<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="research-article" dtd-version="2.3" xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1631039</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2025.1631039</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Resveratrol ameliorates osteogenic differentiation, calcification, and apoptosis of VSMCs through regulating JNK/Bax signaling</article-title>
<alt-title alt-title-type="left-running-head">Hou et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fphar.2025.1631039">10.3389/fphar.2025.1631039</ext-link>
</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hou</surname>
<given-names>Menglin</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2799064/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Hui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cheng</surname>
<given-names>Junmei</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Duan</surname>
<given-names>Xuyan</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ren</surname>
<given-names>Min</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/Writing - review &#x26; editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lu</surname>
<given-names>Yong</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/Writing - review &#x26; editing/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Department of Basic Medical, Heze Medical College</institution>, <addr-line>Heze</addr-line>, <addr-line>Shandong</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Central Laboratory, Heze Medical College</institution>, <addr-line>Heze</addr-line>, <addr-line>Shandong</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1171884/overview">Xinjiang Cai</ext-link>, University of California, Los Angeles, United States</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1321700/overview">Yefan Jiang</ext-link>, Huazhong University of Science and Technology, China</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1872832/overview">Yanzhong Liu</ext-link>, Henan University of Chinese medicine of Pharmacy, China</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Menglin Hou, <email>15065076258@163.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>01</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1631039</elocation-id>
<history>
<date date-type="received">
<day>11</day>
<month>06</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>31</day>
<month>07</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Hou, Wang, Cheng, Duan, Ren and Lu.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Hou, Wang, Cheng, Duan, Ren and Lu</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>Vascular calcification involves pathological mineralization in the vascular wall, which is characterized by the transformation of vascular smooth muscle cells (VSMCs) from a contractile phenotype to a synthetic phenotype. VSMCs undergoing apoptosis were found in vascular calcified plaques. However, the regulatory role of resveratrol in vascular calcification via VSMC apoptosis modulation remains unclear.</p>
</sec>
<sec>
<title>Methods</title>
<p>Rat VSMCs were cultured in calcifying medium (CM) to induce calcification, and treated with resveratrol, the JNK inhibitor SP600125, or the JNK activator anisomycin. Calcium deposition was assessed via alizarin red staining and quantitative calcium content assays. Alkaline phosphatase (ALP) activity, mRNA and protein levels of osteogenic markers, and apoptosis were evaluated. Molecular docking was performed to predict resveratrol-JNK binding. In vivo, vitamin D<sub>3</sub>-induced vascular calcification in mice was treated with resveratrol, and aortic calcification was analyzed via von Kossa and alizarin red staining.</p>
</sec>
<sec>
<title>Results</title>
<p>In CM-induced rat VSMC calcification, resveratrol treatment effectively attenuated the calcification of VSMCs, as evidenced by reduced calcium content, ALP activity, and osteogenic markers including Runx2, BMP2, and Osterix levels. Furthermore, resveratrol treatment significantly suppressed TUNEL-positive cell proportions and caspase-3 activity in CM-treated VSMCs. Mechanistically, resveratrol treatment blocked JNK/Bax activation by reducing the p-JNK and Bax levels in CM-treated VSMCs. The JNK inhibitor SP600125 markedly reduced calcification, downregulated osteogenic markers, and inhibited apoptosis in CM-treated VSMCs. JNK activation reversed resveratrol&#x2019;s anti-calcification and anti-apoptotic effects. In vitamin D<sub>3</sub>-induced calcification models, resveratrol significantly reduced vascular calcification and osteogenic differentiation.</p>
</sec>
<sec>
<title>Discussion</title>
<p>Resveratrol exerted an inhibitory effect on VSMC calcification, osteogenic differentiation, and apoptosis through the inhibition of the JNK/Bax signaling pathway.</p>
</sec>
</abstract>
<kwd-group>
<kwd>resveratrol</kwd>
<kwd>calcification</kwd>
<kwd>JNK/Bax signaling</kwd>
<kwd>vascular smooth muscle cells</kwd>
<kwd>apoptosis</kwd>
</kwd-group>
<counts>
<page-count count="11"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Cardiovascular and Smooth Muscle Pharmacology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1 Introduction</title>
<p>Vascular calcification is defined as the pathological phenomenon of abnormal deposition of calcium and phosphorus crystals in the vascular wall. It is defined as a complication of chronic kidney disease, diabetes, aging, atherosclerosis, and other diseases (<xref ref-type="bibr" rid="B29">Shanahan et al., 2011</xref>; <xref ref-type="bibr" rid="B37">Wilson et al., 2001</xref>). Additionally, vascular calcification primarily affects arterial vessels, contributing to increased arterial stiffness and diastolic and systolic dysfunction, and it further causes a variety of cardiovascular complications (<xref ref-type="bibr" rid="B15">Lacolley et al., 2017</xref>; <xref ref-type="bibr" rid="B16">Lanzer et al., 2021</xref>). Historically, vascular calcification is a passive process of calcium phosphate deposition in vascular cells and the extracellular matrix due to the imbalance of calcium metabolism in the body. Currently, vascular calcification is increasingly recognized as an active process regulated by multiple pathways analogous to bone formation (<xref ref-type="bibr" rid="B5">Chen et al., 2020</xref>; <xref ref-type="bibr" rid="B11">Hodroge et al., 2017</xref>; <xref ref-type="bibr" rid="B36">Villa-Bellosta and Egido, 2017</xref>). Calcification is characterized by the transformation of vascular cells to an osteoblast-like phenotype, upregulation of various osteogenic marker proteins, and increased intracellular alkaline phosphatase activity. However, the molecular regulation of vascular calcification remains to be elucidated.</p>
<p>Resveratrol (Res) is a non-flavonoid polyphenolic compound found in plants belonging to the grapevine, lily, and legume families (<xref ref-type="bibr" rid="B31">Shukla and Singh, 2011</xref>). As a natural and non-toxic compound, Res exhibits diverse biological activities, including cardiovascular protection, anti-tumor, anti-inflammatory, anti-oxidation, and estrogen mimicking (<xref ref-type="bibr" rid="B27">Sadruddin and Arora, 2009</xref>). Furthermore, Res acts as a natural activator of SIRT1 gene expression, which promotes cell survival and protects against apoptosis (<xref ref-type="bibr" rid="B25">Poussier et al., 2005</xref>; <xref ref-type="bibr" rid="B41">Yeung et al., 2004</xref>). Res can be rapidly absorbed, distributed, and metabolized by the human body after oral administration (<xref ref-type="bibr" rid="B2">Bishayee, 2009</xref>). Studies have demonstrated that Res significantly improved endothelial cell damage, atherosclerotic plaque formation, cardiovascular remodeling, and other cardiovascular diseases (<xref ref-type="bibr" rid="B3">Bonnefont-Rousselot, 2016</xref>; <xref ref-type="bibr" rid="B9">Guo et al., 2022</xref>; <xref ref-type="bibr" rid="B18">Li et al., 2019</xref>). As an important element in cardiovascular diseases, vascular smooth muscle cells (VSMCs) are key targets for Res, which inhibits VSMC proliferation, migration, and senescence (<xref ref-type="bibr" rid="B21">Lin et al., 2014</xref>; <xref ref-type="bibr" rid="B35">Uhrin et al., 2018</xref>). However, whether Res has a direct intervention effect on the phenotypic changes of VSMCs and vascular calcification is still not fully known.</p>
<p>In this study, we employed the calcification medium (CM) and vitamin D<sub>3</sub> to induce VSMC calcification and mouse vascular calcification, respectively, and used Res to observe its effect on whole vascular calcification, thereby elucidating its molecular mechanism in inhibiting vascular calcification. Notably, these findings offer novel insights into the prevention and treatment of vascular calcification.</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>2 Materials and methods</title>
<sec id="s2-1">
<title>2.1 Cell culture</title>
<p>VSMCs were isolated from aortic arteries of male Sprague&#x2013;Dawley (SD) rats (150 g&#x2013;180&#xa0;g) using the explant method. VSMCs were cultured in DMEM [10% FBS, penicillin (100 units/mL), and streptomycin (100&#xa0;mg/mL)] at 37 &#xb0;C in an incubator. VSMCs between passages 5 and 8 were used for the experiments. VSMC calcification was induced by the CM [DMEM, &#x3b2;-glycerophosphate (&#x3b2;-GP, 10&#xa0;mM), and CaCl<sub>2</sub> (3&#xa0;mM)]. After the cells were adhered overnight, VSMCs were treated with Res (10&#xa0;&#x3bc;M; Sigma, St. Louis, MO) in the CM for 10 days (<xref ref-type="bibr" rid="B19">Li et al., 2024</xref>; <xref ref-type="bibr" rid="B33">Takemura et al., 2011</xref>). The C-jun N terminal kinase (JNK) inhibitor (SP600125, 10&#xa0;&#x3bc;M; Sigma) or activator (anisomycin, 100&#xa0;ng/mL; Sigma) was added to the medium 1&#xa0;h before Res treatment for use in the experiments (<xref ref-type="bibr" rid="B22">Liu et al., 2021</xref>; <xref ref-type="bibr" rid="B44">Zhang et al., 2015</xref>).</p>
</sec>
<sec id="s2-2">
<title>2.2 Cell viability assays</title>
<p>VSMCs in the logarithmic growth stage were inoculated into a 96-well plates (1,000 cells per/well), with five wells in each group. After 24&#xa0;h of cell inoculation and adherent growth, Res was administered at the final concentrations of 0, 10, 20, 25, 50, 75, and 100&#xa0;&#xb5;M (<xref ref-type="bibr" rid="B19">Li et al., 2024</xref>). After 24&#xa0;h, 10&#xa0;&#xb5;L of CCK-8 solution was added to each well and incubated in the dark for 30&#xa0;min. The absorbance (A) value was measured at 450&#xa0;nm.</p>
</sec>
<sec id="s2-3">
<title>2.3 Determination of cell calcification</title>
<p>After fixed in 4% formaldehyde for 10&#xa0;min in 6-well plates, VSMCs were treated with 2% alizarin red (pH 4.2) for 5&#xa0;min. Then, excess dye was removed by deionized water, and an inverted phase contrast microscope was used to visualize staining. Alizarin red dye was eluted with 10% formic acid and quantified by spectrophotometry. As previously described, the calcium content and alkaline phosphatase (ALP) activity was measured (<xref ref-type="bibr" rid="B12">Hou et al., 2016</xref>; <xref ref-type="bibr" rid="B20">Liao et al., 2013</xref>; <xref ref-type="bibr" rid="B40">Yan et al., 2011</xref>). VSMCs were washed with phosphate-buffered saline (PBS) and extracted with 0.6&#xa0;N HCl for 24&#xa0;h. The protein concentration was quantified using BCA protein assay (Pierce, United States). The calcium content was normalized to protein concentration and expressed as &#xb5;g/mg protein. For ALP activity analysis, VSMCs were harvested with 0.1% Triton X-100 in PBS. p-NPP (180&#xa0;&#xb5;L) substrate was added to the protein samples, and the reaction was incubated for 15&#xa0;min at 37 &#xb0;C. To stop the reaction, NaOH (3&#xa0;M) was added to the mixture. The absorbance was then measured at 405&#xa0;nm, and the ALP activity was presented as nmol/mL p-nitrophenol converted per microgram of protein per minute.</p>
</sec>
<sec id="s2-4">
<title>2.4 Western blot analysis</title>
<p>Total protein was extracted from VSMCs, and the protein concentration was measured using a BCA protein assay kit (Pierce, United States). Equal amounts of protein samples were loaded and separated by 5% SDS-PAGE and then transferred to nitrocellulose membranes (Bio-Rad, United States). The membranes were then blocked with 5% non-fat dried milk for 1&#xa0;h, followed by incubation with primary antibodies including Bax (1:1,000, 2772), JNK (1:1,000, 9252), p-JNK (1:1,000, 9255), and &#x3b2;-actin (1:3,000, ab32572) from Cell Signaling Technology (Beverly, MA, United States), along with Runx2 (1:500, SAB1403638, Millipore, United States) and Osterix2 (1:1,000, ab209484, Abcam, United Kingdom). Then, membranes were incubated with secondary antibodies (1:1,000, 5125, Cell Signaling, United States). SuperSignal West Pico Chemiluminescent Substrate (Pierce, United States) was used to detect the protein signals.</p>
</sec>
<sec id="s2-5">
<title>2.5 Quantitative real-time PCR</title>
<p>TRIzol reagent (Invitrogen, United States), a reverse transcription kit (Takara Company, China), a StepOne Real-Time PCR system (Applied Biosystems, United States), and SYBR Green mixture were utilized for PCR. PCR primers were as follows: Runx2 (forward): GCC GGG AAT GAT GAG AAC TA, Runx2 (reverse): GGA CCG TCC ACT GTC ACT TT; BMP2 (forward): GTT TGG CCT GAA GCA GAG AC, BMP2 (reverse): CTC GAT GGC TTC TTC GTG AT; &#x3b2;-actin (forward): TGT&#x200b;CAC&#x200b;CAA&#x200b;CTG&#x200b;GGA&#x200b;CGA&#x200b;TA, &#x3b2;-actin (reverse): GGG GTG TTG AAG GTC TCA AA; and Osterix (forward): TCT CCA TCT GCC TGA CTC CT, Osterix (reverse): GGG GCT GAA AGG TCA GTG TA. Housekeeping gene &#x3b2;-actin and the comparative Ct method were used to determine the target gene expression in the experimental group.</p>
</sec>
<sec id="s2-6">
<title>2.6 Cell apoptosis assay</title>
<p>The One-Step TUNEL Apoptosis Assay Kit (Beyotime, Shanghai, China) and Caspase-3/CPP32 Colorimetric Assay Kit (BioVision) were used to detect cell apoptosis according to the manufacturers&#x2019; instructions. After treatment, VSMCs were fixed in 4% (w/v) paraformaldehyde at 4 &#xb0;C, followed by incubation with terminal deoxynucleotidyl transferase (TdT) for 1&#xa0;h. The cell nuclei were stained with DAPI. The TUNEL-positive apoptotic VSMCs were detected using a fluorescence microscope (Olympus). In addition, VSMCs were lysed, and the protein concentration was measured using a BCA protein assay kit (Pierce, United States). Protein (100&#xa0;&#xb5;g) was mixed with cell lysis buffer (50&#xa0;&#xb5;L) and reaction buffer (50&#xa0;&#xb5;L). Then, 5&#xa0;&#xb5;L of 4&#xa0;mM DEVD-qNA substrate was added and incubated at 37 &#xb0;C for 2&#xa0;h. The activity of caspase 3 was detected by a microplate reader at 405&#xa0;nm.</p>
</sec>
<sec id="s2-7">
<title>2.7 Immunofluorescence staining and immunohistochemistry staining</title>
<p>VSMCs were incubated with the antibodies Runx2 (1:100, SAB1403638, Millipore), p-JNK (1:200, 9255, Cell Signaling, United States), and Bax (1:200, 2772, Cell Signaling, United States), followed by staining with FITC-conjugated secondary antibody. VSMCs were then double-stained with DAPI for visualizing the nuclei and viewed with a Nikon Eclipse 80iEpi-fluorescence microscope equipped with a digital camera (DS-Ri1, Nikon).</p>
</sec>
<sec id="s2-8">
<title>2.8 Molecular docking</title>
<p>Docking compound Res (compound CID: 445154) was obtained from the PubChem database (<ext-link ext-link-type="uri" xlink:href="https://pubchem.ncbi.nlm.nih.gov/">https://pubchem.ncbi.nlm.nih.gov/</ext-link>), and JNK (ID: P49185) was obtained from the UniProt database (<ext-link ext-link-type="uri" xlink:href="https://www.uniprot.org/">https://www.uniprot.org/</ext-link>). The processing and optimization of the molecular docking process were performed by the Glide module in the Schrodinger Maestro software. For screening in the Glide module, the prepared receptors were imported, the protein protoligand was selected as the binding site of the protein, and the box size was set to 10&#xc5; &#xd7; 10&#xc5; &#xd7; 10&#xc5;. The complexes of the JNK proteins and Res were visualized by PyMOL 2.1.</p>
</sec>
<sec id="s2-9">
<title>2.9 Animals and treatment</title>
<p>All animal experimental procedures in this study were performed in accordance with the requirements of the Ethics Committee for Heze Medical College. The vascular calcification model was established in 8&#x2013;10-week-old male C57BL/6 mice (weighing 20 g&#x2013;25&#xa0;g). The mice were randomly divided into a vehicle group (n &#x3d; 6), a vitamin D<sub>3</sub> group (Vit D group, n &#x3d; 6), and a vitamin D<sub>3</sub> &#x2b; resveratrol group (Vit D &#x2b; Res group, n &#x3d; 6). Briefly, the mice received subcutaneous injection of vitamin D<sub>3</sub> (cholecalciferol, 5 &#xd7; 10<sup>5</sup>&#x2009;IU/kg/day) once a day for 3 consecutive days, as previously described (<xref ref-type="bibr" rid="B1">Bhat et al., 2020</xref>; <xref ref-type="bibr" rid="B42">Zeng et al., 2021</xref>; <xref ref-type="bibr" rid="B46">Zhang et al., 2021</xref>). In the vehicle control group, the mice were treated with an injection of matched vehicle (5% v/v ethanol). In the vitamin D<sub>3</sub> &#x2b; resveratrol group (Vit D&#x2b; Res group), the mice received the same vitamin D<sub>3</sub> regimen. Starting 1&#xa0;day after vitamin D<sub>3</sub> injection, these mice were co-treated with Res (50&#xa0;mg/kg/day) by intraperitoneal injection for 7 consecutive days. All mice were sacrificed at the end of the experimental period, and the aortic vessels were harvested for subsequent experiments.</p>
</sec>
<sec id="s2-10">
<title>2.10 Vascular von Kossa staining</title>
<p>Frozen sections of the aorta were allowed to rewarm at room temperature for 2&#xa0;h and then were hydrated in 1&#xd7; histochemical PBS. A sufficient amount of 5% AgNO<sub>3</sub> solution was applied onto the vascular tissue to completely cover the tissue and then irradiated under UV light for 30 min&#x2013;60&#xa0;min. After discharging the AgNO<sub>3</sub> solution, the sections were washed with distilled water and 5% Na<sub>2</sub>S<sub>2</sub>O<sub>3</sub> solution for 2&#xa0;min, respectively. After staining with the hematoxylin solution, the sections were successively dehydrated with 70%, 80%, 90%, 95%, 100%, and 100% ethanol and then made transparent with xylene. The sections were sealed with neutral gum and baked to dryness in an incubator at 37 &#xb0;C.</p>
</sec>
<sec id="s2-11">
<title>2.11 Statistical analysis</title>
<p>All data were expressed as the mean &#xb1; SD and analyzed using the software package SPSS 17.0. Statistical differences between the two groups were analyzed by Student&#x2019;s t-test, and the differences between more than two groups were compared by one-way ANOVA. A value of p &#x3c; 0.05 was considered statistically significant.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>3 Results</title>
<sec id="s3-1">
<title>3.1 Elevated calcium and phosphate levels promote osteogenic differentiation and calcification of rat VSMCs</title>
<p>To investigate vascular calcification, we established a cell calcification model using CM to treat VSMCs. Alizarin red staining confirmed the successful induction of the cell calcification model, with visible calcium deposition (<xref ref-type="fig" rid="F1">Figures 1A, B</xref>). Calcium concentration in CM-treated VSMCs significantly increased over time (<xref ref-type="fig" rid="F1">Figure 1C</xref>). VSMCs exhibited increased ALP activity after CM treatment (<xref ref-type="sec" rid="s12">Supplementary Figure S1A</xref>). qRT-PCR and Western blotting results showed that the mRNA and protein levels of the calcification markers Runx2, BMP2, and Osterix increased significantly in CM-stimulated VSMCs (<xref ref-type="sec" rid="s12">Supplementary Figure S1B, D</xref>). Given that VSMC apoptosis via calcifying apoptotic bodies is a key driver of vascular calcification (<xref ref-type="bibr" rid="B6">Cui et al., 2020</xref>; <xref ref-type="bibr" rid="B26">Proudfoot et al., 2000</xref>), we next examined whether CM induces VSMC apoptosis. TUNEL staining results showed a significant increase in the proportion of TUNEL-positive cells after CM treatment (<xref ref-type="fig" rid="F1">Figures 1D, E</xref>). The activity of caspase-3 was markedly elevated in CM-treated VSMCs (<xref ref-type="fig" rid="F1">Figure 1F</xref>). These results confirmed that apoptosis is a key event in CM-treated VSMCs and directly contributes to calcification initiation.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Calcification and apoptosis in VSMCs after exposure to CM. VSMCs were treated with GM or CM, respectively. <bold>(A,B)</bold> Alizarin red staining and quantification of alizarin red analysis of calcium deposition in VSMCs. Scale bar &#x3d; 200&#xa0;&#x3bc;m. <bold>(C)</bold> Calcium content analysis of the results of calcium deposition in VSMCs. <bold>(D&#x2013;F)</bold> TUNEL staining and caspase-3 activity assay analysis of cell apoptosis in VSMCs. Scale bar &#x3d; 20&#xa0;&#x3bc;m &#x2a;<italic>P</italic> &#x3c; 0.05 and &#x2a;&#x2a;&#x2a;<italic>p</italic> &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g001.tif">
<alt-text content-type="machine-generated">Images display GM and CM cell comparisons:A) Microscopic images of GM and CM cells, showing more Alizarin red staining in CM.B) Bar graph showing higher Alizarin red levels in CM than GM.C) Bar graph with elevated calcium in CM on Day 10 compared to GM.D) Fluorescent images with TUNEL and DAPI staining, showing more apoptosis in CM.E) Bar graph with increased TUNEL-positive cells in CM.F) Bar graph with higher caspase-3 activity in CM than GM, indicating more cell death. *** indicates significant differences.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-2">
<title>3.2 Resveratrol attenuates osteogenic differentiation and calcification of rat VSMCs</title>
<p>To assess whether Res can regulate VSMC calcification and osteogenic differentiation, we initially performed cytotoxicity assays for Res in VSMCs. After Res treatment at different concentrations, the CCK-8 assay revealed no significant alteration in VSMC viability across varying Res concentrations, indicating that Res had almost no cytotoxicity (<xref ref-type="fig" rid="F2">Figure 2A</xref>). Based on these findings, we selected Res at a concentration of 10&#xa0;&#x3bc;M for further experimental studies, which is consistent with earlier studies. Res treatment markedly reduced the deposition of calcium phosphate minerals in CM-induced VSMCs (<xref ref-type="fig" rid="F2">Figures 2B, C</xref>). Calcium quantification analysis confirmed that Res treatment significantly reduced the CM-induced increase in calcium content (<xref ref-type="fig" rid="F2">Figure 2D</xref>). Furthermore, we investigated the effect of Res on early osteogenic differentiation markers. The activity of ALP was significantly enhanced after CM treatment, but it decreased upon co-treatment with CM and Res (<xref ref-type="fig" rid="F2">Figure 2E</xref>). Co-treatment with Res markedly suppressed the mRNA and protein levels of Runx2, BMP2, and Osterix compared to that with CM alone (<xref ref-type="fig" rid="F2">Figures 2F, G</xref>). Immunofluorescence further demonstrated a significant enhancement in the fluorescence intensity of Runx2 following treatment with CM. Res effectively counteracted the above effect on Runx2 expression (<xref ref-type="fig" rid="F2">Figure 2H</xref>). Importantly, Res reversed CM-induced apoptosis, as indicated by reduced TUNEL-positive cells and the decreased activity of caspase-3 (<xref ref-type="fig" rid="F2">Figures 2I, J</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Effect of resveratrol on osteogenic differentiation and calcification in CM-treated VSMCs. VSMCs were treated with GM, CM, and/or resveratrol (10&#xa0;&#x3bc;M), respectively. <bold>(A)</bold> CCK-8 assay analysis of the cell viability of VSMCs with or without resveratrol (10 &#x3bc;M&#x2013;100&#xa0;&#x3bc;M) treatment for 48&#xa0;h. <bold>(B,C)</bold> Alizarin red staining and quantification of alizarin red analysis of calcium deposition in VSMCs. Scale bar &#x3d; 200&#xa0;&#x3bc;m. <bold>(D)</bold> Calcium content analysis of the results of calcium deposition in VSMCs. <bold>(E)</bold> ALP activity analysis of the results of ALP levels in VSMCs. <bold>(F,G)</bold> Quantification analysis of the qRT-PCR and Western blot results of Runx2, BMP2, and Osterix in VSMCs. <bold>(H)</bold> Representative images of immunofluorescence results of the protein levels of Runx2 in VSMCs. Scale bar &#x3d; 50&#xa0;&#x3bc;m. <bold>(I, J)</bold> TUNEL staining and caspase-3 activity assay analysis of cell apoptosis in VSMCs. Scale bar &#x3d; 20&#xa0;&#x3bc;m &#x2a;&#x2a;&#x2a;P &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g002.tif">
<alt-text content-type="machine-generated">Grouped bar charts, western blots, micrographs, and other graphical data depicting effects of different treatments on cellular markers and activity. In graphs A, C, D, E, F, J show changes in cell number, calcium content, ALP activity, mRNA levels, and caspase-3 activity across GM, CM, and CM with 10 &#xB5;M Res. Panels B, H, and I depict micrographs showing staining of cells under different conditions for marker analysis, including TUNEL assay. Panel G shows western blot results for Runx2, BMP2, and Osterix proteins. Statistical significance is denoted with asterisks.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-3">
<title>3.3 Resveratrol acts as a potential small molecule inhibitor of JNK to inhibit JNK/Bax signaling</title>
<p>The JNK/Bax signaling pathway is involved in the regulation of VSMC calcification and osteogenic differentiation. To explore whether Res inhibits VSMC calcification and osteogenic differentiation by regulating JNK/Bax signaling, we performed molecular docking of Res and JNK. The lowest-energy docking conformations are shown in <xref ref-type="fig" rid="F3">Figure 3A</xref>, with a binding energy of &#x2212;7.783&#xa0;kcal/mol between Res and JNK. The docking calculations showed that Res could form four conventional hydrogen bonds with MET111, GLU109, ASN156, and GLY38 at the active center of JNK, forming a close interaction (<xref ref-type="fig" rid="F3">Figure 3A</xref>). This finding indicated that Res effectively binds to and modulates JNK activity in VSMCs. Subsequently, we validated these findings using Western blot and immunofluorescence assays in CM-treated VSMCs. Western blot results confirmed that CM treatment elevated the protein levels of JNK and Bax, which was inhibited by Res co-treatment (<xref ref-type="fig" rid="F3">Figure 3B</xref>). Furthermore, the results of the immunofluorescence assay demonstrated a significant enhancement in the fluorescence intensity of JNK and Bax following treatment with CM. Conversely, Res co-treatment resulted in a decrease in JNK and Bax fluorescence intensity (<xref ref-type="fig" rid="F3">Figures 3C,D</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>Effect of resveratrol on the JNK/Bax signaling pathway in CM-treated VSMCs. VSMCs were treated with GM, CM, and/or resveratrol (10&#xa0;&#x3bc;M), respectively. <bold>(A)</bold> Docking analysis for predicting the binding mode of resveratrol to JNK. <bold>(B)</bold> Quantification analysis of the Western blot results of JNK, p-JNK, and Bax in VSMCs. <bold>(C,D)</bold> Representative images of the immunofluorescence results of the protein levels of JNK and Bax in VSMCs. Scale bar &#x3d; 50&#xa0;&#x3bc;m &#x2a;&#x2a;P &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;p &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g003.tif">
<alt-text content-type="machine-generated">Panel A shows a molecular interaction diagram with color-coded bonds like hydrogen bonds and pi interactions. Panel B presents a Western blot and bar charts indicating relative protein levels of Bax and p-JNK under different conditions, highlighted by statistical significance markers. Panel C displays stained fluorescence microscopy images of Bax in green and nuclei in blue under various treatments. Panel D shows similar images for p-JNK and nuclei.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-4">
<title>3.4 Inhibition of the JNK/Bax pathway attenuates osteogenic differentiation, calcification, and apoptosis of rat VSMCs</title>
<p>To explore the role of the JNK/Bax signaling pathway in Res-mediated inhibition of vascular calcification, we treated VSMCs with CM or GM for 10&#xa0;days in the presence of JNK inhibitor SP600125 (10&#xa0;&#x3bc;M). Western blot assay revealed that CM-induced increase of JNK and Bax was markedly reduced by SP600125, and no significant difference of JNK and Bax was observed following GM and SP600125 co-treatment (<xref ref-type="fig" rid="F4">Figure 4A</xref>). Alizarin red staining confirmed that SP600125 markedly prevented CM-induced calcium deposition in VSMCs (<xref ref-type="fig" rid="F4">Figures 4B, C</xref>). At the same time, quantitative analysis of the cellular calcium content corroborated these findings (<xref ref-type="fig" rid="F4">Figure 4D</xref>). We found that ALP activity substantially increased in the CM group but was significantly reduced following SP600125 treatment (<xref ref-type="fig" rid="F4">Figure 4E</xref>). Western blotting revealed that SP600125 treatment suppressed CM-induced increases in Runx2, BMP2, and Osterix protein levels (<xref ref-type="fig" rid="F4">Figure 4F</xref>). TUNEL staining and caspase-3 activity assay also demonstrated that CM-induced cell apoptosis was suppressed by SP600125 treatment (<xref ref-type="fig" rid="F4">Figures 4G, H</xref>).</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>SP600125 treatment mediates the change of the JNK/Bax signaling pathways in CM-treated VSMCs. VSMCs were treated with GM and/or GM &#x2b; SP600125 (10&#xa0;&#x3bc;M) and CM and/or CM &#x2b; SP600125 (10&#xa0;&#x3bc;M), respectively. <bold>(A)</bold> Quantification analysis of the Western blot results of JNK, p-JNK, and Bax in VSMCs <bold>(B,C)</bold>. Alizarin red staining and quantification of alizarin red analysis of calcium deposition in VSMCs. Scale bar &#x3d; 200&#xa0;&#x3bc;m. <bold>(D)</bold> Calcium content analysis of the results of calcium deposition in VSMCs. <bold>(E)</bold> ALP activity analysis of the results of ALP levels in VSMCs. <bold>(F)</bold> Quantification analysis of the Western blot results of Runx2, BMP2, and Osterix in VSMCs. <bold>(G, H)</bold> TUNEL staining and caspase-3 activity analysis of cell apoptosis in VSMCs. Scale bar &#x3d; 20&#xa0;&#x3bc;m &#x2a;<italic>P</italic> &#x3c; 0.05, &#x2a;&#x2a;<italic>p</italic> &#x3c; 0.01, and &#x2a;&#x2a;&#x2a;<italic>p</italic> &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g004.tif">
<alt-text content-type="machine-generated">Panel of scientific images and graphs analyzing protein levels and cell activities. A: Western blots and bar graphs show levels of Bax, JNK, and phosphorylated JNK in different treatment groups, emphasizing significant differences with asterisks. B: Microscopy images of four treatment conditions assessing cellular morphology. C and D: Bar graphs depict alkaline phosphatase activity and calcium deposition. E: Bar graph shows ALP activity levels. F: Western blots with corresponding bar graph detail Runx2, BMP2, and Osterix protein levels. G: TUNEL assay images display apoptosis with a graph of TUNEL-positive cells. H: Bar graph illustrates Caspase3 activity levels, with significant differences indicated.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-5">
<title>3.5 Resveratrol attenuates osteogenic differentiation, calcification, and apoptosis of rat VSMCs by the inactivation of the JNK/Bax signaling pathway</title>
<p>Given the preliminary evidence of Res&#x2019;s inhibitory effects on VSMC calcification and the JNK/Bax pathway, we hypothesize that Res regulates VSMC calcification by blocking the activation of the JNK/Bax pathway. As shown in <xref ref-type="fig" rid="F5">Figure 5A</xref>, treatment with the JNK activator (anisomycin, 100&#xa0;ng/mL) significantly reversed Res&#x2019;s inhibitory effects on the expression of p-JNK and Bax proteins (<xref ref-type="fig" rid="F5">Figure 5A</xref>). In CM-induced VSMCs, the downregulation of calcium deposition, calcium content, and ATP by Res was abolished upon co-treatment with anisomycin (<xref ref-type="fig" rid="F5">Figures 5B&#x2013;E</xref>). Similarly, the inhibitory effect of Res on the Runx2, BMP2, and Osterix levels was antagonized when Res was co-administered with anisomycin (<xref ref-type="fig" rid="F5">Figure 5F</xref>). Additionally, Res treatment reduced TUNEL-positive cells and caspase-3 activity, and the combined treatment with anisomycin counteracted its effects on these parameters (<xref ref-type="fig" rid="F5">Figures 5G, H</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>JNK/Bax pathway reverses the effect of resveratrol on CM-treated VSMC calcification and apoptosis. VSMCs were treated with CM, CM &#x2b; Res (10&#xa0;&#x3bc;M), or CM &#x2b; Res &#x2b; anisomycin (100&#xa0;ng/mL), respectively. <bold>(A)</bold> Quantification analysis of the Western blot results of JNK, p-JNK, and Bax in VSMCs. <bold>(B, C)</bold> Alizarin red staining and quantification of alizarin red analysis of calcium deposition in VSMCs. Scale bar &#x3d; 200&#xa0;&#x3bc;m. <bold>(D)</bold> Calcium content analysis of the results of calcium deposition in VSMCs. <bold>(E)</bold> ALP activity analysis of the results of ALP levels in VSMCs. <bold>(F)</bold> Quantification analysis of the Western blot results of Runx2, BMP2, and Osterix in VSMCs. <bold>(G, H)</bold> TUNEL staining and caspase-3 activity analysis of cell apoptosis in VSMCs. Scale bar &#x3d; 20&#xa0;&#x3bc;m &#x2a;&#x2a;<italic>P</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;<italic>p</italic> &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g005.tif">
<alt-text content-type="machine-generated">Western blot images and bar graphs show the effects of CM, CM+Res, and CM+Res+Anisomycin treatments on protein levels and cell activities. Panel A depicts JNK, p-JNK, BAX, and &#x3B2;-actin protein levels. Panel B shows stained cell images under different treatments. Panels C to H present quantitative analysis of Alizarin red staining, collagen levels, ALP activity, Runx2, BMP2, Osterix protein levels, TUNEL staining, and Caspase3 activity, with significant differences indicated by asterisks.</alt-text>
</graphic>
</fig>
</sec>
<sec id="s3-6">
<title>3.6 Resveratrol attenuates vitamin D<sub>3</sub>-induced aortic calcification in mice</title>
<p>We further sought to determine whether Res could inhibit vascular calcification in an animal model of vascular calcification. Vascular calcification was induced in mice via subcutaneous injection of vitamin D<sub>3</sub>. Under the stimulation of vitamin D<sub>3</sub>, alizarin red staining revealed orange&#x2013;red deposits, while von Kossa staining showed black&#x2013;brown precipitates, indicating calcium deposition in the mouse aorta. Res intervention significantly attenuated vitamin D<sub>3</sub>-induced aortic calcification, as evidenced by the diminished orange&#x2013;red alizarin red staining and reduced dark&#x2013;brown von Kossa staining (<xref ref-type="fig" rid="F6">Figures 6A, B</xref>). We lysed the mouse aortae for calcium quantification and confirmed that Res significantly inhibited the vitamin D<sub>3</sub>-induced increase in calcium content (<xref ref-type="fig" rid="F6">Figure 6C</xref>). At the same time, we examined the activity of ALP and the expression of Runx2 as markers of osteogenic differentiation. The results revealed that Res treatment resulted in a decrease in the activity of ALP and Runx2 protein levels in mouse aorta (<xref ref-type="fig" rid="F6">Figures 6D, E</xref>). Importantly, Western blot analysis demonstrated that Res treatment effectively suppressed the expressions of p-JNK and Bax in the aorta of vitamin D3-induced mice (<xref ref-type="fig" rid="F6">Figure 6F</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Impact of resveratrol on vascular calcification in vitamin D<sub>3</sub>-induced mice. <bold>(A)</bold> Alizarin red staining and quantification of alizarin red analysis of calcium deposition in the aortic rings. Scale bar &#x3d; 100&#xa0;&#x3bc;m; scale bar &#x3d; 50&#xa0;&#x3bc;m. (n &#x3d; 6). <bold>(B)</bold> von Kossa staining analysis of calcium deposition in the aortic rings. Scale bar &#x3d; 100&#xa0;&#x3bc;m; scale bar &#x3d; 50&#xa0;&#x3bc;m. (n &#x3d; 6). <bold>(C)</bold> Calcium content analysis of the results of calcium deposition in the aortas. <bold>(D)</bold> ALP activity analysis of the results of ALP levels in the aortic rings. (n &#x3d; 6). <bold>(E)</bold> Representative images of immunohistochemistry results of the protein levels of Runx2 in the aortic rings. Scale bar &#x3d; 100&#xa0;&#x3bc;m. (n &#x3d; 6). <bold>(F)</bold> Quantification analysis of the Western blot results of JNK, p-JNK, and Bax in the aortas. (n &#x3d; 6). &#x2a;&#x2a;&#x2a;<italic>P</italic> &#x3c; 0.001.</p>
</caption>
<graphic xlink:href="fphar-16-1631039-g006.tif">
<alt-text content-type="machine-generated">Histological and biochemical analysis of aortic tissues and protein expression across different treatments. Panels A and B show histological staining with focus on areas of interest. Panel C includes bar graphs of alizarin red staining and calcium content, with significant differences marked by asterisks. Panel D displays bar graphs of ALP activity and related protein levels, also showing significant differences. Panel E shows further histological samples comparing treatments. Panel F presents a protein expression analysis with bands for BAX, JNK, p-JNK, and &#x3B2;-actin under different treatments.</alt-text>
</graphic>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>4 Discussion</title>
<p>Vascular calcification is an active, cell-regulated process similar to bone formation, including the formation of extracellular matrix, the deposition of hydroxyphosphorus ash, and the production of osteoblast marker proteins (<xref ref-type="bibr" rid="B30">Shao et al., 2006</xref>). It is characterized by the transition of vascular cells, especially VSMCs, from a contractile phenotype to a synthetic phenotype. VSMCs located in the tunica media of the vascular wall induce osteogenic/chondrogenic differentiation in response to a variety of stimuli, such as calcium and phosphorus metabolism disorders, oxidative stress, DNA damage, and inflammation (<xref ref-type="bibr" rid="B28">Shanahan et al., 1999</xref>). In the process of transition, VSMCs secrete a variety of osteogenic differentiation marker proteins, such as Runx2, ALP, and bone morphogenetic proteins (BMPs), which promote the occurrence of vascular calcification (<xref ref-type="bibr" rid="B17">Li et al., 2008</xref>; <xref ref-type="bibr" rid="B28">Shanahan et al., 1999</xref>; <xref ref-type="bibr" rid="B32">Steitz et al., 2001</xref>). BMP2 can inhibit VSMC proliferation and promote VSMC apoptosis by promoting calcium and phosphorus uptake (<xref ref-type="bibr" rid="B4">Chen et al., 2013</xref>; <xref ref-type="bibr" rid="B7">Demer and Tintut, 2008</xref>). VSMCs activate vascular calcification by releasing apoptotic bodies (<xref ref-type="bibr" rid="B20">Liao et al., 2013</xref>; <xref ref-type="bibr" rid="B26">Proudfoot et al., 2000</xref>). Therefore, the phenotypic switching of VSMCs is a key mechanism to regulate vascular calcification, and effectively blocking or reversing its phenotypic switching has become the focus for the prevention and treatment of vascular calcification.</p>
<p>In recent years, some new drugs have been developed and used, such as vitamin D receptor agonists, calcium-sensing receptor modulators, sodium thiosulfate, and statins, which have achieved certain clinical effects in the prevention and treatment of vascular calcification, but there is still a gap with the expectations (<xref ref-type="bibr" rid="B23">Lunyera and Scialla, 2018</xref>; <xref ref-type="bibr" rid="B38">Wu et al., 2013</xref>). Res is considered a natural chemical protective agent and plays several beneficial roles in cardiovascular disease progression. Traditional animal model studies have shown that Res administration can reduce atherosclerosis and calcification in uremic mice (<xref ref-type="bibr" rid="B34">Tomayko et al., 2014</xref>). Related studies have shown that Res can inhibit VSMC senescence-related calcification by activating SIRT1 (<xref ref-type="bibr" rid="B33">Takemura et al., 2011</xref>). A cell culture study showed that Res ameliorated VSMC oxidative damage and inhibited the expression of Runx2, OPN, and HO-1; calcium deposition; and mitochondrial dysfunction (<xref ref-type="bibr" rid="B45">Zhang et al., 2016</xref>). In the present study, we verified the anti-osteogenic differentiation and anti-calcification effects of Res and its mechanism by establishing a mouse model of vitamin D<sub>3</sub>-induced aortic calcification and CM-induced VSMCs. Res treatment showed a significant reduction in calcium deposition and in ALP, Runx2, BMP2, and Osterix levels, as well as cell apoptosis in the aortic area of vitamin D<sub>3</sub>-induced mice and CM-induced VSMCs.</p>
<p>JNK is a member of the MAPK superfamily. JNK is activated by a variety of extracellular stimuli and becomes phosphorylated into the active form, which participates in VSMC apoptosis (<xref ref-type="bibr" rid="B10">Han et al., 2010</xref>; <xref ref-type="bibr" rid="B43">Zhang et al., 2014</xref>). Increasing evidence suggests that apoptosis plays an important role in the process of vascular calcification. Excessive activation of JNK can lead to apoptosis, which in turn leads to the formation of apoptotic bodies and initiates the process of vascular calcification (<xref ref-type="bibr" rid="B22">Liu et al., 2021</xref>; <xref ref-type="bibr" rid="B47">Zhou et al., 2021</xref>). In addition, several studies have revealed that JNK is an important signaling pathway regulating osteogenesis, and its activation can enhance the expression of osteogenic differentiation genes, such as Runx2 and BMP2 (<xref ref-type="bibr" rid="B8">Fu et al., 2019</xref>; <xref ref-type="bibr" rid="B13">Kim et al., 2015</xref>; <xref ref-type="bibr" rid="B14">Kusuyama et al., 2019</xref>; <xref ref-type="bibr" rid="B39">Xu et al., 2017</xref>). JNK inhibitor SP600125 can effectively reduce the apoptosis rate, ALP activity, and Runx2 and OPN expression of VSMCs (<xref ref-type="bibr" rid="B12">Hou et al., 2016</xref>; <xref ref-type="bibr" rid="B22">Liu et al., 2021</xref>; <xref ref-type="bibr" rid="B24">Miyazaki-Anzai et al., 2010</xref>). Here, we demonstrated that Res could activate phosphorylation of JNK and further enhance Bax expression. Sp600125 inhibited CM-induced calcium deposition, as indicated by the decreased calcium content and ALP activity; downregulated Runx2, BMP2, and Osterix expression; and reduced VSMC apoptosis. Constitutively, JNK activation removed Res&#x2019;s protection against calcification and apoptosis, confirming the necessity of JNK inhibition. These data establish a causal chain from JNK inactivation to Bax suppression in Res&#x2019;s mechanism of regulation of vascular calcification.</p>
<p>In conclusion, we demonstrated that Res could attenuate vascular calcification in VSMCs and arterial ring tissues. Mechanically, we further demonstrated that the inhibitory effect of Res on VSMC calcination was dependent on the JNK/Bax pathway to induce osteogenic differentiation and apoptosis. As a potential inhibitor of vascular calcification, this study provides new theoretical evidence for the application of Res in the early intervention and treatment of vascular calcification. Future studies employing direct functional assessments are necessary to confirm the beneficial impact of Res on the vascular physiology in the context of calcification.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="s5">
<title>Data availability statement</title>
<p>The original contributions presented in this study are included in the article/<xref ref-type="sec" rid="s12">Supplementary Material</xref>, further inquiries can be directed to the corresponding author.</p>
</sec>
<sec sec-type="ethics-statement" id="s6">
<title>Ethics statement</title>
<p>This animal study was approved by the Ethics Committee of Heze Medical College (No. 2024-003). The study was conducted in accordance with the local legislation and institutional requirements.</p>
</sec>
<sec sec-type="author-contributions" id="s7">
<title>Author contributions</title>
<p>MH: Investigation, Funding acquisition, Methodology, Writing &#x2013; original draft. HW: Methodology, Data curation, Writing &#x2013; original draft, Investigation. JC: Funding acquisition, Writing &#x2013; original draft, Investigation, Methodology. XD: Data curation, Methodology, Investigation, Writing &#x2013; original draft. MR: Supervision, Conceptualization, Writing &#x2013; review and editing. YL: Conceptualization, Writing &#x2013; review and editing, Supervision.</p>
</sec>
<sec sec-type="funding-information" id="s8">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research and/or publication of this article. This study was supported by the Project of Medical and Health Technology Development Program in Shandong Province (No. 202201040819).</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="s10">
<title>Generative AI statement</title>
<p>The author(s) declare that no Generative AI was used in the creation of this manuscript.</p>
</sec>
<sec sec-type="disclaimer" id="s11">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec sec-type="supplementary-material" id="s12">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fphar.2025.1631039/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fphar.2025.1631039/full&#x23;supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="Image1.tif" id="SM1" mimetype="application/tif" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bhat</surname>
<given-names>O. M.</given-names>
</name>
<name>
<surname>Yuan</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Cain</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Salloum</surname>
<given-names>F. N.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>P. L.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Medial calcification in the arterial wall of smooth muscle cell-specific Smpd1 transgenic mice: a ceramide-mediated vasculopathy</article-title>. <source>J. Cell. Mol. Med.</source> <volume>24</volume> (<issue>1</issue>), <fpage>539</fpage>&#x2013;<lpage>553</lpage>. <pub-id pub-id-type="doi">10.1111/jcmm.14761</pub-id>
<pub-id pub-id-type="pmid">31743567</pub-id>
</citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bishayee</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2009</year>). <article-title>Cancer prevention and treatment with resveratrol: from rodent studies to clinical trials</article-title>. <source>Cancer Prev. Res. Phila. Pa</source> <volume>2</volume> (<issue>5</issue>), <fpage>409</fpage>&#x2013;<lpage>418</lpage>. <pub-id pub-id-type="doi">10.1158/1940-6207.CAPR-08-0160</pub-id>
<pub-id pub-id-type="pmid">19401532</pub-id>
</citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bonnefont-Rousselot</surname>
<given-names>D.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Resveratrol and cardiovascular diseases</article-title>. <source>Nutrients</source> <volume>8</volume> (<issue>5</issue>), <fpage>250</fpage>. <pub-id pub-id-type="doi">10.3390/nu8050250</pub-id>
<pub-id pub-id-type="pmid">27144581</pub-id>
</citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>Z. L.</given-names>
</name>
<name>
<surname>Yao</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Norris</surname>
<given-names>E. H.</given-names>
</name>
<name>
<surname>Kruyer</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Jno-Charles</surname>
<given-names>O.</given-names>
</name>
<name>
<surname>Akhmerov</surname>
<given-names>A.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Ablation of astrocytic laminin impairs vascular smooth muscle cell function and leads to hemorrhagic stroke</article-title>. <source>J. cell Biol.</source> <volume>202</volume> (<issue>2</issue>), <fpage>381</fpage>&#x2013;<lpage>395</lpage>. <pub-id pub-id-type="doi">10.1083/jcb.201212032</pub-id>
<pub-id pub-id-type="pmid">23857767</pub-id>
</citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Arterial stiffness: a focus on vascular calcification and its link to bone mineralization</article-title>. <source>Arteriosclerosis, thrombosis, Vasc. Biol.</source> <volume>40</volume> (<issue>5</issue>), <fpage>1078</fpage>&#x2013;<lpage>1093</lpage>. <pub-id pub-id-type="doi">10.1161/ATVBAHA.120.313131</pub-id>
<pub-id pub-id-type="pmid">32237904</pub-id>
</citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cui</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Zheng</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Sun</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Mitoquinone attenuates vascular calcification by suppressing oxidative stress and reducing apoptosis of vascular smooth muscle cells <italic>via</italic> the Keap1/Nrf2 pathway</article-title>. <source>Free Radic. Biol. &#x26; Med.</source> <volume>161</volume>, <fpage>23</fpage>&#x2013;<lpage>31</lpage>. <pub-id pub-id-type="doi">10.1016/j.freeradbiomed.2020.09.028</pub-id>
<pub-id pub-id-type="pmid">33011276</pub-id>
</citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Demer</surname>
<given-names>L. L.</given-names>
</name>
<name>
<surname>Tintut</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2008</year>). <article-title>Vascular calcification: pathobiology of a multifaceted disease</article-title>. <source>Circulation</source> <volume>117</volume> (<issue>22</issue>), <fpage>2938</fpage>&#x2013;<lpage>2948</lpage>. <pub-id pub-id-type="doi">10.1161/CIRCULATIONAHA.107.743161</pub-id>
<pub-id pub-id-type="pmid">18519861</pub-id>
</citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Fu</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Peng</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Ouyang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Tan</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Fu</surname>
<given-names>X.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>LncRNA HOTAIRM1 promotes osteogenesis by controlling JNK/AP-1 signalling-mediated RUNX2 expression</article-title>. <source>J. Cell. Mol. Med.</source> <volume>23</volume> (<issue>11</issue>), <fpage>7517</fpage>&#x2013;<lpage>7524</lpage>. <pub-id pub-id-type="doi">10.1111/jcmm.14620</pub-id>
<pub-id pub-id-type="pmid">31512358</pub-id>
</citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Guo</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Xie</surname>
<given-names>X.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>Resveratrol inhibiting TGF/ERK signaling pathway can improve atherosclerosis: backgrounds, mechanisms and effects</article-title>. <source>Biomed. &#x26; Pharmacother. &#x3d; Biomedecine &#x26; Pharmacother.</source> <volume>155</volume>, <fpage>113775</fpage>. <pub-id pub-id-type="doi">10.1016/j.biopha.2022.113775</pub-id>
<pub-id pub-id-type="pmid">36271557</pub-id>
</citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Han</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Deng</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Tao</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Guo</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Tian</surname>
<given-names>X.</given-names>
</name>
<etal/>
</person-group> (<year>2010</year>). <article-title>Cellular repressor of E1A-stimulated genes inhibits human vascular smooth muscle cell apoptosis <italic>via</italic> blocking P38/JNK MAP kinase activation</article-title>. <source>J. Mol. Cell. Cardiol.</source> <volume>48</volume> (<issue>6</issue>), <fpage>1225</fpage>&#x2013;<lpage>1235</lpage>. <pub-id pub-id-type="doi">10.1016/j.yjmcc.2009.12.018</pub-id>
<pub-id pub-id-type="pmid">20060003</pub-id>
</citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hodroge</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Tr&#xe9;cherel</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Cornu</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Darwiche</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Mansour</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Ait-Mohand</surname>
<given-names>K.</given-names>
</name>
<etal/>
</person-group> (<year>2017</year>). <article-title>Oligogalacturonic acid inhibits vascular calcification by two mechanisms: inhibition of vascular smooth muscle cell osteogenic conversion and interaction with collagen</article-title>. <source>Arteriosclerosis, thrombosis, Vasc. Biol.</source> <volume>37</volume> (<issue>7</issue>), <fpage>1391</fpage>&#x2013;<lpage>1401</lpage>. <pub-id pub-id-type="doi">10.1161/ATVBAHA.117.309513</pub-id>
<pub-id pub-id-type="pmid">28522698</pub-id>
</citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hou</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Song</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Luo</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Ou</surname>
<given-names>J. S.</given-names>
</name>
<name>
<surname>Yu</surname>
<given-names>H.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>Curcumin attenuates osteogenic differentiation and calcification of rat vascular smooth muscle cells</article-title>. <source>Mol. Cell. Biochem.</source> <volume>420</volume> (<issue>1-2</issue>), <fpage>151</fpage>&#x2013;<lpage>160</lpage>. <pub-id pub-id-type="doi">10.1007/s11010-016-2778-y</pub-id>
<pub-id pub-id-type="pmid">27502306</pub-id>
</citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kim</surname>
<given-names>B. S.</given-names>
</name>
<name>
<surname>Kang</surname>
<given-names>H. J.</given-names>
</name>
<name>
<surname>Park</surname>
<given-names>J. Y.</given-names>
</name>
<name>
<surname>Lee</surname>
<given-names>J.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Fucoidan promotes osteoblast differentiation <italic>via</italic> JNK- and ERK-dependent BMP2-Smad 1/5/8 signaling in human mesenchymal stem cells</article-title>. <source>Exp. &#x26; Mol. Med.</source> <volume>47</volume> (<issue>1</issue>), <fpage>e128</fpage>. <pub-id pub-id-type="doi">10.1038/emm.2014.95</pub-id>
<pub-id pub-id-type="pmid">25572360</pub-id>
</citation>
</ref>
<ref id="B14">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kusuyama</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Amir</surname>
<given-names>M. S.</given-names>
</name>
<name>
<surname>Albertson</surname>
<given-names>B. G.</given-names>
</name>
<name>
<surname>Bandow</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Ohnishi</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Nakamura</surname>
<given-names>T.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>JNK inactivation suppresses osteogenic differentiation, but robustly induces osteopontin expression in osteoblasts through the induction of inhibitor of DNA binding 4 (Id4)</article-title>. <source>FASEB J. official Publ. Fed. Am. Soc. Exp. Biol.</source> <volume>33</volume> (<issue>6</issue>), <fpage>7331</fpage>&#x2013;<lpage>7347</lpage>. <pub-id pub-id-type="doi">10.1096/fj.201802465R</pub-id>
<pub-id pub-id-type="pmid">30884976</pub-id>
</citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lacolley</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Regnault</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Segers</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Laurent</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Vascular smooth muscle cells and arterial stiffening: relevance in development, aging, and disease</article-title>. <source>Physiol. Rev.</source> <volume>97</volume> (<issue>4</issue>), <fpage>1555</fpage>&#x2013;<lpage>1617</lpage>. <pub-id pub-id-type="doi">10.1152/physrev.00003.2017</pub-id>
<pub-id pub-id-type="pmid">28954852</pub-id>
</citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lanzer</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Hannan</surname>
<given-names>F. M.</given-names>
</name>
<name>
<surname>Lanzer</surname>
<given-names>J. D.</given-names>
</name>
<name>
<surname>Janzen</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Raggi</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Furniss</surname>
<given-names>D.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Medial arterial calcification: JACC state-of-the-art review</article-title>. <source>J. Am. Coll. Cardiol.</source> <volume>78</volume> (<issue>11</issue>), <fpage>1145</fpage>&#x2013;<lpage>1165</lpage>. <pub-id pub-id-type="doi">10.1016/j.jacc.2021.06.049</pub-id>
<pub-id pub-id-type="pmid">34503684</pub-id>
</citation>
</ref>
<ref id="B17">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>H. Y.</given-names>
</name>
<name>
<surname>Giachelli</surname>
<given-names>C. M.</given-names>
</name>
</person-group> (<year>2008</year>). <article-title>BMP-2 promotes phosphate uptake, phenotypic modulation, and calcification of human vascular smooth muscle cells</article-title>. <source>Atherosclerosis</source> <volume>199</volume> (<issue>2</issue>), <fpage>271</fpage>&#x2013;<lpage>277</lpage>. <pub-id pub-id-type="doi">10.1016/j.atherosclerosis.2007.11.031</pub-id>
<pub-id pub-id-type="pmid">18179800</pub-id>
</citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Xia</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Hasselwander</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Daiber</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Resveratrol and vascular function</article-title>. <source>Int. J. Mol. Sci.</source> <volume>20</volume> (<issue>9</issue>), <fpage>2155</fpage>. <pub-id pub-id-type="doi">10.3390/ijms20092155</pub-id>
<pub-id pub-id-type="pmid">31052341</pub-id>
</citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Yao</surname>
<given-names>Q.</given-names>
</name>
<etal/>
</person-group> (<year>2024</year>). <article-title>Attenuating atherosclerosis through inhibition of the NF-&#x3ba;B/NLRP3/IL-1&#x3b2; pathway-mediated pyroptosis in vascular smooth muscle cells (VSMCs)</article-title>. <source>Cardiovasc. Ther.</source> <volume>2024</volume>, <fpage>1506083</fpage>. <pub-id pub-id-type="doi">10.1155/2024/1506083</pub-id>
<pub-id pub-id-type="pmid">39742016</pub-id>
</citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liao</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Song</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Yu</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Ceramide mediates Ox-LDL-induced human vascular smooth muscle cell calcification via p38 mitogen-activated protein kinase signaling</article-title>. <source>PLoS One</source> <volume>8</volume> (<issue>12</issue>), <fpage>e82379</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0082379</pub-id>
<pub-id pub-id-type="pmid">24358176</pub-id>
</citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lin</surname>
<given-names>Y. C.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>L. H.</given-names>
</name>
<name>
<surname>Varadharajan</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Tsai</surname>
<given-names>M. J.</given-names>
</name>
<name>
<surname>Chia</surname>
<given-names>Y. C.</given-names>
</name>
<name>
<surname>Yuan</surname>
<given-names>T. C.</given-names>
</name>
<etal/>
</person-group> (<year>2014</year>). <article-title>Resveratrol inhibits glucose-induced migration of vascular smooth muscle cells mediated by focal adhesion kinase</article-title>. <source>Mol. Nutr. &#x26; food Res.</source> <volume>58</volume> (<issue>7</issue>), <fpage>1389</fpage>&#x2013;<lpage>1401</lpage>. <pub-id pub-id-type="doi">10.1002/mnfr.201300698</pub-id>
<pub-id pub-id-type="pmid">24659233</pub-id>
</citation>
</ref>
<ref id="B22">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Xiang</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Luo</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhu</surname>
<given-names>J.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Nano-sized hydroxyapatite induces apoptosis and osteogenic differentiation of vascular smooth muscle cells via JNK/c-JUN pathway</article-title>. <source>Int. J. nanomedicine</source> <volume>16</volume>, <fpage>3633</fpage>&#x2013;<lpage>3648</lpage>. <pub-id pub-id-type="doi">10.2147/IJN.S303714</pub-id>
<pub-id pub-id-type="pmid">34079254</pub-id>
</citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lunyera</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Scialla</surname>
<given-names>J. J.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Update on chronic kidney disease mineral and bone disorder in cardiovascular disease</article-title>. <source>Seminars Nephrol.</source> <volume>38</volume> (<issue>6</issue>), <fpage>542</fpage>&#x2013;<lpage>558</lpage>. <pub-id pub-id-type="doi">10.1016/j.semnephrol.2018.08.001</pub-id>
<pub-id pub-id-type="pmid">30413250</pub-id>
</citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Miyazaki-Anzai</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Levi</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Kratzer</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Ting</surname>
<given-names>T. C.</given-names>
</name>
<name>
<surname>Lewis</surname>
<given-names>L. B.</given-names>
</name>
<name>
<surname>Miyazaki</surname>
<given-names>M.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Farnesoid X receptor activation prevents the development of vascular calcification in ApoE-/- mice with chronic kidney disease</article-title>. <source>Circulation Res.</source> <volume>106</volume> (<issue>12</issue>), <fpage>1807</fpage>&#x2013;<lpage>1817</lpage>. <pub-id pub-id-type="doi">10.1161/CIRCRESAHA.109.212969</pub-id>
<pub-id pub-id-type="pmid">20431060</pub-id>
</citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Poussier</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Cordova</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Becquemin</surname>
<given-names>J. P.</given-names>
</name>
<name>
<surname>Sumpio</surname>
<given-names>B. E.</given-names>
</name>
</person-group> (<year>2005</year>). <article-title>Resveratrol inhibits vascular smooth muscle cell proliferation and induces apoptosis</article-title>. <source>J. Vasc. Surg.</source> <volume>42</volume> (<issue>6</issue>), <fpage>1190</fpage>&#x2013;<lpage>1197</lpage>. <pub-id pub-id-type="doi">10.1016/j.jvs.2005.08.014</pub-id>
<pub-id pub-id-type="pmid">16376213</pub-id>
</citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Proudfoot</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Skepper</surname>
<given-names>J. N.</given-names>
</name>
<name>
<surname>Hegyi</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Bennett</surname>
<given-names>M. R.</given-names>
</name>
<name>
<surname>Shanahan</surname>
<given-names>C. M.</given-names>
</name>
<name>
<surname>Weissberg</surname>
<given-names>P. L.</given-names>
</name>
</person-group> (<year>2000</year>). <article-title>Apoptosis regulates human vascular calcification <italic>in vitro:</italic> evidence for initiation of vascular calcification by apoptotic bodies</article-title>. <source>Circulation Res.</source> <volume>87</volume> (<issue>11</issue>), <fpage>1055</fpage>&#x2013;<lpage>1062</lpage>. <pub-id pub-id-type="doi">10.1161/01.res.87.11.1055</pub-id>
<pub-id pub-id-type="pmid">11090552</pub-id>
</citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sadruddin</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Arora</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>2009</year>). <article-title>Resveratrol: biologic and therapeutic implications</article-title>. <source>J. cardiometabolic syndrome</source> <volume>4</volume> (<issue>2</issue>), <fpage>102</fpage>&#x2013;<lpage>106</lpage>. <pub-id pub-id-type="doi">10.1111/j.1559-4572.2008.00039.x</pub-id>
<pub-id pub-id-type="pmid">19614797</pub-id>
</citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shanahan</surname>
<given-names>C. M.</given-names>
</name>
<name>
<surname>Cary</surname>
<given-names>N. R.</given-names>
</name>
<name>
<surname>Salisbury</surname>
<given-names>J. R.</given-names>
</name>
<name>
<surname>Proudfoot</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Weissberg</surname>
<given-names>P. L.</given-names>
</name>
<name>
<surname>Edmonds</surname>
<given-names>M. E.</given-names>
</name>
</person-group> (<year>1999</year>). <article-title>Medial localization of mineralization-regulating proteins in association with M&#xf6;nckeberg&#x27;s sclerosis: evidence for smooth muscle cell-mediated vascular calcification</article-title>. <source>Circulation</source> <volume>100</volume> (<issue>21</issue>), <fpage>2168</fpage>&#x2013;<lpage>2176</lpage>. <pub-id pub-id-type="doi">10.1161/01.cir.100.21.2168</pub-id>
<pub-id pub-id-type="pmid">10571976</pub-id>
</citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shanahan</surname>
<given-names>C. M.</given-names>
</name>
<name>
<surname>Crouthamel</surname>
<given-names>M. H.</given-names>
</name>
<name>
<surname>Kapustin</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Giachelli</surname>
<given-names>C. M.</given-names>
</name>
</person-group> (<year>2011</year>). <article-title>Arterial calcification in chronic kidney disease: key roles for calcium and phosphate</article-title>. <source>Circulation Res.</source> <volume>109</volume> (<issue>6</issue>), <fpage>697</fpage>&#x2013;<lpage>711</lpage>. <pub-id pub-id-type="doi">10.1161/CIRCRESAHA.110.234914</pub-id>
<pub-id pub-id-type="pmid">21885837</pub-id>
</citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shao</surname>
<given-names>J. S.</given-names>
</name>
<name>
<surname>Cai</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Towler</surname>
<given-names>D. A.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>Molecular mechanisms of vascular calcification: lessons learned from the aorta</article-title>. <source>Arteriosclerosis, thrombosis, Vasc. Biol.</source> <volume>26</volume> (<issue>7</issue>), <fpage>1423</fpage>&#x2013;<lpage>1430</lpage>. <pub-id pub-id-type="doi">10.1161/01.ATV.0000220441.42041.20</pub-id>
<pub-id pub-id-type="pmid">16601233</pub-id>
</citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shukla</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Singh</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>2011</year>). <article-title>Resveratrol and cellular mechanisms of cancer prevention</article-title>. <source>Ann. N. Y. Acad. Sci.</source> <volume>1215</volume>, <fpage>1</fpage>&#x2013;<lpage>8</lpage>. <pub-id pub-id-type="doi">10.1111/j.1749-6632.2010.05870.x</pub-id>
<pub-id pub-id-type="pmid">21261635</pub-id>
</citation>
</ref>
<ref id="B32">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Steitz</surname>
<given-names>S. A.</given-names>
</name>
<name>
<surname>Speer</surname>
<given-names>M. Y.</given-names>
</name>
<name>
<surname>Curinga</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>H. Y.</given-names>
</name>
<name>
<surname>Haynes</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Aebersold</surname>
<given-names>R.</given-names>
</name>
<etal/>
</person-group> (<year>2001</year>). <article-title>Smooth muscle cell phenotypic transition associated with calcification: upregulation of Cbfa1 and downregulation of smooth muscle lineage markers</article-title>. <source>Circulation Res.</source> <volume>89</volume> (<issue>12</issue>), <fpage>1147</fpage>&#x2013;<lpage>1154</lpage>. <pub-id pub-id-type="doi">10.1161/hh2401.101070</pub-id>
<pub-id pub-id-type="pmid">11739279</pub-id>
</citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Takemura</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Iijima</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Ota</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Son</surname>
<given-names>B. K.</given-names>
</name>
<name>
<surname>Ito</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Ogawa</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2011</year>). <article-title>Sirtuin 1 retards hyperphosphatemia-induced calcification of vascular smooth muscle cells</article-title>. <source>Arteriosclerosis, thrombosis, Vasc. Biol.</source> <volume>31</volume> (<issue>9</issue>), <fpage>2054</fpage>&#x2013;<lpage>2062</lpage>. <pub-id pub-id-type="doi">10.1161/ATVBAHA.110.216739</pub-id>
<pub-id pub-id-type="pmid">21719763</pub-id>
</citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tomayko</surname>
<given-names>E. J.</given-names>
</name>
<name>
<surname>Cachia</surname>
<given-names>A. J.</given-names>
</name>
<name>
<surname>Chung</surname>
<given-names>H. R.</given-names>
</name>
<name>
<surname>Wilund</surname>
<given-names>K. R.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Resveratrol supplementation reduces aortic atherosclerosis and calcification and attenuates loss of aerobic capacity in a mouse model of uremia</article-title>. <source>J. Med. food</source> <volume>17</volume> (<issue>2</issue>), <fpage>278</fpage>&#x2013;<lpage>283</lpage>. <pub-id pub-id-type="doi">10.1089/jmf.2012.0219</pub-id>
<pub-id pub-id-type="pmid">24476222</pub-id>
</citation>
</ref>
<ref id="B35">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Uhrin</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Mocan</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Waltenberger</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Breuss</surname>
<given-names>J. M.</given-names>
</name>
<name>
<surname>Tewari</surname>
<given-names>D.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>Vascular smooth muscle cell proliferation as a therapeutic target. Part 2: natural products inhibiting proliferation</article-title>. <source>Biotechnol. Adv.</source> <volume>36</volume> (<issue>6</issue>), <fpage>1608</fpage>&#x2013;<lpage>1621</lpage>. <pub-id pub-id-type="doi">10.1016/j.biotechadv.2018.04.002</pub-id>
<pub-id pub-id-type="pmid">29678389</pub-id>
</citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Villa-Bellosta</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Egido</surname>
<given-names>J.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Phosphate, pyrophosphate, and vascular calcification: a question of balance</article-title>. <source>Eur. heart J.</source> <volume>38</volume> (<issue>23</issue>), <fpage>1801</fpage>&#x2013;<lpage>1804</lpage>. <pub-id pub-id-type="doi">10.1093/eurheartj/ehv605</pub-id>
<pub-id pub-id-type="pmid">26546599</pub-id>
</citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wilson</surname>
<given-names>P. W.</given-names>
</name>
<name>
<surname>Kauppila</surname>
<given-names>L. I.</given-names>
</name>
<name>
<surname>O&#x27;Donnell</surname>
<given-names>C. J.</given-names>
</name>
<name>
<surname>Kiel</surname>
<given-names>D. P.</given-names>
</name>
<name>
<surname>Hannan</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Polak</surname>
<given-names>J. M.</given-names>
</name>
<etal/>
</person-group> (<year>2001</year>). <article-title>Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality</article-title>. <source>Circulation</source> <volume>103</volume> (<issue>11</issue>), <fpage>1529</fpage>&#x2013;<lpage>1534</lpage>. <pub-id pub-id-type="doi">10.1161/01.cir.103.11.1529</pub-id>
<pub-id pub-id-type="pmid">11257080</pub-id>
</citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wu</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Rementer</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Giachelli</surname>
<given-names>C. M.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Vascular calcification: an update on mechanisms and challenges in treatment</article-title>. <source>Calcif. tissue Int.</source> <volume>93</volume> (<issue>4</issue>), <fpage>365</fpage>&#x2013;<lpage>373</lpage>. <pub-id pub-id-type="doi">10.1007/s00223-013-9712-z</pub-id>
<pub-id pub-id-type="pmid">23456027</pub-id>
</citation>
</ref>
<ref id="B39">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Xu</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Shin</surname>
<given-names>D. Y.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>J. M.</given-names>
</name>
<name>
<surname>Lalani</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>N.</given-names>
</name>
<etal/>
</person-group> (<year>2017</year>). <article-title>c-Jun N-Terminal kinases (JNKs) are critical mediators of osteoblast activity <italic>in vivo</italic>
</article-title>. <source>J. bone mineral Res. official J. Am. Soc. Bone Mineral Res.</source> <volume>32</volume> (<issue>9</issue>), <fpage>1811</fpage>&#x2013;<lpage>1815</lpage>. <pub-id pub-id-type="doi">10.1002/jbmr.3184</pub-id>
<pub-id pub-id-type="pmid">28561373</pub-id>
</citation>
</ref>
<ref id="B40">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yan</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Stringer</surname>
<given-names>S. E.</given-names>
</name>
<name>
<surname>Hamilton</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Charlton-Menys</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>G&#xf6;tting</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>M&#xfc;ller</surname>
<given-names>B.</given-names>
</name>
<etal/>
</person-group> (<year>2011</year>). <article-title>Decorin GAG synthesis and TGF-&#x3b2; signaling mediate Ox-LDL-induced mineralization of human vascular smooth muscle cells</article-title>. <source>Arteriosclerosis, thrombosis, Vasc. Biol.</source> <volume>31</volume> (<issue>3</issue>), <fpage>608</fpage>&#x2013;<lpage>615</lpage>. <pub-id pub-id-type="doi">10.1161/ATVBAHA.110.220749</pub-id>
<pub-id pub-id-type="pmid">21205989</pub-id>
</citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yeung</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Hoberg</surname>
<given-names>J. E.</given-names>
</name>
<name>
<surname>Ramsey</surname>
<given-names>C. S.</given-names>
</name>
<name>
<surname>Keller</surname>
<given-names>M. D.</given-names>
</name>
<name>
<surname>Jones</surname>
<given-names>D. R.</given-names>
</name>
<name>
<surname>Frye</surname>
<given-names>R. A.</given-names>
</name>
<etal/>
</person-group> (<year>2004</year>). <article-title>Modulation of NF-kappaB-dependent transcription and cell survival by the SIRT1 deacetylase</article-title>. <source>EMBO J.</source> <volume>23</volume> (<issue>12</issue>), <fpage>2369</fpage>&#x2013;<lpage>2380</lpage>. <pub-id pub-id-type="doi">10.1038/sj.emboj.7600244</pub-id>
<pub-id pub-id-type="pmid">15152190</pub-id>
</citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zeng</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Yao</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Ma</surname>
<given-names>C.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>ERK1/2 inhibition reduces vascular calcification by activating miR-126-3p-DKK1/LRP6 pathway</article-title>. <source>Theranostics</source> <volume>11</volume> (<issue>3</issue>), <fpage>1129</fpage>&#x2013;<lpage>1146</lpage>. <pub-id pub-id-type="doi">10.7150/thno.49771</pub-id>
<pub-id pub-id-type="pmid">33391525</pub-id>
</citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Qin</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Weintraub</surname>
<given-names>N. L.</given-names>
</name>
<etal/>
</person-group> (<year>2014</year>). <article-title>miR-92a inhibits vascular smooth muscle cell apoptosis: role of the MKK4-JNK pathway</article-title>. <source>Apoptosis Int. J. Program. cell death</source> <volume>19</volume> (<issue>6</issue>), <fpage>975</fpage>&#x2013;<lpage>983</lpage>. <pub-id pub-id-type="doi">10.1007/s10495-014-0987-y</pub-id>
<pub-id pub-id-type="pmid">24705900</pub-id>
</citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>X. J.</given-names>
</name>
<name>
<surname>He</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Tian</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Su</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Wan</surname>
<given-names>J. B.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Ginsenoside Rb1 attenuates angiotensin II-induced abdominal aortic aneurysm through inactivation of the JNK and p38 signaling pathways</article-title>. <source>Vasc. Pharmacol.</source> <volume>73</volume>, <fpage>86</fpage>&#x2013;<lpage>95</lpage>. <pub-id pub-id-type="doi">10.1016/j.vph.2015.04.003</pub-id>
<pub-id pub-id-type="pmid">25912763</pub-id>
</citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Du</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>F.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Resveratrol ameliorated vascular calcification by regulating Sirt-1 and Nrf2</article-title>. <source>Transplant. Proc.</source> <volume>48</volume> (<issue>10</issue>), <fpage>3378</fpage>&#x2013;<lpage>3386</lpage>. <pub-id pub-id-type="doi">10.1016/j.transproceed.2016.10.023</pub-id>
<pub-id pub-id-type="pmid">27931585</pub-id>
</citation>
</ref>
<ref id="B46">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Ouyang</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Cao</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Gao</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>J.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Liver kinase B1 inhibits smooth muscle calcification via high mobility group box 1</article-title>. <source>Redox Biol.</source> <volume>38</volume>, <fpage>101828</fpage>. <pub-id pub-id-type="doi">10.1016/j.redox.2020.101828</pub-id>
<pub-id pub-id-type="pmid">33338919</pub-id>
</citation>
</ref>
<ref id="B47">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhou</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Xu</surname>
<given-names>S. N.</given-names>
</name>
<name>
<surname>Yuan</surname>
<given-names>S. T.</given-names>
</name>
<name>
<surname>Lei</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Sun</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Xing</surname>
<given-names>L.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Multiple functions of autophagy in vascular calcification</article-title>. <source>Cell &#x26; Biosci.</source> <volume>11</volume> (<issue>1</issue>), <fpage>159</fpage>. <pub-id pub-id-type="doi">10.1186/s13578-021-00639-9</pub-id>
<pub-id pub-id-type="pmid">34399835</pub-id>
</citation>
</ref>
</ref-list>
</back>
</article>