PALMD expression is upregulated in calcified regions of aortic valves from CAVD patients and calcified hVICs.A, H&E staining and B, alizarin red staining for calcified human aortic valves from CAVD patients. C, immunohistochemistry for PALMD expression in calcified human aortic valves from CAVD patients, and the scale bar (left panel) represents 200 μm; enlarged immunohistochemistry images of PALMD expression in calcified regions (right upper panel) and noncalcified regions (right lower panel), and the scale bar (right panel) represents 80 μm. D, aortic valves from CAVD patients were dissected into noncalcified and calcified tissue (left panel), and alizarin red staining for noncalcified and calcified regions (right panel). E–G, RT-qPCR showing MSX2, ALPL, and PALMD mRNA expression between noncalcified and calcified aortic valve tissue, n = 8. Wilcoxon matched-pairs signed rank test. H, RT-qPCR showing PALMD mRNA expression during hVIC in vitro calcification, n = 6. I, representative Western blotting images for PALMD and β-actin protein expression during hVIC in vitro calcification, n = 5. J, semi-quantification of PALMD expression using image J software, n = 5. K, PALMD immunofluorescence staining during hVIC in vitro calcification. IgG only served as negative controls (NC), and the scale bar represents 50 μm. Data are presented as mean ± SEM, and statistical significance was analyzed by a two-tailed unpaired Student’s t test. CAVD, calcific aortic valve disease; hVICs, human valve interstitial cells.