For instance, vascular smooth muscle cells-derived exosomes containing high levels of microRNA (miR)-129 and miR-342 inhibited the osteogenic differentiation of VICs and the development of CAVD, which was achieved by suppressing the eIF2α/ATF4 axis (Huang et al., 2023). The gene discussed is ATF4; the disease is congenital bilateral aplasia of vas deferens from CFTR mutation.