Osteoclasts may play key roles in initiating vascular calcification during atherosclerosis

Abstract

Vascular calcification, characterized by the ectopic deposition of calcium and phosphate crystals or even bone-like tissue, is a major risk factor for cardiovascular diseases such as atherosclerosis. However, the explicit mechanism remains unsettled. Current research demonstrates that atherosclerotic vascular calcification is a form of extraskeletal ossification—an active, cell-mediated process that closely resembles bone from macroscopic features down to the nanoscale structure. The mechanism underlying atherosclerotic calcification may be remarkably similar to those regulating bone remodeling and biomaterials-induced heterotopic ossification. This similarity is notably evidenced by the presence of osteoclast-like cells within vascular plaques. Based on previous findings that osteoclasts play key roles in initiating biomaterial-induced heterotopic ossification, we hypothesize for the first time that osteoclasts formed within the vascular wall may act as an ‘initiating signal’ triggering the development of atherosclerotic vascular calcification. This perspective may open new avenues for research into atherosclerotic calcification and contribute to the future development of strategies for its prevention and treatment.