Figure 6. Schematic illustration of simulating progression of VIC phenotypes in CAVD.
Pathophysiological cellular concept of “active” mineralization in CAVD. Quiescent VICs (qVICs) become activated myofibroblast-like VICs (aVICs) hallmarked by increased α-SMA expression. In healthy valves, cells may return to a quiescent state, but in CAVD, aVICs can differentiate into osteoblast-like VICs (oVICs) characterized by decreased α-SMA expression and increased Runx2 expression. Using a 3D culture platform, the entire cellular driven disease process of CAVD can be modeled.