Griethe W, Schmitt R, Jurgensen JS, Bachmann S, Eckardt KU, Schindler R, et al.
Journal of nephrology. Date of publication 2003 Sep 1;volume 16(5):728-32.
1. J Nephrol. 2003 Sep-Oct;16(5):728-32.
Bone morphogenic protein-4 expression in vascular lesions of calciphylaxis.
Griethe W(1), Schmitt R, Jurgensen JS, Bachmann S, Eckardt KU, Schindler R.
Author information:
(1)Department of Nephrology and Medical Intensive Care, Medical Faculty of the
Charité, Humboldt University, Berlin, Germany. wanja.griethe@charite.de
Calciphylaxis is characterized by an extensive media-calcification of cutaneous
and subcutaneous arterioles and capillaries. Recent studies have provided
evidence that vascular calcification is a process with similarities to bone
metabolism. Bone morphogenic protein-4 (BMP-4) is physiologically involved in
bone development and repair. The presence of BMP-4 in atherosclerosis and in
sclerotic heart valves led us to suggest that BMP-4 is also involved in
calciphylaxis. A 47-year-old male patient developed end-stage renal failure due
to chronic glomerulonephritis. He has had two kidney transplants with an
immunosuppressive regimen consisting of cyclosporine A and steroids. He was
admitted to our hospital because of an increase in serum creatinine (Cr) and he
subsequently developed progressive dermal ulcerations. A skin biopsy led to the
diagnosis of calciphylaxis. Immunohistochemistry for BMP-4 of a skin specimen
from our patient showed strong cytoplasmic immunoreactivity of intradermal cells
with clear spatial association to arterioles and hair follicles. Whereas there
are identified inhibitors and promoters of vascular calcification, the presence
of BMP-4 has not been demonstrated in calcific uremic arteriolopathy. In contrast
to atherosclerosis, BMP-4 in calciphylaxis cannot be found in vascular media, but
in intradermal cells at the border of arterioles and hair follicles. Therefore,
in calciphylaxis BMP-4 can play the role of a cytokine, a growth factor or a
media-calcification promoter.
PMID: 14733421 [Indexed for MEDLINE]
