VICs were seeded on hydrogels (E≃5 kPa, Supplemental Figure 1) and treated with either human recombinant annexin A2 (R&D Systems) or cystatin C (R&D Systems) at various concentrations. For inhibition studies, cells were treated with a known p38 MAPK inhibitor, SB203580 (Selleck Chemicals), at the previously optimized concentration of 20 μM 21 (link). After immunostaining (refer to the following section), gel samples were imaged on a glass-bottom 24 well plate (Cellvis) using either an Operetta High-Content Imaging System (Perkin Elmer, Part no. HH12000000) or Nikon Eclipse Ti2-E. Sample images were analyzed by adapting a publicly sourced MATLAB code from GitHub 26 . Myofibroblast activation was assessed by quantifying α-SMA gradient mean intensity values and osteoblast-like differentiation was measured by quantifying RUNX2 nuclear intensity normalized to RUNX2 cell mask intensity. Individual cell values were analyzed for at least 5 images per gel, with a minimum of two gels per condition.