Fig. 2.

Hierarchical model of mineral-induced stress. The model illustrates the interdependence of the degree of mineral stress and fetuin-A levels, the predominant entities of calcium phosphate mineral particles, their target cells, elicited cellular responses, and possible therapeutic measures. Mineral stress is generally low and reversible under physiological conditions of fetuin-A abundance, when larger, pathological mineral complexes (CPP1 and CPP2) are mostly absent. With decreasing fetuin-A levels, the degree of mineral stress increases due to enhanced formation of CPP. A chronic mineral disbalance eventually leads to irreversible tissue remodeling, inflammation, and calcification