scholarly journals Vitamin K Effects on Gas6 and Soluble Axl Receptors in Intensive Care Patients: An Observational Screening Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4101
Author(s):  
Ulf Schött ◽  
Cecilia Augustsson ◽  
Luukas Lilover ◽  
Caroline Ulfsdotter Nilsson ◽  
Louise Walther-Sturesson ◽  
...  
Keyword(s):  
Intensive Care ◽  
Vitamin K ◽  
Clinical Importance ◽  
Therapy Resistance ◽  
International Normalized Ratio ◽  
Matrix Gla Protein ◽  
Specific Gene ◽  
Vitamin K1 ◽  
Intensive Care Patients ◽  
Screening Study

Growth arrest-specific gene 6 protein (Gas6) is avitamin K-dependent tissue bound protein. Gas6 has been shown to promote growth and therapy resistance among different types of cancer as well as thromboembolism. The aim of this prospective screening study: ClinicalTrials.gov; Identifier: NTC3782025, was to evaluate the effects of intravenously administered vitamin K1 on Gas6 and its soluble (s)Axl receptor plasma levels in intensive care patients. Vitamin K1 was intravenously injected in non-warfarin treated patients with prolonged Owren prothrombin time international normalized ratio (PT-INR) > 1.2 and blood samples were retrieved before and 20–28 h after injection. Citrate plasma samples from 52 intensive care patients were analysed for different vitamin K dependent proteins. There was a significant, but small increase in median Gas6. Only one patient had a large increase in sAxl, but overall, no significant changes in sAxl Gas6 did not correlate to PT-INR, thrombin generation assay, coagulation factors II, VII, IX and X, but to protein S and decarboxylated matrix Gla protein (dp-ucMGP). In conclusion, there was a small increase in Gas6 over 20–28 h. The pathophysiology and clinical importance of this remains to be investigated. To verify a true vitamin K effect, improvement of Gas6 carboxylation defects needs to be studied.

scholarly journals Causes of Vitamin K Deficiency in Patients on Haemodialysis

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2513
Author(s):  
Signe Wikstrøm ◽  
Katrine Aagaard Lentz ◽  
Ditte Hansen ◽  
Lars Melholt Rasmussen ◽  
Jette Jakobsen ◽  
...  
Keyword(s):  
Vitamin K ◽  
Absorption Capacity ◽  
Protein Supplementation ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
High Concentration ◽  
Vitamin K Deficiency ◽  
Before And After ◽  
K Deficiency ◽  
The Difference

Background: A low vitamin K status is common in patients on haemodialysis, and this is considered one of the reasons for the accelerated atherosclerosis in these patients. The vitamin is essential in activation of the protein Matrix Gla Protein (MGP), and the inactive form, dp-ucMGP, is used to measure vitamin K status. The purpose of this study was to investigate possible underlying causes of low vitamin K status, which could potentially be low intake, washout during dialysis or inhibited absorption capacity. Moreover, the aim was to investigate whether the biomarker dp-ucMGP is affected in these patients. Method: Vitamin K intake was assessed by a Food Frequency Questionnaire (FFQ) and absorption capacity by means of D-xylose testing. dp-ucMGP was measured in plasma before and after dialysis, and phylloquinine (vitamin K1) and dp-ucMGP were measured in the dialysate. Changes in dp-ucMGP were measured after 14 days of protein supplementation. Results: All patients had plasma dp-ucMGP above 750 pmol/L, and a low intake of vitamin K. The absorption capacity was normal. The difference in dp-ucMGP before and after dialysis was −1022 pmol/L (p < 0.001). Vitamin K1 was not present in the dialysate but dp-ucMGP was at a high concentration. The change in dp-ucMGP before and after protein supplementation was −165 pmol/L (p = 0.06). Conclusion: All patients had vitamin K deficiency. The reason for the low vitamin K status is not due to removal of vitamin K during dialysis or decreased absorption but is plausibly due to a low intake of vitamin K in food. dp-ucMGP is washed out during dialysis, but not affected by protein intake to a clinically relevant degree.

Leucocytosis following Transfusion with Leucodepleted Red Cells to Non-Bleeding Critically Ill Patients

2013 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
Ezzeldin Saleh ◽  
Timothy S Walsh
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Leucocyte Count ◽  
Clinical Importance ◽  
Red Cells ◽  
Intensive Care Patients ◽  
Routinely Collected Data ◽  
And Storage

Previous studies have shown that transfusion of non-leucodepleted red blood cells can cause leucocytosis in recipients. A small study suggested that pre-storage leucodepletion removed this phenomenon, but has not been further substantiated. We explored whether recipient leucocytosis occurs when leucodepleted red blood cells were transfused to non-bleeding intensive care patients. We used routinely collected data for 95 transfusions in 54 patients. Overall, no leucocytosis was found on the first routine blood sample following transfusion (mean change 0.6 × 109/L; 95% confidence interval - 0.2 to 1.3; p=0.145). However, for the 32 transfusions in patients with normal pre-transfusion leucocyte count there was a clinically small but statistically significant leucocytosis following transfusion, unlikely to have occurred by chance (mean change 1.5 × 109/L; 0.5 to 2.5; p=0.005). No significant change was observed in patients with pre-transfusion leucocytosis. We found no relation between leucocytosis and storage age of red cells. Our data suggest that transfusions with leucodepleted red cells can increase leucocyte counts in recipients. The mechanism of this effect and its clinical importance are uncertain.

Effect of vitamin K intake on the stability of oral anticoagulant treatment: dose-response relationships in healthy subjects

Blood ◽  
2004 ◽  
Vol 104 (9) ◽  
pp. 2682-2689 ◽  
Author(s):  
Leon J. Schurgers ◽  
Martin J. Shearer ◽  
Karly Hamulyák ◽  
Elisabeth Stöcklin ◽  
Cees Vermeer
Keyword(s):  
Vitamin K ◽  
Dose Response ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
Dietary Vitamin ◽  
Undercarboxylated Osteocalcin ◽  
Vitamin K1 ◽  
Oral Anticoagulant Treatment

Abstract Oral anticoagulants exert their effect by blocking the utilization of vitamin K, yet little is known about competitive aspects of their interaction with dietary vitamin K. We carried out systematic dose-response studies in healthy volunteers who had been stably anticoagulated and maintained on their individualized doses for 13 weeks. First, we studied the response to weekly incremental doses (50 μg-500 μg) of vitamin K1 supplements (K1) taken daily for 7 days. The threshold K1 dose causing a statistically significant lowering of the INR was 150 μg/day. In 25% of the participants the INR change was regarded as clinically relevant at a vitamin K intake of 150 μg/day. Circulating undercarboxylated osteocalcin did not decrease until 300 μg K1/day compared with 100 μg K1/day for undercarboxylated FII, suggesting differential antidotal effects on bone and hepatic γ-carboxylation. Next, we tested the response to vitamin K-rich food items. The short-lived response after meals of spinach and broccoli suggested an inefficient bioavailability from these 2 sources. We conclude that short-term variability in intake of K1 is less important to fluctuations in the international normalized ratio (INR) than has been commonly assumed and that food supplements providing 100 μg/day of vitamin K1 do not significantly interfere with oral anticoagulant therapy. (Blood. 2004;104:2682-2689)

scholarly journals Intravenous Vitamin K1 for the Correction of Prolonged Prothrombin Times in Non-Bleeding Critically Ill Patients: A Prospective Observational Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2580
Author(s):  
Sofia Dahlberg ◽  
Ulf Schött ◽  
Emilia Ängeby Eriksson ◽  
Yllnor Tahirsylaj ◽  
Leon Schurgers ◽  
...  
Keyword(s):  
Critically Ill ◽  
Vitamin K ◽  
Critically Ill Patients ◽  
Thrombin Generation ◽  
Coagulation Factors ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
Clotting Factors ◽  
Short And Long Term ◽  
Intravenous Vitamin

The aim of this study was to evaluate the effects of vitamin K1 on various vitamin K-dependent proteins in critically ill patients with prolonged Owren PT. We included critically ill non-bleeding adult patients without liver failure or anticoagulation treatment, with Owren PT > 1.2, who were prescribed intravenous vitamin K1. Blood was drawn at baseline and at 20–28 h after vitamin K1 administration. At both time points, we measured various vitamin K-dependent proteins and coagulation assays. ClinicalTrials.gov; Identifier: NTC3782025. In total, 52 patients were included. Intravenous vitamin K1 reduced Owren PT, Quick PT, protein induced by vitamin K absence/antagonist-II and desphospho-uncarboxylated matrix Gla protein (dp-ucMGP), but not to normal levels. Concomitantly, there were increases in thrombin generation and the activity of coagulation factors II, VII, IX and X that was only counteracted with a small increase in Protein C activity. In conclusion, the results suggest that vitamin K1 strengthens coagulation as measured by PT decrease and increases in the activity of vitamin K-dependent clotting factors and thrombin generation. The decreased dp-ucMGP, and its potential positive short- and long-term non-coagulative effects, merits further research.

Vitamin K–containing dietary supplements: comparison of synthetic vitamin K1 and natto-derived menaquinone-7

Blood ◽  
2006 ◽  
Vol 109 (8) ◽  
pp. 3279-3283 ◽  
Author(s):  
Leon J. Schurgers ◽  
Kirsten J. F. Teunissen ◽  
Karly Hamulyák ◽  
Marjo H. J. Knapen ◽  
Hogne Vik ◽  
...  
Keyword(s):  
Vitamin K ◽  
Serum Vitamin ◽  
Life Time ◽  
Serum Levels ◽  
Coagulation Factors ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
Blood Coagulation Factors ◽  
Oral Anticoagulant Treatment ◽  
Over The Counter

Abstract Vitamin K is a cofactor in the production of blood coagulation factors (in the liver), osteocalcin (in bone), and matrix Gla protein (cartilage and vessel wall). Accumulating evidence suggests that for optimal bone and vascular health, relatively high intakes of vitamin K are required. The synthetic short-chain vitamin K1 is commonly used in food supplements, but recently the natural long-chain menaquinone-7 (MK-7) has also become available as an over-the-counter (OTC) supplement. The purpose of this paper was to compare in healthy volunteers the absorption and efficacy of K1 and MK-7. Serum vitamin K species were used as a marker for absorption and osteocalcin carboxylation as a marker for activity. Both K1 and MK-7 were absorbed well, with peak serum concentrations at 4 hours after intake. A major difference between the 2 vitamin K species is the very long half-life time of MK-7, resulting in much more stable serum levels, and accumulation of MK-7 to higher levels (7- to 8-fold) during prolonged intake. MK-7 induced more complete carboxylation of osteocalcin, and hematologists should be aware that preparations supplying 50 μg/d or more of MK-7 may interfere with oral anticoagulant treatment in a clinically relevant way.

scholarly journals MK-7 and Its Effects on Bone Quality and Strength

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 965 ◽  
Author(s):  
Toshiro Sato ◽  
Naoko Inaba ◽  
Takatoshi Yamashita
Keyword(s):  
Bone Mineral Density ◽  
Bone Quality ◽  
Vitamin K ◽  
Half Life ◽  
Daily Intake ◽  
Vitamin K2 ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
Mineral Density ◽  
The Matrix

Vitamin K acts as a cofactor and is required for post-translational γ-carboxylation of vitamin K-dependent proteins (VKDP). The current recommended daily intake (RDI) of vitamin K in most countries has been established based on normal coagulation requirements. Vitamin K1 and menaquinone (MK)-4 has been shown to decrease osteocalcin (OC) γ-carboxylation at RDI levels. Among the several vitamin K homologs, only MK-7 (vitamin K2) can promote γ-carboxylation of extrahepatic VKDPs, OC, and the matrix Gla protein at a nutritional dose around RDI. MK-7 has higher efficacy due to its higher bioavailability and longer half-life than other vitamin K homologs. As vitamin K1, MK-4, and MK-7 have distinct bioactivities, their RDIs should be established based on their relative activities. MK-7 increases bone mineral density and promotes bone quality and strength. Collagen production, and thus, bone quality may be affected by MK-7 or MK-4 converted from MK-7. In this review, we comprehensively discuss the various properties of MK-7.

Beneficial effects of vitamins D and K on the elastic properties of the vessel wall in postmenopausal women: a follow-up study

2004 ◽  
Vol 91 (02) ◽  
pp. 373-380 ◽  
Author(s):  
Lavienja Braam ◽  
Arnold Hoeks ◽  
Fred Brouns ◽  
Karly Hamulyák ◽  
Monique Gerichhausen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Placebo Group ◽  
Postmenopausal Women ◽  
Elastic Properties ◽  
Vitamin K ◽  
Vessel Wall ◽  
Intima Media Thickness ◽  
Matrix Gla Protein ◽  
Vitamin K1 ◽  
Strong Inhibitor

SummaryMatrix-Gla Protein (MGP) is a strong inhibitor of vascular calcification, the expression of which is vitamin D dependent. MGP contains five γ-carboxyglutamic acid (Gla)-residues which are formed in a vitamin K-dependent carboxylation step and which are essential for its function. Hence vascular vitamin K-deficiency will result in undercarboxylated, inactive MGP which is a potential risk factor for calcification. In the present study we describe the effects of vitamin K1 and D supplementation on vascular properties in postmenopausal women. In a randomized placebo-controlled intervention study, 181 postmenopausal women were given either a placebo or a supplement containing minerals and vitamin D (MD-group), or the same supplement with vitamin K1 (MDK-group). 150 participants completed the study and analysis was performed on 108 participants. At baseline and after three years, vessel wall characteristics, including compliance coefficient (CC), distensibility coefficient (DC), intima-media thickness (IMT) and the Young’s Modulus (E) were measured to assess the effect of the supplements on the change of these parameters. The results showed that the elastic properties of the common carotid artery in the MDK-group remained unchanged over the three-year period, but decreased in the MDand placebo-group. Comparing the MDKand placebo-group, there were significant differences in decrease of DC (8.8%; p<0.05), CC (8.6%; p<0.05), and in increase of PP (6.3%; p<0.05) and E (13.2%, p<0.01).There were no significant differences between the MD-group and placebo. No significant differences were observed in the change of IMT between the three groups. It is concluded that a supplement containing vitamins K1 and D has a beneficial effect on the elastic properties of the arterial vessel wall.

Echis time, under-carboxylated prothrombin and vitamin K status in intensive care patients

2003 ◽  
Vol 25 (6) ◽  
pp. 397-404 ◽  
Author(s):  
D. O'Shaughnessy ◽  
C. Allen ◽  
T. Woodcock ◽  
K. Pearce ◽  
J. Harvey ◽  
...  
Keyword(s):  
Intensive Care ◽  
Vitamin K ◽  
Intensive Care Patients

Vitamin K: The coagulation vitamin that became omnipotent

2007 ◽  
Vol 98 (07) ◽  
pp. 120-125 ◽  
Author(s):  
Ellen Cranenburg ◽  
Leon Schurgers ◽  
Cees Vermeer
Keyword(s):  
Side Effects ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Coagulation Factors ◽  
Matrix Gla Protein ◽  
Specific Gene ◽  
Healthy Individuals ◽  
Oral Anticoagulant Treatment ◽  
Increased Risk ◽  
Effect Of Treatment

SummaryVitamin K, discovered in the 1930s, functions as cofactor for the post-translational carboxylation of glutamate residues. Gammacarboxy glutamic acid (Gla)-residues were first identified in prothrombin and coagulation factors in the 1970s; subsequently, extra-hepatic Gla proteins were described,including osteocalcin and matrix Gla protein (MGP). Impairment of the function of osteocalcin and MGP due to incomplete carboxylation results in an increased risk for developing osteoporosis and vascular calcification, respectively, and is an unexpected side effect of treatment with oral anticoagulants. It is conceivable that other side effects, possible involving growth-arrest-specific gene 6 (Gas6) protein will be identified in forthcoming years. In healthy individuals, substantial fractions of osteocalcin and MGP circulate as incompletely carboxylated species, indicating that the majority of these individuals is subclinically vitamin K-deficient. Potential new application areas for vitamin K are therefore its use in dietary supplements and functional foods for healthy individuals to prevent bone and vascular disease, as well as for patients on oral anticoagulant treatment to offer them protection against coumarin-induced side effects and to reduce diet-induced fluctuations in their INR values.

Sign in / Sign up

Export Citation Format

Share Document