Abstract
Extraosseous calcification is a pathologic mineralization process occurring in soft connective tissues (e.g., skin, vessels, tendons, and cartilage). It can take place on a genetic basis or as a consequence of acquired chronic diseases. In this last case, the etiology is multifactorial, including both extra- and intracellular mechanisms, such as the formation of membrane vesicles (e.g., matrix vesicles and apoptotic bodies), mitochondrial alterations, and oxidative stress. This review is an overview of extraosseous calcification mechanisms focusing on the relationships between apoptosis and mineralization in cartilage and vascular tissues, as these are the two tissues mostly affected by a number of age-related diseases having a progressively increased impact in Western Countries.
Highlights
Extraosseous calcification is a pathologic mineralization process occurring in soft connective tissues
This review aims to provide an overview of extraosseous calcification mechanisms focusing on the relationships between apoptosis and mineralization in cartilage and vascular tissues
Articular cartilage is typically composed of chondrocytes embedded within a rather amorphous extracellular matrix (ECM) comprised of collagen, different proteoglycans, structural proteins involved in cell-matrix and matrix-matrix interactions, proteinases and their inhibitors [108]
Summary
Calcium (Ca2+ ) and inorganic phosphate (Pi) exceed their solubility in most tissues; calcification does not occur in soft connective tissues for the presence of circulating and local inhibitors [15]. When these regulatory mechanisms are skimpy, pathological mineralization overwhelms and takes place through active cellmediated processes partially overlapping those observed during skeletal formation. Minerals are mainly deposited as hydroxyapatite, in contrast, in soft connective tissues, crystals of different compositions have been described (Table 1)
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