Egbuna Ogo, Quinn Steven, Kantham Lakshmi, Butters Robert, Pang Jiang, Pollak Martin, Goltzman David, Brown Edward
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Am J Physiol Renal Physiol. 2009 Sep;297(3):F720-8. doi: 10.1152/ajprenal.00164.2009. Epub 2009 May 27.
1Alpha,25(OH)(2) vitamin D(3) [1,25(OH)(2)D(3)] increases serum Ca(2+) concentration in vivo, an action counteracted by activation of the Ca(2+)-sensing receptor (CaSR), which decreases parathyroid hormone (PTH) secretion and increases renal Ca(2+) excretion. Relatively little is known of the role the CaSR plays in this response through its potentially direct actions in kidney, gut, and bone independently of PTH. We report PTH-independent roles of the CaSR in modulating the response to exogenous 1,25(OH)(2)D(3) in mice with targeted disruption of both the CaSR and PTH genes (C(-)P(-)) compared with that in mice with disruption of the PTH gene alone (C(+)P(-)) or wild-type mice (C(+)P(+)). After intraperitoneal injection of 0.5 ng/g body wt 1,25(OH)(2)D(3), peak calcemic responses were observed at 24 h in all three genotypes in association with 1) a greater increase in serum Ca(2+) in C(-)P(-) mice than in the other genotypes on a Ca(2+)-replete diet that was attenuated by a Ca(2+)-deficient diet and pamidronate, 2) increased urinary Ca(2+)-to-creatinine ratios (UCa/Cr) in the C(+)P(-) and C(+)P(+) mice but a lowered ratio in the C(-)P(-) mice on a Ca(2+)-replete diet, and 3) no increase in calcitonin (CT) secretion in the C(+)P(+) and C(+)P(-) mice and a small increase in the C(-)P(-) mice. PTH deficiency had the anticipated effects on the expression of key genes involved in Ca(2+) transport at baseline in the duodenum and kidney, and injection of 1,25(OH)(2)D(3) increased gene expression 8 h later. However, the changes in the genes evaluated did not fully explain the differences in serum Ca(2+) seen among the genotypes. In conclusion, mice lacking the full-length CaSR have increased sensitivity to the calcemic action of 1,25(OH)(2)D(3) in the setting of PTH deficiency. This is principally from enhanced 1,25(OH)(2)D(3)-mediated gut Ca(2+) absorption and decreased renal Ca(2+) excretion, without any differences in bone-related release of Ca(2+) or CT secretion among the three genotypes that could explain the differences in their calcemic responses.
1α,25(OH)₂维生素D₃[1,25(OH)₂D₃]可在体内升高血清Ca²⁺浓度,而该作用会被钙敏感受体(CaSR)的激活所抵消,CaSR的激活会减少甲状旁腺激素(PTH)分泌并增加肾脏Ca²⁺排泄。关于CaSR通过其在肾脏、肠道和骨骼中独立于PTH的潜在直接作用在这种反应中所起的作用,人们了解得相对较少。我们报告了与仅破坏PTH基因的小鼠(C⁺P⁻)或野生型小鼠(C⁺P⁺)相比,在同时破坏CaSR和PTH基因的小鼠(C⁻P⁻)中,CaSR在调节对外源性1,25(OH)₂D₃的反应方面具有不依赖PTH的作用。腹腔注射0.5 ng/g体重的1,25(OH)₂D₃后,在所有三种基因型中,均在24小时观察到血钙峰值反应,这与以下情况相关:1)在钙充足饮食条件下,C⁻P⁻小鼠血清Ca²⁺的升高幅度大于其他基因型小鼠,而在钙缺乏饮食和帕米膦酸盐作用下这种升高幅度减弱;2)在钙充足饮食条件下,C⁺P⁻和C⁺P⁺小鼠的尿Ca²⁺与肌酐比值(UCa/Cr)升高,而C⁻P⁻小鼠的该比值降低;3)C⁺P⁺和C⁺P⁻小鼠的降钙素(CT)分泌没有增加,而C⁻P⁻小鼠有少量增加。PTH缺乏对十二指肠和肾脏中参与Ca²⁺转运的关键基因在基线时的表达有预期的影响,注射1,25(OH)₂D₃ 8小时后基因表达增加。然而,所评估基因的变化并不能完全解释各基因型之间血清Ca²⁺的差异。总之,在PTH缺乏的情况下,缺乏全长CaSR的小鼠对1,25(OH)₂D₃的血钙作用敏感性增加。这主要源于1,25(OH)₂D₃介导的肠道Ca²⁺吸收增强和肾脏Ca²⁺排泄减少,三种基因型之间在与骨相关的Ca²⁺释放或CT分泌方面没有差异,无法解释它们血钙反应的差异。