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The study was designed to investigate whether endogenous sulfur dioxide (SO 2 ) plays a role in vascular calcification (VC) in rats and its possible mechanisms.  In vivo  medial vascular calcification was induced in rats by vitamin D3 and nicotine for four weeks.  In vitro  calcification of cultured A7r5 vascular smooth muscle cells (VSMCs) was induced by calcifying media containing 5 mmol/L CaCl 2 . Aortic smooth muscle (SM) α-actin, runt-related transcription factor 2 (Runx2), transforming growth factor-β (TGF-β) and Smad expression was measured. VC rats showed dispersed calcified nodules among the elastic fibers in calcified aorta with increased aortic calcium content and alkaline phosphatase (ALP) activity. SM α-actin was markedly decreased, but the osteochondrogenic marker Runx2 concomitantly increased and TGF-β/Smad signaling was activated, in association with the downregulated SO 2 /aspartate aminotransferase (AAT) pathway. However, SO 2  supplementation successfully ameliorated vascular calcification, and increased SM α-actin expression, but inhibited Runx2 and TGF-β/Smad expression. In calcified A7r5 VSMCs, the endogenous SO 2 /AAT pathway was significantly downregulated. SO 2  treatment reduced the calcium deposits, calcium content, ALP activity and Runx2 expression and downregulated the TGF-β/Smad pathway in A7r5 cells but increased SM α-actin expression. In brief, SO 2  significantly ameliorated vascular calcification in association with downregulation of the TGF-β/Smad pathway.

Endogenous Sulfur Dioxide Inhibits Vascular Calcification in Association with the TGF-β/Smad Signaling Pathway