Aldosterone increases vascular calcification in in vitro studies
La aldosterona aumenta la calcificación vascular in vitro
A. J.. de Solísa, F. R.. González-Pachecoa, J. J. P. Deuderoa, F.. Neriaa, O.. Calabiaa, R.. Fernández-Sáncheza, C.. Carameloa
a Laboratorio de Nefrología-Hipertensión, Fundación Jiménez Díaz-Capio. Universidad Autónoma de Madrid. Instituto Reina Sofía de Investigación Nefrológica., Madrid, Madrid, España,
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González-Pacheco, J. J. P. Deudero, F. Neria, O. Calabia, R. Fernández-Sánchez, C. Caramelo" "autores" => array:7 [ 0 => array:3 [ "Iniciales" => "A. J." "apellidos" => "de Solís" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "F. R." "apellidos" => "González-Pacheco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:4 [ "nombre" => "J. J. P." "apellidos" => "Deudero" "email" => array:1 [ 0 => "jjpdeudero@fjd.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "Iniciales" => "F." "apellidos" => "Neria" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "Iniciales" => "O." "apellidos" => "Calabia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 5 => array:3 [ "Iniciales" => "R." "apellidos" => "Fernández-Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 6 => array:3 [ "Iniciales" => "C." "apellidos" => "Caramelo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Laboratorio de Nefrología-Hipertensión, Fundación Jiménez Díaz-Capio. Universidad Autónoma de Madrid. Instituto Reina Sofía de Investigación Nefrológica., Madrid, Madrid, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La aldosterona aumenta la calcificación vascular in vitro" ] ] "textoCompleto" => "<p class="elsevierStylePara">To the editor:</p><p class="elsevierStylePara">We would like to report the results of a recent work performed in our Laboratory about the hypothesis that aldosterone plays a relevant role in vascular calcification. Briefly, the method was an in vitro model of normal vascular smooth muscle cells (VSMC) in a primary culture, induced to get calcified in the presence of beta-glycerophosphate. The study shows that aldosterone increases calcification in VSMC. The effect is inhibited by spironolactone. Until recently, vascular calcification was considered a passive process, provoked by a non specific response of vascular tissues to different insults, with the deposition of calcium phosphate, mainly in the form of hydroxyapatite. Nowadays, it is known that calcification is due to a regulated process, in which several cell types are implicated, as well as a great deal of mediators, both pro-calcifying like alkaline phosphatase (AP), Cbfa-1, osteocalcin, and anti-calcifying agents such as matrix protein gliadin (MPG), osteoprotegerin (OPG) and fetuin-A<span class="elsevierStyleSup">1-3</span>. The normal response of VSCM is anti-calcifying. However, in the uremic states this balance is altered favoring the pro-calcifying factors. The causes are multiple, such as increase of Ca and/or P in the milieu, the above-mentioned inflammatory and oxidative processes, or simply the stress associated to prolonged use accompanying the aging process.</p><p class="elsevierStylePara">Uremic vascular calcifications in the middle layer of the VSMC mainly involve areas of extracellular matrix and the elastic lamina. This kind of calcification is the most frequent and the earliest among uremic calcifications<span class="elsevierStyleSup">2</span>.</p><p class="elsevierStylePara">Aldosterone is currently considered a pro-fibrotic vascular factor. This concept has been widely accepted in the clinical practice, especially after the publication of the RALES study<span class="elsevierStyleSup">4</span>. There are many studies supporting the presence of aldosterone receptors in VSMC, with different functional implications<span class="elsevierStyleSup">5, 6</span>. However, despite the obvious temporal relationship between the development of vascular fibrosis and stiffness, and the appearance of vascular calcifications, no studies have been conducted, exploring the possible relationship between both phenomena. Old reports in the literature suggested that aldosterone could participate in calcium transportation in VSMC<span class="elsevierStyleSup">7</span>. According to our own results, the population on dialysis due to advanced renal disease presents significantly high aldosterone levels compared to normal subjects (Caramelo et al., data not published).</p><p class="elsevierStylePara">The aim of this work was to examine the role of aldosterone in the induction of vascular calcifications in a wellknown experimental model, that is the exposition of VSMC to beta-glycerophosphate. Our hypothesis is that aldosterone possibly participates in this process. The following methods were employed:</p><p class="elsevierStylePara">Primary culture of VSMC from bovine aorta, according to the method described by Campbell<span class="elsevierStyleSup">8</span>. The VSMC were employed between steps 2 and 8.</p><p class="elsevierStylePara">Induction of calcification process: We have used a standardized calcification method, which is used in the Laboratory <span class="elsevierStyleSup">9</span>. The calcification medium was changed every 48 hours during 12 days and it is based on beta-glycerophosphate (10 mM) (Sigma-Aldrich, Madrid). The beta-glycerophosphate acts as a PO<span class="elsevierStyleInf">4</span><span class="elsevierStyleSup">-3</span> donor when it is hydrolyzed by alkaline phosphatase.</p><p class="elsevierStylePara">Quantification of the calcification by <span class="elsevierStyleSup">45</span>Ca accumulation: The cells that are on the calcification process are incubated with 0.5 mCi/mL of <span class="elsevierStyleSup">45</span>Ca (GE Healthcare, Barcelona). The detection of the accumulation is made by means of a scintillation fluid UltimaGold (Perkin Elmer, Waltham, MA) in a Beckman LS6000TA counter.</p><p class="elsevierStylePara">Von Kossa stain: To visualize the calcification process, VSMC were fixed with Merkcofix (Merck KGaA, Darmstadt, Germany), incubated with 5% silver nitrate for 30 minutes in the darkness and exposed to sun light until the stain could be seen. The pictures were made with a digital camera Nikkon Coolpix 995 with an illuminated background.</p><p class="elsevierStylePara">Incubation with aldosterone. During the whole calcifying process, VSMC were incubated with aldosterone or vehicle aggregated to the medium. In each medium change the adequate concentration of aldosterone was added.</p><p class="elsevierStylePara">Statistics: Data were expressed as mean ± standard deviation of the mean. Except when indicated, all values correspond to a minimum of 5 experiments with triplicate samples. Comparisons were made by means of the Student¿s t test with matched pairs or not, and ANOVA test with Scheffé¿s test. Significance was accepted with a P value < 0.05. All calculations were made with SPSS statistical software 10.0 for Windows.</p><p class="elsevierStylePara">The findings show the reliability of the model for the calcium accumulation in the form of crystals positive for von Kossa stain and <span class="elsevierStyleSup">45</span>Ca. The increase was generally higher than 250%. With aldosterone <span class="elsevierStyleSup">45</span>Ca uptake was significantly higher but with high hormone concentrations (fig. 1). The increase was massively inhibited (85 ± 4% inhibition, P < 0.01) in the presence of spironolactone (10-7 and 10-6 M).</p><p class="elsevierStylePara">Jaffe et al. have recently reported a similar finding but using an extremely selective model with calcifying cells and the results cannot be extrapolated to all VSMC<span class="elsevierStyleSup">10</span>. Our results point out that aldosterone favors calcification in normal VSMC, and this fact widely spreads the possible calcifying action of the hormone. Of note, the strong inhibition in the presence of aldosterone indicates that the effect occurs through the mineralocorticoid receptor.</p><p class="elsevierStylePara">It is well known that aldosterone induces pro-fibrotic changes in the protein composition of the arterial wall<span class="elsevierStyleSup">4</span>. But to our knowledge it had not been reported, except for the work of Jaffe et al.<span class="elsevierStyleSup">10</span>, that it also influences the calcification process. It is true that the concentrations at which we detected the calcifying effect were elevated. But many interactions with other pro-calcifying factors can be crucial in vivo, and lower aldosterone concentrations can act as co-adjuvant of other mediators.</p><p class="elsevierStylePara">The presence of extra-bone calcifications in patients with early onset hyperaldosteronism of the childhood, like the Bartter and Gitelman syndromes, are another example, in which the relationship between hyperaldosteronism and calcification can play a role, yet not suspected<span class="elsevierStyleSup">11, 12</span>.</p><p class="elsevierStylePara">In summary, this study shows new data about the factors implicated in vascular calcification. The potential therapeutic interest of aldosterone antagonists cannot be disregarded. If it can be proved that they act on the vascular calcification process, they could be added as a new therapeutic tool to those currently available to control calcifications. </p>" "pdfFichero" => "P-E-S-A511-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Mori K, Shioi A, Jono S, Nishizawa Y, Morii H. Expression of matrix Gla protein (MGP) in an in vitro model of vascular calcification. FEBS Lett 1998; 433 (1-2): 19-22. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9738924" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Proudfoot D, Skepper JN, Shanahan CM, Weissberg PL. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 9 | 21 |
| 2024 October | 38 | 37 | 75 |
| 2024 September | 50 | 31 | 81 |
| 2024 August | 85 | 48 | 133 |
| 2024 July | 41 | 35 | 76 |
| 2024 June | 72 | 38 | 110 |
| 2024 May | 63 | 32 | 95 |
| 2024 April | 43 | 36 | 79 |
| 2024 March | 37 | 27 | 64 |
| 2024 February | 32 | 36 | 68 |
| 2024 January | 33 | 34 | 67 |
| 2023 December | 53 | 28 | 81 |
| 2023 November | 30 | 30 | 60 |
| 2023 October | 63 | 40 | 103 |
| 2023 September | 70 | 32 | 102 |
| 2023 August | 46 | 31 | 77 |
| 2023 July | 28 | 30 | 58 |
| 2023 June | 66 | 18 | 84 |
| 2023 May | 69 | 35 | 104 |
| 2023 April | 55 | 14 | 69 |
| 2023 March | 76 | 23 | 99 |
| 2023 February | 40 | 19 | 59 |
| 2023 January | 31 | 24 | 55 |
| 2022 December | 51 | 35 | 86 |
| 2022 November | 41 | 33 | 74 |
| 2022 October | 36 | 50 | 86 |
| 2022 September | 38 | 30 | 68 |
| 2022 August | 42 | 39 | 81 |
| 2022 July | 32 | 37 | 69 |
| 2022 June | 26 | 21 | 47 |
| 2022 May | 30 | 40 | 70 |
| 2022 April | 33 | 38 | 71 |
| 2022 March | 31 | 38 | 69 |
| 2022 February | 27 | 28 | 55 |
| 2022 January | 28 | 28 | 56 |
| 2021 December | 32 | 36 | 68 |
| 2021 November | 38 | 40 | 78 |
| 2021 October | 34 | 32 | 66 |
| 2021 September | 25 | 34 | 59 |
| 2021 August | 32 | 36 | 68 |
| 2021 July | 37 | 42 | 79 |
| 2021 June | 22 | 27 | 49 |
| 2021 May | 26 | 24 | 50 |
| 2021 April | 62 | 35 | 97 |
| 2021 March | 39 | 32 | 71 |
| 2021 February | 29 | 18 | 47 |
| 2021 January | 24 | 22 | 46 |
| 2020 December | 30 | 16 | 46 |
| 2020 November | 37 | 13 | 50 |
| 2020 October | 15 | 16 | 31 |
| 2020 September | 27 | 6 | 33 |
| 2020 August | 46 | 8 | 54 |
| 2020 July | 40 | 7 | 47 |
| 2020 June | 34 | 15 | 49 |
| 2020 May | 47 | 15 | 62 |
| 2020 April | 27 | 18 | 45 |
| 2020 March | 40 | 9 | 49 |
| 2020 February | 42 | 18 | 60 |
| 2020 January | 52 | 24 | 76 |
| 2019 December | 61 | 27 | 88 |
| 2019 November | 37 | 22 | 59 |
| 2019 October | 31 | 11 | 42 |
| 2019 September | 35 | 14 | 49 |
| 2019 August | 22 | 10 | 32 |
| 2019 July | 30 | 20 | 50 |
| 2019 June | 25 | 9 | 34 |
| 2019 May | 17 | 13 | 30 |
| 2019 April | 44 | 26 | 70 |
| 2019 March | 20 | 15 | 35 |
| 2019 February | 22 | 18 | 40 |
| 2019 January | 23 | 10 | 33 |
| 2018 December | 55 | 31 | 86 |
| 2018 November | 77 | 11 | 88 |
| 2018 October | 53 | 19 | 72 |
| 2018 September | 51 | 10 | 61 |
| 2018 August | 40 | 11 | 51 |
| 2018 July | 42 | 9 | 51 |
| 2018 June | 39 | 16 | 55 |
| 2018 May | 42 | 9 | 51 |
| 2018 April | 43 | 10 | 53 |
| 2018 March | 41 | 10 | 51 |
| 2018 February | 31 | 10 | 41 |
| 2018 January | 36 | 6 | 42 |
| 2017 December | 53 | 12 | 65 |
| 2017 November | 34 | 5 | 39 |
| 2017 October | 32 | 7 | 39 |
| 2017 September | 42 | 15 | 57 |
| 2017 August | 27 | 4 | 31 |
| 2017 July | 34 | 10 | 44 |
| 2017 June | 25 | 7 | 32 |
| 2017 May | 34 | 16 | 50 |
| 2017 April | 33 | 8 | 41 |
| 2017 March | 11 | 12 | 23 |
| 2017 February | 20 | 4 | 24 |
| 2017 January | 16 | 9 | 25 |
| 2016 December | 61 | 3 | 64 |
| 2016 November | 72 | 5 | 77 |
| 2016 October | 87 | 5 | 92 |
| 2016 September | 120 | 1 | 121 |
| 2016 August | 153 | 1 | 154 |
| 2016 July | 152 | 4 | 156 |
| 2016 June | 123 | 0 | 123 |
| 2016 May | 154 | 0 | 154 |
| 2016 April | 82 | 0 | 82 |
| 2016 March | 80 | 0 | 80 |
| 2016 February | 75 | 0 | 75 |
| 2016 January | 84 | 0 | 84 |
| 2015 December | 86 | 0 | 86 |
| 2015 November | 67 | 0 | 67 |
| 2015 October | 82 | 0 | 82 |
| 2015 September | 54 | 0 | 54 |
| 2015 August | 64 | 0 | 64 |
| 2015 July | 67 | 0 | 67 |
| 2015 June | 34 | 0 | 34 |
| 2015 May | 39 | 0 | 39 |
| 2015 April | 5 | 0 | 5 |
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