Transitions between cell fates commonly occur in development and disease. However, reversing an unwanted cell transition in order to treat disease remains an unexplored area. Here, we report a successful process of guiding ill-fated transitions toward normalization in vascular calcification. Vascular calcification is a severe complication that increases all-cause mortality of cardiovascular disease but lacks medical therapy. The vascular endothelium is a contributor of osteoprogenitor cells to vascular calcification through endothelial-mesenchymal transitions, in which endothelial cells (ECs) gain plasticity and ability to differentiate into osteoblast-like cells. We created a high throughput screening and identified SB216763, an inhibitor of glycogen synthase kinase 3 (GSK3), as an inducer of osteoblastic-endothelial transition. We demonstrated that SB216763 limits osteogenic differentiation in ECs at an early stage of vascular calcification. Lineage tracing showed that SB216763 redirected osteoblast-like cells to the endothelial lineage and reduced late-stage calcification. We also find that deletion of GSK3beta in osteoblasts recapitulated osteoblastic-endothelial transition and reduced vascular calcification. Overall, inhibition of GSK3beta promoted the transition of cells with osteoblastic characteristic to endothelial differentiation thereby ameliorating vascular calcification.
Jiayi Yao, Xiuju Wu, Xiaojing Qiao, Daoqin Zhang, Li Zhang, Jocelyn A. Ma, Xinjiang Cai, Kristina I. Boström, Yucheng Yao