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Serum calcification propensity T50 associates with disease severity in patients with pseudoxanthoma elasticum

Lukas Nollet (UGent) , Matthias Van Gils (UGent) , Suzanne Fischer (UGent) , Laurence Campens (UGent) , Swapna Karthik, Andreas Pasch, Julie De Zaeytijd (UGent) , Bart Leroy (UGent) , Daniel Devos (UGent) , Tine De Backer (UGent) , et al.
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Abstract
Pseudoxanthoma elasticum (PXE) is a currently intractable genetic disorder characterized by progressive ectopic calcification in the skin, eyes and arteries. Therapeutic trials in PXE are severely hampered by the lack of reliable biomarkers. Serum calcification propensity T50 is a blood test measuring the functional anticalcifying buffer capacity of serum. Here, we evaluated T50 in PXE patients aiming to investigate its determinants and suitability as a potential biomarker for disease severity. Fifty-seven PXE patients were included in this cross-sectional study, and demographic, clinical, imaging and biochemical data were collected from medical health records. PXE severity was assessed using Phenodex scores. T50 was measured using a validated, nephelometry-based assay. Multivariate models were then created to investigate T50 determinants and associations with disease severity. In short, the mean age of patients was 45.2 years, 68.4% was female and mean serum T50 was 347 min. Multivariate regression analysis identified serum fetuin-A (p < 0.001), phosphorus (p = 0.007) and magnesium levels (p = 0.034) as significant determinants of T50, while no correlations were identified with serum calcium, eGFR, plasma PPi levels or the ABCC6 genotype. After correction for covariates, T50 was found to be an independent determinant of ocular (p = 0.013), vascular (p = 0.013) and overall disease severity (p = 0.016) in PXE. To conclude, shorter serum T50-indicative of a higher calcification propensity-was associated with a more severe phenotype in PXE patients. This study indicates, for the first time, that serum T50 might be a clinically relevant biomarker in PXE and may thus be of importance to future therapeutic trials.
Keywords
General Medicine, pseudoxanthoma elasticum, PXE, ectopic calcification, biomarker, genetics, rare diseases, serum calcification propensity T50, ALL-CAUSE MORTALITY, MOUSE MODEL, SYSTEMIC CALCIFICATION, ECTOPIC MINERALIZATION, CARDIOVASCULAR-DISEASE, FETUIN-A, INHIBITOR, DIAGNOSIS, TISSUES

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MLA
Nollet, Lukas, et al. “Serum Calcification Propensity T50 Associates with Disease Severity in Patients with Pseudoxanthoma Elasticum.” JOURNAL OF CLINICAL MEDICINE, vol. 11, no. 13, 2022, doi:10.3390/jcm11133727.
APA
Nollet, L., Van Gils, M., Fischer, S., Campens, L., Karthik, S., Pasch, A., … Vanakker, O. (2022). Serum calcification propensity T50 associates with disease severity in patients with pseudoxanthoma elasticum. JOURNAL OF CLINICAL MEDICINE, 11(13). https://doi.org/10.3390/jcm11133727
Chicago author-date
Nollet, Lukas, Matthias Van Gils, Suzanne Fischer, Laurence Campens, Swapna Karthik, Andreas Pasch, Julie De Zaeytijd, et al. 2022. “Serum Calcification Propensity T50 Associates with Disease Severity in Patients with Pseudoxanthoma Elasticum.” JOURNAL OF CLINICAL MEDICINE 11 (13). https://doi.org/10.3390/jcm11133727.
Chicago author-date (all authors)
Nollet, Lukas, Matthias Van Gils, Suzanne Fischer, Laurence Campens, Swapna Karthik, Andreas Pasch, Julie De Zaeytijd, Bart Leroy, Daniel Devos, Tine De Backer, Paul Coucke, and Olivier Vanakker. 2022. “Serum Calcification Propensity T50 Associates with Disease Severity in Patients with Pseudoxanthoma Elasticum.” JOURNAL OF CLINICAL MEDICINE 11 (13). doi:10.3390/jcm11133727.
Vancouver
1.
Nollet L, Van Gils M, Fischer S, Campens L, Karthik S, Pasch A, et al. Serum calcification propensity T50 associates with disease severity in patients with pseudoxanthoma elasticum. JOURNAL OF CLINICAL MEDICINE. 2022;11(13).
IEEE
[1]
L. Nollet et al., “Serum calcification propensity T50 associates with disease severity in patients with pseudoxanthoma elasticum,” JOURNAL OF CLINICAL MEDICINE, vol. 11, no. 13, 2022.
@article{8766593,
  abstract     = {{Pseudoxanthoma elasticum (PXE) is a currently intractable genetic disorder characterized by progressive ectopic calcification in the skin, eyes and arteries. Therapeutic trials in PXE are severely hampered by the lack of reliable biomarkers. Serum calcification propensity T50 is a blood test measuring the functional anticalcifying buffer capacity of serum. Here, we evaluated T50 in PXE patients aiming to investigate its determinants and suitability as a potential biomarker for disease severity. Fifty-seven PXE patients were included in this cross-sectional study, and demographic, clinical, imaging and biochemical data were collected from medical health records. PXE severity was assessed using Phenodex scores. T50 was measured using a validated, nephelometry-based assay. Multivariate models were then created to investigate T50 determinants and associations with disease severity. In short, the mean age of patients was 45.2 years, 68.4% was female and mean serum T50 was 347 min. Multivariate regression analysis identified serum fetuin-A (p < 0.001), phosphorus (p = 0.007) and magnesium levels (p = 0.034) as significant determinants of T50, while no correlations were identified with serum calcium, eGFR, plasma PPi levels or the ABCC6 genotype. After correction for covariates, T50 was found to be an independent determinant of ocular (p = 0.013), vascular (p = 0.013) and overall disease severity (p = 0.016) in PXE. To conclude, shorter serum T50-indicative of a higher calcification propensity-was associated with a more severe phenotype in PXE patients. This study indicates, for the first time, that serum T50 might be a clinically relevant biomarker in PXE and may thus be of importance to future therapeutic trials.}},
  articleno    = {{3727}},
  author       = {{Nollet, Lukas and Van Gils, Matthias and Fischer, Suzanne and Campens, Laurence and Karthik, Swapna and Pasch, Andreas and De Zaeytijd, Julie and Leroy, Bart and Devos, Daniel and De Backer, Tine and Coucke, Paul and Vanakker, Olivier}},
  issn         = {{2077-0383}},
  journal      = {{JOURNAL OF CLINICAL MEDICINE}},
  keywords     = {{General Medicine,pseudoxanthoma elasticum,PXE,ectopic calcification,biomarker,genetics,rare diseases,serum calcification propensity T50,ALL-CAUSE MORTALITY,MOUSE MODEL,SYSTEMIC CALCIFICATION,ECTOPIC MINERALIZATION,CARDIOVASCULAR-DISEASE,FETUIN-A,INHIBITOR,DIAGNOSIS,TISSUES}},
  language     = {{eng}},
  number       = {{13}},
  pages        = {{14}},
  title        = {{Serum calcification propensity T50 associates with disease severity in patients with pseudoxanthoma elasticum}},
  url          = {{http://doi.org/10.3390/jcm11133727}},
  volume       = {{11}},
  year         = {{2022}},
}

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