# Vascular calcification and atherosclerosis

> **NIH NIH R01** · NEW YORK INST OF TECHNOLOGY · 2021 · $380,750

## Abstract

Project Summary/Abstract
Cardiovascular disease (CVD) is the leading cause of death in the U.S., with the annual total cost of care
estimated at $351 billion. Vascular calcification is a nontraditional CVD risk factor associated with a significant
increase in morbidity and mortality in the general population. Unlike other established risk factors, it is not yet
regarded as a modifiable factor. However, there is emerging evidence that it may drive the pathogenesis of
atherosclerosis and play an important role in the regression of atherosclerotic plaques. Our data demonstrated
that overexpression of tissue-nonspecific alkaline phosphatase (TNAP) in endothelial cells accelerated
coronary atherosclerosis in hyperlipidemic mice, while the TNAP inhibitor SBI-425 reduced manifestations of
coronary artery disease in this model. Subendothelial microcalcification was frequently observed in the internal
elastic lamina in mice and in human arteries and was predicted by computational fluid structure interaction
(FSI) modeling to redistribute wall shear stress on the endothelium. The idea that calcification can promote
atherosclerosis was further supported by an observation of increased low density lipoprotein (LDL) uptake by
endothelial cells cultured on surfaces textured with hydroxyapatite particles. More evidence from mouse
models showed that TNAP activity in macrophages was sufficient to increase calcification during progression
of atherosclerosis and interfere with plaque regression, leading to maladaptive dilation of the aortic root.
We hypothesize that calcification is a modifiable factor in atherosclerosis and that inhibiting TNAP-mediated
vascular calcification may have therapeutic value. The overarching goal of this project is to gain a better
understanding of the role of calcification during atherosclerotic lesion initiation, progression, and resolution,
and to determine whether calcification is an active pathogenic factor in atherosclerosis or a mere, likely benign,
secondary response. The project will use computational and in vivo models to delineate hemodynamic
mechanism by which subendothelial microcalcifications increases retention of LDL in the arterial wall. The
effects of the conditional genetic ablation of TNAP in macrophages or an increase of TNAP activity in plasma
will then be tested in a mouse model of familial hypercholesterolemia. Because regression of calcified plaques
can lead to eccentric aortic root remodeling during lipid lowering, we will interrogate whether inhibition of TNAP
with SBI-425 could suppress calcification and alleviate maladaptive remodeling of the aortic root in a mouse
model during reversal of atherosclerosis. In testing TNAP inhibition for its therapeutic utility for atherosclerotic
calcification, we will keep close attention on potential bone side effects by monitoring bone microarchitecture
using micro-computed tomography. The results of this project will establish whether calcification is a
modifiable risk fa...

## Key facts

- **NIH application ID:** 10121665
- **Project number:** 1R01HL149864-01A1
- **Recipient organization:** NEW YORK INST OF TECHNOLOGY
- **Principal Investigator:** Olga V. Savinova
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $380,750
- **Award type:** 1
- **Project period:** 2021-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10121665

## Citation

> US National Institutes of Health, RePORTER application 10121665, Vascular calcification and atherosclerosis (1R01HL149864-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10121665. Licensed CC0.

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