Multiple functions of autophagy in vascular calcification

Area of Science:

• Cardiovascular Biology
• Cellular Biology
• Molecular Medicine

Background:

• Vascular calcification is a significant risk factor for cardiovascular diseases, including atherosclerosis, chronic kidney disease, diabetes, and hypertension.
• The severity of vascular calcification correlates with adverse clinical outcomes and mortality.
• The precise role of autophagy in vascular calcification remains incompletely understood.

Purpose of the Study:

• To review the known mechanisms of autophagy in vascular calcification.
• To discuss the potential of targeting autophagy for therapeutic interventions against vascular calcification.

Main Methods:

• Literature review of current research on autophagy and vascular calcification.
• Analysis of molecular pathways linking autophagy to vascular calcification.
• Discussion of therapeutic implications.

Main Results:

• Autophagy can inhibit vascular calcification by suppressing VSMC osteogenic differentiation via pathways like ANCR, ERα, and mTOR.
• Conversely, autophagy can promote calcification through CREB and H19/DUSP5-mediated ERK signaling.
• Autophagy influences apoptosis, with mitophagy failure linked to vascular calcification.
• Autophagy regulates osteogenesis and bone mineralization processes involved in vascular calcification.

Conclusions:

• The relationship between autophagy and vascular calcification is complex, influenced by disease state, location, and microenvironment.
• Autophagy activation is protective in damaged cells, whereas defective autophagy in healthy cells can lead to apoptosis.
• Targeting the balance of autophagy may offer a novel clinical strategy for reducing vascular calcification.