用。