{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T09:56:51Z","timestamp":1779184611236,"version":"3.51.4"},"reference-count":61,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TH Open"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background\u2003Intimal calcification typically develops in advanced atherosclerosis, and microcalcification may promote plaque progression and instability. Conversely, intraplaque hemorrhage and erythrocyte extravasation may stimulate osteoblastic differentiation and intralesional calcium phosphate deposition. The presence of erythrocytes and their main cellular components (membranes, hemoglobin, and iron) and colocalization with calcification has never been systematically studied.<\/jats:p><jats:p>Methods and Results\u2003We examined three types of diseased vascular tissue specimens, namely, degenerative aortic valve stenosis (n\u2009=\u200946), atherosclerotic carotid artery plaques (n\u2009=\u20099), and abdominal aortic aneurysms (n\u2009=\u200914). Biomaterial was obtained from symptomatic patients undergoing elective aortic valve replacement, carotid artery endatherectomy, or aortic aneurysm repair, respectively. Serial sections were stained using Masson\u2013Goldner trichrome, Alizarin red S, and Perl's iron stain to visualize erythrocytes, extracelluar matrix and osteoid, calcium phosphate deposition, or the presence of iron and hemosiderin, respectively. Immunohistochemistry was employed to detect erythrocyte membranes (CD235a), hemoglobin or the hemoglobin scavenger receptor (CD163), endothelial cells (CD31), myofibroblasts (SMA), mesenchymal cells (osteopontin), or osteoblasts (periostin). Our analyses revealed a varying degree of intraplaque hemorrhage and that the majority of extravasated erythrocytes were lysed. Osteoid and calcifications also were frequently present, and erythrocyte membranes were significantly more prevalent in areas with calcification. Areas with extravasated erythrocytes frequently contained CD163-positive cells, although calcification also occurred in areas without CD163 immunosignals.<\/jats:p><jats:p>Conclusion\u2003Our findings underline the presence of extravasated erythrocytes and their membranes in different types of vascular lesions, and their association with areas of calcification suggests an active role of erythrocytes in vascular disease processes.<\/jats:p>","DOI":"10.1055\/s-0041-1725042","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T22:34:35Z","timestamp":1618439675000},"page":"e113-e124","source":"Crossref","is-referenced-by-count":5,"title":["Colocalization of Erythrocytes and Vascular Calcification in Human Atherosclerosis: A Systematic Histomorphometric Analysis"],"prefix":"10.1055","volume":"05","author":[{"given":"Elsa Wilma","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pavlaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Chalikias","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Mikroulis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George S.","family":"Georgiadis","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios N.","family":"Tziakas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros","family":"Konstantinides","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center, Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1161\/01.ATV.0000110786.02097.0c","article-title":"Patterns and risk factors for systemic calcified 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