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Calcifying circulating cells: an uncharted area in the setting of vascular calcification in CKD patients

Giuseppe Cianciolo1, Irene Capelli1, Maria Cappuccilli1

  • 1Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, Department of Experimental Diagnostic and Specialty Medicine (DIMES) , University of Bologna , Bologna , Italy.

Clinical Kidney Journal
|March 18, 2016
PubMed

Insights

Circulating calcifying cells (CCCs) contribute to vascular calcification, a complication linked to chronic kidney disease-mineral and bone disorders (CKD-MBD). Research is exploring CCC origins and the role of CKD-MBD in their formation and vascular disease progression.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Endocrinology

Background:

  • Vascular calcification is a significant risk factor for cardiovascular morbidity and mortality, particularly in patients with chronic kidney disease-mineral and bone disorders (CKD-MBD).
  • Vascular calcification involves an osteogenic cellular program, with circulating calcifying cells (CCCs), derived from bone marrow (BM), implicated in intima calcification.
  • The role of CCCs in conditions like diabetes and atherosclerosis, and their precise origin (BM, bloodstream, or both), remain largely unexplored.

Purpose of the Study:

  • To investigate the role of circulating calcifying cells (CCCs) in vascular calcification, especially in the context of chronic kidney disease-mineral and bone disorders (CKD-MBD).
  • To explore the potential link between CKD-MBD and the formation and function of CCCs.
  • To understand the factors influencing CCC formation and their contribution to the bone-vascular axis.

Main Methods:

  • Analysis of existing studies on circulating calcifying cells (CCCs) and their association with vascular calcification.
  • Review of preliminary data concerning CKD patients and the impact of mineral bone disease on vascular calcification.
  • Exploration of the potential role of parathyroid hormone and osteoblasts in regulating hematopoietic stem/progenitor cells and CCC formation.

Main Results:

  • Studies in non-CKD patients have not found associations between CCCs and bone metabolism markers.
  • Preliminary findings in CKD patients suggest that disruptions in bone marrow (BM) niches due to CKD-MBD may contribute to vascular calcification.
  • CKD-MBD is hypothesized to promote CCC formation due to its effects on hematopoietic stem/progenitor cells.

Conclusions:

  • Circulating calcifying cells (CCCs) are implicated in vascular calcification, a process linked to CKD-MBD.
  • CKD-MBD may promote vascular calcification by disrupting bone marrow (BM) integrity and potentially increasing CCC formation.
  • Further research is needed to elucidate the exact mechanisms of CCC formation and their role in the bone-vascular axis, particularly in the context of CKD, diabetes, and atherosclerosis.

Keywords:
atherosclerosiscalcifying circulating cellschronic kidney disease-mineral and bone disordersmineral metabolismvascular calcification

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