Sortilin mediates vascular calcification via its recruitment into extracellular vesicles

J Clin Invest. 2016 Apr 1;126(4):1323-36. doi: 10.1172/JCI80851. Epub 2016 Mar 7.

Abstract

Vascular calcification is a common feature of major cardiovascular diseases. Extracellular vesicles participate in the formation of microcalcifications that are implicated in atherosclerotic plaque rupture; however, the mechanisms that regulate formation of calcifying extracellular vesicles remain obscure. Here, we have demonstrated that sortilin is a key regulator of smooth muscle cell (SMC) calcification via its recruitment to extracellular vesicles. Sortilin localized to calcifying vessels in human and mouse atheromata and participated in formation of microcalcifications in SMC culture. Sortilin regulated the loading of the calcification protein tissue nonspecific alkaline phosphatase (TNAP) into extracellular vesicles, thereby conferring its calcification potential. Furthermore, SMC calcification required Rab11-dependent trafficking and FAM20C/casein kinase 2-dependent C-terminal phosphorylation of sortilin. In a murine model, Sort1-deficiency reduced arterial calcification but did not affect bone mineralization. Additionally, transfer of sortilin-deficient BM cells to irradiated atherosclerotic mice did not affect vascular calcification, indicating a primary role of SMC-derived sortilin. Together, the results of this study identify sortilin phosphorylation as a potential therapeutic target for ectopic calcification/microcalcification and may clarify the mechanism that underlies the genetic association between the SORT1 gene locus and coronary artery calcification.

Publication types

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

MeSH terms

  • Adaptor Proteins, Vesicular Transport / genetics
  • Adaptor Proteins, Vesicular Transport / metabolism*
  • Alkaline Phosphatase / biosynthesis
  • Alkaline Phosphatase / genetics
  • Animals
  • Calcium-Binding Proteins / genetics
  • Calcium-Binding Proteins / metabolism
  • Carrier Proteins / biosynthesis
  • Carrier Proteins / genetics
  • Casein Kinase I / genetics
  • Casein Kinase I / metabolism
  • Casein Kinase II / metabolism
  • Cell-Derived Microparticles / genetics
  • Cell-Derived Microparticles / metabolism*
  • Cells, Cultured
  • Extracellular Matrix Proteins / genetics
  • Extracellular Matrix Proteins / metabolism
  • Humans
  • Mice
  • Mice, Knockout
  • Muscle, Smooth, Vascular / metabolism*
  • Muscle, Smooth, Vascular / pathology
  • Myocytes, Smooth Muscle / metabolism*
  • Myocytes, Smooth Muscle / pathology
  • Phosphorylation
  • Plaque, Atherosclerotic / metabolism
  • Plaque, Atherosclerotic / pathology
  • Protein Transport
  • Vascular Calcification / genetics
  • Vascular Calcification / metabolism*
  • Vascular Calcification / pathology
  • rab GTP-Binding Proteins / genetics
  • rab GTP-Binding Proteins / metabolism

Substances

  • Adaptor Proteins, Vesicular Transport
  • Calcium-Binding Proteins
  • Carrier Proteins
  • Extracellular Matrix Proteins
  • FAM20C protein, mouse
  • Casein Kinase I
  • Casein Kinase II
  • FAM20C protein, human
  • ALPL protein, human
  • ALPL protein, mouse
  • Alkaline Phosphatase
  • rab11 protein
  • rab GTP-Binding Proteins
  • sortilin