Medial artery calcification develops in diabetes, chronic kidney disease, and as part of the aging process. It is associated with increased morbidity and mortality in vascular patients. Bone morphogenetic proteins (BMPs) have previously been implicated in the initiation and progression of vascular calcification. We thus evaluated whether DMH1, a highly specific BMP inhibitor, could attenuate vascular calcification in vitro and in an organ culture model of medial calcification.
Methods
Confluent human aortic smooth muscle cells (HASMCs) were cultured in calcification medium containing 3.0 mM inorganic phosphate (Pi) for 7 days with or without DMH1. Medial calcification was assessed using an aortic organ culture model. Calcification was visualized by Alizarin Red S staining, and calcium concentration was assessed by an o-cresolphthalein complexone calcium assay. Osteogenic cell and vascular smooth muscle cell (SMC) markers were determined by Western blot, qRT-PCR and immunohistochemistry staining.
Results
DMH1 reduced Pi-induced calcium deposition in human SMCs. It also antagonized human recombinant BMP2-induced calcium accumulation. Western blot further revealed that DMH1 was able to block Pi-mediated up-regulation of osteoblast markers including osterix and alkaline phosphatase (ALP), and down-regulation of SMC markers such as smooth muscle cell markers myosin heavy chain (SM-MHC) and SM22α, as well as P-Smad1/5/8, suggesting that DMH1 may regulate SMC osteogenic differentiation via the BMP/Smad1/5/8 signal pathway. Finally, utilizing an ex vivo aortic ring organ culture model, we observed that DMH1 has an ability to reduce Pi-induced aortic medial calcification.
Conclusions
The selective BMP inhibitor DMH1 can inhibit calcium accumulation in vascular smooth muscle cells and arterial segments exposed to elevated phosphate levels. Such small molecules may have clinical utility in reducing medial artery calcification in our vascular patient population.