Van den Branden Astrid, Verhulst Anja, D'Haese Patrick C, Opdebeeck Britt
Laboratory of Pathophysiology, Department Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium.
Metabolites. 2022 Apr 5;12(4):327. doi: 10.3390/metabo12040327.
The presence of arterial media calcification, a highly complex and multifactorial disease, puts patients at high risk for developing serious cardiovascular consequences and mortality. Despite the numerous insights into the mechanisms underlying this pathological mineralization process, there is still a lack of effective treatment therapies interfering with the calcification process in the vessel wall. Current anti-calcifying therapeutics may induce detrimental side effects at the level of the bone, as arterial media calcification is regulated in a molecular and cellular similar way as physiological bone mineralization. This especially is a complication in patients with chronic kidney disease and diabetes, who are the prime targets of this pathology, as they already suffer from a disturbed mineral and bone metabolism. This review outlines recent treatment strategies tackling arterial calcification, underlining their potential to influence the bone mineralization process, including targeting vascular cell transdifferentiation, calcification inhibitors and stimulators, vascular smooth muscle cell (VSMC) death and oxidative stress: are they a friend or foe? Furthermore, this review highlights nutritional additives and a targeted, local approach as alternative strategies to combat arterial media calcification. Paving a way for the development of effective and more precise therapeutic approaches without inducing osseous side effects is crucial for this highly prevalent and mortal disease.
动脉中层钙化是一种高度复杂的多因素疾病，它使患者面临发生严重心血管后果和死亡的高风险。尽管对这种病理性矿化过程的潜在机制有诸多见解，但仍缺乏有效的治疗方法来干预血管壁的钙化过程。由于动脉中层钙化在分子和细胞水平上与生理性骨矿化的调节方式相似，目前的抗钙化治疗可能会在骨骼层面引发有害的副作用。这在慢性肾病和糖尿病患者中尤其成为一个并发症，因为他们是这种病理状况的主要目标人群，本身就存在矿物质和骨代谢紊乱的问题。本综述概述了近期应对动脉钙化的治疗策略，强调了它们影响骨矿化过程的潜力，包括针对血管细胞转分化、钙化抑制剂和刺激剂、血管平滑肌细胞（VSMC）死亡以及氧化应激：它们是助力还是阻力？此外，本综述强调营养添加剂和靶向局部治疗方法是对抗动脉中层钙化的替代策略。为开发有效且更精确的治疗方法且不引发骨相关副作用铺平道路，对于这种高度普遍且致命的疾病至关重要。
