Elevated uric acid levels were causally associated with valvular heart disease and promoted aortic valve calcification via HIF-1α-mediated osteogenic differentiation and endothelial dysfunction.
Does hyperuricemia promote aortic valve calcification in experimental models and correlate with calcification in humans?
Hyperuricemia promotes aortic valve calcification through HIF-1alpha-mediated osteogenic differentiation and endothelial dysfunction, suggesting uric acid-lowering therapies as a potential treatment.
Abstract Aortic valve calcification is a lethal valvular heart disease lacking effective drug therapy. However, whether uric acid is involved in the development of aortic valve calcification is unclear. Two‐sample Mendelian randomization (MR) analyses confirmed the causal relationship between uric acid and valvular heart disease. Uric acid levels were assessed in aortic valve tissue from patients with/without aortic valve calcification. To investigate the impact of hyperuricemia on aortic valve calcification, apolipoprotein E knockout (ApoE −/− ) mice fed a high‐fat diet (HFD) were also given an adenine diet, with some receiving allopurinol in their drinking water. RNA sequencing was performed on valve interstitial cells (VICs) and endothelial cells (VECs) with/without uric acid. MR analysis has revealed a causal effect of uric acid levels on valvular heart disease. Furthermore, our clinical data indicate a positive correlation between elevated serum uric acid levels and aortic valve calcium score. Specifically, uric acid levels were upregulated in calcified valves. In ApoE −/− mice, an adenine‐diet‐induced hyperuricemia accelerated aortic valve calcification. RNA sequencing analysis demonstrated that uric acid‐promoted osteogenic differentiation, primarily through the activation of hypoxia‐inducible factor‐1alpha (HIF‐α). Additionally, uric acid impaired endothelial barrier function by activating HIF‐α, resulting in increased macrophage infiltration in ApoE −/− mice. Inhibiting HIF‐1α suppressed osteogenic differentiation and reduced endothelial injury both in vitro and in vivo in the presence of uric acid. This study reveals a new role of hyperuricemia in aortic valve calcification, suggesting uric acid‐lowering drugs or HIF‐1α inhibition as potential treatments for associated aortic valve calcification.
Zhang et al. (Tue,) conducted a other in Aortic valve calcification. Uric acid vs. Without uric acid was evaluated on Aortic valve calcification and valvular heart disease. Elevated uric acid levels were causally associated with valvular heart disease and promoted aortic valve calcification via HIF-1α-mediated osteogenic differentiation and endothelial dysfunction.