Henry Ford Hospital Medical Journal


Observations that link gammacarboxyglutamic acid (Gla) peptides with ectopic calcification are accumulating in the literature and may be summarized as follows: 1) Gla peptides selectively bind calcium and hydroxyapatite. 2) The presence of detectable levels of Gla in calcified tissue is concurrent with the onset of mineralization. 3) In an animal model, osteocalcin (a Gla-containing protein) accounts for more than 90% of all the Gla found in the resulting subcutaneously implanted calcified leaflet. 4) Vitamin D stimulates osteocalcin synthesis in cultures of osteosarcoma cells, and in vitamin D deficient rats subcutaneously implanted valve leaflets are not calcified. 5) Gla content and the degree of calcification in degenerated porcine bioprosthetic valves removed from humans are positively correlated. 6) Porcine bioprosthetic valves implanted in children are calcified more rapidly than those of adults, and the normal GIa levels in the urine of children are more than twice those of normal adults.