Decoding the regulatory role of noncoding RNAs in biological and vascular calcification

Cardiovascular diseases, including vascular calcification (VC), cardiac hypertrophy, myocardial infarction and atherosclerosis, remain the leading causes of morbidity and mortality worldwide. Among these, VC involves the pathological deposition of calcium in arterial walls, leading to vascular stenosis and remodelling through the endothelial-to-mesenchymal transition (EndMT). This process mirrors biological bone formation, where osteoblasts and osteoclasts coordinate bone homeostasis. Notably, osteogenic markers identified in vascular tissues highlight the overlap between bone and vascular calcification. Recent advancements in next-generation sequencing (NGS) have revealed the pivotal role of noncoding RNAs(ncRNAs), such as microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs), in regulating biological and vascular calcification. These ncRNAs influence transcription, translation, and epigenetic modifications while modulating oxidative stress, inflammation, and endothelial dysfunction. This review elucidates the role of ncRNAs in modulating the pathophysiology of biological and vascular calcification, with a focus on the differential expression of ncRNAs and their implications for vascular and skeletal health.