Cardiac Fibroblasts Adopt Osteogenic Fates and Can Be Targeted to Attenuate Pathological Heart Calcification

Cell Stem Cell. 2017 Feb 2;20(2):218-232.e5. doi: 10.1016/j.stem.2016.10.005. Epub 2016 Nov 17.

Abstract

Mammalian tissues calcify with age and injury. Analogous to bone formation, osteogenic cells are thought to be recruited to the affected tissue and induce mineralization. In the heart, calcification of cardiac muscle leads to conduction system disturbances and is one of the most common pathologies underlying heart blocks. However the cell identity and mechanisms contributing to pathological heart muscle calcification remain unknown. Using lineage tracing, murine models of heart calcification and in vivo transplantation assays, we show that cardiac fibroblasts (CFs) adopt an osteoblast cell-like fate and contribute directly to heart muscle calcification. Small-molecule inhibition of ENPP1, an enzyme that is induced upon injury and regulates bone mineralization, significantly attenuated cardiac calcification. Inhibitors of bone mineralization completely prevented ectopic cardiac calcification and improved post injury heart function. Taken together, these findings highlight the plasticity of fibroblasts in contributing to ectopic calcification and identify pharmacological targets for therapeutic development.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Basic Helix-Loop-Helix Transcription Factors / metabolism
  • Biomarkers / metabolism
  • Calcification, Physiologic
  • Calcinosis / pathology*
  • Calcinosis / physiopathology
  • Cardiomyopathies / pathology*
  • Cardiomyopathies / physiopathology
  • Cell Differentiation
  • Cell Lineage*
  • Cell Separation
  • Diphosphates / metabolism
  • Disease Models, Animal
  • Female
  • Fibroblasts / metabolism
  • Fibroblasts / pathology*
  • Humans
  • Male
  • Mice, Inbred C57BL
  • Myocardial Infarction / pathology
  • Myocardium / metabolism
  • Myocardium / pathology*
  • Osteogenesis*
  • Phosphates / metabolism
  • Phosphoric Diester Hydrolases / metabolism
  • Pyrophosphatases / metabolism

Substances

  • Basic Helix-Loop-Helix Transcription Factors
  • Biomarkers
  • Diphosphates
  • Phosphates
  • Tcf21 protein, mouse
  • Phosphoric Diester Hydrolases
  • ectonucleotide pyrophosphatase phosphodiesterase 1
  • Pyrophosphatases