Multiple Pathways for Pathological Calcification in the Human Body

• Published in: Advanced healthcare materials 2021-02, Vol.10 (4), p.e2001271-n/a
• Main Authors: Vidavsky, Netta, Kunitake, Jennie A. M. R., Estroff, Lara A.
• Format: Article
• Language: English
• Subjects: Abnormalities; apatite; Biomaterials; Biomedical materials; biomineralization; Bone and Bones; Bone Remodeling; Brain cancer; Breast cancer; breast cancer microcalcifications; Calcification; Calcification, Physiologic; Calcinosis; Calcium phosphates; cardiovascular calcifications; Cardiovascular diseases; Cellular structure; Crystal growth; Human Body; Humans; Materials science; Meningioma; Mineralization; Nucleation; Ovarian cancer; psammoma bodies; Soft tissues; Structural hierarchy; Surgical implants; Thyroid cancer
• ISSN: 2192-2640; 2192-2659; 2192-2659
• DOI: 10.1002/adhm.202001271

Biomineralization of skeletal components (e.g., bone and teeth) is generally accepted to occur under strict cellular regulation, leading to mineral–organic composites with hierarchical structures and properties optimized for their designated function. Such cellular regulation includes promoting mineralization at desired sites as well as inhibiting mineralization in soft tissues and other undesirable locations. In contrast, pathological mineralization, with potentially harmful health effects, can occur as a result of tissue or metabolic abnormalities, disease, or implantation of certain biomaterials. This progress report defines mineralization pathway components and identifies the commonalities (and differences) between physiological (e.g., bone remodeling) and pathological calcification formation pathways, based, in part, upon the extent of cellular control within the system. These concepts are discussed in representative examples of calcium phosphate‐based pathological mineralization in cancer (breast, thyroid, ovarian, and meningioma) and in cardiovascular disease. In‐depth mechanistic understanding of pathological mineralization requires utilizing state‐of‐the‐art materials science imaging and characterization techniques, focusing not only on the final deposits, but also on the earlier stages of crystal nucleation, growth, and aggregation. Such mechanistic understanding will further enable the use of pathological calcifications in diagnosis and prognosis, as well as possibly provide insights into preventative treatments for detrimental mineralization in disease. Physiological biomineralization is a tightly regulated process characterized by multiple levels of synchronized cellular controls. In contrast, pathological calcification, occurring in nonskeletal tissues including vasculature and cancers, occurs via multiple pathways, with varying degrees of cellular regulation. Identifying “pathway components,” e.g., cell death, mineralization proteins, vesicle secretion, and mineralized collagen, provides a framework which is used to describe pathological mineralization pathways.