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Mu et al. Microstructures 2023;3:2023030 https://dx.doi.org/10.20517/microstructures.2023.05 Page 7 of 21

Table 1. A summary of pathological/ectopic mineralization in terms of the composition and the involvement of cells
Involvement of cellular
Tissue Composition References
activities
Bone HAp Cell-induced [112]
Joint CPPD, HAp, TCP, OCP, whitlockite, sodium urate Cell-derived articular cartilage [120,123,124,237]
vesicles
Tendon Carbonate HAp Cell-induced [94,128,130-132]
Teeth Brushite, dicalcium phosphate dihydrate, OCP, HAp, whitlockite Cell-mediated [134,135]
Salivary gland HAp, whitlockite, brushite, OCP Unknown [137-139]
Heart and blood HAp, whitlockite Cell-induced [20,35,140-142]
vessel
Kidney CaOx, CaP, the mixture of struvite magnesium ammonium Cell-mediated [151,153-155]
phosphate, carbonate HAp
Brain HAp Unknown [171,172]
Ocular Whitlockite, HAp Unknown [20,21]
Breast CaPs (carbonate HAp and whitlockite), CaO x Cell-induced [182-185]
Pancreas CaCO Unknown [188,189]
3
Prostate Carbonate HAp, whitlockite, CaO , Cell-mediated [191,192,238]
x
Placental CaPs Cell-mediated [194,195]
Lymph nodes HAp, whitlockite Unknown [197,198]

Figure 4. Pathological mineralization in soft tissues (blood vessels, brain, ocular, prostate, joint & tendon, placental, pancreas, kidney,
and breast). The major forms of pathological/ectopic mineralization are calcium phosphates, calcium carbonate, and calcium oxalates.

regulating the bone remodeling process. The disruption in the balance between bone resorption and bone
formation resulting from several pathological cues will affect bone health, metabolism, or homeostasis and
lead to irregular remodeling activity and pathological bone mineralization . Pathological bone
[103]
mineralization can be roughly categorized as hypomineralization, hypermineralization, and other abnormal
mineralization patterns.

Hypomineralization
Hypomineralization refers to insufficient mineralization of the bone matrix, resulting in reduced bone
[104]
density and increased fracture risk . Some several factors and conditions contribute to
hypomineralization [105-107] . Rickets and osteomalacia are examples of pathological hypomineralization
[103]
conditions . Rickets, a disorder affecting children, and osteomalacia, its adult counterpart, can be caused
by insufficient intake of essential nutrients, such as calcium and vitamin D, and hereditary factors . The
[103]