Abstract

Inorganic phosphate (Pi) is essential for maintaining cellular function but excess of Pi leads to serious complications, including vascular calcification. Accumulating evidence suggests that oxidative stress contributes to the pathogenic progression of calcific changes. However, the molecular mechanism underlying Pi-induced reactive oxygen species (ROS) generation and its detrimental consequences remain unclear. Type III Na+-dependent Pi cotransporter, PiT-1/-2, play a significant role in Pi uptake of vascular smooth muscle cells. Pi influx via PiT-1/-2 increases the abundance of PiT-1/-2 and depolarization-activated Ca2+ entry due to its electrogenic properties, which may lead to Ca2+ and Pi overload and oxidative stress. At least four mitochondrial Pi transporters are suggested, among which the phosphate carrier (PiC) is known to be mainly involved in mitochondrial Pi uptake. Pi transport via PiC may induce hyperpolarization and superoxide generation, which may lead to mitochondrial dysfunction and endoplasmic reticulum stress, together with generation of cytosolic ROS. Increase in net influx of Ca2+ and Pi and their accumulation in the cytosol and mitochondrial matrix synergistically increases oxidative stress and osteogenic differentiation, which could be prevented by suppressing either Ca2+ or Pi overload. Therapeutic strategies targeting plasmalemmal and mitochondrial Pi transports can protect against Pi-induced oxidative stress and vascular calcification.

Highlights

  • Vascular calcification includes intimal and medial calcification, which occur via two different pathological mechanisms

  • We introduced the pathophysiological characteristics of plasmalemmal Pi transporters and mitochondrial Pi carriers in vascular calcification, focusing on the vicious cycle between Pi uptake and oxidative stress

  • For ATP production and mitochondrial activation, Pi should be delivered from the cytosol via mitochondrial Pi transporters, such as phosphate carrier (PiC) [38], dicarboxylate carrier (DIC) [39], Mg-ATP/Pi transporter [40], and uncoupling protein-2 (UCP2) [41]

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Summary

Introduction

Vascular calcification includes intimal and medial calcification, which occur via two different pathological mechanisms. Medial calcification is an active and complex cell-mediated process characterized by the absence of inflammatory cells and is associated with inorganic phosphate (Pi) and calcium overload in vascular smooth muscle cells (VSMCs). It is known as Mönckeberg’s sclerosis and causes arterial stiffness and decreases the compliance of vessels, which is observed in aging individuals and those with chronic kidney disease and diabetes mellitus. We introduced the pathophysiological characteristics of plasmalemmal Pi transporters and mitochondrial Pi carriers in vascular calcification, focusing on the vicious cycle between Pi uptake and oxidative stress

Plasmalemmal Phosphate Transporters
SLC34A Family
SLC34A
SLC20A Family phatemia, accompanied by increase in urinary loss of
Cytosolic Phosphate Exporter
Oxidative Stress Related to Plasmalemmal Pi Transporters
Mitochondrial Phosphate Transporters
Mg-ATP/Pi Carrier
Oxidative Stress Due to Mitochondrial Pi Transport
Oxidative Stress and Vascular Medial Calcification
Conclusions
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