Pseudoxanthoma Elasticum Clinical Trial
Official title:
Intestinal Microbiota and Vitamin K Levels in PXE Patients (IMPROVE Study)
This study aims to demonstrate a potential association between gut microbiota composition, plasma levels of various forms of vitamin K, and severity of clinical manifestations of Pseudoxanthoma Elasticum (PXE).
Vitamin K deficiency contributes to pathological calcification which underlies the clinical
picture of pseudoxanthoma elasticum (PXE), an inherited autosomal recessive disease. A
substantial proportion of vitamin K, namely the K2 form (menaquinones), is produced by gut
microbiota. In healthy volunteers fecal levels of the major menaquinone producers,
Escherichia coli and Bacteroides species, are approximately 5 and 9 log10 CFU/g dry weight
respectively. There is however a lack of data on gut microbiota in PXE patients. The
objective of our project is to demonstrate a potential association between gut microbiota
composition, plasma levels of various forms of vitamin K and severity of clinical
manifestations in PXE patients.
This study will be performed as Research surrounding bio collection "Clinical and biological
exploration of PXE patients" kept at the Center of Biological Resources of Angers University
Hospital (bio collection n° DC 20116-14-67, authorization to transfer n° 2016-27-99). Fecal
samples, plasma samples and clinical data will be collected from patients diagnosed with PXE
who will be monitored at the Angers University Hospital Referral Center (France) in
2019-2020. Clinical severity of PXE will be assessed using modified Phenodex score. Gut
microbiota will be analyzed using metagenomic sequencing. Plasma Vitamin K species and fecal
excretion of menaquinones will be assessed using HPLC. Plasma dp-ucMGP (circulating biomarker
of vitamin K status) and serum PIVKA-II (protein induced by vitamin K absence-II) will be
assessed using immunoassay. Results will be compared to healthy age- and gender-matched
controls from the pre-existing Biofortis database.
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