Why the study?
Aortic valve sclerosis represents a critical window for early clinical intervention, but its underlying cellular drivers during ageing remain poorly understood.
Population
Human scRNA-seq datasets and natural ageing and D-galactose-induced mouse models
Design
Preclinical mechanistic study using genetic lineage tracing, bone marrow chimeras, and single-cell RNA sequencing
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for targeting CD34+ progenitors in aortic valve sclerosis; leaves open clinical translation and efficacy in humans.
Aortic valve sclerosis (AVS), characterised by fibrocalcific remodelling without significant hemodynamic obstruction, represents a critical window for early clinical intervention; however, its underlying cellular drivers during ageing remain poorly understood. Here, genetic lineage tracing and single‐cell RNA sequencing (scRNA‐seq) techniques were used to examine the temporal and spatial functions of CD34 + valvular interstitial cells (VICs) in ageing‐associated AVS. Human scRNA‐seq datasets were used in combination with natural ageing and D‐galactose (D‐gal)‐induced mouse models, and a significant age‐dependent downregulation of CD34 in VICs was identified. Lineage tracing and bone marrow (BM) chimeras confirmed that non‐BM CD34 + progenitor VICs (prog‐VICs), rather than bone marrow‐derived cells, serve as the origin of periostin + myofibroblast‐like VICs (myo‐VICs) during ageing. Functionally, the systemic or non‐BM‐specific ablation of CD34 + cells or the CD34 + Periostin + transitional subpopulation markedly attenuated age‐related leaflet thickening and fibrotic remodelling. Mechanistically, the JNK–JUNB signalling pathway, mediated by PDGFR, was found to be crucial for the pathological transdifferentiation of CD34 + prog‐VICs into periostin + myo‐VICs. Non‐BM CD34 + prog‐VICs were found to aggravate senescence‐associated AVS; thus, targeting the PDGFR–JNK–JUNB axis or preserving the prog‐VIC identity may offer therapeutic avenues to arrest early calcific aortic valve disease (CAVD) progression.
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Yang et al. (2026) studied this question.
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