The Causal Effect of Vitamin D Binding Protein (DBP) Levels on Calcemic and Cardiometabolic Diseases: A Mendelian Randomization Study

Background

Observational studies have shown that vitamin D binding protein (DBP) levels, a key determinant of 25-hydroxy-vitamin D (25OHD) levels, and 25OHD levels themselves both associate with risk of disease. If 25OHD levels have a causal influence on disease, and DBP lies in this causal pathway, then DBP levels should likewise be causally associated with disease. We undertook a Mendelian randomization study to determine whether DBP levels have causal effects on common calcemic and cardiometabolic disease.

Methods and Findings

We measured DBP and 25OHD levels in 2,254 individuals, followed for up to 10 y, in the Canadian Multicentre Osteoporosis Study (CaMos). Using the single nucleotide polymorphism rs2282679 as an instrumental variable, we applied Mendelian randomization methods to determine the causal effect of DBP on calcemic (osteoporosis and hyperparathyroidism) and cardiometabolic diseases (hypertension, type 2 diabetes, coronary artery disease, and stroke) and related traits, first in CaMos and then in large-scale genome-wide association study consortia. The effect allele was associated with an age- and sex-adjusted decrease in DBP level of 27.4 mg/l (95% CI 24.7, 30.0; n = 2,254). DBP had a strong observational and causal association with 25OHD levels (p = 3.2×10⁻¹⁹). While DBP levels were observationally associated with calcium and body mass index (BMI), these associations were not supported by causal analyses. Despite well-powered sample sizes from consortia, there were no associations of rs2282679 with any other traits and diseases: fasting glucose (0.00 mmol/l [95% CI −0.01, 0.01]; p = 1.00; n = 46,186); fasting insulin (0.01 pmol/l [95% CI −0.00, 0.01,]; p = 0.22; n = 46,186); BMI (0.00 kg/m² [95% CI −0.01, 0.01]; p = 0.80; n = 127,587); bone mineral density (0.01 g/cm² [95% CI −0.01, 0.03]; p = 0.36; n = 32,961); mean arterial pressure (−0.06 mm Hg [95% CI −0.19, 0.07]); p = 0.36; n = 28,775); ischemic stroke (odds ratio [OR] = 1.00 [95% CI 0.97, 1.04]; p = 0.92; n = 12,389/62,004 cases/controls); coronary artery disease (OR = 1.02 [95% CI 0.99, 1.05]; p = 0.31; n = 22,233/64,762); or type 2 diabetes (OR = 1.01 [95% CI 0.97, 1.05]; p = 0.76; n = 9,580/53,810).

Conclusions

DBP has no demonstrable causal effect on any of the diseases or traits investigated here, except 25OHD levels. It remains to be determined whether 25OHD has a causal effect on these outcomes independent of DBP. Please see later in the article for the Editors'' Summary     

Chondrocalcin is internalized by chondrocytes and triggers cartilage destruction via an interleukin-1β-dependent pathway

Chondrocalcin is among the most highly synthesized polypeptides in cartilage. This protein is released from its parent molecule, type II pro-collagen, after secretion by chondrocytes. A participation of extracellular, isolated chondrocalcin in mineralization was proposed more than 25 years ago, but never demonstrated. Here, exogenous chondrocalcin was found to trigger MMP13 secretion and cartilage destruction ex vivo in human cartilage explants and did so by modulating the expression of interleukin-1β in primary chondrocyte cultures in vitro. Chondrocalcin was found internalized by chondrocytes. Uptake was found mediated by a single 18-mer peptide of chondrocalcin, which does not exhibit homology to any known cell-penetrating peptide. The isolated peptide, when artificially linked as a tetramer, inhibited gene expression regulation by chondrocalcin, suggesting a functional link between uptake and gene expression regulation. At the same time, the tetrameric peptide potentiated chondrocalcin uptake by chondrocytes, suggesting a cooperative mechanism of entry. The corresponding peptide from type I pro-collagen supported identical cell-penetration, suggesting that this property may be conserved among C-propeptides of fibrillar pro-collagens. Structural modeling localized this peptide to the tips of procollagen C-propeptide trimers. Our findings shed light on unexpected function and mechanism of action of these highly expressed proteins from vertebrates.     

Population size and habitat associations of the endemic Guadeloupe Woodpecker

ABSTRACT Guadeloupe Woodpeckers (Melanerpes herminieri) are the only endemic bird species on the Caribbean island of Guadeloupe. These woodpeckers were classified as Near Threatened on the IUCN Red List following a population survey in 1994. To reassess the Guadeloupe Woodpecker population, we conducted a new survey in 2007, with 21 transects distributed across eight habitats known to be used by the woodpeckers. Habitats with the highest estimated population densities were seasonal evergreen secondary growth forest, followed by swamp forest and rainforest. Surveys revealed an estimated population of 8469 pairs in 2007 compared to 7368 pairs in 1994, a difference that was not significant. However, our 2007 survey revealed that Guadeloupe Woodpeckers had recolonized the last large patch of available forest on Basse‐Terre, one of the two main islands in the Guadeloupe archipelago. Although our results suggest that the Guadeloupe Woodpecker population has remained relatively stable since 1994, deforestation remains a serious threat and we recommend that the IUCN Red List status of Near Threatened be retained. Management measures that would benefit Guadeloupe Woodpeckers include halting deforestation and providing financial support to people on private land to plant trees and leave dead trees standing. Regular monitoring will be important for determining the possible effects of such measures on the Guadeloupe Woodpecker population.     

Adriamycin induced resistance of sensitive K 562 cells to natural killer lymphocyte attack

Summary The effect of Adriamycin (ADM) on eryhtroleukaemia K 562 cell susceptibility to human natural killer (NK) cell activity has been studied. When cultivated for 3 days in the presence of 10 to 40 nM ADM, K 562 cells decreased their susceptibility to NK-mediated lysis in a dose-dependent fashion. At a concentration of 40 nM, previously found to induce optimal differentiation-associated properties in K 562 cells, the induced resistance to NK-mediated lysis increased progressively from day 1 to day 3 of culture. ADM treatment did not induce K 562 cells to release factors which interfered with NK activity since supernatants from ADM-treated K 562 cell cultures caused no significant modification in the NK lytic process. Binding to NK of ADM-treated K 562 cells was unaffected since treated and untreated cells had identical capacities in a conjugate-forming cell assay or adsorption of NK cells on target cell monolayers. In cold target competition assays ADM-treated K 562 cells acted as more effective competitors than untreated K 562 cells. These observations imply that the reduced killing of the ADM-treated K 562 cells was independent of target-NK cell recognition, and suggest that ADM treatment could allow malignant cells to escape NK surveillance.     

Regulation of ENaC and CFTR expression with K+ channel modulators and effect on fluid absorption across alveolar epithelial cells

In a recent study (Leroy C, Dagenais A, Berthiaume Y, and Brochiero E. Am J Physiol Lung Cell Mol Physiol 286: L1027-L1037, 2004), we identified an ATP-sensitive K(+) (K(ATP)) channel in alveolar epithelial cells, formed by inwardly rectifying K(+) channel Kir6.1/sulfonylurea receptor (SUR)2B subunits. We found that short applications of K(ATP), voltage-dependent K(+) channel KvLQT1, and calcium-activated K(+) (K(Ca)) channel modulators modified Na(+) and Cl(-) currents in alveolar monolayers. In addition, it was shown previously that a K(ATP) opener increased alveolar liquid clearance in human lungs by a mechanism possibly related to epithelial sodium channels (ENaC). We therefore hypothesized that prolonged treatment with K(+) channel modulators could induce a sustained regulation of ENaC activity and/or expression. Alveolar monolayers were treated for 24 h with inhibitors of K(ATP), KvLQT1, and K(Ca) channels identified by PCR. Glibenclamide and clofilium (K(ATP) and KvLQT1 inhibitors) strongly reduced basal transepithelial current, amiloride-sensitive Na(+) current, and forskolin-activated Cl(-) currents, whereas pinacidil, a K(ATP) activator, increased them. Interestingly, K(+) inhibitors or membrane depolarization (induced by valinomycin in high-K(+) medium) decreased alpha-, beta-, and gamma-ENaC and CFTR mRNA. alpha-ENaC and CFTR proteins also declined after glibenclamide or clofilium treatment. Conversely, pinacidil augmented ENaC and CFTR mRNAs and proteins. Since alveolar fluid transport was found to be driven, at least in part, by Na(+) transport through ENaC, we tested the impact of K(+) channel modulators on fluid absorption across alveolar monolayers. We found that glibenclamide and clofilium reduced fluid absorption to a level similar to that seen in the presence of amiloride, whereas pinacidil slightly enhanced it. Long-term regulation of ENaC and CFTR expression by K(+) channel activity could benefit patients with pulmonary diseases affecting ion transport and fluid clearance.     

Change in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents

Background

Measurement of bone mineral density is the most common method of diagnosing and assessing osteoporosis. We sought to estimate the average rate of change in bone mineral density as a function of age among Canadians aged 25–85, stratified by sex and use of antiresorptive agents.

Methods

We examined a longitudinal cohort of 9423 participants. We measured the bone mineral density in the lumbar spine, total hip and femoral neck at baseline in 1995–1997, and at 3-year (participants aged 40–60 years only) and 5-year follow-up visits. We used the measurements to compute individual rates of change.

Results

Bone loss in all 3 skeletal sites began among women at age 40–44. Bone loss was particularly rapid in the total hip and was greatest among women aged 50–54 who were transitioning from premenopause to postmenopause, with a change from baseline of –6.8% (95% confidence interval [CI] –7.5% to –4.9%) over 5 years. The rate of decline, particularly in the total hip, increased again among women older than 70 years. Bone loss in all 3 skeletal sites began at an earlier age (25–39) among men than among women. The rate of decline of bone density in the total hip was nearly constant among men 35 and older and then increased among men older than 65. Use of antiresorptive agents was associated with attenuated bone loss in both sexes among participants aged 50–79.

Interpretation

The period of accelerated loss of bone mineral density in the hip bones occurring among women and men older than 65 may be an important contributor to the increased incidence of hip fracture among patients in that age group. The extent of bone loss that we observed in both sexes indicates that, in the absence of additional risk factors or therapy, repeat testing of bone mineral density to diagnose osteoporosis could be delayed to every 5 years.Low bone mineral density is one of the most important risk factors for fracture.^1,2,3–7 Treatment with antiresorptive agents has been widely used for several decades, and the results of randomized controlled trials have shown that at least part of their efficacy is associated with their capacity to increase or stabilize bone density.⁴ Although clinical guidelines recommend measurement of bone density, among other important risk factors, when assessing a patient''s risk for fracture,^3,8,9 there is no international consensus on the optimal age at which to begin measurement, or on the frequency of measurement.¹⁰ The Canadian guidelines recommend it for patients aged 65 and older, even in the absence of risk factors or treatment, and suggest a frequency of every 2–3 years.⁸ Furthermore, it has been suggested that the rate of decline rather than a single measurement of bone density may better identify patients with an elevated risk for fracture.¹¹ Consequently, determining changes in bone density over time may provide clues on the pathophysiology of fractures and provide more accurate estimates of the optimal timing for repeat measurement.Previous studies of change in bone mineral density as a function of age have had a number of limitations. Many were cross-sectional; had small samples, limited age ranges or differing inclusion and exclusion criteria; and most excluded men.^12–20 The third National Health and Nutrition Examination Survey,²¹ a large cross-sectional study based in the United States included women and men aged 20 years and older but excluded only those who were pregnant or who had a fracture in both hips. It reported that, based on a single measurement of bone density in the hip, age-dependent bone loss in the hips begins early (20–40 years) and continues in both sexes throughout life. Cross-sectional data from the ongoing Canadian Multicentre Osteoporosis Study suggested that, although this finding may hold true for the femoral neck, which consists of both cortical and trabecular bone, it is not true for the largely trabecular lumbar spine.²² Furthermore, the use of cross-sectional data to estimate changes over time has fundamental limitations: the effect of age cannot be separated from the effect of birth cohort and survivorship, and estimates are based on between-group differences rather than changes in an individual participant.The use of longitudinal data would allow examination of the rate of change of bone mineral density over time with and without antiresorptive therapy. We sought to assess the average rate of change in bone density as a function of age among Canadians aged 25–85, stratified by sex and use of antiresorptive agents.     

Age-dependent increase in hydrogen peroxide production by cardiac monoamine oxidase A in rats

Oxidative stress is one of the factors involved in age-related impairment of cardiac function. In the present study, we investigated the role of the catecholamine-degrading enzyme monoamine oxidase (MAO) in H(2)O(2) production in the hearts of young, adult, and old rats. MAO-dependent H(2)O(2) production, measured by a chemiluminescence-based assay, increased with age, reaching the maximum in 24-mo-old rats (7.5-fold increase vs. 1-mo-old rats). The following observations indicate that the age-dependent increase in H(2)O(2) generation was fully related to the MAO-A isoform: 1) at all the ages tested, chemiluminescence production was inhibited by the MAO-A inhibitor clorgyline but not by the MAO-B inhibitor RO-19 6327; 2) enzyme assay, Western blot, and semiquantitative RT-PCR analysis showed an age-dependent increase in cardiac MAO-A activity, immunodetection, and mRNA expression, respectively; and 3) the MAO-B isoform was undetectable by enzyme assay and Western blot analysis. These results suggest that MAO-A could be a major source of H(2)O(2) in the aging heart.     

Sensitivity of Na-coupled d-glucose uptake, Mg-ATPase and sucrase to perturbations of the fluidity of brush-border membrane vesicles induced by n-aliphatic alcohols

The aim of our work is to show the importance of the role of hydrophobic bonds in maintaining Mg²⁺-ATPase or sucrase activity and Na⁺-coupled d-glucose uptake normal for the brush border of rat enterocytes. The activity of the two enzymes and the d-glucose uptake were therefore measured under the action of n-aliphatic alcohols and related to the fluidity determined by ESR. Three concentrations were used for the first eight alcohols, those of octanol being about 1500-times lower than those of methanol. For each alcohol the d-glucose uptake and the fluidity were linear functions of the logarithm of the concentration, the linear regressions being practically parallel and equidistant. The concentrations (C) of the eight alcohols inhibiting the d-glucose uptake by 80% were similar to those increasing the membrane fluidity by 3%. The linear relationship which existed in both cases between log 1 / C and log P, P being octanol / water partition coefficients of the alcohols, was evidence of great sensitivity to the hydrophobic effect of the alcohols. Only the first alcohols, however, produced any notable inhibition of Mg²⁺-ATPase and sucrase. Hydrophobic bonds are thus shown to have little influence in maintaining the activity of Mg²⁺-ATPase and sucrase, but they modulate the Na⁺-coupled d-glucose uptake.