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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
The association of bone and osteoclasts with vascular calcification
Kum Hyun Han1, Randolph A Hennigar2, W Charles O'Neill3
1Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
Insights
Bone formation in arteries is rare and secondary to heavy calcification, suggesting limited potential for reversing vascular calcification. Osteoclasts, bone-resorbing cells, are infrequently found, indicating a low capacity for bone removal in these vessels.
Area of Science:
- Vascular Biology
- Bone Biology
- Pathophysiology
Background:
- Vascular calcification is a significant risk factor for cardiovascular disease.
- The presence and role of bone tissue and osteoclasts in arterial calcification are poorly understood.
- Investigating bone in calcified arteries may offer insights into calcification pathophysiology and reversibility.
Purpose of the Study:
- To determine the prevalence, distribution, and patient-associated factors of bone and osteoclasts in calcified arteries.
- To explore the relationship between bone formation and vascular calcification characteristics.
- To assess the potential for osteoclast activity in the context of vascular bone.
Main Methods:
- Retrospective analysis of 386 lower limb arteries from 108 amputation patients.
- Histological examination for calcification, bone presence, and osteoclasts.
- Staining for bone-specific proteins (osteocalcin, osterix) in calcified arteries.
- Correlation of bone presence with patient demographics, comorbidities (diabetes), and medications (warfarin).
Main Results:
- Bone was found in 6% of all arteries, but in 25% of heavily calcified arteries.
- Bone was more prevalent in medial (10%) versus intimal (3%) calcifications.
- Older patients, those with diabetes, or on warfarin were more likely to have bone in heavily calcified arteries.
- Osteoclasts were present in 4.9% of arteries, primarily in those with heavy calcification and bone.
- Bone-specific protein staining (osteocalcin, osterix) was detected in heavily calcified arteries without visible bone.
Conclusions:
- Bone formation in arteries appears to be a secondary event, closely associated with heavy calcification.
- The distribution and patient factors suggest specific conditions favor bone development in calcified vessels.
- The rare presence of osteoclasts indicates a limited capacity for reversing vascular bone and calcification.
Abstract:
The presence of bone tissue in calcified arteries may provide insights into the pathophysiology and potential reversibility of calcification, but the prevalence, distribution, and determinants of bone and osteoclasts in calcified arteries are unknown. Specimens of 386 arteries from lower limb amputations in 108 patients were examined retrospectively. Calcification was present in 282 arteries from 89 patients, which was medial in 64%, intimal in 9%, and both in 27%. Bone was present in 6% of arteries, essentially all of which were heavily calcified. Multiple sampling revealed that the true prevalence of bone in heavily calcified arteries was 25%. Bone was more common in medial rather than intimal calcifications (10% vs 3%, p=0.03) but did not vary with artery location (above vs below the knee). Heavily calcified arteries with bone were more likely to come from patients who were older (p=0.04), had diabetes (p=0.06), or were receiving warfarin (p=0.06), but there was no association with gender or renal failure. Bone was almost always adjacent to calcifications, along the periphery, but never within. Staining for the bone-specific proteins osteocalcin and osterix was noted in 20% and 45% of heavily calcified arteries without visible bone. Osteoclasts were present in 4.9% of arteries, all of which were heavily calcified and most of which contained bone. The frequent absence of bone in heavily calcified vessels and the histologic pattern strongly suggests a secondary rather than primary event. Recruitment of osteoclasts to vascular calcifications can occur but is rare, suggesting a limited capacity to reverse calcifications.
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