ESPE Abstracts (2021) 94 S11.1

ESPE2021 Symposia Calcium and Phosphate Beyond Bone (2 abstracts)

Phosphate toxicity: focus on medial vascular calcification

Jakob Voelkl


JKU, Linz, Austria. Charite, Berlin, Germany


Inorganic phosphate is essential for bone stability and various cellular metabolic pathways. Serum phosphate levels are regulated by an endocrine triangle of calcitriol, parathyroid hormone and fibroblast growth factor 23. In addition, a mineral buffering system is required to prevent mineral stress and ectopic calcification by spontaneous precipitation of calcium and phosphate. Current research indicates a complex interplay of phosphate homeostasis and inflammatory processes, especially in the cardiovascular system. Elevations of serum phosphate levels have been associated with increased cardiovascular mortality, not only in patients with chronic kidney disease but also in the general population. A critical process presumably underlying this association is medial vascular calcification. Especially in vascular smooth muscle cells, exposure to elevated phosphate conditions induces complex signalling events to promote pro-calcific alterations. These cells can foster a pro-calcific environment and augment an active calcification process by various mechanisms, such as cytokine and vesicle release, matrix remodelling and degradation of the calcification inhibitor pyrophosphate. Inflammatory mediators and signalling pathways have recently been connected to vascular smooth muscle cell calcification. Nonetheless, multiple gaps remain in the understanding of the complex role of phosphate and mineral stress on the cardiovascular system and until now, no broadly applicable therapeutic strategy is available to prevent medial vascular calcification.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

Online,
22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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