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Blood 2022 Jun 29. Epub 2022 Jun 29.

Lerner Research Institute/Cleveland Clinic Foundation, Cleveland, Ohio, United States.

The gamma-glutamyl carboxylase (GGCX) generates multiple carboxylated Glus (Glas) in vitamin K-dependent (VKD) proteins that are required for their functions. GGCX is processive, remaining bound to VKD proteins throughout the multiple Glu carboxylations, and this study reveals the essentiality of processivity to VKD protein function. GGCX mutants (V255M, S300F) whose combined heterozygosity causes defective clotting and calcification were studied using a novel assay that mimics in vivo carboxylation: complexes between variant carboxylases and VKD proteins important to hemostasis (factor IX (fIX)) or calcification (Matrix Gla Protein (MGP)) were reacted in the presence of a challenge VKD protein that could potentially interfere with carboxylation of VKD protein in the complex. Read More

BMC Pediatr 2022 Jun 24;22(1):361. Epub 2022 Jun 24.

Department of Midwifery,Collage of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.

Background: Neonatal Mortality Ratio (NMR) could not be reversed sufficiently in Ethiopia in the last couple of years. Neonatal bleeding is one of the major causes of neonatal deaths. Administration of vitamin K prophylaxis at birth is the proven strategy to reduce neonatal death which can be caused by vitamin K deficiency bleeding. Read More

S D Med 2022 May;75(5):220-223

Sanford Children's Hospital, Sioux Falls, South Dakota.

We present a case of a 6-week-old infant who presented with seizure-like activity. Workup revealed abnormal coagulation and imaging confirmed intracranial hemorrhage. Parental refusal of vitamin K treatment at birth suggested vitamin K deficiency bleeding (VKDB) in this newborn. Read More

Nephrol Dial Transplant 2022 May 31. Epub 2022 May 31.

Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.

Background: Vitamin K activates matrix Gla protein (MGP), a key inhibitor of vascular calcification. There is a high prevalence of sub-clinical vitamin K deficiency in patients with end stage kidney disease.

Methods: A parallel randomized placebo-controlled pilot trial designed to determine whether 10 mg of phylloquinone thrice weekly versus placebo modifies coronary artery calcification progression over 12 months in patients requiring hemodialysis with a coronary artery calcium score (CAC) ≥ 30 Agatston units. Read More

Int J Mol Sci 2022 May 9;23(9). Epub 2022 May 9.

Department of Health Sciences, "Magna Graecia" University, I-88100 Catanzaro, Italy.

Chronic kidney disease (CKD) is commonly associated with vitamin K deficiency. Some of the serious complications of CKD are represented by cardiovascular disease (CVD) and skeletal fragility with an increased risk of morbidity and mortality. A complex pathogenetic link between hormonal and ionic disturbances, bone tissue and metabolism alterations, and vascular calcification (VC) exists and has been defined as chronic kidney disease-mineral and bone disorder (CKD-MBD). Read More

Matern Child Health J 2022 May 12. Epub 2022 May 12.

Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Background: The American Academy of Pediatrics recommends one intramuscular (IM) vitamin K injection at birth to prevent Vitamin K Deficiency Bleeding of the Newborn (VKDB). Among factors associated with IM vitamin K refusal, investigators have reported an increased frequency of IM vitamin K refusal among parents who select midwife-assisted deliveries. Reasons behind this association are unclear. Read More

Clin Case Rep 2022 May 5;10(5):e05829. Epub 2022 May 5.

Department of Pediatrics Okanami General Hospital Iga Japan.

We encountered an 11-day-old male neonate with vitamin K deficiency-induced intracranial hemorrhage, despite receiving oral vitamin K (menaquinone-4) prophylaxis according to Japanese guidelines. This case suggests that the current vitamin K deficiency-bleeding prophylaxis programs cannot prevent bleeding completely. Better prophylaxis programs using both intramuscular and oral administration should be considered. Read More

Microorganisms 2022 Feb 28;10(3). Epub 2022 Feb 28.

Department of Microbial Natural Products, Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Campus E8 1, 66123 Saarbrücken, Germany.

Vitamin K is an essential, lipid soluble vitamin that plays an important role in the human blood coagulation cascade as well as in the life cycle of bacteria and plants. In this study, we report the isolation and structure elucidation of unprecedented polyhydroxylated menaquinone variants named myxoquinones that are produced by myxobacteria and structurally belong to the Vitamin K family. We analyze the occurrence of myxoquinones across an LC-MS data collection from myxobacterial extracts and shed light on the distribution of myxoquinone-type biosynthetic gene clusters among publicly available myxobacterial genomes. Read More

Healthcare (Basel) 2022 Mar 16;10(3). Epub 2022 Mar 16.

Preventive Medicine and Interdisciplinary Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

(1) Background. Vitamin K is recommended worldwide as a standard of care for the prophylaxis of vitamin-K-deficiency bleeding (VKDB). This is also a standard practice in Romania, but due to the rising number of refusals by parents of basic interventions in the neonatal period, we aimed to assess the Romanian neonatologists' opinions and current practice regarding vitamin K administration at birth. Read More

BMC Oral Health 2022 03 13;22(1):69. Epub 2022 Mar 13.

The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.

Background: Uncontrollable bleeding after tooth extraction usually occurs in patients with coagulation diseases, including hemophilia, von Willebrand's disease, vitamin K deficiency, platelet deficiency, and taking anticoagulant drugs. Hemophilia A is an X-linked recessive disorder caused by insufficiency of coagulation factor VIII. Mild hemophilia, defined by factor level between 0. Read More

Nutrients 2022 Feb 22;14(5). Epub 2022 Feb 22.

Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.

Chronic Kidney Disease (CKD) patients are at high risk of presenting with arterial calcification or stiffness, which confers increased cardiovascular mortality and morbidity. In recent years, it has become evident that VC is an active process regulated by various molecules that may act as inhibitors of vessel mineralization. Matrix Gla Protein (MGP), one the most powerful naturally occurring inhibitors of arterial calcification, requires vitamin K as a co-factor in order to undergo post-translational γ-carboxylation and phosphrorylation and become biologically active. Read More

Pediatrics 2022 03;149(3)

Department of Pediatrics, Dell Medical School at the University of Texas-Austin, Austin, Texas.

Intramuscular administration of vitamin K for prevention of vitamin K deficiency bleeding (VKDB) has been a standard of care since the American Academy of Pediatrics recommended it in 1961. Despite the success of prevention of VKDB with vitamin K administration, the incidence of VKDB appears to be on the rise. This increase in incidence of VKDB is attributable to parental refusal as well as lowered efficacy of alternate methods of administration. Read More

Clin Kidney J 2022 Feb 20;15(2):354-356. Epub 2021 Oct 20.

Canberra Health Services, Garran, ACT, Australia.

Calciphylaxis has high mortality. Vitamin K deficiency is common in haemodialysis patients and may be a trigger for calciphylaxis due to its role in activating a tissue inhibitor of calcification, matrix Gla protein. We report a second case of a female haemodialysis patient who developed calciphylaxis twice and was successfully treated with vitamin K supplementation on both occasions. Read More

Curr Vasc Pharmacol 2022 ;20(2):121-126

Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.

Vascular calcification (VC) is highly prevalent in Chronic Kidney Disease (CKD) patients, progresses gradually with deterioration of kidney function and is a strong, independent predictor of cardiovascular (CV) mortality. Matrix Gla Protein (MGP), the most potent inhibitor of VC, requires vitamin K as a co-factor to become biologically active. Accumulating epidemiological data have associated vitamin K depletion with VC progression and CV outcomes. Read More

Fujita Med J 2021 16;7(4):136-138. Epub 2020 Dec 16.

Department of Nephrology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.

Objectives: Vascular calcification is common in patients with advanced chronic kidney disease (CKD) and contributes to cardiovascular disease. Accumulating evidence indicates that CKD patients often acquire subclinical vitamin K deficiency, which is associated with vascular calcification.

Methods: This prospective, randomized, parallel group, multicenter trial (UMINID000011490) will include 200 dialysis patients in an open-label, two-arm design. Read More

J Emerg Med 2022 May 31;62(5):e101-e104. Epub 2022 Jan 31.

Department of Emergency Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan.

Background: Short bowel syndrome (SBS) refers to a malabsorptive state caused by extensive resection of the intestinal tract that leads to chronic diarrhea, electrolyte disturbances, and malnutrition. Although relatively uncommon, patients with SBS can present to the emergency department with more serious complications that are potentially life-threatening. Among these complications, coagulopathy secondary to SBS is an underrecognized condition. Read More

Neoreviews 2022 02;23(2):e82-e95

Department of Pediatric Hematology Oncology, Children's Hospital of Michigan, Detroit, MI.

Developmental hemostasis describes the evolution of the coagulation system from the neonatal period through adulthood. Neonates have lower levels of coagulation factors and elevated screening levels at birth. These levels can be influenced by various circumstances including gestational age, labor effects, and clinical status. Read More

Front Immunol 2021 5;12:791565. Epub 2022 Jan 5.

State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, China.

Intestinal diseases, such as inflammatory bowel diseases (IBDs) and colorectal cancer (CRC) generally characterized by clinical symptoms, including malabsorption, intestinal dysfunction, injury, and microbiome imbalance, as well as certain secondary intestinal disease complications, continue to be serious public health problems worldwide. The role of vitamin K (VK) on intestinal health has drawn growing interest in recent years. In addition to its role in blood coagulation and bone health, several investigations continue to explore the role of VK as an emerging novel biological compound with the potential function of improving intestinal health. Read More

Nutrients 2022 Jan 8;14(2). Epub 2022 Jan 8.

Department of Propaedeutics of Internal Medicine and Social Pharmacology, Medical University of Lodz, Żeromski St. 113, 90-549 Lodz, Poland.

Vitamin K (VK) plays many important functions in the body. The most important of them include the contribution in calcium homeostasis and anticoagulation. Vascular calcification (VC) is one of the most important mechanisms of renal pathology. Read More

Children (Basel) 2022 Jan 5;9(1). Epub 2022 Jan 5.

International Science & Health Foundation, 30-134 Kraków, Poland.

Vitamin K2 activates vitamin K-dependent proteins that support many biological functions, such as bone mineralization, the inhibition of vascular stiffness, the improvement of endothelial function, the maintenance of strong teeth, brain development, joint health, and optimal body weight. Due to the transformation of food habits in developed countries over the last five decades, vitamin K and, specifically, vitamin K2 intakes among parents and their offspring have decreased significantly, resulting in serious health implications. The therapeutics used in pediatric practice (antibiotics and glucocorticoids) are also to blame for this situation. Read More

Medicine (Baltimore) 2022 Jan;101(1):e28434

Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Rationale: Fetal brain hemorrhage is rare. It is caused mainly by maternal trauma or fetal coagulation disorder, but in some cases, vitamin K deficiency may be the cause.

Patient Concerns: We describe the case of a pregnant woman with bowel obstruction who was susceptible to vitamin K deficiency due to oral diet restriction, decreased intestinal absorption, and limited intravenous vitamin K supplementation. Read More

J Diet Suppl 2022 Jan 11:1-7. Epub 2022 Jan 11.

Department of Pediatrics, East Tennessee State University, Johnson City, TN, USA.

Vitamin K acts a cofactor for the gamma-carboxylation of several proteins in the coagulation cascade. The clinical spectrum of vitamin K deficiency (VKD) can be asymptomatic to a significant bleeding. VKD is classically seen in newborns. Read More

AIDS 2022 04;36(5):647-655

Clinical Research Center.

Background: People with HIV (PWH) experience increased systemic inflammation and monocyte activation, leading to increased risk of cardiovascular events (death, stroke, and myocardial infarction) and higher coronary artery calcium scores (CACs). Vitamins D and K2 have significant anti-inflammatory effects; in addition, vitamin K2 is involved in preventing vascular calcifications in the general population. The roles of vitamins D and K in increased coronary calcifications in successfully treated PWH is less understood. Read More

Nutrients 2021 Nov 16;13(11). Epub 2021 Nov 16.

Department of Pediatrics, ZNA Queen Paola Children's Hospital, Faculty of Medicine UA, 2020 Antwerp, Belgium.

Neonatal vitamin K prophylaxis is essential to prevent vitamin K deficiency bleeding (VKDB) with a clear benefit compared to placebo. Various routes (intramuscular (IM), oral, intravenous (IV)) and dosing regimens were explored. A literature review was conducted to compare vitamin K regimens on VKDB incidence. Read More

Nutrients 2021 Nov 10;13(11). Epub 2021 Nov 10.

Internal Medicine & Hepatology Section, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties-PROMISE, University of Palermo Medical School, 90127 Palermo, Italy.

Over the past few years, growing interest has been shown for the impact of dietary requirements and nutritional factors on chronic diseases. As a result, nutritional programs have been reinforced by public health policies. The precise role of micronutrients in chronic liver disease is currently receiving particular attention since abnormalities in vitamin levels are often detected. Read More

Kidney Int 2022 02 11;101(2):338-348. Epub 2021 Nov 11.

Department of Nephrology and Clinical Immunology, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany.

Chronic kidney disease (CKD) is accompanied with extensive cardiovascular calcification, in part correlating with functional vitamin K deficiency. Here, we sought to determine causes for vitamin K deficiency beyond reduced dietary intake. Initially, vitamin K uptake and distribution into circulating lipoproteins after a single administration of vitamin K1 plus K2 (menaquinone 4 and menaquinone 7, respectively) was determined in patients on dialysis therapy and healthy individuals. Read More

Intern Med 2022 May 6;61(10):1503-1509. Epub 2021 Nov 6.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan.

Panitumumab, a fully human anti-epidermal growth factor receptor (EGFR) monoclonal antibody, has been shown to be useful in treating either advanced or recurrent KRAS/NRAS/BRAF wild-type colorectal cancer. We herein report the case of a 60-year-old man with short bowel syndrome who developed hematochezia due to panitumumab-induced colitis with vitamin K deficiency during third-line chemotherapy. The cause of vitamin K deficiency was the lack of intravenous vitamin K supplementation following a change from central venous nutrition to peripheral venous nutrition. Read More

Nephrol Dial Transplant 2022 03;37(4):652-662

Department of Biochemistry, CARIM, Maastricht University, Maastricht, The Netherlands.

Background: Hyperphosphataemia is strongly associated with cardiovascular disease and mortality. Recently, phosphate binders (PBs), which are used to bind intestinal phosphate, have been shown to bind vitamin K, thereby potentially aggravating vitamin K deficiency. This vitamin K binding by PBs may offset the beneficial effects of phosphate reduction in reducing vascular calcification (VC). Read More

Nutrients 2021 Oct 1;13(10). Epub 2021 Oct 1.

Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands.

Vitamin K dependent proteins (VKDP), such as hepatic coagulation factors and vascular matrix Gla protein (MGP), play key roles in maintaining physiological functions. Vitamin K deficiency results in inactive VKDP and is strongly linked to vascular calcification (VC), one of the major risk factors for cardiovascular morbidity and mortality. In this study we investigated how two vitamin K surrogate markers, dephosphorylated-undercarboxylated MGP (dp-ucMGP) and protein induced by vitamin K absence II (PIVKA-II), reflect vitamin K status in patients on hemodialysis or with calcific uremic arteriolopathy (CUA) and patients with atrial fibrillation or aortic valve stenosis. Read More