Figure 3.

Suggested pathogenesis of medial calcifications. Shown are simplified molecular pathways potentially associated with initiation and propagation of medial calcifications. Nanocrystals of calcium phosphates could be nucleated and either deposited on elastine fibres and extracellular vesicles or endocysted and directed to lysosomes where they are then dissolved at low pH and Ca²⁺ are released to the cytosol. Cell death or osteochodrotic transdifferentiation could follow the transient increase in calcium concentration.