Inhibition of tissue non-specific alkaline phosphatase, a novel therapy against arterial media calcification?

Arterial media calcification refers to ectopic mineralization in the arterial wall and favors arterial stiffness and cardiovascular events. Patients with chronic kidney disease (CKD), diabetes, or osteoporosis are highly vulnerable to the development of arterial media calcifications. Tissue non-specific alkaline phosphatase (TNAP) is upregulated in calcified arteries and plays a key role in the degradation of the calcification inhibitor pyrophosphate into inorganic phosphate ions. A recent study published in The Journal of Pathology showed that an oral dosage of 10 or 30 mg/kg/day SBI-425, a selective TNAP inhibitor, inhibited the development of arterial media calcification in mice with CKD, without affecting bone mineralization. Their results indicated that SBI-425 is an effective and safe treatment for arterial media calcification. However, additional studies regarding the effect of TNAP-inhibitor SBI-425 on the progression and even the reversion of pre-existing pathological arterial media calcifications without affecting physiological bone mineralization are deserved. Furthermore, investigating the extent to which SBI-425 inhibits arterial calcification in a non-CKD context would be of particular interest to treat this comorbidity in diabetes and osteoporosis patients. (c) 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.