Department of Pediatric Nephrology, Campus Virchow Klinikum, Berlin, Germany.
J Hypertens. 2011 Feb;29(2):339-48. doi: 10.1097/HJH.0b013e328340aa30.
Whether treatment with vitamin D receptor activators contributes to cardiovascular disease in patients with chronic kidney disease is a matter of debate. We studied mechanisms involved in vitamin D-related vascular calcifications in vivo and in vitro.
Aortic calcifications were induced in subtotally nephrectomized (SNX) rats by treatment with a high dose (0.25 μg/kg per day) of 1,25-dihydroxyvitamin D3 (calcitriol) given for 6 weeks. Likewise, primary rat vascular smooth muscle cells (VSMCs) were incubated with calcitriol at concentrations ranging from 10 to 10 mol/l. Immunohistochemistry revealed that the aortic expression of osteopontin, osteocalcin and bone sialoprotein was significantly increased in calcitriol-treated SNX rats compared to untreated SNX controls. In addition, aortic expression of the transient receptor potential vanilloid calcium channel 6 (TRPV6) and calbindin D9k was significantly up-regulated by treatment with calcitriol. Furthermore, calcitriol significantly increased expression of the osteogenic transcription factor osterix. In-vitro studies showed similar results, confirming that these effects could be attributed to treatment with calcitriol.
High-dose calcitriol treatment induces an osteoblastic phenotype in VSMC both in SNX rats and in vitro, associated with up-regulation of proteins regulating mineralization and calcium transport, and of the osteogenic transcription factor osterix.
维生素 D 受体激活剂治疗是否会导致慢性肾脏病患者发生心血管疾病,这是一个有争议的问题。我们研究了维生素 D 相关血管钙化的体内和体外机制。
通过用 1,25-二羟维生素 D3(骨化三醇)治疗,使部分肾切除(SNX)大鼠发生主动脉钙化,治疗剂量为每天 0.25μg/kg,持续 6 周。同样,用骨化三醇孵育原代大鼠血管平滑肌细胞(VSMCs),浓度范围为 10 到 10 mol/l。免疫组织化学显示,与未治疗的 SNX 对照组相比,骨化三醇治疗的 SNX 大鼠主动脉中骨桥蛋白、骨钙素和骨唾液蛋白的表达明显增加。此外,骨化三醇治疗还显著上调了瞬时受体电位香草酸钙通道 6(TRPV6)和钙结合蛋白 D9k 的表达。此外,骨化三醇还显著增加了成骨转录因子骨桥蛋白的表达。体外研究也得到了类似的结果,证实这些作用可以归因于骨化三醇的治疗。
高剂量骨化三醇治疗会诱导 SNX 大鼠和体外的 VSMC 出现成骨样表型,与调节矿化和钙转运的蛋白以及成骨转录因子骨桥蛋白的上调有关。