St-Arnaud René, Arabian Alice, Akhouayri Omar, Knutson Joyce C, Strugnell Stephen A
Genetics Unit, Shriners Hospital for Children, Montreal, Qué., Canada.
Nephron Exp Nephrol. 2011;119(3):e67-74. doi: 10.1159/000329663. Epub 2011 Aug 18.
BACKGROUND/AIMS: Kidney disease patients experience declining calcitriol levels and develop secondary hyperparathyroidism (SHPT). Animal models of uremia based on 5/6 nephrectomy (NTX) do not consistently reproduce this calcitriol deficiency. We developed an animal model, the NTX Cyp27b1-null mouse, which completely lacks endogenous calcitriol, and examined the suitability of this model for evaluation of treatment with vitamin D analogs in uremia.
NTX was performed at 2 months of age. One week post-NTX, animals were treated for 4 weeks with vehicle; doxercalciferol at 30, 100 or 300 pg/g body weight (b.w.); or paricalcitol at 100, 300 or 1,000 pg/g b.w. by gavage 3 times per week.
Serum blood urea nitrogen and creatinine were elevated. Vehicle-treated NTX null mice had hypocalcemia and SHPT. Doxercalciferol at 100 or 300 pg/g b.w. normalized serum calcium and parathyroid hormone (PTH) levels. Paricalcitol at 300 or 1,000 pg/g normalized serum calcium, but PTH levels remained elevated. Osteomalacia was corrected by 100 pg/g b.w. of doxercalciferol or 1,000 pg/g b.w. of paricalcitol. The highest dose of doxercalciferol, but not of paricalcitol, significantly reduced osteitis fibrosa.
Our results reveal the differential efficacy of doxercalciferol and paricalcitol in this novel animal model incorporating both calcitriol deficiency and renal insufficiency.
背景/目的:肾病患者会出现骨化三醇水平下降并发展为继发性甲状旁腺功能亢进(SHPT)。基于5/6肾切除术(NTX)的尿毒症动物模型并不能始终如一地再现这种骨化三醇缺乏的情况。我们开发了一种动物模型,即NTX Cyp27b1基因敲除小鼠,其完全缺乏内源性骨化三醇,并研究了该模型用于评估尿毒症中维生素D类似物治疗的适用性。
在2月龄时进行NTX。NTX术后1周,动物用赋形剂;剂量为30、100或300 pg/g体重(b.w.)的多西骨化醇;或剂量为100、300或1000 pg/g b.w.的帕立骨化醇通过灌胃每周3次治疗4周。
血清血尿素氮和肌酐升高。用赋形剂治疗的NTX基因敲除小鼠出现低钙血症和SHPT。剂量为100或300 pg/g b.w.的多西骨化醇使血清钙和甲状旁腺激素(PTH)水平恢复正常。剂量为300或1000 pg/g的帕立骨化醇使血清钙恢复正常,但PTH水平仍升高。剂量为100 pg/g b.w.的多西骨化醇或1000 pg/g b.w.的帕立骨化醇纠正了骨软化症。多西骨化醇的最高剂量可显著减少纤维性骨炎,但帕立骨化醇则不能。
我们的结果揭示了在这种同时存在骨化三醇缺乏和肾功能不全的新型动物模型中,多西骨化醇和帕立骨化醇的不同疗效。