Identification and characterization of noncalcemic, tissue-selective, nonsecosteroidal vitamin D receptor modulators

Vitamin D receptor (VDR) ligands are therapeutic agents for the treatment of psoriasis, osteoporosis, and secondary hyperparathyroidism. VDR ligands also show immense potential as therapeutic agents for autoimmune diseases and cancers of skin, prostate, colon, and breast as well as leukemia. However, the major side effect of VDR ligands that limits their expanded use and clinical development is hypercalcemia that develops as a result of the action of these compounds mainly on intestine. In order to discover VDR ligands with less hypercalcemia liability, we sought to identify tissue-selective VDR modulators (VDRMs) that act as agonists in some cell types and lack activity in others. Here, we describe LY2108491 and LY2109866 as nonsecosteroidal VDRMs that function as potent agonists in keratinocytes, osteoblasts, and peripheral blood mononuclear cells but show poor activity in intestinal cells. Finally, these nonsecosteroidal VDRMs were less calcemic in vivo, and LY2108491 exhibited more than 270-fold improved therapeutic index over the naturally occurring VDR ligand 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] in an in vivo preclinical surrogate model of psoriasis.     

Defective binding and function of 1,25-dihydroxyvitamin D3 receptors in peripheral mononuclear cells of patients with end-organ resistance to 1,25-dihydroxyvitamin D.

Lectin-induced DNA synthesis by peripheral mononuclear cells from 17 normal donors was inhibited (40-60%) by 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) at physiological concentrations (10(-10)-10(-9) M). The lymphocytes acquire specific receptors for 1,25(OH)2D3 upon activation by the lectins. This process precedes the inhibitory effect of 1,25(OH)2D3. We studied lymphocytes from six patients from four different kindreds with the syndrome of hereditary end-organ resistance to 1,25(OH)2D (the so-called vitamin D-dependent rickets type II). In five patients (three kindreds) peripheral blood mononuclear cells did not acquire receptors for 1,25(OH)2D3 upon phytohemagglutinin-induced activation. Moreover, in contrast to normal lymphocytes, the mitogenic stimulation of these patients' lymphocytes by phytohemagglutinin and concanavalin A was not inhibited by 1,25(OH)2D3. Activated lymphocytes of the sixth patient from a fourth kindred exhibited normal binding of [3H]1,25(OH)2D3 but the hormone failed to inhibit the mitogenic stimulation. A similar pattern of the vitamin D effector system was previously observed in fibroblasts cultured from skin biopsies of the same group of patients. The conclusions from these findings are: (a) the inhibition of mitogenic stimulation by 1,25(OH)2D3 is mediated by specific functional receptors to the hormone; and (b) the receptors for 1,25(OH)2D3 in mononuclear cells are probably controlled genetically by the same mechanisms as the effector system in well-characterized target organs of the hormone, such as intestine and kidney.     

良性原发性甲状旁腺功能亢进症患者血清1,25-二羟基维生素D3水平变化

目的探讨良性原发性甲状旁腺功能亢进症(primary hyperparathyproidism,PHPT)患者血清1,25-二羟基维生素D3[1,25-dihydroxyvitamin D3,1,25(OH)2D3]水平变化及与甲状旁腺激素(parathyroid hormone,PTH)、血钙、血磷的关系。方法良性PHPT患者56例为观察组,同期体检健康者1118例为对照组,采用电化学发光法检测2组血清1,25(OH)2D3、PTH水平,比色法测定血钙水平,磷钼酸盐法测定血磷水平。比较2组维生素D缺乏[1,25(OH)2D3<20μg/L]、严重缺乏[1,25(OH)2D3<10μg/L]的比率及不同年龄分层患者血清1,25(OH)2D3水平变化,Pearson法分析观察组维生素D缺乏、严重缺乏患者血清1,25(OH)2D3与PTH、血钙及血磷的相关性。结果观察组维生素D缺乏比率、严重缺乏比率(94.64%、46.43%)高于对照组(62.79%、14.13%)(P<0.05);Pearson相关分析显示,观察组血清1,25(OH)2D3与PTH、血钙及血磷均无线性相关性(r=-0.226,P=0.352;r=-0.274,P=0.256;r=0.073,P=0.593)。观察组年龄18~40岁、>40~60岁、>60岁患者血清1,25(OH)2D3[(10.76±3.17)、(10.61±5.01)、(10.72±4.85)μg/L]低于对照组[18~40岁:(18.19±9.86)μg/L,>40~60岁:(17.18±9.19)μg/L,>60岁:(17.91±10.52)μg/L](P<0.05);观察组维生素D缺乏患者血清PTH[(818.86±233.49)ng/L]、血钙[(2.98±0.59)mmol/L]、血磷[(0.78±0.17)mmol/L]与维生素D严重缺乏患者[(640.09±622.69)ng/L、(2.96±0.69)mmol/L、(0.75±0.20)mmol/L]比较差异无统计学意义(P>0.05);观察组维生素D缺乏、严重缺乏患者血清1,25(OH)2D3与PTH(r=-0.360,P=0.060;r=0.071,P=0.723)、血钙(r=-0.225,P=0.250;r=-0.228,P=0.252)、及血磷(r=0.239,P=0.221;r=-0.208,P=0.297)均无线性相关。结论良性PHPT患者血清1,25(OH)2D3低于正常人群,维生素D缺乏比率较高,且血清1,25(OH)2D3与PTH、血钙及.血磷无线性相关。     

1,25-Dihydroxyvitamin D3 and its analogues inhibit acute myelogenous leukemia progenitor proliferation by suppressing interleukin-1beta production.

We hypothesized that 1,25-dihydroxyvitamin D3 (1,25D3) and its analogues may inhibit acute myelogenous leukemia (AML) proliferation by interrupting IL-1beta-mediated growth-stimulatory signals. The incubation of the IL-1beta- responsive AML cell line OCIM2 with 10 nM 1,25D3 reduced growth 80% in liquid culture, and a 100-1000-fold lower concentration of 20-epi analogues (MC1288 and MC1301) was sufficient to achieve similar growth inhibition. The growth inhibition was associated with a rapid but transient downregulation of IL-1beta and IL-1beta-converting enzyme (ICE) mRNAs in 1,25D3- and 20-epi analogue- treated cells, and the 20-epi analogue was more effective than 1,25D3 in repressing ICE expression. An examination of long-term changes in the levels of mature IL-1beta and its precursor revealed that 24-h incubation of OCIM2 with either 1,25D3 or its 20-epi analogues abolished the production of mature IL-1beta. The effect of 1,25D3 and its analogues on growth of fresh bone marrow cells from seven AML patients was tested by a clonogenic assay. Growth inhibition of 60% was reached in only one of seven 1,25D3-treated samples, but all seven samples were inhibited 60-90% by the 20-epi analogue MC1301. Growth inhibition by 1,25D3 and the analogue was reversible by addition of IL-1beta. These results suggest that 1,25D3 and its 20-epi analogues interrupt IL-1beta autocrine growth regulation by inhibiting IL-1beta production and processing but not the response to IL-1beta.     

Cisplatin potentiates 1,25-dihydroxyvitamin D3-induced apoptosis in association with increased mitogen-activated protein kinase kinase kinase 1 (MEKK-1) expression

1,25-Dihydroxyvitamin D3 (1,25D3) exhibits potent antitumor activity in the murine squamous cell carcinoma (SCC) SCCVII/SF, and the combination of 1,25D3 with cisplatin (1,25D3/cisplatin) demonstrates even greater activity. Because these agents possess different mechanisms of cytotoxicity, studies were initiated to define the mechanism by which the combination displays enhanced activity. Median dose-effect analysis demonstrates that 1,25D3 and cisplatin act synergistically to inhibit SCC growth. When SCC cells were treated with 1,25D3 (10 nM) and/or cisplatin (0.5 microg/ml), greater caspase-3 activation was observed for the combination than for either agent alone. This suggests that the enhanced cytotoxicity is, at least in part, due to greater induction of apoptosis. No alterations in cellular platinum concentration or platinum-DNA adducts were observed for 1,25D3/cisplatin cotreatment compared with cisplatin treatment alone. Effects of the combination on cisplatin and 1,25D3 signaling pathways in adherent (nonapoptotic) and floating (apoptotic) cells were explored. Cisplatin induced p53 and its downstream targets, p21(Cip1) (p21) and Bax, in both cell populations. In contrast, 1,25D3 reduced p53, p21, and Bax to nearly undetectable levels in adherent cells. In the floating cells, 1,25D3 reduced levels of p53 and p21, but Bax expression was maintained at control levels. Expression of these proteins in cells treated with 1,25D3/cisplatin was similar to treatment with 1,25D3 alone. The two agents also had divergent effects on survival and stress signaling pathways. Phospho-extracellular signal-regulated kinase 1/2 and phospho-Jun levels increased after treatment with cisplatin but decreased after treatment with 1,25D3 and 1,25D3/cisplatin. Moreover, cisplatin decreased levels of mitogen-activated protein kinase kinase kinase (MEKK-1), whereas 1,25D3 up-regulated MEKK-1, and 1,25D3/cisplatin further up-regulated MEKK-1. We propose that the increased cytotoxicity for 1,25D3/cisplatin results from cisplatin enhancement of 1,25D3-induced apoptotic signaling through MEKK-1.     

Retinoic acid uses divergent mechanisms to activate or suppress mitogenesis in rat aortic smooth muscle cells.

In different experimental models, retinoid has been shown to stimulate or suppress mitogenesis in cultured cells. The mechanisms underlying this seemingly paradoxical activity remain only partially understood. We have examined the ability of all-trans retinoic acid (ATRA), as well as a number of synthetic retinoids, either alone or in the presence of a mitogenic stimulus (i.e., endothelin), to regulate DNA synthesis and cell replication in cultured rat aortic smooth muscle cells. ATRA alone stimulates [3H]thymidine incorporation (approximately twofold) and increases cell number (approximately twofold) in these cultures but suppresses [3H]thymidine incorporation and reduces cell number in cultures treated with endothelin. The reduction in endothelin-stimulated DNA synthesis correlates closely with the ability of ATRA to inhibit endothelin-stimulated extracellular signal-regulated kinase but not c-Jun NH2-terminal kinase activity. Activation of mitogenesis, seen in the presence of ATRA alone, was independent of extracellular signal-regulated kinase activation but correlated well with increased expression of cyclin D1 mRNA and protein. Concomitant activation of the cdk inhibitor p21 led to truncation of ATRA's mitogenic activity at higher doses of ligand. Collectively, these data indicate that the role of retinoids in the regulation of mitogenesis in vascular smooth muscle is complex. Under quiescent conditions they activate mitogenesis, while in the presence of growth stimulation, as is frequently seen with vasculopathic conditions, they suppress mitogenesis. It appears that independent circuitry is involved in signaling each of these effects.     

Pertussis toxin inhibits hormonal stimulation of bone resorption in fetal rat limb bones.

The cellular basis for hormonal control of bone resorption is poorly understood. As the identifiable receptors for bone resorbing agents such as parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] are located on osteoblasts rather than osteoclasts, the nature of cellular signaling is obscure. Here it is reported that exposure of fetal rat limb bones to pertussis toxin, a bacterial protein that inhibits certain GTP binding proteins (G-proteins) involved in signal transduction, markedly inhibits bone resorption elicited by PTH, 1,25(OH)2D3 and prostaglandin E2. Pertussis toxin does not block the inhibition of alkaline phosphatase activity by PTH or 1,25(OH)2D3, and it potentiates the cyclic AMP response to PTH. These data support the existence of a pertussis toxin-sensitive G-protein that participates in regulation of bone resorption. The putative G-protein is apparently not involved in the initial transduction of hormonal signals, but it may be part of a final common pathway through which the osteoclast is activated by agents with widely divergent initial actions.     

Correction of enhanced Na(+)-H+ exchange of rat small intestinal brush-border membranes in streptozotocin-induced diabetes by insulin or 1,25-dihydroxycholecalciferol.

Diabetes was induced in rats by administration of a single i.p. injection of streptozotocin (50 mg/kg body wt). After 7 d, diabetic rats were further treated with insulin or 1,25-dihydroxycholecalciferol [1,25(OH)2D3] for an additional 5-7 d. Control, diabetic, diabetic + insulin, and diabetic + 1,25(OH)2D3 rats were then killed, their proximal small intestines were removed, and villus-tip epithelial cells were isolated and used to prepare brush-border membrane vesicles. Preparations from each of these groups were then analyzed and compared with respect to their amiloride-sensitive, electroneutral Na(+)-H+ exchange activity, using 22Na uptake as well as acridine orange techniques. The results of these experiments demonstrated that (a) H+ gradient-dependent 22Na uptake as well as Na+ gradient-dependent transmembrane H+ fluxes were significantly increased in diabetic vesicles compared to their control counterparts, (b) kinetic studies demonstrated that this enhanced 22Na uptake in diabetes was a result of increased maximal velocity (Vmax) of this exchanger with no change in apparent affinity (Km) for Na+, (c) serum levels of 1,25(OH)2D3 were significantly lower in diabetic animals compared with their control counterparts; and (d) insulin or 1,25(OH)2D3 treatment restored the Vmax alterations to control values, without any significant changes in Km, concomitant with significantly increasing the serum levels of 1,25(OH)2D3 in diabetic animals. These results indicate that Na(+)-H+ activity is significantly increased in proximal small intestinal luminal membranes of streptozotocin-induced diabetic rats. Moreover, alterations in the serum levels of 1,25(OH)2D3 may, at least in part, explain this enhanced antiporter activity and its correction by insulin.     

The influence of calciotrophic hormones on lymphocyte transformation and interleukin-2 production in human mononuclear cells

Peripheral blood mononuclear cells (PBMC) display receptors for parathyroid hormone (PTH) and calcitonin (CT) and, when activated, express receptors for 1,25 dihydroxyvitamin D3 (1,25(OH)2D3). The role of these receptors in unclear. It is well established that 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) has a significant effect on lymphocyte transformation and interleukin-2 (IL-2) activity in PBMC's. We have proceeded to compare the effects of the calciotrophic hormones, 1,25(OH)2D3, 24,25 dihydroxyvitamin D3 (24,25(OH)2D3), 25 dihydroxyvitamin D3 (25(OH)D3), bovine (1-35)PTH (b(1-35)PTH) and salmon CT on both lymphocyte transformation and IL-2 activity in PBMC's from normal human volunteers. We have also sought an indication as to which subset of cells is responsible for the 1,25(OH)2D3 effect. Unlike the other calciotrophic hormones 1,25(OH)2D3 inhibited the proliferation of phytohemagglutinin (PHA), concanavalin A (ConA) and pokeweed mitogen (PWM) stimulated cells. 1,25(OH)2D3 had a significantly greater effect on PHA induced cell proliferation and only inhibited cells with the T-helper/inducer (TH, CD4 + ve) phenotype, this suggested that 1,25(OH)2D3 may act selectively on the cells with CD4 + ve phenotype. In addition, of the calciotrophic hormones, 1,25(OH)2D3 had a greater effect on IL-2 activity. These findings indicate that 1,25(OH)2D3 and not the other calciotrophic hormones has a significant immunomodulatory effect.     

1,25-DIHYDROXYCHOLECALCIFEROL INDUCES AN INCREASE IN PGE1 - AND FORSKOLIN-STIMULATED CYCLIC-AMP PRODUCTION IN T47D HUMAN BREAST CANCER CELL LINE

The effect of 1,25-dihydroxycholecalciferol [1,25(OH)2D3], the active form of vitamin D3, on cell growth, clonogenicity, and cyclic adenosine monophosphate (cAMP) production was examined in human breast cancer cell line T47D. 1,25(OH)2D3 markedly inhibited proliferation of T47D cells in a time- and concentration-dependent manner. 1,25(OH)2D3 5 X 10(-7) reduced to 70% [3H]thymidine incorporation into DNA. Specific high affinity nuclear receptors for 1,25(OH)2D3 were present in this cell line. The cAMP produced by T47D cells was measured during 10 min stimulation by effectors (prostaglandin E1 or forskolin). Without effector, T47D cells produced similar amounts of cAMP in control and 1,25(OH)2D3-treated cells. After 3 days in the presence of 1,25(OH)2D3, cAMP production was significantly increased compared to control cells when stimulated by 10(-4) M prostaglandin E1 or 5 X 10(-7) M forskolin (3.2- and 2.4-fold increase, respectively). This cAMP increase was concentration dependent within the same range that inhibited cell growth and clonogenicity. These results suggest that 1,25(OH)2D3 may indirectly affect cAMP production by modulating the target cell response to stimulatory agents of cAMP production.     

Effect of amiloride on the compensatory renal growth that follows uninephrectomy in mice

The increase in contralateral kidney mass that follows the removal of one kidney is caused primarily by the hypertrophy and, to a lesser extent, the hyperplasia of tubule cells. Amiloride inhibits the proliferation of cells in tissue culture environments and diminishes compensatory hyperplasia of liver cells after partial hepatectomy. In the current study, we determined the extent to which amiloride diminished the compensatory increase in contralateral kidney weight and protein content after uninephrectomy. Caworth Farms mice, 3 to 4 months of age, received amiloride by daily intraperitoneal injection for 7 days before the left kidney was removed and for an additional 4 days after nephrectomy. Four days after uninephrectomy, compensatory hypertrophy was quantified by the increase in weight and protein content of the right kidney in comparison with the left (R - L divided by L x 100; [weight] +24.7% +/- 2.9% and [protein] +20.6% +/- 4.4%). Treatment with amiloride reversibly reduced the compensatory increase in kidney weight and protein content (dose required to achieve 50% inhibition, 11.4 and 2.4 mg/kg/day, respectively). Hexamethylene amiloride, an analog with weak affinity for conductive Na+ channels and high affinity for Na+-H+ exchangers, had no effect on compensatory hypertrophy. Spironolactone, a natriuretic and antikaliuretic agent of potency similar to that of amiloride, but with a different cellular mechanism of action, had no effect on compensatory hypertrophy. We conclude that amiloride reversibly blunts the compensatory renal hypertrophy after uninephrectomy in mice by mechanisms that appear to be separate from the drug's effects to block Na+-H+ exchange and transepithelial Na+ and K+ transport.     

Serum 1,25 dihydroxy vitamin D (1,25(OH)2D3), 25 hydroxy vitamin D (25(OH)D) and parathormone levels in diabetic retinopathy

OBJECTIVES: To investigate whether there is a relationship between serum 1,25 dihydroxy vitamin D3 [1,25(OH)2D3], which is an inhibitor of angiogenesis, concentrations and severity of diabetic retinopathy (DR). DESIGN AND METHODS: Serum 1,25(OH)2D3, 25 hydroxy vitamin D [25(OH)D] and parathormone (PTH) concentrations were measured in diabetic patients (n = 66) and nondiabetic healthy subjects (n = 20). RESULTS: The mean serum 1,25(OH)2D3 concentration in diabetic patients was lower than that in nondiabetics (57.3+/-21.44 vs. 89.4+/-18.01 pmol/L, p<0.001); mean 1,25(OH)2D3 concentrations fell with increasing severity of DR [being 63.4+/-17.26 pmol/L for background DR (BDR), 47.7+/-13.27 pmol/L for preproliferative DR (pre-PDR), and 43.1+/-19.45 pmol/L for proliferative DR (PDR)]. Compared with the control group, serum 25(OH)D concentrations were found to be decreased in diabetic patients (p<0.001).There were negative correlations between 1,25(OH)2D3 and age (r = -0.331, p<0.01) and duration of diabetes (r = -0.255, p<0.05). CONCLUSION: From these findings, it was found that there was an inverse relationship between the severity of the retinopathy, i.e., neovascularization, and serum 1,25(OH)2D3 concentrations, being the lowest in PDR and the highest in diabetic patients without retinopathy (NDR) patients. The measurement of serum 1,25(OH)2D3 concentrations might be helpful to predict severity of DR in patients with diabetes mellitus.