{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:39:44Z","timestamp":1790422784212,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,10,23]],"date-time":"2008-10-23T00:00:00Z","timestamp":1224720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:p><jats:bold>Abstract:\u2002<\/jats:bold> Pseudoxanthoma elasticum (PXE), a prototype of heritable multisystem disorders, is characterised by pathologic mineralisation of connective tissues, with primary clinical manifestations in the skin, eyes and the cardiovascular system. The causative gene was initially identified as <jats:italic>ABCC6<\/jats:italic> which encodes an ABC transporter protein (ABCC6) expressed primarily in the liver and the kidneys. The critical role of <jats:italic>ABCC6<\/jats:italic> in ectopic mineralisation has been confirmed by the development of <jats:italic>Abcc6<\/jats:italic><jats:sup><jats:italic>\u2212\/\u2212<\/jats:italic><\/jats:sup> knock\u2010out mice which recapitulate the features of connective tissue mineralisation characteristic of PXE. Over 300 distinct loss\u2010of\u2010function mutations representative of over 1000 mutant alleles in <jats:italic>ABCC6<\/jats:italic> have been identified by streamlined mutation detection strategies in this autosomal recessive disease. More recently, missense mutations in the <jats:italic>GGCX<\/jats:italic> gene, either in compound heterozygous state or digenic with a recurrent ABCC6 nonsense mutation (p.R1141X), have been identified in patients with PXE\u2010like cutaneous findings and vitamin K\u2010dependent coagulation factor deficiency. <jats:italic>GGCX<\/jats:italic> encodes a carboxylase which catalyses \u03b3\u2010glutamyl carboxylation of coagulation factors as well as of matrix gla protein (MGP) which in fully carboxylated form serves as a systemic inhibitor of pathologic mineralisation. Collectively, these observations suggest the hypothesis that a consequence of loss\u2010of\u2010function mutations in the <jats:italic>ABCC6<\/jats:italic> gene is the reduced vitamin K\u2010dependent \u03b3\u2010glutamyl carboxylation of MGP, with subsequent connective tissue mineralisation. Further progress in understanding the detailed pathomechanisms of PXE should provide novel strategies to counteract, and perhaps cure, this complex heritable disorder at the genome\u2013environment interface.<\/jats:p>","DOI":"10.1111\/j.1600-0625.2008.00795.x","type":"journal-article","created":{"date-parts":[[2008,12,9]],"date-time":"2008-12-09T23:19:32Z","timestamp":1228864772000},"page":"1-11","source":"Crossref","is-referenced-by-count":148,"title":["Pseudoxanthoma elasticum: clinical phenotypes, molecular genetics and putative 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