Department of Nephrology, Provincial Hospital Affiliated to Shandong University, Shandong 250021, P.R. China.
Life Sci. 2013 Oct 17;93(17):646-53. doi: 10.1016/j.lfs.2013.08.013. Epub 2013 Sep 6.
High cardiovascular mortality in patients with end-stage renal disease is closely associated with arterial medial calcification (AMC) caused by hyperphosphatemia, the mechanism of which associated hormones (FGF-23, klotho) and osteochondrogenic events is unclear. We examined the effect of Lanthanum carbonate on AMC via regulating the abnormalities in phosphorus metabolism of uremic rats.
45 healthy SD rats were randomly divided into 3 groups: Normal group (n=15), CRF group (n=15), CRF diet supplemented with 2% La (n=15). AMC in great arteries were evaluated by VonKossa. Osteochondrogenic specific genes were analyzed by Immunohistochemistry and qRT-PCR. Serum FGF-23 and klotho levels were detected by ELISA kit.
Serum phosphate was markedly increased in CRF group (6.94 ± 0.97 mmol/L) and 2%La group (5.12 ± 0.84 mmol/L) at week 4, while the latter became hypophosphatemic (2.92 ± 0.73 mmol/L vs CRF group, p<0.01) at week 10. Inhibitory effect of 2%La on development of AMC was reflected by downregulated Runx2, Osterix, BSP, Osteocalcin and collagenII and a reduction of FGF-23 at week 4(vs CRF group, p<0.01) but not week 10.
Beneficial effects of Lanthanum carbonate on progression of AMC in CRF could be mainly due to the decreased phosphate retention and FGF-23 in early stage and likewise a reduction of bone-associated proteins via osteochondrogenic pathway. Lanthanum carbonate has no effect on soluble klotho and serum FGF-23 in late stage of CRF.
终末期肾病患者心血管死亡率高与高磷血症引起的动脉中层钙化(AMC)密切相关,其相关激素(FGF-23、klotho)和骨软骨生成事件的机制尚不清楚。我们通过调节尿毒症大鼠磷代谢异常,研究碳酸镧对 AMC 的影响。
45 只健康 SD 大鼠随机分为 3 组:正常组(n=15)、CRF 组(n=15)、CRF 饮食补充 2%La 组(n=15)。VonKossa 评价大动脉 AMC。免疫组化和 qRT-PCR 分析骨软骨生成特异性基因。ELISA 试剂盒检测血清 FGF-23 和 klotho 水平。
CRF 组(6.94±0.97mmol/L)和 2%La 组(5.12±0.84mmol/L)在第 4 周时血清磷酸盐明显升高,而后者在第 10 周时出现低磷血症(2.92±0.73mmol/L 与 CRF 组相比,p<0.01)。2%La 对 AMC 发展的抑制作用表现为 Runx2、Osterix、BSP、Osteocalcin 和胶原 II 下调,第 4 周(与 CRF 组相比,p<0.01)而不是第 10 周时 FGF-23 减少。
碳酸镧对 CRF 中 AMC 进展的有益作用主要可能是由于早期磷潴留和 FGF-23 减少,以及通过骨软骨生成途径减少骨相关蛋白。碳酸镧对 CRF 晚期可溶性 klotho 和血清 FGF-23 无影响。