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维生素D与II型钠依赖性磷酸盐共转运体

Vitamin D and type II sodium-dependent phosphate cotransporters.

作者信息

Kido Shinsuke, Kaneko Ichiro, Tatsumi Sawako, Segawa Hiroko, Miyamoto Ken-ichi

机构信息

Department of Molecular Nutrition, University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Japan.

出版信息

Contrib Nephrol. 2013;180:86-97. doi: 10.1159/000346786. Epub 2013 May 6.

Abstract

The type II sodium-dependent Pi (NaPi) cotransporters (NaPi-IIa, NaPi-IIb and NaPi-IIc) contribute to renal and intestinal Pi absorption. 1,25-Dihydroxyvitamin D [1,25(OH)2D3] is an important factor for NaPi-II transporters in the small intestine and kidney. In a previous study, low levels of 1,25(OH)2D3 appeared to suppress the expression of renal NaPi cotransporters. We identified a functional vitamin D receptor-responsive element in the human NaPi-IIa and NaPi-IIc genes in renal epithelial cells. In an analysis of vitamin D receptor (VDR)-null mice, we observed early onset of hypophosphatemia. The cause of the hypophosphatemia in VDR-null mice before weaning appeared to be increased plasma parathyroid hormone (PTH) levels during the suckling periods. A rescue diet (high calcium diet) decreased plasma PTH levels in VDR-null mice. The reduced plasma PTH levels normalized the renal Npt2a and Npt2c protein levels in weanling animals. Thus, the dietary intervention completely normalized the expression of the renal Pi transporters (Npt2a/Npt2c) in VDR-null mice, suggesting that the lack of VDR activity was not the cause of the impaired renal Pi reabsorption. In suckling animals, 1,25(OH)2D3 may be essential for the prevention of the phosphaturic action of PTH. In adult animals, 1,25(OH)2D3 is thought to be an important factor for posttranscriptional regulation of the Npt2b gene in the small intestine. Fibroblast growth factor 23 (FGF23) is a novel phosphaturic factor that influences vitamin D metabolism and renal reabsorption of Pi. We characterized the role of the VDR in the action of FGF23 using VDR-null mice. FGF23 reduced renal Pi transport and 25-hydroxyvitamin D 1a-hydroxylase levels by a mechanism that was independent of the VDR. By contrast, the induction of 25-hydroxyvitamin D 24-hydroxylase and the reduction in serum 1,25(OH)2D3 levels induced by FGF23 were dependent on the VDR. Thus, the VDR is not essential for the phosphaturic action of FGF23, but is essential for control of the plasma 1,25(OH)2D3 level. Moreover, FGF23 reduces intestinal NaPi transport activity and Npt2b protein levels by a mechanism that is dependent on the VDR. Klotho functions as a co-receptor for FGF23 and is increased by 1,25(OH)2D3. Klotho induces phosphaturia by inhibiting the renal NaPi-IIa transporter. In this review, we discuss the roles of 1,25(OH)2D3/VDR in the regulation of renal type II NaPi cotransporters in the kidney and small intestine.

摘要

II型钠依赖性磷酸盐(NaPi)共转运体(NaPi-IIa、NaPi-IIb和NaPi-IIc)参与肾脏和肠道对磷酸盐的吸收。1,25-二羟基维生素D [1,25(OH)2D3]是小肠和肾脏中NaPi-II转运体的重要影响因素。在之前的一项研究中,低水平的1,25(OH)2D3似乎会抑制肾脏NaPi共转运体的表达。我们在肾上皮细胞的人NaPi-IIa和NaPi-IIc基因中鉴定出一个功能性维生素D受体反应元件。在对维生素D受体(VDR)基因敲除小鼠的分析中,我们观察到低磷血症的早期发生。断奶前VDR基因敲除小鼠出现低磷血症的原因似乎是哺乳期血浆甲状旁腺激素(PTH)水平升高。一种补救性饮食(高钙饮食)降低了VDR基因敲除小鼠的血浆PTH水平。断奶动物血浆PTH水平的降低使肾脏Npt2a和Npt2c蛋白水平恢复正常。因此,饮食干预使VDR基因敲除小鼠肾脏磷酸盐转运体(Npt2a/Npt2c)的表达完全恢复正常,这表明VDR活性的缺乏不是肾脏磷酸盐重吸收受损的原因。在哺乳动物中,1,25(OH)2D3对于预防PTH的排磷作用可能至关重要。在成年动物中,1,25(OH)2D3被认为是小肠中Npt2b基因转录后调控的重要因素。成纤维细胞生长因子23(FGF23)是一种新型的排磷因子,可影响维生素D代谢和肾脏对磷酸盐的重吸收。我们利用VDR基因敲除小鼠研究了VDR在FGF23作用中的角色。FGF23通过一种独立于VDR的机制降低肾脏磷酸盐转运及25-羟基维生素D 1α-羟化酶水平。相比之下,FGF23诱导的25-羟基维生素D 24-羟化酶的上调及血清1,25(OH)2D3水平的降低依赖于VDR。因此,VDR对于FGF23的排磷作用并非必不可少,但对于控制血浆1,25(OH)2D3水平至关重要。此外,FGF23通过一种依赖于VDR的机制降低肠道NaPi转运活性和Npt2b蛋白水平。klotho作为FGF23的共受体,其表达受1,25(OH)2D3上调。klotho通过抑制肾脏NaPi-IIa转运体诱导排磷。在本综述中,我们讨论了1,25(OH)2D3/VDR在调节肾脏和小肠中II型NaPi共转运体方面的作用。

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