1
|
Silva AP, Viegas CS, Mendes F, Macedo A, Guilherme P, Tavares N, Dias C, Rato F, Santos N, Faísca M, de Almeida E, Neves PL, Simes DC. Gla-Rich Protein (GRP) as an Early and Novel Marker of Vascular Calcification and Kidney Dysfunction in Diabetic Patients with CKD: A Pilot Cross-Sectional Study. J Clin Med 2020; 9:jcm9030635. [PMID: 32120910 PMCID: PMC7141108 DOI: 10.3390/jcm9030635] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/18/2022] Open
Abstract
Vascular calcification (VC) is one of the strongest predictors of cardiovascular risk in chronic kidney disease (CKD) patients. New diagnostic/prognostic tools are required for early detection of VC allowing interventional strategies. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor, whose clinical utility is here highlighted. The present study explores, for the first time, correlations between levels of GRP in serum with CKD developmental stage, mineral metabolism markers, VC and pulse pressure (PP), in a cohort of 80 diabetic patients with mild to moderate CKD (stages 2–4). Spearman’s correlation analysis revealed a positive association of GRP serum levels with estimated glomerular filtration rate (eGFR) and α-Klotho, while a negative correlation with phosphate (P), fibroblast growth factor 23 (FGF-23), vascular calcification score (VCS), PP, calcium (x) phosphate (CaxP) and interleukin 6 (IL-6). Serum GRP levels were found to progressively decrease from stage 2 to stage 4 CKD. Multivariate analysis identified low levels of eGFR and GRP, and high levels of FGF-23 associated with both the VCS and PP. These results indicate an association between GRP, renal dysfunction and CKD-mineral and bone disorder. The relationship between low levels of GRP and vascular calcifications suggests a future, potential utility for GRP as an early marker of vascular damage in CKD.
Collapse
Affiliation(s)
- Ana P. Silva
- Department of Nephrology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (A.P.S.); (F.M.); (P.L.N.)
- Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal; (A.M.); (C.D.)
| | - Carla S.B. Viegas
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal;
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal
| | - Filipa Mendes
- Department of Nephrology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (A.P.S.); (F.M.); (P.L.N.)
| | - Ana Macedo
- Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal; (A.M.); (C.D.)
- Keypoint Group, 1495-190 Miraflores, Portugal
| | - Patrícia Guilherme
- Department of Cardiology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (P.G.); (N.T.)
| | - Nelson Tavares
- Department of Cardiology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (P.G.); (N.T.)
| | - Carolina Dias
- Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal; (A.M.); (C.D.)
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal;
| | - Fátima Rato
- Pathology Clinic, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (F.R.); (N.S.); (M.F.)
| | - Nélio Santos
- Pathology Clinic, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (F.R.); (N.S.); (M.F.)
| | - Marília Faísca
- Pathology Clinic, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (F.R.); (N.S.); (M.F.)
| | - Edgar de Almeida
- Faculdade de Medicina da Universidade de Lisboa, 1600-190 Lisboa, Portugal;
| | - Pedro L. Neves
- Department of Nephrology, Centro Hospitalar Universitário do Algarve, 8000-386 Faro, Portugal; (A.P.S.); (F.M.); (P.L.N.)
- Department of Biomedical Sciences and Medicine, Universidade do Algarve, 8005-139 Faro, Portugal; (A.M.); (C.D.)
| | - Dina C. Simes
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal;
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal
- Correspondence: ; Tel.: +351-289-800-100; Fax: +351-289-800-069
| |
Collapse
|
2
|
Cancela ML, Ohresser MC, Reia JP, Viegas CS, Williamson MK, Price PA. Matrix Gla protein in Xenopus laevis: molecular cloning, tissue distribution, and evolutionary considerations. J Bone Miner Res 2001; 16:1611-21. [PMID: 11550673 DOI: 10.1359/jbmr.2001.16.9.1611] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Matrix Gla protein (MGP) belongs to the family of vitamin K-dependent, Gla-containing proteins and in higher vertebrates, is found in the extracellular matrix of mineralized tissues and soft tissues. MGP synthesis is highly regulated at the transcription and posttranscription levels and is now known to be involved in the regulation of extracellular matrix calcification and maintenance of cartilage and soft tissue integrity during growth and development. However, its mode of action at the molecular level remains unknown. Because there is a large degree of conservation between amino acid sequences of shark and human MGP, the function of MGP probably has been conserved throughout evolution. Given the complexity of the mammalian system, the study of MGP in a lower vertebrate might be advantageous to relate the onset of MGP expression with specific events during development. Toward this goal, MGP was purified from Xenopus long bones and its N-terminal amino acid sequence was determined and used to clone the Xenopus MGP complementary DNA (cDNA) by a mixture of reverse-transcription (RT)- and 5'- rapid amplification of cDNA ends (RACE)-polymerase chain reaction (PCR). MGP messenger RNA (mRNA) was present in all tissues analyzed although predominantly expressed in Xenopus bone and heart and its presence was detected early in development at the onset of chondrocranium development and long before the appearance of the first calcified structures and metamorphosis. These results show that in this system, as in mammals, MGP may be required to delay or prevent mineralization of cartilage and soft tissues during the early stages of development and indicate that Xenopus is an adequate model organism to further study MGP function during growth and development.
Collapse
Affiliation(s)
- M L Cancela
- Centro de Ciências do Mar, Universidade do Algarve, Faro, Portugal
| | | | | | | | | | | |
Collapse
|