Ectopic calcification in beta-thalassemia patients is associated with increased oxidative stress and lower MGP carboxylation

Federica Boraldi, Maria Garcia-Fernandez, Chiara Paolinelli-deVincenzi, Giulia Annovi, Leon Schurgers, Cees Vermeer, Paolo Cianciulli, Ivonne Ronchetti, Daniela Quaglino*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)


A number of beta-thalassemia (beta-thal) patients in the course of the disease exhibit ectopic calcification affecting skin, eyes and the cardiovascular system. Clinical and histopathological features have been described similar to those in pseudoxanthoma elasticum (PXE), although different genes are affected in the two diseases. Cultured dermal fibroblasts from beta-thal patients with and without PXE-like clinical manifestations have been compared for parameters of redox balance and for the expression of proteins, which have been already associated with the pathologic mineralisation of soft connective tissues. Even though oxidative stress is a well-known condition of beta-thal patients, our results indicate that the occurrence of mineralized elastin is associated with a more pronounced redox disequilibrium, as demonstrated by the intracellular increase of anion superoxide and of oxidized proteins and lipids. Moreover, fibroblasts from beta-thal PXE-like patients are characterized by decreased availability of carboxylated matrix Gla protein (MGP), as well as by altered expression of proteins involved in the vitamin K-dependent carboxylation process. Results demonstrate that elastic fibre calcification is promoted when redox balance threshold levels are exceeded and the vitamin K-dependent carboxylation process is affected decreasing the activity of MGP, a well-known inhibitor of ectopic calcification. Furthermore, independently from the primary gene defect, these pathways are similarly involved in fibroblasts from PXE and from beta-thal PXE-like patients as well as in other diseases leading to ectopic calcification, thus suggesting that can be used as markers of pathologic mineralisation.
Original languageEnglish
Pages (from-to)2077-2084
JournalBiochimica et Biophysica Acta-Molecular Basis of Disease
Issue number12
Publication statusPublished - Dec 2013


  • Elastin
  • Oxidative stress
  • Matrix Gla protein
  • Ectopic calcification
  • Beta-thalassemia

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