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The liver regulates ectopic calcification in Abcc6-deficient models of pseudoxanthoma elasticum
Yijie Wang, Baiming Sun, Feiyang Ma, Bo Tao, Yiqian Gu, Zhiqiang Zhou, Jason Kim, Linlin Zhang, Zhihao Liu, Johanna ten Hoeve, Linsey Stiles, Lucia Fernandez del Rio, Calvin Pan, Orian Shirihai, Shili Xu, Thomas G. Graeber, Tamer Sallam, Matteo Pellegrini, Aldons J. Lusis, Arjun Deb
Yijie Wang, Baiming Sun, Feiyang Ma, Bo Tao, Yiqian Gu, Zhiqiang Zhou, Jason Kim, Linlin Zhang, Zhihao Liu, Johanna ten Hoeve, Linsey Stiles, Lucia Fernandez del Rio, Calvin Pan, Orian Shirihai, Shili Xu, Thomas G. Graeber, Tamer Sallam, Matteo Pellegrini, Aldons J. Lusis, Arjun Deb
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Research Article Cardiology Metabolism

The liver regulates ectopic calcification in Abcc6-deficient models of pseudoxanthoma elasticum

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Abstract

Pseudoxanthoma Elasticum (PXE) is a rare disease caused by loss of function of the ATP-binding cassette C (ABC) member 6 (Abcc6) gene and characterized by ectopic calcification of multiple tissues, but the physiological reasons underlying ectopic calcification in PXE remain unclear. In a murine model of Abcc6-deficient PXE in which animals developed robust cardiac calcification after heart injury, we show the critical importance of the liver in mediating ectopic cardiac calcification. Tissue-specific deletion of Abcc6 in the liver, but not in the heart, was sufficient to cause post-injury cardiac calcification. Metabolomics and gene expression analysis demonstrated deficiencies in nucleotide metabolism, cellular energetics, and defects in cellular respiration underlying ectopic calcification in PXE. Functional abnormalities in cellular respiration in the injured heart were similar in animals with global or liver-specific Abcc6 deficiency, showing that hepatic Abcc6 expression regulated cellular respiration in the injured heart. We show that ectopic calcification in PXE was primarily dystrophic and that treatment with clodronate or etidronate, which prevent the growth of calcium hydroxyapatite mineralization, was sufficient to rescue the phenotype of ectopic cardiac calcification in Abcc6-deficient states. Taken together, these observations highlight the role of the liver in regulating target tissue metabolic and mitochondrial function in causing ectopic calcification in Abcc6-deficient states.

Authors

Yijie Wang, Baiming Sun, Feiyang Ma, Bo Tao, Yiqian Gu, Zhiqiang Zhou, Jason Kim, Linlin Zhang, Zhihao Liu, Johanna ten Hoeve, Linsey Stiles, Lucia Fernandez del Rio, Calvin Pan, Orian Shirihai, Shili Xu, Thomas G. Graeber, Tamer Sallam, Matteo Pellegrini, Aldons J. Lusis, Arjun Deb

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Figure 5

Liver-specific deletion of Abcc6 leads to metabolic abnormalities in the injured heart similar to metabolic pathways affected in the injured hearts of Abcc6-KO animals.

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Liver-specific deletion of Abcc6 leads to metabolic abnormalities in the...
(A) Schematic of scar tissue collection from Abcc6fl/fl and Alb-Cre: Abcc6-CKO animals for metabolomic analysis. (B) Untargeted metabolomics by LC/MS of injured tissue from Abcc6fl/fl and Alb-Cre Abcc6-CKO animals at day 3 after cryo-injury, highlighting significantly altered metabolites in Alb-Cre: Abcc6-CKO hearts (n=5 per group; *P < 0.05, **P < 0.01, ***P < 0.001 determined by one-way ANOVA). Metabolites labeled in red overlap with those altered in injured hearts of global Abcc6-KO versus WT animals. (C) Venn diagram depicting metabolites differentially present between injured hearts of Abcc6-KO versus WT (left) and Alb-Cre Abcc6-CKO versus Abcc6fl/fl (right) mice. (D) KEGG analysis of metabolic pathways of the commonly altered metabolites that were significantly downregulated in injured tissue of Abcc6-KO versus WT and Alb-Cre Abcc6-CKO versus Abcc6fl/fl mice.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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