Regulation of renal vitamin D hydroxylase activity in vitamin D deficient rats

The regulation of renal mitochondrial 1-hydroxylase activity in chronic vitamin D deficiency was studied in male rats. These rats were born of mothers who had been raised from weaning (21 days) on a vitamin D deficient diet and who had no detectable serum 1,25-dihydroxycholecalciferol (1,25-(OH)2D) at the time their offspring were weaned (28 days). In the pups, renal mitochondrial 1-hydroxylase activity was undetectable before the 3rd week of life even though the animals were severely hypocalcemic from birth. The 1-hydroxylase activity first became detectable at 26 days of age, rapidly reached a maximum at day 34, then decreased to become undetectable again by 65 days. Throughout this time serum calcium concentration was less than 5.0 mg/dL and serum parathyroid hormone (PTH) concentration, measured by a midmolecule radioimmunoassay, was two- to five-fold greater than that found in vitamin D replete rats. 1-Hydroxylase activity could be restored in the +65-day-old animals by administration of a single dose of 2.5 micrograms vitamin D3. Enzyme activity was detected within 24 h, was maximal at 72 h, and returned to undetectable levels by 96 h after administration of the vitamin. Serum 1,25-(OH)2D which was undetectable before administration of the vitamin D3, was 108 and 458 pg/mL at 16 and 40 h, respectively, after the injection. The serum concentration of this metabolite then decreased progressively to 80 pg/mL by 6 days. 24-Hydroxylase activity first became detectable 48 h after vitamin D administration, increased to a maximum at 96 h, and thereafter decreased to become undetectable by 7 days.(ABSTRACT TRUNCATED AT 250 WORDS)     

A role for the cytoskeleton in renal vitamin D metabolism

Conversion of circulating 25-hydroxyvitamin D3 (25(OH)D3) to its active metabolite 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) occurs in the renal tubule mitochondrion. Recent reports have implicated the cytoskeleton in certain other steroid metabolizing cells as a mediator of a rate-limiting mitochondrial transport step. Whilst the activity of the renal converting enzyme, a typical steroid hydroxylase, is known to be regulated closely by a number of well studied factors, no information is available to indicate whether an analogous transport step is relevant to the regulation of vitamin D metabolism. Cytochalasin B and vinblastine were used as chemical antagonists of the microfilamentous and microtubular elements of the cytoskeleton. Both agents inhibited the conversion of 25(OH)D3 to 1,25(OH)2D3 by isolated vitamin D-deficient chick renal tubules in a dose-dependent manner. At the concentrations required to inhibit 25(OH)D3-1 alpha-hydroxylase activity in whole cells, these agents inhibited neither isolated mitochondrial 1,25(OH)2D3 production, nor 24,25(OH)2D3 synthesis by vitamin D-replete tubules. The cytoskeletal antagonists were found to increase the content of labelled 1,25(OH)2D3 and 25(OH)D3 in a mitochondrial fraction prepared by Percoll fractionation of tubule cells pre-exposed to the antagonists and labelled 25(OH)D3 substrate. The data suggest that disruption of the cytoskeleton may result in inhibition of transport of newly synthesised 1,25(OH)2D3 out of the mitochondrion and through the cell, and accumulating 1,25(OH)2D3 may oppose its further synthesis. This is consistent with a transport process mediated by the cytoskeleton being involved in the regulation of renal vitamin D metabolism.     

Effect of alcohol on renal vitamin D metabolism in chickens.

Intraperitoneal administration of ethanol to young chickens (both vitamin D-replete and vitamin D-deficient) produced a significant impairment of renal 25 hydroxyvitamin D₃ 1α-hydroxylase (EC 1.14.13.13) activity with no significant change in serum calcium or phosphorus. In ethanol treated D-replete chicks the renal 25 hydroxyvitamin D₃ 24-hydroxylase activity was enhanced, and serum 25 hydroxyvitamin D₃ was significantly increased. The alkaline phosphatase levels in the D-deficient ethanol treated chicks were significantly less than the controls. Our data suggest that the impairment of the metabolic effects of vitamin D due to ethanol occurs chiefly via a renal, rather than a hepatic mechanism. Furthermore, 1α -hydroxylated metabolites of vitamin D would appear to be the logical treatment of choice for the bone disease of alcoholism.     

Hypophosphatemia is responsible for skeletal muscle weakness of vitamin D deficiency

A deficiency of vitamin D results in muscle weakness as well as rickets in children and osteomalacia in the adult. To study the basis for this weakness, severe vitamin D deficiency was produced in rats as revealed by a low level or absence of 25-hydroxyvitamin D₃ in the serum. Vitamin D deficiency was achieved by feeding purified diets to weanlings for 16 weeks. Muscle force, peak contraction (P), time-to-half contraction (T_1/2), time-to-peak contraction (T_P), and time-to-half recovery (T_1/2r) were measured. A significant reduction in muscle force was found when vitamin D deficiency was accompanied by hypophosphatemia. Within 2 days of correcting the hypophosphatemia, muscle strength was normalized. When serum calcium and serum phosphorus were maintained in the normal range in vitamin D-deficient rats, muscle weakness did not develop. Further, hypocalcemia together with vitamin D deficiency did not produce muscle weakness. These results strongly suggest that muscle weakness noted in rachitic patients is the result of the hypophosphatemia of vitamin D deficiency.     

Intestinal absorption of vitamin E in experimental renal failure

We studied intestinal absorption of vitamin E in rats with experimental renal failure (RF) and in sham-operated normal and pair-fed controls using in vivo perfusion and in vitro everted sacs. The in vivo absorption rates per unit of intestine length were significantly reduced in RF and pair-fed groups. Expression of data per unit of intestine weight gave normal values in the pair-fed but depressed values in the RF animals. Vitamin E uptake in vitro was significantly increased in RF animals, suggesting enhanced permeability. We conclude: (i) vitamin E absorption in vivo is impaired in experimental RF; (ii) this is in part due to reduced nutrient intake; and (iii) disparity between in vivo and in vitro results suggests the presence of some inhibitory influence(s) in intact animals with RF.     

Morphometric analysis of skeletal response to vitamin D in uremic rats fed a low calcium diet.

The response of tibial metaphyses to pharmacologic levels of vitamin D in uremic rats fed a low calcium diet was evaluated morphometrically. Uremic (5/6 nephrectomized) rats given vitamin D had increased percent metaphyseal hard tissue, trabecular surface perimeter and percent trabecular osteoid surface and reduced numbers of osteoblasts and osteoclasts per millimeter of trabecular perimeter compared to either uremic rats given placebo or sham-operated rats given vitamin D. It was concluded that the resistance of metaphyseal trabeculae in uremic rats to vitamin D was due in part to the increase in osteoid-covered surfaces which inhibited osteoclasis and subsequent remodeling. The pathogenesis of worsening osteomalacia as a consequence of vitamin D administration to uremic rats on a low calcium diet remains unclear.     

Role of pituitary hormones in regulating renal vitamin D metabolism in man.

Studies in animals and tissue culture have shown the importance of prolactin and growth hormone in regulating renal 1 alpha-hydroxylase activity and plasma concentrations of 1,25-dihydroxycholecalciferol (1,25(OH)2D3). Evidence for a similar role for these hormones in man was sought by using a radioreceptor assay to measure plasma 1,25(OH)2D3 concentrations in 20 normal subjects, 12 patients receiving dialysis, 11 patients with primary hyperparathyroidism, 10 pregnant women, seven women with prolactinoma, and 14 patients with acromegaly. Circulating 1,25(OH)2D3 concentrations were appreciably raised in the patients with primary hyperparathyroidism and the pregnant women (P less than 0.001), slightly but significantly increased in the patients with prolactinoma (P less than 0.05), and greatly raised in those with acromegaly (P less than 0.001). These results suggest that prolactin and growth hormone are important regulators of renal vitamin D metabolism in the physiological conditions of pregnancy, lactation, and growth in man.     

Response of renal calcium-binding protein. Independence of kidney vitamin D hydroxylation.

Dietary calcium and dietary phosphorus restriction were studied in chicks fed either cholecalciferol or 1alpha-hydroxycholecalciferol. Intestinal calcium absorption and calcium-binding protein of 1alpha-hydroxycholecalciferol-treated chicks remained unchanged under dietary calcium restriction, but increased under dietary phosphorus restriction. Kidney calcium-binding protein was not altered by dietary caclium restriction in chidks treated with either cholecalciferol or 1alpha-hydroxycholecalciferol, but increased under dietary phosphorus restriction independent of the vitamin D source. In contrast to the intestine, calcium-binding activity of the kidney was found to be poorly related to the calcium-binding protein concentration. It is suggested that kidney calcium-binding protein is regulated by a mechanism different from that of intestinal calcium-binding protein, and that its concentration in renal tissue is related to renal caclium excretion or plasma calcium level.     

Use of genetically modified mice to examine the skeletal anabolic activity of vitamin D

We employed genetically modified mice to examine the role of 1,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃] on skeletal and calcium homeostasis. In mice expressing the null mutation for 25-hydroxyvitamin D 1 hydroxylase (1OHase^−/−), or the vitamin D receptor (VDR^−/−), 1,25(OH)₂D₃ and calcium were both required for optimal epiphyseal growth plate development, serum calcium and phosphorus alone were sufficient to mineralize skeletal tissue independent of 1,25(OH)₂D₃ and the VDR, and endogenous 1,25(OH)₂D₃ and the VDR were essential for baseline bone formation. In 2-week-old 1OHase^−/− mice and in 2-week-old mice homozygous for the PTH null mutation(PTH^−/−), PTH and 1,25(OH)₂D₃ were each found to exert independent and complementary effects on skeletal anabolism, with PTH predominantly affecting appositional trabecular bone growth and 1,25(OH)₂D₃ influencing both endochondral bone formation and appositional bone growth. Endogenous 1,25(OH)₂D₃ maintained serum calcium homeostasis predominantly by modifying intestinal and renal calcium transporters but not by producing net bone resorption. Administration of exogenous 1,25(OH)₂D₃ to double mutant PTH^−/−1OHase^−/− mice produced skeletal effects consistent with the actions of endogenous 1,25(OH)₂D₃. These studies reveal an important skeletal anabolic role for both endogenous and exogenous 1,25(OH)₂D₃ and point to a potential role for 1,25(OH)₂D₃ analogs in the treatment of disorders of bone loss.     

Parathyroid hormone response to vitamin D insufficiency in elderly males with chronic heart failure

Secondary hyperparathyroidism (SHPT) may contribute to the systemic illness that accompanies chronic heart failure (CHF). Healthy elderly with vitamin D deficiency who did not develop hyperparathyroidism (functional hypoparathyroidism, FHPT) had lower mortality than those who did. This study was designed to examine determinants of the PTH response in the vitamin D insufficient CHF patients. Sixty five vitamin D insufficient males with NYHA class II and III and 20 control subjects age >/=55 years were recruited. Echocardiography, physical performance, NT-pro-BNP, PTH, 25-hydroxyvitamin D (25(OH)D), adiponectin and bone activity surrogate markers (OPG, RANKL, OC, beta-CTx) were assessed. Increased NYHA class was associated with SHPT, while physical performance was inferior compared to FHPT. SHPT was associated with lower left ventricular ejection fraction (LVEF) and flow mediated dilatation, but with higher left heart dimensions, left ventricular mass index and right ventricular systolic pressure. CHF patients with SHPT had increased NT-pro-BNP, adiponectin and bone markers, but decreased 25(OH)D compared to those with FHPT. Independent determinants for SHPT in CHF patients with vitamin D insufficiency were LVEF, adiponectin and beta-CTx, irrespective of renal function and serum vitamin D levels. In conclusion, increased PTH levels, but not low vitamin D, demonstrated close relation to CHF severity.     

Acute responsiveness to calcitonin in chronic renal failure.

The acute effect of porcine calcitonin was tested in 17 patients undergoing chronic haemodialysis. In normal adults calcitonin has no effect on plasma calcium or phosphate levels, but in nine patients both concentrations were substantially reduced after calcitonin. This hypocalcaemic and hypophosphataemic effect was a function of the initial plasma phosphate level but was unrelated to the initial plasma calcium level. Plasma hydroxyproline levels were not significantly different in the two groups an were unaffected by calcitonin. In 11 patients fasting plasma calcitonin levels were undetectable with an assay sensitive to 0-1 mug/1. Calcitonin seems to have an acute effect in chronic renal failure which may not operate by arresting bone resorption but is dependent on the plasma phosphate concentration.