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Updated: Jun 25, 2025

Isolation of Mouse Interstitial Valve Cells to Study the Calcification of the Aortic Valve In Vitro
Published on: May 10, 2021
FOXO1 regulates RUNX2 ubiquitination through SMURF2 in calcific aortic valve disease
Chen Jiang1, Dingyi Yao1, Zongtao Liu1
1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
Abstract:
The prevalence of calcific aortic valve disease (CAVD) remains substantial while there is currently no medical therapy available. Forkhead box O1 (FOXO1) is known to be involved in the pathogenesis of cardiovascular diseases, including vascular calcification and atherosclerosis; however, its specific role in calcific aortic valve disease remains to be elucidated. In this study, we identified FOXO1 significantly down-regulated in the aortic valve interstitial cells (VICs) of calcified aortic valves by investigating clinical specimens and GEO database analysis. FOXO1 silencing or inhibition promoted VICs osteogenic differentiation in vitro and aortic valve calcification in Apoe-/- mice, respectively. We identified that FOXO1 facilitated the ubiquitination and degradation of RUNX2, which process was mainly mediated by SMAD-specific E3 ubiquitin ligase 2 (SMURF2). Our discoveries unveil a heretofore unacknowledged mechanism involving the FOXO1/SMURF2/RUNX2 axis in CAVD, thereby proposing the potential therapeutic utility of FOXO1 or SMURF2 as viable strategies to impede the progression of CAVD.
Insights
Forkhead box O1 (FOXO1) is down-regulated in calcific aortic valve disease (CAVD), promoting valve calcification by stabilizing RUNX2. Targeting the FOXO1/SMURF2/RUNX2 pathway may offer new therapies for CAVD.
Area of Science:
- Cardiovascular Biology
- Molecular Medicine
- Pathogenesis of Valve Disease
Background:
- Calcific aortic valve disease (CAVD) is prevalent with no current medical treatments.
- Forkhead box O1 (FOXO1) is implicated in cardiovascular diseases, but its role in CAVD is unclear.
Purpose of the Study:
- To elucidate the specific role of FOXO1 in the pathogenesis of CAVD.
- To identify potential therapeutic targets for CAVD based on FOXO1's function.
Main Methods:
- Analysis of clinical specimens and GEO database to assess FOXO1 expression in CAVD.
- In vitro experiments involving FOXO1 silencing in valve interstitial cells (VICs).
- In vivo studies using Apoe-/- mice to evaluate the impact of FOXO1 inhibition on aortic valve calcification.
Main Results:
- FOXO1 was significantly downregulated in VICs from calcified aortic valves.
- FOXO1 silencing or inhibition accelerated VIC osteogenic differentiation and aortic valve calcification.
- FOXO1 promotes RUNX2 ubiquitination and degradation, mediated by SMURF2.
Conclusions:
- A novel mechanism involving the FOXO1/SMURF2/RUNX2 axis in CAVD pathogenesis was uncovered.
- FOXO1 or SMURF2 modulation presents a potential therapeutic strategy to inhibit CAVD progression.
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