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Viegas C, Araújo N, Marreiros C, Simes D. The interplay between mineral metabolism, vascular calcification and inflammation in Chronic Kidney Disease (CKD): challenging old concepts with new facts. Aging (Albany NY) 2019; 11:4274-4299. [PMID: 31241466 PMCID: PMC6628989 DOI: 10.18632/aging.102046] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/17/2019] [Indexed: 12/11/2022]
Abstract
Chronic kidney disease (CKD) is one of the most powerful predictors of premature cardiovascular disease (CVD), with heightened susceptibility to vascular intimal and medial calcification associated with a high cardiovascular mortality. Abnormal mineral metabolism of calcium (Ca) and phosphate (P) and underlying (dys)regulated hormonal control in CKD-mineral and bone disorder (MBD) is often accompanied by bone loss and increased vascular calcification (VC). While VC is known to be a multifactorial process and a major risk factor for CVD, the view of primary triggers and molecular mechanisms complexity has been shifting with novel scientific knowledge over the last years. In this review we highlight the importance of calcium-phosphate (CaP) mineral crystals in VC with an integrated view over the complexity of CKD, while discuss past and recent literature aiming to highlight novel horizons on this major health burden. Exacerbated VC in CKD patients might result from several interconnected mechanisms involving abnormal mineral metabolism, dysregulation of endogenous calcification inhibitors and inflammatory pathways, which function in a feedback loop driving disease progression and cardiovascular outcomes. We propose that novel approaches targeting simultaneously VC and inflammation might represent valuable new prognostic tools and targets for therapeutics and management of cardiovascular risk in the CKD population.
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Affiliation(s)
- Carla Viegas
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
| | - Nuna Araújo
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
| | - Catarina Marreiros
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
| | - Dina Simes
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro 8005-139, Portugal
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52
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Witham MD, Price RJG, Band MM, Hannah MS, Fulton RL, Clarke CL, Donnan PT, McNamee P, Cvoro V, Soiza RL. Effect of Vitamin K2 on Postural Sway in Older People Who Fall: A Randomized Controlled Trial. J Am Geriatr Soc 2019; 67:2102-2107. [PMID: 31211416 PMCID: PMC6851824 DOI: 10.1111/jgs.16024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/12/2019] [Accepted: 05/19/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. We tested the effect of vitamin K2 supplementation on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls. DESIGN Parallel‐group double‐blind randomized placebo‐controlled trial. SETTING Fourteen primary care practices in Scotland, UK. PARTICIPANTS A total of 95 community‐dwelling participants aged 65 and older with at least two falls, or one injurious fall, in the previous year. INTERVENTION Once/day placebo, 200 μg or 400 μg of oral vitamin K2 for 1 year. MEASUREMENTS The primary outcome was anteroposterior sway measured using sway plates at 12 months, adjusted for baseline. Secondary outcomes included the Short Physical Performance Battery, Berg Balance Scale, Timed Up & Go Test, quality of life, health and social care costs, falls, and adverse events. RESULTS Mean participant age was 75 (standard deviation [SD] = 7) years. Overall, 58 of 95 (61%) were female; 77 of 95 (81%) attended the 12‐month visit. No significant effect of either vitamin K2 dose was seen on the primary outcome of anteroposterior sway (200 μg vs placebo: −.19 cm [95% confidence interval [CI] −.68 to .30; P = .44]; 400 μg vs placebo: .17 cm [95% CI −.33 to .66; P = .50]; or 400 μg vs 200 μg: .36 cm [95% CI −.11 to .83; P = .14]). Adjusted falls rates were similar in each group. No significant treatment effects were seen for other measures of sway or secondary outcomes. Costs were higher in both vitamin K2 arms than in the placebo arm. CONCLUSION Oral vitamin K2 supplementation did not improve postural sway or physical function in older people at risk of falls. J Am Geriatr Soc 67:2102–2107, 2019
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Affiliation(s)
- Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals Trust, Newcastle upon Tyne, United Kingdom.,School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Rosemary J G Price
- Tayside Clinical Trials Unit, University of Dundee, Dundee, United Kingdom
| | - Margaret M Band
- Tayside Clinical Trials Unit, University of Dundee, Dundee, United Kingdom
| | - Michael S Hannah
- Tayside Clinical Trials Unit, University of Dundee, Dundee, United Kingdom
| | | | - Clare L Clarke
- Tayside Clinical Trials Unit, University of Dundee, Dundee, United Kingdom
| | - Peter T Donnan
- Tayside Clinical Trials Unit, University of Dundee, Dundee, United Kingdom
| | - Paul McNamee
- Health Economics Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Vera Cvoro
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK and NHS Fife, Kirkcaldy, United Kingdom
| | - Roy L Soiza
- Ageing Clinical and Experimental Research, School of Medicine & Dentistry, University of Aberdeen, Aberdeen, United Kingdom
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53
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Petsophonsakul P, Furmanik M, Forsythe R, Dweck M, Schurink GW, Natour E, Reutelingsperger C, Jacobs M, Mees B, Schurgers L. Role of Vascular Smooth Muscle Cell Phenotypic Switching and Calcification in Aortic Aneurysm Formation. Arterioscler Thromb Vasc Biol 2019; 39:1351-1368. [PMID: 31144989 DOI: 10.1161/atvbaha.119.312787] [Citation(s) in RCA: 209] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Aortic aneurysm is a vascular disease whereby the ECM (extracellular matrix) of a blood vessel degenerates, leading to dilation and eventually vessel wall rupture. Recently, it was shown that calcification of the vessel wall is involved in both the initiation and progression of aneurysms. Changes in aortic wall structure that lead to aneurysm formation and vascular calcification are actively mediated by vascular smooth muscle cells. Vascular smooth muscle cells in a healthy vessel wall are termed contractile as they maintain vascular tone and remain quiescent. However, in pathological conditions they can dedifferentiate into a synthetic phenotype, whereby they secrete extracellular vesicles, proliferate, and migrate to repair injury. This process is called phenotypic switching and is often the first step in vascular pathology. Additionally, healthy vascular smooth muscle cells synthesize VKDPs (vitamin K-dependent proteins), which are involved in inhibition of vascular calcification. The metabolism of these proteins is known to be disrupted in vascular pathologies. In this review, we summarize the current literature on vascular smooth muscle cell phenotypic switching and vascular calcification in relation to aneurysm. Moreover, we address the role of vitamin K and VKDPs that are involved in vascular calcification and aneurysm. Visual Overview- An online visual overview is available for this article.
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Affiliation(s)
- Ploingarm Petsophonsakul
- From the Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands (P.P., M.F., C.R., L.S.)
| | - Malgorzata Furmanik
- From the Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands (P.P., M.F., C.R., L.S.)
| | - Rachael Forsythe
- Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (R.F., M.D.)
| | - Marc Dweck
- Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (R.F., M.D.)
| | - Geert Willem Schurink
- Department of Vascular Surgery (G.W.S., M.J., B.M.), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands
| | - Ehsan Natour
- Department of Cardiovascular Surgery (E.N.), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands.,European Vascular Center Aachen-Maastricht, Maastricht, the Netherlands (E.N., M.J., B.M.)
| | - Chris Reutelingsperger
- From the Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands (P.P., M.F., C.R., L.S.)
| | - Michael Jacobs
- Department of Vascular Surgery (G.W.S., M.J., B.M.), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands.,European Vascular Center Aachen-Maastricht, Maastricht, the Netherlands (E.N., M.J., B.M.)
| | - Barend Mees
- Department of Vascular Surgery (G.W.S., M.J., B.M.), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands.,European Vascular Center Aachen-Maastricht, Maastricht, the Netherlands (E.N., M.J., B.M.)
| | - Leon Schurgers
- From the Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands (P.P., M.F., C.R., L.S.)
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54
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Nollet L, Van Gils M, Verschuere S, Vanakker O. The Role of Vitamin K and Its Related Compounds in Mendelian and Acquired Ectopic Mineralization Disorders. Int J Mol Sci 2019; 20:E2142. [PMID: 31052252 PMCID: PMC6540172 DOI: 10.3390/ijms20092142] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 12/11/2022] Open
Abstract
Ectopic mineralization disorders comprise a broad spectrum of inherited or acquired diseases characterized by aberrant deposition of calcium crystals in multiple organs, such as the skin, eyes, kidneys, and blood vessels. Although the precise mechanisms leading to ectopic calcification are still incompletely known to date, various molecular targets leading to a disturbed balance between pro- and anti-mineralizing pathways have been identified in recent years. Vitamin K and its related compounds, mainly those post-translationally activated by vitamin K-dependent carboxylation, may play an important role in the pathogenesis of ectopic mineralization as has been demonstrated in studies on rare Mendelian diseases, but also on highly prevalent disorders, like vascular calcification. This narrative review compiles and summarizes the current knowledge regarding the role of vitamin K, its metabolism, and associated compounds in the pathophysiology of both monogenic ectopic mineralization disorders, like pseudoxanthoma elasticum or Keutel syndrome, as well as acquired multifactorial diseases, like chronic kidney disease. Clinical and molecular aspects of the various disorders are discussed according to the state-of-the-art, followed by a comprehensive literature review regarding the role of vitamin K in molecular pathophysiology and as a therapeutic target in both human and animal models of ectopic mineralization disorders.
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Affiliation(s)
- Lukas Nollet
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Matthias Van Gils
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium.
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium.
| | - Shana Verschuere
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium.
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium.
| | - Olivier Vanakker
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium.
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, Belgium.
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55
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Silaghi CN, Ilyés T, Filip VP, Farcaș M, van Ballegooijen AJ, Crăciun AM. Vitamin K Dependent Proteins in Kidney Disease. Int J Mol Sci 2019; 20:ijms20071571. [PMID: 30934817 PMCID: PMC6479974 DOI: 10.3390/ijms20071571] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/24/2019] [Accepted: 03/27/2019] [Indexed: 12/12/2022] Open
Abstract
Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins (VKDPs) act mainly as calcification inhibitors, but their involvement in the onset and progression of CKD are not completely elucidated. This review is an update of the current state of knowledge about the relationship between CKD and four extrahepatic VKDPs: matrix Gla protein, osteocalcin, growth-arrest specific protein 6 and Gla-rich protein. Based on published literature in the last ten years, the purpose of this review is to address fundamental aspects about the link between CKD and circulating VKDPs levels as well as to raise new topics about how the interplay between molecular weight and charge could influence the modifications of circulating VKDPs at the glomerular level, or whether distinct renal etiologies have effect on VKDPs. This review is the output of a systematic literature search and may open future research avenues in this niche domain.
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Affiliation(s)
- Ciprian N Silaghi
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.
| | - Tamás Ilyés
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.
| | - Vladimir P Filip
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.
| | - Marius Farcaș
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.
| | - Adriana J van Ballegooijen
- Department of Nephrology & Epidemiology and Biostatistics, Amsterdam University Medical Center, VUmc, 1117 HV Amsterdam, The Netherlands.
| | - Alexandra M Crăciun
- Department of Molecular Sciences, University of Medicine and Pharmacy "Iuliu Hațieganu", 400012 Cluj-Napoca, Romania.
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56
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A dual role for GRP in cardiovascular disease. Aging (Albany NY) 2019; 11:1323-1324. [PMID: 30852562 PMCID: PMC6428097 DOI: 10.18632/aging.101851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/05/2019] [Indexed: 01/07/2023]
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57
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Halder M, Petsophonsakul P, Akbulut AC, Pavlic A, Bohan F, Anderson E, Maresz K, Kramann R, Schurgers L. Vitamin K: Double Bonds beyond Coagulation Insights into Differences between Vitamin K1 and K2 in Health and Disease. Int J Mol Sci 2019; 20:E896. [PMID: 30791399 PMCID: PMC6413124 DOI: 10.3390/ijms20040896] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 01/27/2023] Open
Abstract
Vitamin K is an essential bioactive compound required for optimal body function. Vitamin K can be present in various isoforms, distinguishable by two main structures, namely, phylloquinone (K1) and menaquinones (K2). The difference in structure between K1 and K2 is seen in different absorption rates, tissue distribution, and bioavailability. Although differing in structure, both act as cofactor for the enzyme gamma-glutamylcarboxylase, encompassing both hepatic and extrahepatic activity. Only carboxylated proteins are active and promote a health profile like hemostasis. Furthermore, vitamin K2 in the form of MK-7 has been shown to be a bioactive compound in regulating osteoporosis, atherosclerosis, cancer and inflammatory diseases without risk of negative side effects or overdosing. This review is the first to highlight differences between isoforms vitamin K1 and K2 by means of source, function, and extrahepatic activity.
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Affiliation(s)
- Maurice Halder
- Division of Nephrology, RWTH Aachen University, 52074 Aachen, Germany.
| | - Ploingarm Petsophonsakul
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200MD Maastricht, The Netherlands.
| | - Asim Cengiz Akbulut
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200MD Maastricht, The Netherlands.
| | - Angelina Pavlic
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200MD Maastricht, The Netherlands.
| | | | | | - Katarzyna Maresz
- International Science & Health Foundation, 30-134 Krakow, Poland.
| | - Rafael Kramann
- Division of Nephrology, RWTH Aachen University, 52074 Aachen, Germany.
| | - Leon Schurgers
- Division of Nephrology, RWTH Aachen University, 52074 Aachen, Germany.
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200MD Maastricht, The Netherlands.
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58
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Uhlin F, Fernström A, Knapen MHJ, Vermeer C, Magnusson P. Long-term follow-up of biomarkers of vascular calcification after switch from traditional hemodialysis to online hemodiafiltration. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:174-181. [PMID: 30775941 DOI: 10.1080/00365513.2019.1576218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Rapid progression of vascular calcification (VC) in hemodialysis (HD) patients is caused by several factors including inflammation and an imbalance between active inducers and inhibitors of VC. Growing evidence shows that online hemodiafiltration (ol-HDF), a combination of diffusive and convective solute transport, has positive effects on the uremic environment that affects patients on dialysis. However, we recently reported that serum 25-hydroxyvitamin D (25(OH)D) decreased after a switch from HD to ol-HDF. As a consequence of this finding, the present study was undertaken to investigate if inducers and inhibitors of VC (i.e. the inactive matrix Gla protein fractions dp-ucMGP and t-ucMGP, fetuin-A, Gla-rich protein (GRP), osteopontin (OPN), bone-specific alkaline phosphatase (BALP), and osteoprotegerin (OPG)) also are affected by ol-HDF. This non-comparative prospective study comprised 35 prevalent patients who were investigated 6, 12, and 24 months after their switch from HD to ol-HDF. Most patients had increased levels of the calcification inhibitors OPN and OPG; and of the inactive calcification inhibitor dp-ucMGP during the study period irrespective of the dialysis modality. BALP and t-ucMGP were mostly within the reference interval, but fetuin-A was mostly below the reference interval during the study period. OPN was significantly associated with BALP and parathyroid hormone, r = 0.62 and r = 0.65 (p < .001), respectively. In conclusion, in contrast to decreased 25(OH)D levels, no differences were found for any of the measured biomarkers of VC following the switch from HD to ol-HDF. Further studies are needed to elucidate how these biomarkers can contribute to calcification risk assessment.
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Affiliation(s)
- Fredrik Uhlin
- a Department of Nephrology and Department of Medical and Health Sciences , Linköping University , Linköping , Sweden.,b Department of Health Technologies , Technomedicum, Tallinn University of Technology , Tallinn , Estonia
| | - Anders Fernström
- a Department of Nephrology and Department of Medical and Health Sciences , Linköping University , Linköping , Sweden
| | - Marjo H J Knapen
- c R&D Group VitaK, Maastricht University , Maastricht , The Netherlands
| | - Cees Vermeer
- c R&D Group VitaK, Maastricht University , Maastricht , The Netherlands
| | - Per Magnusson
- d Department of Clinical Chemistry and Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden
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59
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Wasilewski GB, Vervloet MG, Schurgers LJ. The Bone-Vasculature Axis: Calcium Supplementation and the Role of Vitamin K. Front Cardiovasc Med 2019; 6:6. [PMID: 30805347 PMCID: PMC6370658 DOI: 10.3389/fcvm.2019.00006] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
Calcium supplements are broadly prescribed to treat osteoporosis either as monotherapy or together with vitamin D to enhance calcium absorption. It is still unclear whether calcium supplementation significantly contributes to the reduction of bone fragility and fracture risk. Data suggest that supplementing post-menopausal women with high doses of calcium has a detrimental impact on cardiovascular morbidity and mortality. Chronic kidney disease (CKD) patients are prone to vascular calcification in part due to impaired phosphate excretion. Calcium-based phosphate binders further increase risk of vascular calcification progression. In both bone and vascular tissue, vitamin K-dependent processes play an important role in calcium homeostasis and it is tempting to speculate that vitamin K supplementation might protect from the potentially untoward effects of calcium supplementation. This review provides an update on current literature on calcium supplementation among post-menopausal women and CKD patients and discusses underlying molecular mechanisms of vascular calcification. We propose therapeutic strategies with vitamin K2 treatment to prevent or hold progression of vascular calcification as a consequence of excessive calcium intake.
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Affiliation(s)
- Grzegorz B Wasilewski
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands.,Nattopharma ASA, Hovik, Norway
| | - Marc G Vervloet
- Department of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
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60
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Michaux A, Matagrin B, Debaux JV, Schurgers LJ, Benoit E, Lattard V. Missense mutation of VKORC1 leads to medial arterial calcification in rats. Sci Rep 2018; 8:13733. [PMID: 30214074 PMCID: PMC6137107 DOI: 10.1038/s41598-018-31788-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/21/2018] [Indexed: 01/22/2023] Open
Abstract
Vitamin K plays a crucial role in the regulation of vascular calcifications by allowing activation of matrix Gla protein. The dietary requirement for vitamin K is low because of an efficient recycling of vitamin K by vitamin K epoxide reductase (VKORC1). However, decreased VKORC1 activity may result in vascular calcification. More than 30 coding mutations of VKORC1 have been described. While these mutations have been suspected of causing anticoagulant resistance, their association with an increase in the risk of vascular calcification has never been considered. We thus investigated functional cardiovascular characteristics in a rat model mutated in VKORC1. This study revealed that limited intake in vitamin K in mutated rat induced massive calcified areas in the media of arteries of lung, aortic arch, kidneys and testis. Development of calcifications could be inhibited by vitamin K supplementation. In calcified areas, inactive Matrix Gla protein expression increased, while corresponding mRNA expression was not modified. Mutation in VKORC1 associated with a limited vitamin K intake is thus a major risk for cardiovascular disease. Our model is the first non-invasive rat model that shows spontaneous medial calcifications and would be useful for studying physiological function of vitamin K.
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Affiliation(s)
- Arnaud Michaux
- USC 1233 RS2GP, INRA, VetAgro Sup, Univ Lyon, F-69280, Marcy l'Etoile, France
| | - Benjamin Matagrin
- USC 1233 RS2GP, INRA, VetAgro Sup, Univ Lyon, F-69280, Marcy l'Etoile, France
| | - Jean-Valéry Debaux
- USC 1233 RS2GP, INRA, VetAgro Sup, Univ Lyon, F-69280, Marcy l'Etoile, France
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Etienne Benoit
- USC 1233 RS2GP, INRA, VetAgro Sup, Univ Lyon, F-69280, Marcy l'Etoile, France
| | - Virginie Lattard
- USC 1233 RS2GP, INRA, VetAgro Sup, Univ Lyon, F-69280, Marcy l'Etoile, France.
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61
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Lindholt JS, Frandsen NE, Fredgart MH, Øvrehus KA, Dahl JS, Møller JE, Folkestad L, Urbonaviciene G, Becker SW, Lambrechtsen J, Auscher S, Hosbond S, Alan DH, Rasmussen LM, Gerke O, Mickley H, Diederichsen A. Effects of menaquinone-7 supplementation in patients with aortic valve calcification: study protocol for a randomised controlled trial. BMJ Open 2018; 8:e022019. [PMID: 30139903 PMCID: PMC6112404 DOI: 10.1136/bmjopen-2018-022019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Aortic stenosis is a common heart valve disease, and due to the growing elderly population, the prevalence is increasing. The disease is progressive with increasing calcification of the valve cusps. A few attempts with medical preventive treatment have failed; thus, presently, the only effective treatment of aortic stenosis is surgery. This study will examine the effect of menaquinone-7 (MK-7) supplementation on progression of aortic valve calcification (AVC). We hypothesise that MK-7 supplementation will slow down the calcification process. METHODS AND ANALYSIS In this multicenter and double-blinded, placebo-controlled study, 400 men aged 65-74 years with substantial AVC are randomised (1:1) to treatment with MK-7 (720 µg/day) supplemented by the recommended daily dose of vitamin D (25 µg/day) or placebo treatment (no active treatment) for 2 years. Exclusion criteria are treatment with vitamin K antagonist or coagulation disorders. To evaluate AVC score, a non-contrast CT scan is performed at baseline and repeated after 12 and 24 months of follow-up. Primary outcome is difference in AVC score from baseline to follow-up at 2 years. Intention-to-treat principle is used for all analyses. ETHICS AND DISSEMINATION There are no reported adverse effects associated with the use of MK-7. The protocol is approved by the Regional Scientific Ethical Committee for Southern Denmark (S-20170059) and the Data Protection Agency (17/19010). It is conducted in accordance with the Declaration of Helsinki. Positive as well as negative findings will be reported. TRIAL REGISTRATION NUMBER NCT03243890.
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Affiliation(s)
- Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense Universitetshospital, Odense, Denmark
- Centre for Individualized Medicine in Arterial Diseases, Odense Universitetshospital, Odense, Denmark
| | | | | | | | | | | | - Lars Folkestad
- Department of Endocrinology, Odense Universitetshospital, Odense, Denmark
| | | | | | - Jess Lambrechtsen
- Department of Cardiology, Svendborg Sygehus, Svendborg, Syddanmark, Denmark
| | - Søren Auscher
- Department of Cardiology, Svendborg Sygehus, Svendborg, Syddanmark, Denmark
| | | | | | - Lars Melholt Rasmussen
- Centre for Individualized Medicine in Arterial Diseases, Odense Universitetshospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense Universitetshospital, Odense, Denmark
| | - Oke Gerke
- Department of Nuclear Medicine, Odense Universitetshospital, Odense C, Denmark
| | - Hans Mickley
- Department of Cardiology, Odense Universitetshospital, Odense, Denmark
| | - Axel Diederichsen
- Centre for Individualized Medicine in Arterial Diseases, Odense Universitetshospital, Odense, Denmark
- Department of Cardiology, Odense Universitetshospital, Odense, Denmark
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62
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Wen L, Chen J, Duan L, Li S. Vitamin K‑dependent proteins involved in bone and cardiovascular health (Review). Mol Med Rep 2018; 18:3-15. [PMID: 29749440 PMCID: PMC6059683 DOI: 10.3892/mmr.2018.8940] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/13/2018] [Indexed: 12/19/2022] Open
Abstract
In postmenopausal women and elderly men, bone density decreases with age and vascular calcification is aggravated. This condition is closely associated with vitamin K2 deficiency. A total of 17 different vitamin K-dependent proteins have been identified to date. Vitamin K-dependent proteins are located within the bone, heart and blood vessels. For instance, carboxylated osteocalcin is beneficial for bone and aids the deposition of calcium into the bone matrix. Carboxylated matrix Gla protein effectively protects blood vessels and may prevent calcification within the vascular wall. Furthermore, carboxylated Gla-rich protein has been reported to act as an inhibitor in the calcification of the cardiovascular system, while growth arrest-specific protein-6 protects endothelial cells and vascular smooth muscle cells, resists apoptosis and inhibits the calcification of blood vessels by inhibiting the apoptosis of vascular smooth muscle cells. In addition, periostin may promote the differentiation, aggregation, adhesion and proliferation of osteoblasts. Periostin also occurs in the heart and may be associated with the reconstruction of heart function. These vitamin K-dependent proteins may exert their functions following γ-carboxylation with vitamin K, and different vitamin K-dependent proteins may exhibit synergistic effects or antagonistic effects on each other. In the cardiovascular system with vitamin K antagonist supplement or vitamin K deficiency, calcification occurs in the endothelium of blood vessels and vascular smooth muscle cells are transformed into osteoblast-like cells, a phenomenon that resembles bone growth. Both the bone and cardiovascular system are closely associated during embryonic development. Thus, the present study hypothesized that embryonic developmental position and tissue calcification may have a certain association for the bone and the cardiovascular system. This review describes and briefly discusses several important vitamin K-dependent proteins that serve an important role in bone and the cardiovascular system. The results of the review suggest that the vascular calcification and osteogenic differentiation of vascular smooth muscle cells may be associated with the location of the bone and cardiovascular system during embryonic development.
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Affiliation(s)
- Lianpu Wen
- Department of Physiology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Jiepeng Chen
- Sungen Bioscience Co., Ltd., Shantou, Guangdong 515000, P.R. China
| | - Lili Duan
- Sungen Bioscience Co., Ltd., Shantou, Guangdong 515000, P.R. China
| | - Shuzhuang Li
- Department of Physiology, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
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Chiyoya M, Seya K, Yu Z, Daitoku K, Motomura S, Imaizumi T, Fukuda I, Furukawa KI. Matrix Gla protein negatively regulates calcification of human aortic valve interstitial cells isolated from calcified aortic valves. J Pharmacol Sci 2018; 136:257-265. [PMID: 29653899 DOI: 10.1016/j.jphs.2018.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/23/2018] [Accepted: 03/20/2018] [Indexed: 02/05/2023] Open
Abstract
Calcified aortic valve stenosis (CAS) is a common heart valve disease in elderly people, and is mostly accompanied by ectopic valve calcification. We recently demonstrated that tumor necrosis factor-α (TNF-α) induces calcification of human aortic valve interstitial cells (HAVICs) obtained from CAS patients. In this study, we investigated the role of matrix Gla protein (MGP), a known calcification inhibitor that antagonizes bone morphogenetic protein 2 (BMP2) in TNF-α-induced calcification of HAVICs. HAVICs isolated from aortic valves were cultured, and calcification was significantly induced with 30 ng/mL TNF-α. Gene expression of the calcigenic marker, BMP2, was significantly increased in response to TNF-α, while the gene and protein expression of MGP was strongly decreased. To confirm the role of MGP, MGP-knockdown HAVICs and HAVICs overexpressing MGP were generated. In HAVICs, in which MGP expression was inhibited by small interfering RNA, calcification and BMP2 gene expression were induced following long-term culture for 32 days in the absence of TNF-α. In contrast, HAVICs overexpressing MGP had significantly decreased TNF-α-induced calcification. These results suggest that MGP acts as a negative regulator of HAVIC calcification, and as such, may be helpful in the development of new therapies for ectopic calcification of the aortic valve.
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Affiliation(s)
- Mari Chiyoya
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Kazuhiko Seya
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Zaiqiang Yu
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Kazuyuki Daitoku
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Shigeru Motomura
- Department of Pharmacology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Tadaatsu Imaizumi
- Department of Vascular Biology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Ikuo Fukuda
- Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Ken-Ichi Furukawa
- Department of Pharmacology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
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64
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Ucma/GRP inhibits phosphate-induced vascular smooth muscle cell calcification via SMAD-dependent BMP signalling. Sci Rep 2018; 8:4961. [PMID: 29563538 PMCID: PMC5862840 DOI: 10.1038/s41598-018-23353-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/09/2018] [Indexed: 12/22/2022] Open
Abstract
Vascular calcification (VC) is the process of deposition of calcium phosphate crystals in the blood vessel wall, with a central role for vascular smooth muscle cells (VSMCs). VC is highly prevalent in chronic kidney disease (CKD) patients and thought, in part, to be induced by phosphate imbalance. The molecular mechanisms that regulate VC are not fully known. Here we propose a novel role for the mineralisation regulator Ucma/GRP (Upper zone of growth plate and Cartilage Matrix Associated protein/Gla Rich Protein) in phosphate-induced VSMC calcification. We show that Ucma/GRP is present in calcified atherosclerotic plaques and highly expressed in calcifying VSMCs in vitro. VSMCs from Ucma/GRP−/− mice showed increased mineralisation and expression of osteo/chondrogenic markers (BMP-2, Runx2, β-catenin, p-SMAD1/5/8, ALP, OCN), and decreased expression of mineralisation inhibitor MGP, suggesting that Ucma/GRP is an inhibitor of mineralisation. Using BMP signalling inhibitor noggin and SMAD1/5/8 signalling inhibitor dorsomorphin we showed that Ucma/GRP is involved in inhibiting the BMP-2-SMAD1/5/8 osteo/chondrogenic signalling pathway in VSMCs treated with elevated phosphate concentrations. Additionally, we showed for the first time evidence of a direct interaction between Ucma/GRP and BMP-2. These results demonstrate an important role of Ucma/GRP in regulating osteo/chondrogenic differentiation and phosphate-induced mineralisation of VSMCs.
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Ni J, Sun Y, Liu Z. The Potential of Stem Cells and Stem Cell-Derived Exosomes in Treating Cardiovascular Diseases. J Cardiovasc Transl Res 2018. [PMID: 29525884 DOI: 10.1007/s12265-018-9799-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In recent years, the cardiac protective mechanisms of stem cells have become a research focus. Increasing evidence has suggested that stem cells release vesicles, including exosomes and micro-vesicles. The content of these vesicles relies on an extracellular stimulus, and active ingredients are extensively being studied. Previous studies have confirmed that stem cell-derived exosomes have a cardiac protective function similar to that of stem cells, and promote angiogenesis, decrease apoptosis, and respond to stress. Compared to stem cells, exosomes are more stable without aneuploidy and immune rejection, and may be a promising and effective therapy for cardiovascular diseases. In this review, the biological functions and molecular mechanisms of stem cells and stem cell-derived exosomes are discussed.
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Affiliation(s)
- Jing Ni
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China.,Pan-Vascular Research Institute, Heart, Lung, and Blood Center, Tongji University School of Medicine, Shanghai, China
| | - Yuxi Sun
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China.,Pan-Vascular Research Institute, Heart, Lung, and Blood Center, Tongji University School of Medicine, Shanghai, China
| | - Zheng Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China. .,Pan-Vascular Research Institute, Heart, Lung, and Blood Center, Tongji University School of Medicine, Shanghai, China.
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66
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Bottini M, Mebarek S, Anderson KL, Strzelecka-Kiliszek A, Bozycki L, Simão AMS, Bolean M, Ciancaglini P, Pikula JB, Pikula S, Magne D, Volkmann N, Hanein D, Millán JL, Buchet R. Matrix vesicles from chondrocytes and osteoblasts: Their biogenesis, properties, functions and biomimetic models. Biochim Biophys Acta Gen Subj 2018; 1862:532-546. [PMID: 29108957 PMCID: PMC5801150 DOI: 10.1016/j.bbagen.2017.11.005] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/28/2017] [Accepted: 11/01/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Matrix vesicles (MVs) are released from hypertrophic chondrocytes and from mature osteoblasts, the cells responsible for endochondral and membranous ossification. Under pathological conditions, they can also be released from cells of non-skeletal tissues such as vascular smooth muscle cells. MVs are extracellular vesicles of approximately 100-300nm diameter harboring the biochemical machinery needed to induce mineralization. SCOPE OF THE REVIEW The review comprehensively delineates our current knowledge of MV biology and highlights open questions aiming to stimulate further research. The review is constructed as a series of questions addressing issues of MVs ranging from their biogenesis and functions, to biomimetic models. It critically evaluates experimental data including their isolation and characterization methods, like lipidomics, proteomics, transmission electron microscopy, atomic force microscopy and proteoliposome models mimicking MVs. MAJOR CONCLUSIONS MVs have a relatively well-defined function as initiators of mineralization. They bind to collagen and their composition reflects the composition of lipid rafts. We call attention to the as yet unclear mechanisms leading to the biogenesis of MVs, and how minerals form and when they are formed. We discuss the prospects of employing upcoming experimental models to deepen our understanding of MV-mediated mineralization and mineralization disorders such as the use of reconstituted lipid vesicles, proteoliposomes and, native sample preparations and high-resolution technologies. GENERAL SIGNIFICANCE MVs have been extensively investigated owing to their roles in skeletal and ectopic mineralization. MVs serve as a model system for lipid raft structures, and for the mechanisms of genesis and release of extracellular vesicles.
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Affiliation(s)
- Massimo Bottini
- University of Rome Tor Vergata, Department of Experimental Medicine and Surgery, 00133 Roma, Italy; Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Saida Mebarek
- Universite Lyon 1, UFR Chimie Biochimie, 69 622 Villeurbanne Cedex, France; ICBMS UMR 5246 CNRS, 69 622 Villeurbanne Cedex, France; INSA, Lyon, 69 622 Villeurbanne Cedex, France; CPE, Lyon, 69 622 Villeurbanne Cedex, France; Universite de Lyon, 69 622 Villeurbanne Cedex, France
| | - Karen L Anderson
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Agnieszka Strzelecka-Kiliszek
- Nencki Institute of Experimental Biology, Department of Biochemistry, Polish Academy of Sciences, 02-093 Warsaw, Poland
| | - Lukasz Bozycki
- Nencki Institute of Experimental Biology, Department of Biochemistry, Polish Academy of Sciences, 02-093 Warsaw, Poland
| | - Ana Maria Sper Simão
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, USP, Departamento de Química, 14040-901 Ribeirão Preto, SP, Brazil
| | - Maytê Bolean
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, USP, Departamento de Química, 14040-901 Ribeirão Preto, SP, Brazil
| | - Pietro Ciancaglini
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, USP, Departamento de Química, 14040-901 Ribeirão Preto, SP, Brazil
| | - Joanna Bandorowicz Pikula
- Nencki Institute of Experimental Biology, Department of Biochemistry, Polish Academy of Sciences, 02-093 Warsaw, Poland
| | - Slawomir Pikula
- Nencki Institute of Experimental Biology, Department of Biochemistry, Polish Academy of Sciences, 02-093 Warsaw, Poland
| | - David Magne
- Universite Lyon 1, UFR Chimie Biochimie, 69 622 Villeurbanne Cedex, France; ICBMS UMR 5246 CNRS, 69 622 Villeurbanne Cedex, France; INSA, Lyon, 69 622 Villeurbanne Cedex, France; CPE, Lyon, 69 622 Villeurbanne Cedex, France; Universite de Lyon, 69 622 Villeurbanne Cedex, France
| | - Niels Volkmann
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Dorit Hanein
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - José Luis Millán
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Rene Buchet
- Universite Lyon 1, UFR Chimie Biochimie, 69 622 Villeurbanne Cedex, France; ICBMS UMR 5246 CNRS, 69 622 Villeurbanne Cedex, France; INSA, Lyon, 69 622 Villeurbanne Cedex, France; CPE, Lyon, 69 622 Villeurbanne Cedex, France; Universite de Lyon, 69 622 Villeurbanne Cedex, France.
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67
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Implication of a novel vitamin K dependent protein, GRP/Ucma in the pathophysiological conditions associated with vascular and soft tissue calcification, osteoarthritis, inflammation, and carcinoma. Int J Biol Macromol 2018; 113:309-316. [PMID: 29499263 DOI: 10.1016/j.ijbiomac.2018.02.150] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/23/2018] [Accepted: 02/24/2018] [Indexed: 12/13/2022]
Abstract
Gla-rich protein (GRP) or unique cartilage matrix-associated protein (Ucma), the newest member of vitamin K dependent proteins, carries exceptionally high number of γ-carboxyglutamic acid (Gla) residues which contributes to its outstanding capacity of binding with calcium in the extracellular environment indicating its potential role as a global calcium modulator. Recent studies demonstrated a critical function of GRP in the regulation of different pathophysiological conditions associated with vascular and soft tissue calcification including cardiovascular diseases, osteoarthritis, inflammation, and skin and breast carcinomas. These findings established an important relationship between γ-carboxylation of GRP and calcification associated disease pathology suggesting a critical role of vitamin K in the pathophysiological features of various health disorders. This review for the first time summarizes all of the updated findings related to the functional activities of GRP in the pathogenesis of several diseases associated with vascular and soft tissue mineralization, osteoarthritis, inflammation, and carcinoma. The outcome of this review will improve the understanding about the role of GRP in the pathogenesis of tissue calcification and its associated health disorders, which should in turn lead to the design of clinical interventions to improve the condition of patients associated with these health disorders.
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68
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Viegas CSB, Santos L, Macedo AL, Matos AA, Silva AP, Neves PL, Staes A, Gevaert K, Morais R, Vermeer C, Schurgers L, Simes DC. Chronic Kidney Disease Circulating Calciprotein Particles and Extracellular Vesicles Promote Vascular Calcification: A Role for GRP (Gla-Rich Protein). Arterioscler Thromb Vasc Biol 2018; 38:575-587. [PMID: 29301790 DOI: 10.1161/atvbaha.117.310578] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 12/15/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Inhibition of mineral crystal formation is a crucial step in ectopic calcification. Serum calciprotein particles (CPPs) have been linked to chronic kidney disease (CKD) calcification propensity, but additional knowledge is required to understand their function, assemblage, and composition. The role of other circulating nanostructures, such as extracellular vesicles (EVs) in vascular calcification is currently unknown. Here, we investigated the association of GRP (Gla-rich protein) with circulating CPP and EVs and the role of CKD CPPs and EVs in vascular calcification. APPROACH AND RESULTS Biological CPPs and EVs were isolated from healthy and CKD patients and comparatively characterized using ultrastructural, analytic, molecular, and immuno-based techniques. Our results show that GRP is a constitutive component of circulating CPPs and EVs. CKD stage 5 serum CPPs and EVs are characterized by lower levels of fetuin-A and GRP, and CPPs CKD stage 5 have increased mineral maturation, resembling secondary CPP particles. Vascular smooth muscle cell calcification assays reveal that CPPs CKD stage 5 and EVs CKD stage 5 are taken up by vascular smooth muscle cells and induce vascular calcification by promoting cell osteochondrogenic differentiation and inflammation. These effects were rescued by incubation of CPPs CKD stage 5 with γ-carboxylated GRP. In vitro, formation and maturation of basic calcium phosphate crystals was highly reduced in the presence of γ-carboxylated GRP, fetuin-A, and MGP (matrix gla protein), and a similar antimineralization system was identified in vivo. CONCLUSIONS Uremic CPPs and EVs are important players in the mechanisms of widespread calcification in CKD. We propose a major role for cGRP as inhibitory factor to prevent calcification at systemic and tissue levels.
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Affiliation(s)
- Carla S B Viegas
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Lúcia Santos
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Anjos L Macedo
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - António A Matos
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Ana P Silva
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Pedro L Neves
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - An Staes
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Kris Gevaert
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Rute Morais
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Cees Vermeer
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Leon Schurgers
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands
| | - Dina C Simes
- From the Centre of Marine Sciences (C.S.B.V., L.S., D.C.S.), GenoGla Diagnostics, Centre of Marine Sciences (C.S.B.V., D.C.S.), and Department of Biomedical Sciences and Medicine (A.P.S., P.L.N.), University of Algarve, Faro, Portugal; UCIBIO-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal (A.L.M., R.M.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal (A.A.M.); Nephrology Department, Centro Hospitalar do Algarve, Faro, Portugal (A.P.S., P.L.N.); VIB-UGent Center for Medical Biotechnology Center and UGent Department of Biochemistry, Ghent, Belgium (A.S., K.G.); and R&D Group VitaK (C.V.) and Department of Biochemistry - Vascular Aspects, Faculty of Medicine, Health and Life Science (L.S.), Maastricht University, The Netherlands.
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Willy K, Girndt M, Voelkl J, Fiedler R, Martus P, Storr M, Schindler R, Zickler D. Expanded Haemodialysis Therapy of Chronic Haemodialysis Patients Prevents Calcification and Apoptosis of Vascular Smooth Muscle Cells in vitro. Blood Purif 2017; 45:131-138. [PMID: 29402827 DOI: 10.1159/000484925] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/02/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Vascular calcification is a common phenomenon in patients with chronic kidney disease and strongly associated with increased cardiovascular mortality. Vascular calcification is an active process mediated in part by inflammatory processes in vascular smooth muscle cells (VSMC). These could be modified by the insufficient removal of proinflammatory cytokines through conventional high-flux (HF) membranes. Recent trials demonstrated a reduction of inflammation in VSMC by use of dialysis membranes with a higher and steeper cut-off. These membranes caused significant albumin loss. Therefore, the effect of high retention Onset (HRO) dialysis membranes on vascular calcification and its implications in vitro was evaluated. METHODS In the PERCI II trial, 48 chronic dialysis patients were dialyzed using HF and HRO dialyzers and serum samples were collected. Calcifying VSMC were incubated with the serum samples. Calcification was determined using alizarin red staining (AZR) and determination of alkaline phosphatase (ALP) activity. Furthermore, apoptosis was evaluated, and release of matrix Gla protein (MGP), osteopontin (OPN) and growth differentiation factor 15 (GDF-15) were measured in cell supernatants. RESULTS Vascular calcification in vitro was significantly reduced by 24% (ALP) and 36% (AZR) after 4 weeks of HRO dialysis and by 33% (ALP) and 48% (AZR) after 12 weeks of dialysis using HRO membranes compared to HF dialysis. Apoptosis was significantly lower in the HRO group. The concentrations of MGP and OPN were significantly elevated after incubation with HF serum compared to HRO serum and healthy controls. Similarly, GDF-15 release in the supernatant was elevated after incubation with HF serum, an effect significantly ameliorated after treatment with HRO medium. CONCLUSIONS Expanded haemodialysis therapy reduces the pro-calcific potential of serum from dialysis patients in vitro. With a markedly reduced albumin filtration compared to high cut-off dialysis, use of the HRO dialyzers may possibly provide a treatment option for chronic dialysis patients to reduce the progression of vascular calcification.
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Affiliation(s)
- Kevin Willy
- Charité University Medicine Berlin, Campus Virchow Clinic, Department of Nephrology and Internal Intensive Care Medicine, Berlin, Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Jakob Voelkl
- Department of Internal Medicine and Cardiology, Charité Campus Virchow, Charité Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Roman Fiedler
- Department of Internal Medicine II, Martin-Luther-University Halle, Halle, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Markus Storr
- Department of Research and Development, Gambro Dialysatoren GmbH, Hechingen, Germany
| | - Ralf Schindler
- Charité University Medicine Berlin, Campus Virchow Clinic, Department of Nephrology and Internal Intensive Care Medicine, Berlin, Germany
| | - Daniel Zickler
- Charité University Medicine Berlin, Campus Virchow Clinic, Department of Nephrology and Internal Intensive Care Medicine, Berlin, Germany
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70
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Rilla K, Mustonen AM, Arasu UT, Härkönen K, Matilainen J, Nieminen P. Extracellular vesicles are integral and functional components of the extracellular matrix. Matrix Biol 2017; 75-76:201-219. [PMID: 29066152 DOI: 10.1016/j.matbio.2017.10.003] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/10/2017] [Accepted: 10/16/2017] [Indexed: 12/18/2022]
Abstract
Extracellular vesicles (EV) are small plasma membrane-derived particles released into the extracellular space by virtually all cell types. Recently, EV have received increased interest because of their capability to carry nucleic acids, proteins, lipids and signaling molecules and to transfer their cargo into the target cells. Less attention has been paid to their role in modifying the composition of the extracellular matrix (ECM), either directly or indirectly via regulating the ability of target cells to synthesize or degrade matrix molecules. Based on recent results, EV can be considered one of the structural and functional components of the ECM that participate in matrix organization, regulation of cells within it, and in determining the physical properties of soft connective tissues, bone, cartilage and dentin. This review addresses the relevance of EV as specific modulators of the ECM, such as during the assembly and disassembly of the molecular network, signaling through the ECM and formation of niches suitable for tissue regeneration, inflammation and tumor progression. Finally, we assess the potential of these aspects of EV biology to translational medicine.
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Affiliation(s)
- Kirsi Rilla
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland.
| | - Anne-Mari Mustonen
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland
| | - Uma Thanigai Arasu
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland
| | - Kai Härkönen
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland
| | - Johanna Matilainen
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland
| | - Petteri Nieminen
- Faculty of Health Sciences, School of Medicine, Institute of Biomedicine, University of Eastern Finland, P.O. Box 1627, FI 70211, Kuopio, Finland
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71
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Douthit MK, Fain ME, Nguyen JT, Williams CF, Jasti AH, Gutin B, Pollock NK. Phylloquinone Intake Is Associated with Cardiac Structure and Function in Adolescents. J Nutr 2017; 147:1960-1967. [PMID: 28794209 PMCID: PMC5610549 DOI: 10.3945/jn.117.253666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/12/2017] [Accepted: 07/07/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Associations between childhood vitamin K consumption and cardiac structure and function have not been investigated. OBJECTIVE We determined associations between phylloquinone (vitamin K-1) intake and left ventricular (LV) structure and function in adolescents. METHODS We assessed diet with three to seven 24-h recalls and physical activity (PA) by accelerometry in 766 adolescents (aged 14-18 y, 50% female, 49% black). Fat-free soft tissue (FFST) mass and fat mass were measured by dual-energy X-ray absorptiometry. LV structure [LV mass (g)/height (m)2.7 (LV mass index) and relative wall thickness] and function [midwall fractional shortening (MFS) and ejection fraction] were assessed by echocardiography. Associations were evaluated by comparing the LV structure and function variables across tertiles of phylloquinone intake. Prevalence and OR of LV hypertrophy (LV mass index >95th percentile for age and sex) were also assessed by phylloquinone tertiles. RESULTS The prevalence of LV hypertrophy progressively decreased across tertiles of phylloquinone intake (P-trend < 0.01). Multinomial logistic regression-adjusting for age, sex, race, Tanner stage, systolic blood pressure, FFST mass, fat mass, socioeconomic status, PA, and intakes of energy, fiber, calcium, vitamin C, vitamin D, and sodium-revealed that compared with the highest phylloquinone intake tertile (reference group), the adjusted OR for LV hypertrophy was 3.3 (95% CI: 1.2, 7.4) for those in the lowest phylloquinone intake tertile. When LV structure variables were compared across phylloquinone intake tertiles adjusting for the same covariates, there were significant linear downward trends for LV mass index (6.5% difference, tertile 1 compared with tertile 3) and relative wall thickness (9.2% difference, tertile 1 compared with tertile 3; both P-trend ≤ 0.02). Conversely, significant linear upward trends across phylloquinone intake tertiles were observed for MFS (3.4% difference, tertile 1 compared with tertile 3) and ejection fraction (2.6% difference, tertile 1 compared with tertile 3; both P-trend < 0.04). CONCLUSION Our adolescent data suggest that subclinical cardiac structure and function variables are most favorable at higher phylloquinone intakes.
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Affiliation(s)
- Mary K Douthit
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Mary Ellen Fain
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Joshua T Nguyen
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Celestine F Williams
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Allison H Jasti
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Bernard Gutin
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
| | - Norman K Pollock
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA
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72
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Viegas CSB, Costa RM, Santos L, Videira PA, Silva Z, Araújo N, Macedo AL, Matos AP, Vermeer C, Simes DC. Gla-rich protein function as an anti-inflammatory agent in monocytes/macrophages: Implications for calcification-related chronic inflammatory diseases. PLoS One 2017; 12:e0177829. [PMID: 28542410 PMCID: PMC5436823 DOI: 10.1371/journal.pone.0177829] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/03/2017] [Indexed: 12/19/2022] Open
Abstract
Calcification-related chronic inflammatory diseases are multifactorial pathological processes, involving a complex interplay between inflammation and calcification events in a positive feed-back loop driving disease progression. Gla-rich protein (GRP) is a vitamin K dependent protein (VKDP) shown to function as a calcification inhibitor in cardiovascular and articular tissues, and proposed as an anti-inflammatory agent in chondrocytes and synoviocytes, acting as a new crosstalk factor between these two interconnected events in osteoarthritis. However, a possible function of GRP in the immune system has never been studied. Here we focused our investigation in the involvement of GRP in the cell inflammatory response mechanisms, using a combination of freshly isolated human leucocytes and undifferentiated/differentiated THP-1 cell line. Our results demonstrate that VKDPs such as GRP and matrix gla protein (MGP) are synthesized and γ-carboxylated in the majority of human immune system cells either involved in innate or adaptive immune responses. Stimulation of THP-1 monocytes/macrophages with LPS or hydroxyapatite (HA) up-regulated GRP expression, and treatments with GRP or GRP-coated basic calcium phosphate crystals resulted in the down-regulation of mediators of inflammation and inflammatory cytokines, independently of the protein γ-carboxylation status. Moreover, overexpression of GRP in THP-1 cells rescued the inflammation induced by LPS and HA, by down-regulation of the proinflammatory cytokines TNFα, IL-1β and NFkB. Interestingly, GRP was detected at protein and mRNA levels in extracellular vesicles released by macrophages, which may act as vehicles for extracellular trafficking and release. Our data indicate GRP as an endogenous mediator of inflammatory responses acting as an anti-inflammatory agent in monocytes/macrophages. We propose that in a context of chronic inflammation and calcification-related pathologies, GRP might act as a novel molecular mediator linking inflammation and calcification events, with potential therapeutic application.
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Affiliation(s)
- Carla S. B. Viegas
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Rúben M. Costa
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Lúcia Santos
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Paula A. Videira
- UCIBIO@REQUIMTE Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Zélia Silva
- UCIBIO@REQUIMTE Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Nuna Araújo
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Anjos L. Macedo
- UCIBIO@REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica, Portugal
| | - António P. Matos
- Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior CRL, Caparica, Portugal
| | - Cees Vermeer
- VitaK, Maastricht University, Maastricht, The Netherlands
| | - Dina C. Simes
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
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73
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Kapustin AN, Schoppet M, Schurgers LJ, Reynolds JL, McNair R, Heiss A, Jahnen-Dechent W, Hackeng TM, Schlieper G, Harrison P, Shanahan CM. Prothrombin Loading of Vascular Smooth Muscle Cell-Derived Exosomes Regulates Coagulation and Calcification. Arterioscler Thromb Vasc Biol 2017; 37:e22-e32. [PMID: 28104608 DOI: 10.1161/atvbaha.116.308886] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/28/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The drug warfarin blocks carboxylation of vitamin K-dependent proteins and acts as an anticoagulant and an accelerant of vascular calcification. The calcification inhibitor MGP (matrix Gla [carboxyglutamic acid] protein), produced by vascular smooth muscle cells (VSMCs), is a key target of warfarin action in promoting calcification; however, it remains unclear whether proteins in the coagulation cascade also play a role in calcification. APPROACH AND RESULTS Vascular calcification is initiated by exosomes, and proteomic analysis revealed that VSMC exosomes are loaded with Gla-containing coagulation factors: IX and X, PT (prothrombin), and proteins C and S. Tracing of Alexa488-labeled PT showed that exosome loading occurs by direct binding to externalized phosphatidylserine (PS) on the exosomal surface and by endocytosis and recycling via late endosomes/multivesicular bodies. Notably, the PT Gla domain and a synthetic Gla domain peptide inhibited exosome-mediated VSMC calcification by preventing nucleation site formation on the exosomal surface. PT was deposited in the calcified vasculature, and there was a negative correlation between vascular calcification and the levels of circulating PT. In addition, we found that VSMC exosomes induced thrombogenesis in a tissue factor-dependent and PS-dependent manner. CONCLUSIONS Gamma-carboxylated coagulation proteins are potent inhibitors of vascular calcification suggesting warfarin action on these factors also contributes to accelerated calcification in patients receiving this drug. VSMC exosomes link calcification and coagulation acting as novel activators of the extrinsic coagulation pathway and inducers of calcification in the absence of Gla-containing inhibitors.
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MESH Headings
- Aged
- Anticoagulants/adverse effects
- Blood Coagulation/drug effects
- Calcium-Binding Proteins/metabolism
- Cells, Cultured
- Endocytosis
- Endosomes/metabolism
- Exosomes/drug effects
- Exosomes/metabolism
- Extracellular Matrix Proteins/metabolism
- Female
- Humans
- Male
- Middle Aged
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Peptides/pharmacology
- Phosphatidylserines/metabolism
- Protein Binding
- Protein Interaction Domains and Motifs
- Protein Transport
- Prothrombin/metabolism
- Signal Transduction
- Vascular Calcification/chemically induced
- Vascular Calcification/metabolism
- Vascular Calcification/pathology
- Vascular Calcification/prevention & control
- Warfarin/adverse effects
- Matrix Gla Protein
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Affiliation(s)
- Alexander N Kapustin
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Michael Schoppet
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Leon J Schurgers
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Joanne L Reynolds
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Rosamund McNair
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Alexander Heiss
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Willi Jahnen-Dechent
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Tilman M Hackeng
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Georg Schlieper
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Paul Harrison
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.)
| | - Catherine M Shanahan
- From the BHF Centre of Research Excellence, Department of Cardiology, Cardiovascular Division, King's College London, United Kingdom (A.N.K., J.L.R., R.M.N., C.M.S.); Department of Internal Medicine and Cardiology, Philipps-University, Marburg, Germany (M.S.); Department of Biochemistry, Cardiovascular Research Institute CARIM, University of Maastricht, The Netherlands (L.J.S., T.M.H.); Department of Biomedical Engineering (A.H., W.J.-D.) and Department of Nephrology and Clinical Immunology (G.S.), RWTH Aachen University, Germany; and Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom (P.H.).
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74
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Morais R, Viegas CSB, Simes DC, Matos APA, Macedo AL. Application of TEM techniques for the study of vascular calcification: Monitoring extracellular vesicles and nanogold immunodetection of fetuin-A, GRP, and CD9. Ultrastruct Pathol 2017. [DOI: 10.1080/01913123.2016.1272670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rute Morais
- UCIBIO-Requimte, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica, Portugal
| | - Carla S. B. Viegas
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Dina C. Simes
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - António P. A. Matos
- CiiEM - Centro de Investigação Interdisciplinar Egas Moniz, Campus Universitário, Quinta da Granja, Caparica, Portugal
| | - Anjos L. Macedo
- UCIBIO-Requimte, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica, Portugal
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75
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Dubovyk YI, Harbuzova VY, Obukhova OA, Ataman AV. [ANALYSIS OF γ-GLUTAMYL CARBOXYLASE GENE rs2592551 POLYMORPHISM ASSOCIATION WITH ISCHEMIC ATHEROTHROMBOTIC STROKE]. ACTA ACUST UNITED AC 2017; 63:33-42. [PMID: 29975826 DOI: 10.15407/fz63.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The results of γ-glutamyl carboxylase gene rs2592551 polymorphism determining in 170 patients with ischemic atherothrombotic stroke and 124 subjects without acute cerebrovascular disease (control group) have been evaluated. Obtained results revealed that rs2592551 polymorphism was related to ischemic stroke in Ukrainian population. The risk for this disease in patients with T/T genotype was higher than in major C-allele carriers (odds ratio (OR) = 3.117; 95% confidence interval (CI) = 1.016-9.566; P = 0.047). After dividing patients into subgroups, formed by the presence of certain risk factors for atherosclerosis, similar association has been established for women and non-smokers. At the same time, the heterozygous genotype (C/T) in females had significantly protective effect against ischemic stroke development when compared to C/C and T/T genotypes (OR = 0.460; 95% CI 0.213-0.994; P = 0.048). Statistical significance of these results persisted even after adjustment for age, body mass index, smoking and hypertension.
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76
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G-1639A but Not C1173T VKORC1 Gene Polymorphism Is Related to Ischemic Stroke and Its Various Risk Factors in Ukrainian Population. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1298198. [PMID: 27703968 PMCID: PMC5040782 DOI: 10.1155/2016/1298198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/25/2016] [Accepted: 08/17/2016] [Indexed: 11/18/2022]
Abstract
Vitamin K epoxide reductase complex subunit 1 (VKORC1) is integral 163-amino acid long transmembrane protein which mediates recycling of vitamin K 2,3-epoxide to vitamin K hydroquinone and it is necessary for activation of vitamin K-dependent proteins (VKDPs). Herein, the association between G-1639A (rs9923231) and C1173T (rs9934438) single-nucleotide polymorphisms (SNPs) of the VKORC1 gene and ischemic stroke (IS) was tested in Ukrainian population. Genotyping was performed in 170 IS patients and 124 control subjects (total 294 DNA samples) using PCR-RFLP (polymerase chain reaction with following restriction fragment length polymorphism analysis) method. Our data showed that G-1639A but not C1173T polymorphism was related to IS, regardless of adjustment for age, sex, body mass index, smoking status, and arterial hypertension. The risk for IS in -1639A allele carriers (OR = 2.138, P = 0.015) was higher than in individuals with G/G genotype. Haplotype analysis demonstrated that -1639G/1173T and -1639A/1173C were related to increased risk for IS (OR = 3.813, P = 0.010, and OR = 2.189, P = 0.011, resp.), while -1639G/1173C was a protective factor for IS (OR = 0.548, P < 0.001). Obtained results suggested that -1639A allele can be a possible genetic risk factor for IS in Ukrainian population.
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St Hilaire C, Liberman M, Miller JD. Bidirectional Translation in Cardiovascular Calcification. Arterioscler Thromb Vasc Biol 2016; 36:e19-24. [PMID: 26912744 DOI: 10.1161/atvbaha.115.307056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Cynthia St Hilaire
- From the Department of Medicine, Division of Cardiology & Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA (C.S.H.); Departments of Critical Care Medicine and Cardiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil (M.L.); and Departments of Surgery and Physiology & BME, Mayo Clinic, Rochester, MN (J.D.M)
| | - Marcel Liberman
- From the Department of Medicine, Division of Cardiology & Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA (C.S.H.); Departments of Critical Care Medicine and Cardiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil (M.L.); and Departments of Surgery and Physiology & BME, Mayo Clinic, Rochester, MN (J.D.M)
| | - Jordan D Miller
- From the Department of Medicine, Division of Cardiology & Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA (C.S.H.); Departments of Critical Care Medicine and Cardiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil (M.L.); and Departments of Surgery and Physiology & BME, Mayo Clinic, Rochester, MN (J.D.M)
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Cui L, Houston DA, Farquharson C, MacRae VE. Characterisation of matrix vesicles in skeletal and soft tissue mineralisation. Bone 2016; 87:147-58. [PMID: 27072517 DOI: 10.1016/j.bone.2016.04.007] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/25/2016] [Accepted: 04/06/2016] [Indexed: 12/16/2022]
Abstract
The importance of matrix vesicles (MVs) has been repeatedly highlighted in the formation of cartilage, bone, and dentin since their discovery in 1967. These nano-vesicular structures, which are found in the extracellular matrix, are believed to be one of the sites of mineral nucleation that occurs in the organic matrix of the skeletal tissues. In the more recent years, there have been numerous reports on the observation of MV-like particles in calcified vascular tissues that could be playing a similar role. Therefore, here, we review the characteristics MVs possess that enable them to participate in mineral deposition. Additionally, we outline the content of skeletal tissue- and soft tissue-derived MVs, and discuss their key mineralisation mediators that could be targeted for future therapeutic use.
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Affiliation(s)
- L Cui
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK.
| | - D A Houston
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
| | - C Farquharson
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
| | - V E MacRae
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, The University of Edinburgh Easter Bush Campus, Edinburgh, Midlothian, EH25 9RG, UK
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79
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Kaesler N, Immendorf S, Ouyang C, Herfs M, Drummen N, Carmeliet P, Vermeer C, Floege J, Krüger T, Schlieper G. Gas6 protein: its role in cardiovascular calcification. BMC Nephrol 2016; 17:52. [PMID: 27230889 PMCID: PMC4880820 DOI: 10.1186/s12882-016-0265-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cardiovascular calcifications can be prevented by vitamin K and are accelerated by vitamin K antagonists. These effects are believed to be mainly mediated by the vitamin K-dependent matrix Gla protein. Another vitamin K-dependent protein, Gas6, is also expressed in vascular smooth muscle cells (VSMC). In vitro Gas6 expression was shown to be regulated in VSMC calcification and apoptotic processes. METHODS We investigated the role of Gas6 in vitro using VSMC cultures and in vivo in young and old Gas6-deficient (Gas6(-/-)) and wildtype (WT) mice. In addition, Gas6(-/-) and WT mice were challenged by (a) warfarin administration, (b) uninephrectomy (UniNX) plus high phosphate diet, or (c) UniNX plus high phosphate plus electrocautery of the residual kidney. RESULTS In vitro VSMC from WT and Gas6(-/-) mice exposed to warfarin showed increased apoptosis and calcified similarly. In vivo, aortic, cardiac and renal calcium content in all groups was similar, except for a lower cardiac calcium content in Gas6(-/-) mice (group a). Von Kossa staining revealed small vascular calcifications in both WT and Gas6(-/-) mice (groups a-c). In aging, non-manipulated mice, no significant differences in vascular calcification were identified between Gas6(-/-) and WT mice. Gas6(-/-) mice exhibited no upregulation of matrix Gla protein in any group. Cardiac output was similar in all treatment groups. CONCLUSIONS Taken together, in our study Gas6 fails to aggravate calcification against the previous assumption.
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Affiliation(s)
| | | | - Chun Ouyang
- Uniklinik RWTH Aachen, Nephrology, Aachen, Germany
| | - Marjolein Herfs
- University of Maastricht, R&D Group, Maastricht, Netherlands
| | - Nadja Drummen
- University of Maastricht, R&D Group, Maastricht, Netherlands
| | - Peter Carmeliet
- University of Leuven, Vesalius Research Center, VIB, Leuven, Belgium
| | - Cees Vermeer
- University of Maastricht, R&D Group, Maastricht, Netherlands
| | | | - Thilo Krüger
- Uniklinik RWTH Aachen, Nephrology, Aachen, Germany
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80
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Szulc P. Abdominal aortic calcification: A reappraisal of epidemiological and pathophysiological data. Bone 2016; 84:25-37. [PMID: 26688274 DOI: 10.1016/j.bone.2015.12.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/30/2015] [Accepted: 12/09/2015] [Indexed: 12/16/2022]
Abstract
In men and women, there is a significant association between the risk of cardiovascular event (myocardial infarction, stroke) and risk of major fragility fracture (hip, vertebra). Abdominal aortic calcification (AAC) can be assessed using semiquantitative scores on spine radiographs and spine scans obtained by DXA. Severe AAC is associated with higher risk of major cardiovascular event. Not only does severe AAC reflect poor cardiovascular health status, but also directly disturbs blood flow in the vascular system. Severe (but not mild or moderate) AAC is associated with lower bone mineral density (BMD), faster bone loss and higher risk of major fragility fracture. The fracture risk remains increased after adjustment for BMD and other potential risk factors. The association between severe AAC and fracture risk was found in both sexes, mainly in the follow-ups of less than 10years. Many factors contribute to initiation and progression of AAC: lifestyle, co-morbidities, inorganic ions, dyslipidemia, hormones, cytokines (e.g. inflammatory cytokines, RANKL), matrix vesicles, microRNAs, structural proteins (e.g. elastin), vitamin K-dependent proteins, and medications (e.g. vitamin K antagonists). Osteogenic transdifferentiation of vascular smooth muscle cells (VSMC) and circulating osteoprogenitors penetrating into vascular wall plays a major role in the AAC initiation and progression. Vitamin K-dependent proteins protect vascular tunica media against formation of calcified deposits (matrix GLA protein, GLA-rich protein) and against VSMC apoptosis (Gas6). Further studies are needed to investigate clinical utility of AAC for the assessment of fracture and cardiovascular risk at the individual level and develop new medications permitting to prevent AAC progression.
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Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France.
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81
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Cavaco S, Viegas CSB, Rafael MS, Ramos A, Magalhães J, Blanco FJ, Vermeer C, Simes DC. Gla-rich protein is involved in the cross-talk between calcification and inflammation in osteoarthritis. Cell Mol Life Sci 2016; 73:1051-65. [PMID: 26337479 PMCID: PMC11108449 DOI: 10.1007/s00018-015-2033-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 12/25/2022]
Abstract
Osteoarthritis (OA) is a whole-joint disease characterized by articular cartilage loss, tissue inflammation, abnormal bone formation and extracellular matrix (ECM) mineralization. Disease-modifying treatments are not yet available and a better understanding of osteoarthritis pathophysiology should lead to the discovery of more effective treatments. Gla-rich protein (GRP) has been proposed to act as a mineralization inhibitor and was recently shown to be associated with OA in vivo. Here, we further investigated the association of GRP with OA mineralization-inflammation processes. Using a synoviocyte and chondrocyte OA cell system, we showed that GRP expression was up-regulated following cell differentiation throughout ECM calcification, and that inflammatory stimulation with IL-1β results in an increased expression of COX2 and MMP13 and up-regulation of GRP. Importantly, while treatment of articular cells with γ-carboxylated GRP inhibited ECM calcification, treatment with either GRP or GRP-coated basic calcium phosphate (BCP) crystals resulted in the down-regulation of inflammatory cytokines and mediators of inflammation, independently of its γ-carboxylation status. Our results strengthen the calcification inhibitory function of GRP and strongly suggest GRP as a novel anti-inflammatory agent, with potential beneficial effects on the main processes responsible for osteoarthritis progression. In conclusion, GRP is a strong candidate target to develop new therapeutic approaches.
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Affiliation(s)
- Sofia Cavaco
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal
| | - Carla S B Viegas
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
| | - Marta S Rafael
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal
| | - Acácio Ramos
- Department of Orthopedics and Traumatology, Algarve Medical Centre (CHAlgarve), Faro, Portugal
| | - Joana Magalhães
- Grupo de Bioingeniería Tisular y Terapia Celular (GBTTC-CHUAC), Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC), A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Francisco J Blanco
- Grupo de Bioingeniería Tisular y Terapia Celular (GBTTC-CHUAC), Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidad de A Coruña (UDC), A Coruña, Spain
| | - Cees Vermeer
- VitaK, Maastricht University, Maastricht, The Netherlands
| | - Dina C Simes
- Centre of Marine Sciences (CCMAR), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal.
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal.
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Shea MK, Loeser RF, Hsu FC, Booth SL, Nevitt M, Simonsick EM, Strotmeyer ES, Vermeer C, Kritchevsky SB. Vitamin K Status and Lower Extremity Function in Older Adults: The Health Aging and Body Composition Study. J Gerontol A Biol Sci Med Sci 2015; 71:1348-55. [PMID: 26576842 DOI: 10.1093/gerona/glv209] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/22/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While low vitamin K status has been associated with several chronic diseases that can lead to lower extremity disability, it is not known if low vitamin K status is associated with worse lower extremity function. METHODS Vitamin K status was measured according to plasma phylloquinone (vitamin K1) and dephosphorylated-uncarboxylated MGP (dp-ucMGP) in 1,089 community-dwelling older adults (mean ± SD age =74±3 years; 67% female). Lower extremity function was assessed using the short physical performance battery (SPPB), gait speed, and isokinetic leg strength. Linear regression and mixed models were used to determine the cross-sectional and longitudinal associations between vitamin K status and functional outcome measures. RESULTS Cross-sectionally, higher plasma phylloquinone was associated with better SPPB scores and 20-m gait speed (p ≤ .05). After 4-5 years, those with ≥1.0nM plasma phylloquinone (the concentration achieved when recommended intakes are met) had better SPPB scores (p = .03) and 20-m gait speed (p < .05). Lower plasma dp-ucMGP (reflective of better vitamin K status) was associated with better SPPB scores and leg strength cross-sectionally (p ≤ .04), but not longitudinally. Neither measure of vitamin K status was associated with walking endurance or with the rate of decline in function. CONCLUSION Older adults with higher vitamin K status had better physical performance scores at baseline, but data are less consistent longitudinally. Since lower extremity disability is a common consequence of multiple chronic diseases for which a role of vitamin K has been suggested, future studies are needed to determine if vitamin K supplementation could improve function in those with vitamin K insufficiency and clarify underlying mechanism(s).
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Affiliation(s)
- M Kyla Shea
- Tufts University USDA Human Nutrition Research Center on Aging, Boston, Massachusetts.
| | - Richard F Loeser
- Division of Rheumatology, Allergy and Immunology, University of North Carolina, Chapel Hill
| | - Fang-Chi Hsu
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem North Carolina
| | - Sarah L Booth
- Tufts University USDA Human Nutrition Research Center on Aging, Boston, Massachusetts
| | - Michael Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | | | - Elsa S Strotmeyer
- Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | | | - Stephen B Kritchevsky
- Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina
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83
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van Gorp RH, Schurgers LJ. New Insights into the Pros and Cons of the Clinical Use of Vitamin K Antagonists (VKAs) Versus Direct Oral Anticoagulants (DOACs). Nutrients 2015; 7:9538-57. [PMID: 26593943 PMCID: PMC4663607 DOI: 10.3390/nu7115479] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/28/2015] [Accepted: 11/05/2015] [Indexed: 12/19/2022] Open
Abstract
Vitamin K-antagonists (VKA) are the most widely used anticoagulant drugs to treat patients at risk of arterial and venous thrombosis for the past 50 years. Due to unfavorable pharmacokinetics VKA have a small therapeutic window, require frequent monitoring, and are susceptible to drug and nutritional interactions. Additionally, the effect of VKA is not limited to coagulation, but affects all vitamin K-dependent proteins. As a consequence, VKA have detrimental side effects by enhancing medial and intimal calcification. These limitations stimulated the development of alternative anticoagulant drugs, resulting in direct oral anticoagulant (DOAC) drugs, which specifically target coagulation factor Xa and thrombin. DOACs also display non-hemostatic vascular effects via protease-activated receptors (PARs). As atherosclerosis is characterized by a hypercoagulable state indicating the involvement of activated coagulation factors in the genesis of atherosclerosis, anticoagulation could have beneficial effects on atherosclerosis. Additionally, accumulating evidence demonstrates vascular benefit from high vitamin K intake. This review gives an update on oral anticoagulant treatment on the vasculature with a special focus on calcification and vitamin K interaction.
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Affiliation(s)
- Rick H van Gorp
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
- Nattopharma ASA, 1363 Høvik, Norway.
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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Scheiber D, Veulemans V, Horn P, Chatrou ML, Potthoff SA, Kelm M, Schurgers LJ, Westenfeld R. High-Dose Menaquinone-7 Supplementation Reduces Cardiovascular Calcification in a Murine Model of Extraosseous Calcification. Nutrients 2015; 7:6991-7011. [PMID: 26295257 PMCID: PMC4555157 DOI: 10.3390/nu7085318] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/30/2015] [Accepted: 08/06/2015] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular calcification is prevalent in the aging population and in patients with chronic kidney disease (CKD) and diabetes mellitus, giving rise to substantial morbidity and mortality. Vitamin K-dependent matrix Gla-protein (MGP) is an important inhibitor of calcification. The aim of this study was to evaluate the impact of high-dose menaquinone-7 (MK-7) supplementation (100 µg/g diet) on the development of extraosseous calcification in a murine model. Calcification was induced by 5/6 nephrectomy combined with high phosphate diet in rats. Sham operated animals served as controls. Animals received high or low MK-7 diets for 12 weeks. We assessed vital parameters, serum chemistry, creatinine clearance, and cardiac function. CKD provoked increased aortic (1.3 fold; p < 0.05) and myocardial (2.4 fold; p < 0.05) calcification in line with increased alkaline phosphatase levels (2.2 fold; p < 0.01). MK-7 supplementation inhibited cardiovascular calcification and decreased aortic alkaline phosphatase tissue concentrations. Furthermore, MK-7 supplementation increased aortic MGP messenger ribonucleic acid (mRNA) expression (10-fold; p < 0.05). CKD-induced arterial hypertension with secondary myocardial hypertrophy and increased elastic fiber breaking points in the arterial tunica media did not change with MK-7 supplementation. Our results show that high-dose MK-7 supplementation inhibits the development of cardiovascular calcification. The protective effect of MK-7 may be related to the inhibition of secondary mineralization of damaged vascular structures.
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Affiliation(s)
- Daniel Scheiber
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf 40225, Germany.
| | - Verena Veulemans
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf 40225, Germany.
| | - Patrick Horn
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf 40225, Germany.
| | - Martijn L Chatrou
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht 6229 ER, The Netherlands.
| | - Sebastian A Potthoff
- Department of Nephrology, University Duesseldorf, Medical Faculty, Duesseldorf 40225, Germany.
| | - Malte Kelm
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf 40225, Germany.
- Cardiovascular Research Institute Duesseldorf, University Duesseldorf, Medical Faculty, Duesseldorf 40225, Germany.
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht 6229 ER, The Netherlands.
| | - Ralf Westenfeld
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf 40225, Germany.
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Adeva-Andany MM, Fernández-Fernández C, Sánchez-Bello R, Donapetry-García C, Martínez-Rodríguez J. The role of carbonic anhydrase in the pathogenesis of vascular calcification in humans. Atherosclerosis 2015; 241:183-91. [PMID: 26005791 DOI: 10.1016/j.atherosclerosis.2015.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 11/19/2022]
Abstract
Carbonic anhydrases are a group of isoenzymes that catalyze the reversible conversion of carbon dioxide into bicarbonate. They participate in a constellation of physiological processes in humans, including respiration, bone metabolism, and the formation of body fluids, including urine, bile, pancreatic juice, gastric secretion, saliva, aqueous humor, cerebrospinal fluid, and sweat. In addition, carbonic anhydrase may provide carbon dioxide/bicarbonate to carboxylation reactions that incorporate carbon dioxide to substrates. Several isoforms of carbonic anhydrase have been identified in humans, but their precise physiological role and the consequences of their dysfunction are mostly unknown. Carbonic anhydrase isoenzymes are involved in calcification processes in a number of biological systems, including the formation of calcareous spicules from sponges, the formation of shell in some animals, and the precipitation of calcium salts induced by several microorganisms, particularly urease-producing bacteria. In human tissues, carbonic anhydrase is implicated in calcification processes either directly by facilitating calcium carbonate deposition which in turn serves to facilitate calcium phosphate mineralization, or indirectly via its action upon γ-glutamyl-carboxylase, a carboxylase that enables the biological activation of proteins involved in calcification, such as matrix Gla protein, bone Gla protein, and Gla-rich protein. Carbonic anhydrase is implicated in calcification of human tissues, including bone and soft-tissue calcification in rheumatological disorders such as ankylosing spondylitis and dermatomyositis. Carbonic anhydrase may be also involved in bile and kidney stone formation and carcinoma-associated microcalcifications. The aim of this review is to evaluate the possible association between carbonic anhydrase isoenzymes and vascular calcification in humans.
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Affiliation(s)
- María M Adeva-Andany
- Nephrology Division, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain.
| | | | - Rocío Sánchez-Bello
- Nephrology Division, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain
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