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      Aged bone matrix-derived extracellular vesicles as a messenger for calcification paradox

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          Abstract

          Adipocyte differentiation of bone marrow mesenchymal stem/stromal cells (BMSCs) instead of osteoblast formation contributes to age- and menopause-related marrow adiposity and osteoporosis. Vascular calcification often occurs with osteoporosis, a contradictory association called “calcification paradox”. Here we show that extracellular vesicles derived from aged bone matrix (AB-EVs) during bone resorption favor BMSC adipogenesis rather than osteogenesis and augment calcification of vascular smooth muscle cells. Intravenous or intramedullary injection of AB-EVs promotes bone-fat imbalance and exacerbates Vitamin D3 (VD3)-induced vascular calcification in young or old mice. Alendronate (ALE), a bone resorption inhibitor, down-regulates AB-EVs release and attenuates aging- and ovariectomy-induced bone-fat imbalance. In the VD3-treated aged mice, ALE suppresses the ovariectomy-induced aggravation of vascular calcification. MiR-483-5p and miR-2861 are enriched in AB-EVs and essential for the AB-EVs-induced bone-fat imbalance and exacerbation of vascular calcification. Our study uncovers the role of AB-EVs as a messenger for calcification paradox by transferring miR-483-5p and miR-2861.

          Abstract

          This study uncovers the role of extracellular vesicles from bone matrix as a messenger in the development of osteoporosis and vascular calcification (calcification paradox) during skeletal aging and menopause by transferring miR-483-5p and miR-2861.

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          Most cited references80

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          Clinical Practice. Postmenopausal Osteoporosis.

          Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.
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            Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness

            Abstract Vascular calcification is associated with a significant increase in all-cause mortality and atherosclerotic plaque rupture. Calcification has been determined to be an active process driven in part by vascular smooth muscle cell (VSMC) transdifferentiation within the vascular wall. Historically, VSMC phenotype switching has been viewed as binary, with the cells able to adopt a physiological contractile phenotype or an alternate ‘synthetic’ phenotype in response to injury. More recent work, including lineage tracing has however revealed that VSMCs are able to adopt a number of phenotypes, including calcific (osteogenic, chondrocytic, and osteoclastic), adipogenic, and macrophagic phenotypes. Whilst the mechanisms that drive VSMC differentiation are still being elucidated it is becoming clear that medial calcification may differ in several ways from the intimal calcification seen in atherosclerotic lesions, including risk factors and specific drivers for VSMC phenotype changes and calcification. This article aims to compare and contrast the role of VSMCs in driving calcification in both atherosclerosis and in the vessel media focusing on the major drivers of calcification, including aging, uraemia, mechanical stress, oxidative stress, and inflammation. The review also discusses novel findings that have also brought attention to specific pro- and anti-calcifying proteins, extracellular vesicles, mitochondrial dysfunction, and a uraemic milieu as major determinants of vascular calcification.
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              Romosozumab or Alendronate for Fracture Prevention in Women with Osteoporosis

              Romosozumab is a monoclonal antibody that binds to and inhibits sclerostin, increases bone formation, and decreases bone resorption.
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                Author and article information

                Contributors
                chency19@csu.edu.cn
                huixie@csu.edu.cn
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                18 March 2022
                18 March 2022
                2022
                : 13
                : 1453
                Affiliations
                [1 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Department of Orthopedics, Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [2 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Movement System Injury and Repair Research Center, Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [3 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, The Second Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [4 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Xiangya Nursing School, , Central South University, ; Changsha, Hunan China
                [5 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of Laboratory Medicine, Affiliated Zhejiang Hospital, , Zhejiang University School of Medicine, Hangzhou, ; Zhejiang, China
                [6 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Department of Emergency Medicine, Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [7 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, Department of Sports Medicine, Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [8 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, , Central South University, ; Changsha, Hunan China
                [9 ]Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan China
                [10 ]Hunan Key Laboratory of Bone Joint Degeneration and Injury, Changsha, Hunan China
                Author information
                http://orcid.org/0000-0003-1575-1459
                http://orcid.org/0000-0002-9508-1397
                http://orcid.org/0000-0003-0659-2775
                http://orcid.org/0000-0001-8602-7113
                http://orcid.org/0000-0001-7808-533X
                http://orcid.org/0000-0002-8526-2637
                Article
                29191
                10.1038/s41467-022-29191-x
                8933454
                35304471
                84ea4874-fcf5-459a-8d27-555a04bce98f
                © The Author(s) 2022

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 9 December 2020
                : 25 February 2022
                Funding
                Funded by: FundRef https://doi.org/10.13039/501100001809, National Natural Science Foundation of China (National Science Foundation of China);
                Award ID: 81600699
                Award ID: 81974127
                Award ID: 81702237
                Award ID: 81871822
                Award ID: 82072504
                Award ID: 81522012
                Award ID: 81670807
                Award Recipient :
                Funded by: Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (Grant No. 2019-RC-HL-024)
                Categories
                Article
                Custom metadata
                © The Author(s) 2022

                Uncategorized
                calcification,osteoporosis,bone
                Uncategorized
                calcification, osteoporosis, bone

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