The role of insulin in the stimulation of renal 1,25-dihydroxyvitamin D synthesis by parathyroid hormone in rats

To evaluate the role of insulin in 1,25-dihydroxyvitamin D [1,25(OH)2D] production in response to PTH, 25-hydroxyvitamin D-1 alpha-hydroxylase activity in kidney homogenates as well as serum 1,25(OH)2D concentration was measured both after dietary calcium (Ca) deprivation and after PTH infusion in control and streptozotocin-diabetic rats. Although serum Ca and phosphate (Pi) levels did not change significantly after dietary Ca deprivation for 1 week, urinary cAMP excretion increased significantly, indicating that dietary Ca deprivation caused secondary hyperparathyroidism without a significant change in serum Ca level. In control rats, renal 1 alpha-hydroxylase activity increased markedly from 0.11 +/- 0.05 to 1.70 +/- 0.46 ng/300 mg tissue/20 min in parallel with the change in serum 1,25(OH)2D level from 121 +/- 8 to 360 +/- 54 pg/ml in response to Ca deprivation. In contrast, serum 1,25(OH)2D level (82 +/- 3 pg/ml) and 1 alpha-hydroxylase activity (0.07 +/- 0.02 ng/300 mg tissue.20 min) were lower in the diabetic rats on a normal Ca diet than those in control rats, and the increase in both 1,25(OH)2D level and 1 alpha-hydroxylase activity in response to Ca deprivation was suppressed in diabetic rats (136 +/- 24 pg/ml and 0.38 +/- 0.12 ng/300 mg tissue.20 min, respectively, after Ca deprivation). Insulin treatment of the diabetic rats restored the baseline levels of serum 1,25(OH)2D (125 +/- 14 pg/ml) and renal 1 alpha-hydroxylase activity (0.21 +/- 0.02 ng/300 mg tissue.20 min) as well as those after Ca deprivation (340 +/- 52 pg/ml and 2.05 +/- 0.30 ng/300 mg tissue.20 min, respectively). Furthermore, when control and diabetic rats were thyroparathyroidectomized and infused with a maximal stimulatory dose of PTH, the increase in serum 1,25(OH)2D and renal 1 alpha-hydroxylase activity in response to PTH was markedly inhibited in diabetic rats. In addition, the baseline levels of serum 1,25(OH)2D and renal 1 alpha-hydroxylase activity in thyroparathyroidectomized diabetic rats were not different from those in control rats. These results are consistent with the conclusion that insulin plays an important role in the regulation of renal 1 alpha-hydroxylase activity and serum 1,25(OH)2D levels in response to PTH.     

Stimulatory effect of insulin-like growth factor-1 on renal Pi transport and plasma 1,25-dihydroxyvitamin D3

Administration of GH increases both the tubular reabsorption of inorganic phosphate (Pi) and the plasma level of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. These two effects could be induced by a common mediator, possibly the GH-generated insulin-like growth factor 1 (IGF-1). In the present work, the influence of recombinant human IGF-1 on renal Pi transport and plasma 1,25-(OH)2D3 was examined in hypophysectomized (HPX) rats. IGF-1, infused by miniosmotic pump at the dose of 10 micrograms/h for 6 days, significantly increased the maximal tubular reabsorption of Pi per unit volume of glomerular filtrate (max TRPi/m1GFR): IGF-1 3.50 +/- 0.16; vehicle: 2.78 +/- 0.14 mumol/m1GFR, P less than 0.005. The response was associated with a marked stimulation of plasma 1,25-(OH)2D3 (IGF-1; 409 +/- 23; vehicle: 208 +/- 22 pmol/liter, P less than 0.001). As previously reported for GH, IGF-1 also increased GFR and reduced urinary sodium excretion. In brush border membrane vesicles isolated from renal cortex of HPX rats, the Na-dependent Pi transport was stimulated by IGF-1. Neither the Na-dependent glucose transport nor that of alanine was affected by the growth factor. The stimulatory effect of IGF-1 on maxTRPi/m1GFR was also expressed in thyroparathyroidectomized (TPTX) HPX rats (IGF-1: 5.20 +/- 0.29; vehicle: 3.88 +/- 0.37 mumol/m1GFR, P less than 0.025). In conclusion, administration of IGF-1 in HPX rats mimics the stimulatory effects of GH on maxTRPi/m1GFR and on plasma 1,25-(OH)2D3. As described for GH the change in maxTRPi/m1GFR is mediated by a PTH independent mechanism and is expressed at the level of the luminal membrane of proximal tubules. These results suggest that IGF-1 could be an important factor in the control of Pi metabolism, particularly during growth, and might play a significant role in mediating the effect of GH on the renal handling of Pi and production of 1,25-(OH)2D3.     

Changes in calcium homeostasis in acromegaly treated by pituitary adenomectomy

Patients with acromegaly have alterations in mineral metabolism. To determine the effect of correction of excess GH secretion on calcium metabolism, we studied 12 acromegalic patients before and 3-4 weeks after pituitary adenomectomy. Treatment of acromegaly resulted in significant decreases in both serum calcium [from 9.3 +/- 0.2 to 8.7 +/- 0.1 mg/dl (mean +/- SEM); P less than 0.01] and urinary calcium excretion (from 200 +/- 24 to 88 +/- 12 mg/24 h; P less than 0.0002). Serum phosphate also decreased significantly (P less than 0.01) from 4.8 +/- 0.2 to 4.3 +/- 0.2 mg/dl. Both serum immunoreactive PTH and calcitonin levels were normal initially and did not change after surgery. The mean serum 25-hydroxyvitamin D (25OHD) level was significantly (P less than 0.01) lower and the 1,25-dihydroxyvitamin D [1,25-(OH)2D] level was significantly (P less than 0.0001) higher in acromegaly compared with measurements in 25 normal subjects. After surgery, the serum 25OHD level did not change; however, the serum 1,25-(OH)2D concentration fell significantly (P less than 0.0001) from 60 +/- 4 to 43 +/- 2 pg/ml. A positive correlation was found between the decrements in urinary calcium excretion and the serum 1,25-(OH)2D level when the comparison was made between the decrements as percentages of pretreatment values (r = 0.64; P less than 0.05). The accumulated data suggest that the hypercalciuria in acromegaly might be due to intestinal calcium hyperabsorption, which could be attributed to the elevated circulating 1,25-(OH)2D level. Excessive GH secretion might stimulate the production of 1,25-(OH)2D and might also directly stimulate calcium absorption.     

Parathyroid hormone modulation of 25-hydroxyvitamin D3 metabolism by cultured chick kidney cells is mimicked and enhanced by forskolin

In order to determine whether cAMP mediates the effects of PTH on the metabolism of 25-hydroxyvitamin D3 (25-OH-D3) on chick kidney cells in primary culture, the effect of forskolin on the production of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] and 24,25-dihydroxyvitamin D3 [24,25-(OH)2D3] was assessed. In 4-h incubations with [3H]25-OH-D3 and forskolin, (1-10 microM) [3H]1,25-(OH)2D3 accumulation was increased 50-100%, and that of [3H]24,25-(OH)2D3 was decreased 30-60%. PTH (1-10 ng/ml) brought about identical changes. Similar results were observed when cultures were preincubated with nonradioactive 25-OH-D3 for 4 h in the presence of PTH and forskolin, followed by a 30-min incubation with radioactive substrate. At a low concentration (0.05 microM), forskolin alone had no effect on the metabolism of [3H]25-OH-D3 but markedly enhanced that of PTH. At maximal concentrations of PTH (10 ng/ml) and forskolin (10 microM), the effects of the two on 25-OH-D3 metabolism were not additive. Both PTH and forskolin decreased the further metabolism of [3H]1,25-(OH)2D3, probably by inhibiting its 24-hydroxylation, but there are also cycloheximide-sensitive steps in the metabolism of 1,25-(OH)2D3 that are not affected by PTH and forskolin. In time course experiments, increased [3H]1,25-(OH)2D3 accumulation could be observed before the detection of 24-hydroxylase activity suggesting that the primary effect of PTH and forskolin is on the production of [3H] 1,25-(OH)2D3 rather than its catabolism. Raising the calcium concentration of the medium to 2.5 mM from the normal 1.8 mM or lowering it to 0.5 mM for 24 h in serum-free medium did not alter the response of 25-OH-D3 metabolism to these agents. The results of these studies indicate that the effects of PTH on the metabolism of 25-OH-D3 by chick kidney cells are mediated by cAMP, since they can be enhanced and mimicked by forskolin, that they are exerted at the level of both 1- and 24-hydroxylase activity, and that they are not dependent on the calcium concentration of the medium.     

Lack of effect of 24,25-dihydroxyvitamin D3 administration on parameters of calcium metabolism

Seven patients with disordered calcium metabolism and high normal or elevated serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] were studied before and after the administration of 24,25-(OH)2D3 to determine its effects on calcium metabolism. Despite a significant increase in the mean serum 24,25-(OH)2D level [2.1 +/- 0.6 (+/- SE) to 16.7 +/- 6.2 nmol/L; P less than 0.05] after a daily dose of 20 micrograms for 1 month, there were no consistent changes in serum calcium, immunoreactive PTH, or 1,25-(OH)2D concentrations. Intestinal calcium absorption and urinary calcium excretion rose slightly during 24,25-(OH)2D administration in the majority of the patients. In the three patients in whom it was measured, serum 1,24,25-trihydroxyvitamin D levels did not change (19 +/- 5 vs. 20 +/- 5 pmol/L). We conclude that exogenous 24,25-(OH)2D3 at this dose has no significant antagonistic action on 1,25-(OH)2D and may have weak agonistic action.     

Parathyroid hormone sensitivity in familial X-linked hypophosphatemic rickets

X-Linked hypophosphatemic rickets is associated with low or normal serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] concentrations despite low circulating levels of inorganic phosphate. It is generally believed that the enzyme 25-hydroxyvitamin D 1 alpha-hydroxylase does not respond appropriately to either hypophosphatemia or PTH in this condition. We performed 6-h human PTH-(1-34) infusions in five patients with X-linked hypophosphatemic rickets who were receiving vitamin D and phosphate therapy. We measured changes in serum 1,25-(OH)2D, serum calcium, urinary nephrogenous cAMP, and phosphate clearance. Human PTH-(1-34) caused a rise in serum calcium, a rise in nephrogenous cAMP, a fall in renal phosphate reabsorption, and, in particular, a rise in serum 1,25-(OH)2D. All of these responses were indistinguishable from those in normal subjects or patients with surgical or idiopathic hypoparathyroidism. The population studied was not homogeneous, and in one elderly man with mild renal impairment serum 1,25-(OH)2D concentrations did not increase. Nevertheless, these results suggest that absolute PTH resistance is not a feature of X-linked hypophosphatemic ricket, although subtle forms of resistance at the level of the 25-hydroxyvitamin D 1 alpha-hydroxylase enzyme are not excluded by these data.     

Absence of effect of 24,25-dihydroxyvitamin D3 in primary hyperparathyroidism

Nineteen patients with primary hyperparathyroidism were treated with 25 micrograms 24,25-dihydroxyvitamin D3 or placebo daily for 3 months according to double-blind cross-over protocol. Serum immunoreactive PTH, total and ionized calcium, urinary calcium excretion, tubular reabsorption of phosphate/glomerular filtrate, and urinary hydroxyproline excretion did not change significantly. Serum 24,25-dihydroxyvitamin D3 levels increased significantly from 1.4 +/- 2.2 (SD) nmol/liter to 38 +/- 11 nmol/liter during the treatment period. Serum 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 levels did not change. We conclude that pharmacological doses of 24,25-dihydroxyvitamin D3 have no suppressive effect on parathyroid function in primary hyperparathyroidism.     

Contribution of the biliary pathway to the homeostasis of vitamin D3 and of 1,25-dihydroxyvitamin D3.

The role of the biliary pathway in the homeostasis of the vitamin D3 (D3) group of compounds is poorly understood. The purpose of the studies was to investigate the biliary excretion pattern of materials derived from the parent compound D3 and from the hormone 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) during constant iv infusion, and to probe the influence of 1,25(OH)2D3 pretreatment on the excretion into the bile of D3-derived materials. Under anesthesia, the bile duct, duodenum (for bile replacement), and jugular veins were cannulated. The experiments were then carried out in fully awake rats with access to food and water ad libitum during a period of 6 h. Data indicate that before steady state was reached, biliary excretion of 1,25(OH)2[3H]D3 was much more important than that of [14C]D3 with bile/plasma concentration ratios above 1 in 1,25(OH)2[3H]D3-infused animals from the 15th-60th min of infusion compared to ratios between 0.12-0.40 in [14C]D3-infused rats (P less than 0.0001); this led to a cumulative excretion 6.3-fold higher after 1,25(OH)2[3H]D3 than after [14C]D3 administration, with 3.9 +/- 0.4% and 0.6 +/- 0.1% of the dose being recovered into the bile during the first hour of excretion. However, once stable plasma concentrations were reached, the rate of excretion of the two compounds became similar, with bile/plasma concentration ratios of 0.64 +/- 0.02 and 0.70 +/- 0.02 (P greater than 0.05), and plasma bile clearance of 26.4 +/- 1.0 and 25.7 +/- 1.7 microliters/min.kg for 1,25(OH)2[3H]D3 and [14C]D3, respectively (P greater than 0.05). During that period, the MCR of 1,25(OH)2D3 was estimated to be 118.3 +/- 10.5 microliters/min.kg. On the other hand, 1,25(OH)2D3 pretreatment as constant ip infusion (14 pmol/24 h for 6 days) significantly increased bile flow [1,25(OH)2D3 treated, 44.9 +/- 1.6 microliters/min.kg; untreated, 36.6 +/- 0.5 microliters/min.kg, P less than 0.01)], leading to significant increases in the plasma bile clearance of [14C]D3-derived compounds early in the course of the study (P less than 0.004) in the presence of similar bile/plasma concentration ratios in the two groups. During the steady state phase of investigation, however, bile/plasma concentration ratios became lower in 1,25(OH)2D3-than in placebo-treated animals (P less than 0.05), but due to the 1,25(OH)2D3-mediated increase in bile flow, similar plasma bile clearances were observed in both groups.(ABSTRACT TRUNCATED AT 400 WORDS)     

Fibroblast growth factor-23 relationship to dietary phosphate and renal phosphate handling in healthy young men

The renal handling of inorganic phosphate (Pi) is controlled not only by PTH, but also by hitherto undetermined mechanisms dependent on phosphate intake. Recently, fibroblast growth factor (FGF)-23 was identified as a novel phosphaturic factor in tumor-induced osteomalacia and autosomal-dominant hypophosphatemic rickets. We hypothesized that phosphate intake could influence FGF-23 concomitantly to the changes in renal Pi handling. Twenty-nine healthy males were subjected to a 5-d low-phosphate diet and a phosphate binder, followed by a high-phosphate diet including supplements. Concomitant modifications in calcium intake allowed minimizing PTH changes in response to dietary phosphate. Serum FGF-23 levels significantly decreased on the low-phosphate diet, then increased with the oral phosphate load. Changes in FGF-23 were positively correlated with changes in 24-h urinary Pi excretion and negatively correlated with changes in the maximal tubular reabsorption of Pi and 1,25(OH)(2)D(3) (calcitriol), whereas PTH was not. In multivariate analysis, changes in FGF-23 remained the most significantly correlated to changes in 1,25(OH)(2)D(3) and maximal tubular reabsorption of Pi. Moreover, FGF-23 was positively correlated to serum osteocalcin, a marker of osteoblastic activity. In summary, FGF-23 was inversely related to renal Pi transport and serum calcitriol levels in healthy young men. These data suggest that FGF-23 may be implicated in the physiological regulation of Pi homeostasis in response to dietary phosphate changes, independent of PTH.     

Parathyroid hormone down-regulates 1,25-dihydroxyvitamin D receptors (VDR) and VDR messenger ribonucleic acid in vitro and blocks homologous up-regulation of VDR in vivo

1,25-Dihydroxyvitamin D3 [1,25(OH)2D3) is a known up-regulator of 1,25(OH)2D3 receptor (VDR) both in vitro and in vivo. However, a 5- to 10-fold increase in plasma 1,25(OH)2D3 induced by dietary calcium deficiency does not result in up-regulation of intestinal VDR, and kidney VDR is down-regulated. Under certain physiological stresses, an increase in plasma PTH precedes increased plasma 1,25(OH)2D3. Therefore, the present study examined the effect of PTH on VDR regulation in vitro in ROS 17/2.8 cells and in vivo in male Holtzman rats. Treatment of ROS cells with PTH (0-5 nM) resulted in a dose and time-dependent decline in VDR from 95 +/- 9 to 35 +/- 5 fmol/mg protein at 18 h of exposure. The ED50 for PTH was 1 nM. This decline in VDR protein was attended by a 50% decline in VDR messenger RNA (mRNA). The PTH-mediated down-regulation of VDR occurred without affecting the affinity of VDR for 1,25(OH)2D3 as determined by Scatchard analysis. Also, the effect of PTH on VDR regulation was specific since cell glucocorticoid receptor concentration was not affected by PTH treatment. In accompanying experiments, 1,25(OH)2[3H]D3 treatment of ROS cells was shown to result in a 3- to 4-fold increased expression of VDR and VDR mRNA. The simultaneous addition of PTH and 1,25(OH)2[3H]D3 resulted in inhibition of the 1,25(OH)2[3H]D3-mediated up-regulation of VDR and VDR mRNA. Similarly, PTH also inhibited heterologous up-regulation of VDR and VDR mRNA induced by retinoic acid. In in vivo experiments, rats infused for 5 days with 1,25(OH)2D3 (1.5 ng/h) increased their expression of intestinal VDR, kidney VDR, and kidney 24-hydroxylase by 31, 336, and 4000%, respectively. Coinfusion of PTH (1.8 IU/h) along with 1,25(OH)2D3 completely inhibited the 1,25(OH)2D3-mediated increases in intestinal VDR and kidney 24-hydroxylase and reduced the 1,25(OH)2D3-mediated up-regulation of kidney VDR by more than half. These data suggest that PTH is a potent down-regulator of VDR and that PTH and 1,25(OH)2D3 have opposing effects on the expression of certain genes.     

Calcium-regulating hormones across the menstrual cycle

Midcycle elevations of serum PTH, calcitonin (CT), and 1,25-dihydroxyvitamin D [1,25-(OH)2D] in women have been reported. To examine the effects of cyclic changes in ovarian steroid secretion on calcitropic hormone concentrations, we used a cytoreceptor assay for 1,25-(OH)2D and homologous RIAs for PTH and CT to measure these hormones in daily blood samples obtained from six women throughout the menstrual cycle. Significant changes in serum PTH, CT, 1,25-(OH)2D, calcium, and phosphorus concentrations during the cycle were not found; transverse means (+/- SE) were 101 +/- 3.5 pg/ml for PTH, 30.8 +/- 1.8 pg/ml for CT, and 40.1 +/- 1.7 pg/ml for 1,25-(OH)2D. In addition, CT reserve was assessed by calcium infusion (3 mg/kg, iv, in 10 min) during the early and late follicular and midluteal phases of the cycle. Although serum CT increased significantly (P less than 0.01) after calcium infusion, the mean (+/- SE) increment (23.2 +/- 2.2 pg/ml) did not significantly differ in the three phases of the cycle (early follicular, 23.8 +/- 4.0; late follicular, 23.3 +/- 3.4; midluteal, 22.5 +/- 4.1). Our data do not support previous reports of midcycle elevations in serum PTH, CT, and 1,25-(OH)2D concentrations, and we conclude that serum concentrations of the calcitropic hormones do not significantly vary during the menstrual cycle.     

Infusions of parathyroid hormone in ruminants: hypercalcemia and reduced plasma 1,25-dihydroxyvitamin D concentrations

The relationship between infused synthetic bovine PTH-(1-34) and plasma concentrations of minerals and vitamin D metabolites was studied in eight calves (150-230 kg) and two thyroparathyroidectomized goats. Calves were infused iv with saline for 15-20 h. Then, calves were infused with one of three types of solution for an additional 35-h period. Three of the eight calves received 3 ng/kg X min (group H), three received 0.75 ng/kg X min (group L), and the remaining two calves received control saline over a 33-h period (group C). Blood samples were taken every 4-6 h. Plasma calcium, phosphorus, hydroxyproline, and 1,25-dihydroxyvitamin D [1,25-(OH)2D] remained relatively constant in control calves. PTH infusions into calves in group H resulted in an increase in plasma calcium from 2.4 to a plateau of 3.0 mmol/liter. PTH infusion caused no change in plasma phosphorus, but increased urinary excretion of phosphorus. Infusion of PTH caused a moderate increase in urinary calcium excretion, followed by pronounced calciuria after PTH withdrawal. Plasma concentrations of 1,25-(OH)2D decreased from about 30 pg/ml at the start of infusion to undetectable levels (less than 5 pg/ml) at the end of the infusion and for 30 h thereafter. Similar, but less pronounced, changes in plasma calcium and 1,25-(OH)2D concentration were observed in group L. Hypocalcemia and hypophosphatemia developed in the two lactating goats after thyroparathyroidectomy, and plasma 1,25-(OH)2D concentrations were decreased. PTH infusion (3 ng/kg X min) corrected the hypocalcemia and hypophosphatemia and markedly raised plasma 1,25-(OH)2D concentrations. When calcium chloride was infused in addition to PTH, the resulting hypercalcemia (3 mmol/liter) was associated with a marked reduction in plasma 1,25-(OH)2D. We conclude that the concentration of calcium in plasma has the major regulatory role on plasma 1,25-(OH)2D concentrations in ruminant species when potentially conflicting signals, such as hypercalcemia and high PTH concentrations, are present simultaneously.     

Parathyroid hormone effects on serum 1,25-dihydroxyvitamin D levels in patients with X-linked hypophosphatemic rickets: evidence for abnormal 25-hydroxyvitamin D-1-hydroxylase activity

Patients with X-linked hypophosphatemic rickets (XLH) have normal or marginally low serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] levels despite manifesting hypophosphatemia and phosphate depletion, which increase 1,25-(OH)2D production in many animal species. These data are consistent with the possibility that regulation of vitamin D metabolism is abnormal in XLH. However, controversy concerning the role of phosphate in the regulation of 25-hydroxyvitamin D-1-hydroxylase activity in man has raised doubt about this proposed defect. The presence of a defect in vitamin D metabolism could be established if hormonal or metabolic factors, other than hypophosphatemia, were unable to stimulate 25-hydroxyvitamin D-1-hydroxylase activity normally in patients with XLH. Thus, we compared the effects of parathyroid hormone infusion on serum 1,25-(OH)2D levels in patients with XLH and normals. In response to iv infusion of parathyroid extract (200 U at 0915 and 1700 h), the serum 1,25-(OH)2D concentration increased 218% above base line (from 34.0 +/- 3.0 to 108.8 +/- 2.5 pg/ml) in normals and only 68% (from 30.6 +/- 3.0 to 48.8 +/- 5.5 pg/ml) in patients with XLH. The disparate response occurred in spite of an equivalent increase in urinary cAMP excretion in the normals (from 3.00 +/- 0.14 to 8.70 +/- 0.25 mumol/g creatinine . 24 h) and XLH patients (from 3.10 +/- 0.39 to 8.30 +/- 1.0 mumol/g creatinine . 24 h) as well as equivalent decreases in the renal tubular maximum for the reabsorption of phosphate per liter glomerular filtrate (1.2 +/- 0.1 and 0.9 +/- 0.2 mg/dl, respectively). These observations support the possibility that regulation of vitamin D metabolism is abnormal in XLH.     

Response to parathyroid hormone and 1,25-dihydroxyvitamin D3 of bone-derived cells isolated from normal children and children with abnormalities in skeletal development

In order to evaluate the role of intrinsic defects in osteoblast function in the pathogenesis of diseases of skeletal development, we developed techniques which permit the evaluation of the metabolic properties of bone-derived cells in vitro. Cells from control children demonstrated a variety of properties classically attributed to osteoblasts (presence of alkaline phosphatase positive cells and synthesis of bone gla protein) and responded to PTH (cAMP production) and to 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) ([3H]25-hydroxyvitamin D3 conversion into [3H]24,25-dihydroxyvitamin D3 and bone gla protein secretion). Using these techniques we evaluated the function of cultured bone cells from patients with three rare diseases of skeletal development. Cells from a patient with rickets resistant to 1,25(OH)2D3 were resistant to 1,25(OH)2D3 but responded normally to PTH. Cells from a patient with acroosteolysis with osteoporosis responded normally to PTH and 1,25(OH)2D3. Cells from a patient with hyperphosphatasia with osteoectasia responded normally to 1,25(OH)2D3 but did not respond to PTH. The results demonstrate that bone cell cultures can provide information about the role of osteoblast dysfunction in such diseases.     

1,25-dihydroxyvitamin D3 receptors in the seminiferous tubules of the rat testis increase at puberty

Whether 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] receptor levels correlate with the rapid in vivo growth rate of the testes in the prepubertal rat was examined. Low salt chromatin-localized 1,25-(OH)2D3 receptors were compared in the testes and intestinal mucosa (control) of prepubertal, peripubertal, and mature rats (37, 49, and 90 days old, respectively). The number of 1,25-(OH)2D3 receptors per g wet wt was significantly (P less than 0.02) reduced in the testes of the prepubertal rats compared to those in the peripubertal and mature groups. Conversely, no changes were observed in the 1,25-(OH)2D3 receptor levels in the control tissue intestinal mucosa among these age groups. Further experiments confirmed the identity of the testicular 1,25-(OH)2D3 receptors. The specific [3H]1,25-(OH)2D3-binding component was predominantly localized in the nuclei/chromatin fraction in hypotonic buffers. Scatchard analysis of [3H]1,25-(OH)2D3 binding to the testicular chromatin of adult rats yielded a single specific binding component with a Kd of 0.33 +/- 0.06 nM and a Nmax of 102.3 +/- 6.4 fmol/g tissue (n = 6), which was inhibited by excess 1,25-(OH)2D3, but only minimally by 50 nM 25-hydroxyvitamin D3. Sucrose gradient analysis required hydroxylapatite treatment of fractions after centrifugation to remove free 3H-labeled steroid. With this modification, a discrete 3.6S peak of [3H]1,25-(OH)2D3 was unmasked, which was eliminated by excess 1,25-(OH)2D3, but not by 50 nM 25-hydroxyvitamin D3, or 1 microM cortisol, or the progesterone analog promegestone. In spite of its seemingly ubiquitous distribution, the 1,25-(OH)2D3 receptor does exhibit tissue specificity, since it appears to be absent in the prostate and, at best, greatly reduced in the epididymis. The cellular localization of the testicular 1,25-(OH)2D3 receptors was examined by mechanically separating interstitial cells (93.7% of the total [125I]hCG binding) from the tubules. Under these conditions, 91.3% of the specific [3H]1,25-(OH)2D3 binding occurred in the tubular chromatin preparation. Thus, these data provide evidence for the presence of a specific 1,25-(OH)2D3 receptor in the seminiferous tubules of the rat testis. Moreover, the temporal correlation of increased 1,25-(OH)2D3 receptor levels with testicular maturation suggests a better correlation to testicular function and spermatogenesis than to growth of the organ in vivo.     

Hyperphosphatemic tumoral calcinosis: effects of phosphate depletion on vitamin D metabolism, and of acute hypocalcemia on parathyroid hormone secretion and action

In hyperphosphatemic tumoral calcinosis, plasma 1,25-dihydroxyvitamin D [1,25(OH)2D] levels are inappropriately elevated, suggesting an abnormality in vitamin D metabolism. To define this abnormality further, we measured vitamin D metabolites in two patients and four controls before and after phosphate depletion. The patients showed elevated plasma levels of 1,25(OH)2D in the basal state. Phosphate depletion reduced serum phosphate in patients from a mean of 6.1 to 2.6 mg/dl; this was accompanied by a rise in plasma 25-hydroxyvitamin D from 33.6 to 41.9 ng/dl, and in 1,25(OH)2D from 67.7 to 93.2 pg/ml. The absolute rise in 1,25(OH)2D was similar to that of controls. EDTA infusion produced a normal increase of serum immunoreactive PTH levels and urinary cAMP excretion. In this form of tumoral calcinosis, 1,25(OH)2D levels are elevated despite hyperphosphatemia, normal immunoreactive PTH, and normal serum calcium concentrations, suggesting an abnormality in the regulation of 1,25(OH)2D synthesis or metabolism, or alternatively, another undefined stimulus for 1,25(OH)2D synthesis. These patients appear to have concurrent abnormalities of renal tubular phosphate transport and vitamin D metabolism.     

Production of 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3 by growth zone and resting zone chondrocytes is dependent on cell maturation and is regulated by hormones and growth factors.

1,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] and 24,25-(OH)2D3 have been shown to promote chondrocyte proliferation and differentiation; resting zone chondrocytes respond primarily to 24,25-(OH)2D3, whereas growth zone chondrocytes respond primarily to 1,25-(OH)2D3. This study determined whether resting zone and growth zone cells produce 24,25-(OH)2D3 or 1,25-(OH)2D3; whether this production is regulated by 1,25-(OH)2D3 (10(-8) M), 24,25-(OH)2D3 (10(-7) M), dexamethasone (10(-7) M), or recombinant human transforming growth factor-beta 1 (11 ng/ml); and whether the metabolites produced are biologically active. Confluent fourth passage rat costochondral growth zone or resting zone chondrocytes were cultured in Dulbecco's Modified Eagle's Medium containing [3H]25-hydroxyvitamin D3 ([3H]25OHD3), 2% fetal bovine serum, and antibiotics. Metabolism of [3H]25OHD3 was measured by analyzing the lipid extracts of the conditioned medium and the cell layer for [3H]1,25OHD3, [3H]1,25-(OH)2D3, and [3H]24,25-(OH)2D3 using flow-through scintillation spectroscopy of HPLC eluates. Chemically synthesized radioinert vitamin D3 metabolites were used as standards, and their migration was determined by absorbance at 254 nm. To ensure that the radioactive peaks were 1,25-(OH)2D3 and 24,25-(OH)2D3, the fractions were rechromatographed into three other HPLC solvent systems. Biological activity was confirmed; the addition of HPLC-purified 1,25-(OH)2D3 produced by growth zone chondrocytes elicited a dose-dependent stimulation of alkaline phosphatase specific activity in growth zone cell cultures, but had no effect on the resting zone cells. There was a time-dependent increase in both [3H]1,25-(OH)2D3 and [3H]24,25-(OH)2D3 in the conditioned medium of both types of cultures. At 24 h, the percent conversion of [3H]25OHD3 to [3H]1,25-(OH)2D3 was 5.3 +/- 1.2, and the percent conversion to [3H]24,25-(OH)2D3 was 1.8 +/- 0.4 in growth zone chondrocyte cultures. No such effect was found in cultures freeze-thawed five times or without cells. When resting zone cells were cultured with [3H]25OHD3, the percent conversion to 1,25-(OH)2D3 and 24,25-(OH)2D3 was 4.5 +/- 1.0 and 1.7 +/- 0.4, respectively. The addition of dexamethasone significantly increased the percent production of 1,25-(OH)2D3 at 6 and 24 h and at 6 h by resting zone and growth zone cells, respectively, compared to the control values. Recombinant human transforming growth factor-beta 1 increased the percent production of 1,25-(OH)2D3 after 1 h in resting zone cells and, after 24 h, the production of 24,25-(OH)2D3 in growth zone cells. Radiolabeled 1,25-(OH)2D3 and 24,25-(OH)2D3 were not detected in the cell layer.(ABSTRACT TRUNCATED AT 400 WORDS)     

Calcitonin stimulates 1,25-dihydroxyvitamin D production in diabetic rat kidney

In diabetic animals, there is a decrease in serum 1,25-dihydroxyvitamin D [1,25(OH)2D] and in renal production of 1,25(OH)2D. In nondiabetic animals, renal 1,25(OH)2D production is markedly stimulated by parathyroid hormone (PTH) and calcitonin (CT). There is evidence that diabetes impairs the responsiveness of the kidney to PTH. The effect of diabetes on responsiveness to CT is unknown. The studies reported here determined the effect of streptozotocin-induced diabetes on renal responsiveness to PTH and CT. Experiments were performed in 7- to 8-week-old rats that were fed a diet sufficient in calcium and vitamin D and were thyroparathyroidectomized (TPTX) 5 days before hormone treatment. PTH (0.33 U/g body weight at 24, 12, and 2 hours before death) significantly increased renal 1,25(OH)2D production by threefold in nondiabetic rats. This effect was markedly attenuated by diabetes. On the other hand, CT (20 U/100 g body weight at 12 and 2 hours before death) produced a maximal response in both groups of animals. In diabetic rats, CT stimulated renal 1,25(OH)2D production fivefold, whereas PTH stimulated production only 1.5-fold. Diabetes did not affect the capacity of PTH to increase serum calcium or decrease renal tubular reabsorption of phosphorus (TRP). These findings suggest that the decrease in renal 1,25(OH)2D production seen in experimental diabetes may be due to decreased renal responsiveness to PTH, but not to decreased responsiveness to CT.     

Renal magnesium wasting in a patient with short bowel syndrome with magnesium deficiency: effect of 1 alpha-hydroxyvitamin D3 treatment

We studied a patient with severe hypomagnesemia due to small bowel resection who had marked renal magnesium (Mg) loss in response to iv Mg infusion. She had an undetectable serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] level before treatment. Although Mg infusion increased her serum Mg levels and enhanced renal PTH action, as evidenced by an elevation in nephrogenous cAMP, the serum 1,25-(OH)2D level remained low. After the administration of 1 alpha-hydroxyvitamin D3, her serum 1,25-(OH)2D level increased, and fractional excretion of Mg decreased. With the elevation in serum 1,25-(OH)2D, serum Mg levels could be maintained without Mg infusion, although they were still subnormal. These results are consistent with the assumption that patients with the short bowel syndrome and Mg deficiency have reduced renal tubular Mg reabsorption which causes renal Mg loss, and that impaired tubular Mg reabsorption is due at least in part to deficient renal action of 1,25-(OH)2D. Because depressed serum 1,25-(OH)2D levels cannot be corrected rapidly by Mg infusion, administration of 1 alpha-hydroxyvitamin D3 or 1,25-(OH)2D3 appears to be the treatment of choice for Mg deficiency in patients with short bowel syndrome.     

Glucocorticoids and 1,25-dihydroxyvitamin D3 regulate parathyroid hormone stimulation of adenosine 3',5'-monophosphate-dependent protein kinase in rat osteosarcoma cells

Glucocorticoids increase and 1,25-dihydoxyvitamin D3 [1,25-(OH)2D3] decreases the activity of PTH-responsive adenylate cyclase, altering intracellular cAMP in a rat osteoblast-like cell line (ROS 17/2.8). This study was undertaken to measure the subsequent activation of the cAMP-dependent protein kinase (PKA). Pretreatment of ROS cells for 2 days with the glucocorticoid triamcinolone acetonide (TRM), shifted the dose-response curve for PKA activation by PTH upward compared to the control value. Basal PKA activity was enhanced 50% by TRM, and the PTH concentration required for maximal activation of PKA decreased from 1.0 to 0.05 ng/ml. At the lowest effective PTH concentration (0.05 ng/ml) the mean PKA activity ratio increased to 0.73 in TRM-treated cells compared with 0.45 in untreated cells. Pretreatment with 1,25-(OH)2D3 had opposite effects, shifting the dose-response curve for PKA activation by PTH downward and to the right, decreasing the basal activity ratio from 0.26 to 0.16, and increasing the PTH concentration required for maximal activation to 10 ng/ml. 1,25-(OH)2D3-treated cells stimulated with 0.5-1 ng/ml PTH consistently had lower PKA activity ratios than untreated cells. Simultaneous treatment with 1,25-(OH)2D3 reversed the effect of TRM. There were no differences in total PKA activity (2.57 +/- 0.09 pmol 32P/min.micrograms protein) between treatment groups, suggesting that TRM and 1,25-(OH)2D3 do not alter the cellular PKA concentration. In control experiments exogenous PKA was added to sonication buffer of PTH-stimulated cells to verify that the TRM and 1,25-(OH)2D3 shifts in PKA activation at low PTH doses occur before sonication. cAMP-dependent protein kinase activation was also studied by measuring the progressive occupation of regulatory subunit-binding sites by hormonally stimulated endogenous cAMP. [3H] cAMP binding was expressed as the percent change in bound [3H]cAMP per microgram protein compared to that in unstimulated cells not steroid treated. [3H]cAMP binding to all cytosol fractions decreased as PTH increased over the concentration range predicted by our PKA activation experiments. TRM treatment shifted the curve for [3H]cAMP binding to regulatory subunit downward and to the left, and 1,25-(OH)2D3 treatment shifted it upward and to the right. In cells treated with both TRM and 1,25-(OH)2D3, the curve was similar to control curve. Sonicating unstimulated cells in buffer containing comparable concentrations of added cAMP did not alter [3H]cAMP binding. These and the previous controls suggest that changes in PKA activation at low doses of PKA reflect cellular events occurring before cell disruption.(ABSTRACT TRUNCATED AT 400 WORDS)