Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Endocrinology. 2010 Oct;151(10):4607-12. doi: 10.1210/en.2010-0354. Epub 2010 Aug 4.
Rickets is a growth plate abnormality observed in growing animals and humans. Rachitic expansion of the hypertrophic chondrocyte layer of the growth plate, in the setting of hypophosphatemia, is due to impaired apoptosis of these cells. Rickets is observed in humans and mice with X-linked hypophosphatemia that is associated with renal phosphate wasting secondary to elevated levels of fibroblast growth factor-23. Rickets is also seen in settings of impaired vitamin D action, due to elevated PTH levels that increase renal phosphate excretion. However, mice with hypophosphatemia secondary to ablation of the renal sodium-dependent phosphate transport protein 2a (Npt2a), have not been reported to develop rickets. Because activation of the mitochondrial apoptotic pathway by phosphate is required for hypertrophic chondrocyte apoptosis in vivo, investigations were undertaken to address this paradox. Analyses of the Npt2a null growth plate demonstrate expansion of the hypertrophic chondrocyte layer at 2 wk of age, with resolution of this abnormality by 5 wk of age. This is temporally associated with an increase in circulating levels of 1,25-dihydroxyvitamin D. To address whether the receptor-dependent actions of this steroid hormone are required for normalization of the growth plate phenotype, the Npt2a null mice were mated with mice lacking the vitamin D receptor or were rendered vitamin D deficient. These studies demonstrate that the receptor-dependent actions of 1,25-dihydroxyvitamin D are required for maintenance of a normal growth plate phenotype in the Npt2a null mice.
佝偻病是一种在生长中的动物和人类中观察到的生长板异常。在低磷血症的情况下,生长板的肥大软骨细胞层的佝偻病扩张是由于这些细胞的凋亡受损所致。在与成纤维细胞生长因子 23 水平升高相关的肾磷酸盐丢失有关的 X 连锁低磷血症的人类和小鼠中观察到佝偻病。佝偻病也见于维生素 D 作用受损的情况下,由于甲状旁腺激素水平升高导致肾磷酸盐排泄增加。然而,由于肾钠依赖性磷酸盐转运蛋白 2a (Npt2a) 的消融导致低磷血症的小鼠尚未报道发生佝偻病。由于磷酸盐对线粒体凋亡途径的激活对于体内肥大软骨细胞凋亡是必需的,因此进行了研究以解决这一悖论。对 Npt2a 缺失生长板的分析表明,在 2 周龄时肥大软骨细胞层扩张,在 5 周龄时这种异常得到解决。这与循环中 1,25-二羟维生素 D 水平的增加有关。为了解释这种类固醇激素的受体依赖性作用是否需要使生长板表型正常化,将 Npt2a 缺失的小鼠与缺乏维生素 D 受体的小鼠或维生素 D 缺乏的小鼠交配。这些研究表明,1,25-二羟维生素 D 的受体依赖性作用对于维持 Npt2a 缺失小鼠的正常生长板表型是必需的。