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Review
. 2019 Apr 1:2019:2875189.
doi: 10.1155/2019/2875189. eCollection 2019.

The Emerging Role of Mesenchymal Stem Cells in Vascular Calcification

Changming Xie  1   2 , Liu Ouyang  2 , Jie Chen  3 , Huanji Zhang  1 , Pei Luo  4 , Jingfeng Wang  2 , Hui Huang  1   2
Affiliations
Review

The Emerging Role of Mesenchymal Stem Cells in Vascular Calcification

Changming Xie et al. Stem Cells Int. .

Abstract

Vascular calcification (VC), characterized by hydroxyapatite crystal depositing in the vessel wall, is a common pathological condition shared by many chronic diseases and an independent risk factor for cardiovascular events. Recently, VC is regarded as an active, dynamic cell-mediated process, during which calcifying cell transition is critical. Mesenchymal stem cells (MSCs), with a multidirectional differentiation ability and great potential for clinical application, play a duplex role in the VC process. MSCs facilitate VC mainly through osteogenic transformation and apoptosis. Meanwhile, several studies have reported the protective role of MSCs. Anti-inflammation, blockade of the BMP2 signal, downregulation of the Wnt signal, and antiapoptosis through paracrine signaling are possible mechanisms. This review displays the evidence both on the facilitating role and on the protective role of MSCs, then discusses the key factors determining this divergence.

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Figures

Figure 1
Figure 1
A brief illustration of MSCs and VC and alternation of the microenvironment. In the damaged vessel under the calcification process, SDF-1, PDGF, and TGF-β are released to recruit MSCs from bone marrow and circulation. (a) In this microenvironment, damage of the vessel wall is slight and the effect of oxidative stress and inflammation is very minimal. In addition, fewer VSMCs have been induced to osteoblasts. MSCs are viable and inhibit VSMC osteogenesis differentiation by a paracrine mechanism. (b) In this microenvironment, the vessel is damaged a lot by heavy oxidative stress and inflammation. Several phenotypic transformations of VSMCs have taken place. MSCs tend to undergo apoptosis and differentiate into osteoblast-like cells, which facilitate the VC progress.
Figure 2
Figure 2
How the MSCs propel the calcification process: in the calcification microenvironment, MSCs are induced to differentiate into osteoblast-like cells, which synthesize the osteogenesis matrix. On the other hand, under adverse condition, MSC apoptosis or necrosis happens. Then, the fragments serve as a core of calcification deposit. Meanwhile, less MSCs differentiate into VSMCs and ECs, which creates a vicious cycle.
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