Calcification

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Density-Dependent Colour Scanning Electron Micrograph SEM (DDC-SEM) of cardiovascular calcification, showing in orange calcium phosphate spherical particles (denser material) and, in green, the extracellular matrix (less dense material). Cardiovascular calcification - Sergio Bertazzo.tif
Density-Dependent Colour Scanning Electron Micrograph SEM (DDC-SEM) of cardiovascular calcification, showing in orange calcium phosphate spherical particles (denser material) and, in green, the extracellular matrix (less dense material).

Calcification is the accumulation of calcium salts in a body tissue. It normally occurs in the formation of bone, but calcium can be deposited abnormally in soft tissue, [1] [2] causing it to harden. Calcifications may be classified on whether there is mineral balance or not, and the location of the calcification. [3] Calcification may also refer to the processes of normal mineral deposition in biological systems, such as the formation of stromatolites or mollusc shells (see Mineralization (biology) or Biomineralization).

Contents

Signs and symptoms

Calcification can manifest itself in many ways in the body depending on the location.[ citation needed ]

Causes of soft tissue calcification

Calcification of soft tissue (arteries, cartilage, heart valves, [1] [2] etc.) can be caused by vitamin K2 deficiency or by poor calcium absorption due to a high calcium/vitamin D ratio. This can occur with or without a mineral imbalance.

Intake of excessive vitamin D can cause vitamin D poisoning and excessive intake of calcium from the intestine, when accompanied by a deficiency of vitamin K (perhaps induced by an anticoagulant) can result in calcification of arteries and other soft tissue. [4] Such metastatic soft tissue calcification is mainly in tissues containing "calcium catchers" such as elastic fibres or sour mucopolysaccharides. These tissues especially include the lungs (pumice lung) and the aorta. [5]

Mineral balance

Forms

Calcification can be pathological or a standard part of the aging process. Nearly all adults show calcification of the pineal gland. [6]

Location

Pattern

Patterns of calcifications may indicate pathological processes. Laminated appearance suggests granulomatous disease while popcorn calcification indicates hamartoma. Malignant lesions may have stippled or eccentric calcification.[ citation needed ]

Breast disease

In a number of breast pathologies, calcium is often deposited at sites of cell death or in association secretions or hyalinized stroma, resulting in pathologic calcification. For example, small, irregular, linear calcifications may be seen, via mammography, in a ductal carcinoma-in-situ to produce visible radio-opacities. [8]

Diagnosis

In terms of diagnosis, in this case vascular calcification, an ultrasound and radiography of said area is sufficient. [9]

Treatment

Treatment of high calcium/vitamin D ratio may most easily be accomplished by intake of more vitamin D if vitamin K is normal. Intake of too much vitamin D would be evident by anorexia, loss of appetite, or soft tissue calcification.

See also

Related Research Articles

Vitamin K vitamin

Vitamin K is a group of structurally similar, fat-soluble vitamins found in foods and in dietary supplements. The human body requires vitamin K for complete synthesis of certain proteins that are needed for blood coagulation or for controlling binding of calcium in bones and other tissues. The vitamin K–related modification of the proteins allows them to bind calcium ions, which they cannot do otherwise. Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs. Preliminary clinical research indicates that deficiency of vitamin K may weaken bones, potentially leading to osteoporosis, and may promote calcification of arteries and other soft tissues.

Atherosclerosis form of arteriosclerosis

Atherosclerosis is a disease in which the inside of an artery narrows due to the build up of plaque. Initially, there are generally no symptoms. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected. Symptoms, if they occur, generally do not begin until middle age.

Calcium ions (Ca2+) contribute to the physiology and biochemistry of organisms cell. They play an important role in signal transduction pathways, where they act as a second messenger, in neurotransmitter release from neurons, in contraction of all muscle cell types, and in fertilization. Many enzymes require calcium ions as a cofactor, including several of the coagulation factors. Extracellular calcium is also important for maintaining the potential difference across excitable cell membranes, as well as proper bone formation.

Osteomalacia bone remodeling disease that has material basis in a vitamin D deficiency which results in softening located in bone

Osteomalacia is a disease characterized by the softening of the bones caused by impaired bone metabolism primarily due to inadequate levels of available phosphate, calcium, and vitamin D, or because of resorption of calcium. The impairment of bone metabolism causes inadequate bone mineralization. Osteomalacia in children is known as rickets, and because of this, use of the term "osteomalacia" is often restricted to the milder, adult form of the disease. Signs and symptoms can include diffuse body pains, muscle weakness, and fragility of the bones. In addition to low systemic levels of circulating mineral ions necessary for bone and tooth mineralization, accumulation of mineralization-inhibiting proteins and peptides occurs in the extracellular matrix of bones and teeth, likely contributing locally to cause matrix hypomineralization (osteomalacia).

Dystrophic calcification Calcification occurring in degenerated or necrotic tissue

Dystrophic calcification (DC) is the calcification occurring in degenerated or necrotic tissue, as in hyalinized scars, degenerated foci in leiomyomas, and caseous nodules. This occurs as a reaction to tissue damage, including as a consequence of medical device implantation. Dystrophic calcification can occur even if the amount of calcium in the blood is not elevated and cause metastatic calcification. Basophilic calcium salt deposits aggregate, first in the mitochondria, then progressively throughout the cell. These calcifications are an indication of previous microscopic cell injury, occurring in areas of cell necrosis when activated phosphatases bind calcium ions to phospholipids in the membrane.

Calcinosis calcium metabolism disease that is the result of the formation of calcium deposits in any soft tissue

Calcinosis is the formation of calcium deposits in any soft tissue. It is a rare condition that has many different causes. These range from infection and injury to systemic diseases like kidney failure.

Renal osteodystrophy is currently defined as an alteration of bone morphology in patients with chronic kidney disease (CKD). It is one measure of the skeletal component of the systemic disorder of chronic kidney disease-mineral and bone disorder (CKD-MBD). The term "renal osteodystrophy" was coined in 1943, 60 years after an association was identified between bone disease and kidney failure.

Hypervitaminosis D Human disease

Hypervitaminosis D is a state of vitamin D toxicity. The normal range for blood concentration is 30.0 to 74.0 nanograms per milliliter (ng/mL).

Secondary hyperparathyroidism Human disease

Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia, with resultant hyperplasia of these glands. This disorder is primarily seen in patients with chronic kidney failure. It is sometimes abbreviated "SHPT" in medical literature.

Metastatic calcification Metastatic Calcification

Metastatic calcification is deposition of calcium salts in otherwise normal tissue, because of elevated serum levels of calcium, which can occur because of deranged metabolism as well as increased absorption or decreased excretion of calcium and related minerals, as seen in hyperparathyroidism.

Calciphylaxis Human disease

Calciphylaxis, also known as calcific uremic arteriolopathy (CUA) or “Grey Scale”, is a rare painful syndrome of calcification of the small blood vessels located within the fatty tissue and deeper layers of the skin, blood clots, and the death of skin cells due to too little blood flow. It is seen mostly in people with end-stage kidney disease but can occur in the earlier stages of chronic kidney disease and rarely in people with normally functioning kidneys. It results in chronic non-healing wounds and is usually fatal. Calciphylaxis is a rare but serious disease, believed to affect 1-4% of all dialysis patients.

Monckebergs arteriosclerosis Humans arterial pathology

Mönckeberg's arteriosclerosis, or Mönckeberg's sclerosis, is a form of arteriosclerosis or vessel hardening, where calcium deposits are found in the muscular middle layer of the walls of arteries. It is an example of dystrophic calcification. This condition occurs as an age-related degenerative process. However, it can occur in pseudoxanthoma elasticum and idiopathic arterial calcification of infancy as a pathological condition, as well. Its clinical significance and cause are not well understood and its relationship to atherosclerosis and other forms of vascular calcification are the subject of disagreement. Mönckeberg's arteriosclerosis is named after Johann Georg Mönckeberg, who first described it in 1903.

Matrix gla protein protein-coding gene in the species Homo sapiens

Matrix gla protein (MGP) is member of a family of vitamin-K2 dependent, Gla-containing proteins. MGP has a high affinity binding to calcium ions, similar to other Gla-containing proteins. The protein acts as an inhibitor of vascular mineralization and plays a role in bone organization.

Keutel syndrome Keutel syndrome is characterised by diffuse cartilage calcification, brachytelephalangism, peripheral pulmonary artery stenoses and facial dysmorphism

Keutel syndrome (KS) is a rare autosomal recessive genetic disorder characterized by abnormal diffuse cartilage calcification, hypoplasia of the mid-face, peripheral pulmonary stenosis, hearing loss, short distal phalanges (tips) of the fingers and mild mental retardation. Individuals with KS often present with peripheral pulmonary stenosis, brachytelephalangism, sloping forehead, midface hypoplasia, and receding chin. It is associated with abnormalities in the gene coding for matrix gla protein (MGP). Being an autosomal recessive disorder, it may be inherited from two unaffected, abnormal MGP-carrying parents. Thus, people who inherit two affected MGP genes will likely inherit KS.

Ectopic calcification is a pathologic deposition of calcium salts in tissues or bone growth in soft tissues. This can be a symptom of hyperphosphatemia. Formation of osseous tissue in soft tissues such as the lungs, eyes, arteries, or other organs is known as ectopic calcification, dystrophic calcification, or ectopic ossification.

An endocrine bone disease is a bone disease associated with a disorder of the endocrine system. An example is osteitis fibrosa cystica.

Vitamin D Group of molecules used as vitamin

Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and multiple other biological effects. In humans, the most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol).

GACI - Pronounced "GACK-EE"

Vitamin K2 or menaquinone is one of three types of vitamin K, the other two being vitamin K1 (phylloquinone) and K3 (menadione). K2 is both a tissue and bacterial product (derived from vitamin K1 in both cases) and is usually found in animal products or fermented foods.

Chronic kidney disease–mineral and bone disorder (CKD-MBD) is one of the many complications associated with chronic kidney disease. It represents a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following:

References

  1. 1 2 3 Bertazzo, Sergio; Gentleman, Eileen; Cloyd, Kristy L.; Chester, Adrian H.; Yacoub, Magdi H.; Stevens, Molly M. (2013). "Nano-analytical electron microscopy reveals fundamental insights into human cardiovascular tissue calcification". Nature Materials. 12 (6): 576–583. doi:10.1038/nmat3627. ISSN   1476-1122. PMC   5833942 . PMID   23603848.
  2. 1 2 Miller, J. D. Cardiovascular calcification: Orbicular origins. Nature Materials12, 476-478 (2013).
  3. Calcification The American Heritage Science Dictionary. Retrieved 2013-03-23.
  4. Paul Price, et al., "Warfarin-Induced Artery Calcification Is Accelerated by Growth and Vitamin D", Arteriosclerosis, Thrombosis, and Vascular Biology, 2000, Vol. 20, pp. 317-327.
  5. McGavin, Zachary. Pathologic basis of veterinary disease, fourth edition; Elsevier 2007.
  6. Zimmerman, Robert A (1982). "Age-Related Incidence of Pineal Calcification Detected by Computed Tomography" (PDF). Radiology. Radiological Society of North America. 142 (3): 659–62. doi:10.1148/radiology.142.3.7063680. PMID   7063680. Archived from the original (PDF) on 2012-03-24. Retrieved 21 June 2012.
  7. calcification in ovarian tumours
  8. Robbins and Cotran (2009), Pathologic Basis of Disease, 8th edition, Elsevier.
  9. Raggi, Paolo; Bellasi, Antonio (2007). "Clinical assessment of vascular calcification". Advances in Chronic Kidney Disease. 14 (1): 37–43. doi:10.1053/j.ackd.2006.10.006. ISSN   1548-5595. PMID   17200042.