Figure 3.

Signal transduction pathways implicated in ROS-induced osteochondrogenic phenotype switch of VSMCs. Various signal transduction pathways are involved in osteochondrogenic transdifferentiation of VSMCs. Some of these pathways are regulated by ROS or produce ROS upon activation. Activation of these pathways leads to nuclear translocation of transcription factors, such as β-catenin, Msx2, hypoxia inducible factor alpha subunit (HIF-1α), nuclear factor kappa B (NF-κB), activating transcription factor 4 (ATF4), and CCAAT-enhancer-binding protein homologous protein (CHOP). These transcription factors are involved in the transcriptional regulation of the VSMC phenotype transition from a contractile to an osteochondrogenic type.