Jablonski G, Mortensen B M, Klem K H, Mosekilde L, Danielsen C C, Gordeladze J O
Institute for Surgical Research, National Hospital, Rikshospitalet, Oslo, Norway.
Calcif Tissue Int. 1995 Nov;57(5):385-91. doi: 10.1007/BF00302075.
We have previously established an uremic rat model which is suitable for investigating the effect of various treatment modalities on the progression of renal osteodystrophy [1]. Four months subsequent to 5/6 nephrectomy, animals were treated three times a week for 3 months with either vehicle, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], 1,25(OH)2D3 + 24,25-dihydroxyvitamin D3 [24,25(OH)2D3], 1,25(OH)2D3 + calcitonin (CT), or 1,25(OH)2D3 + 24,25(OH)2D3 + CT. At termination of the study, clinical chemistry, chemical composition, and mechanical properties of femurs, calvarial parathyroid hormone (PTH)-elicited adenylate cyclase (AC), and phospholipase C (PL-C) activities, femoral cross-sectional area, and bone histomorphometry were analyzed. The main findings were that 1,25(OH)2D3 +/- 24,25(OH)2D3 treatment enhanced elasticity as well as time to fracture at the femoral metaphysis. CT potentiated the increase in elasticity obtained by 1,25(OH)2D3 +/- 24,25(OH)2D3 treatment. Only 24,25(OH)2D3 administration rectified the supernormal PTH-stimulated uremic bone AC, and only 1,25(OH)2D3 medication normalized the diminished CT-elicited AC. The obliterated uremic bone PTH-sensitive PL-C was fully normalized by all drug regimens. Femoral shaft inner zone diameter was enhanced by uremia, however, all drug treatments normalized it. Ditto effect was registered with either drug treatment on the subnormal outer and inner zone widths. Histomorphometrical analyses showed that 1,25(OH)2D3 administration reduced both eroded and osteoid surfaces. Most prominently, adjuvant 24,25(OH)2D3 or CT administration potentiated the beneficial effect of 1,25(OH)2D3 on fibrosis and osteomalacia. We assert that vitamin D3 treatment markedly reverses the development of renal osteodystrophy, and CT potentiates the effect of vitamin D3.
我们之前建立了一种适合研究各种治疗方式对肾性骨营养不良进展影响的尿毒症大鼠模型[1]。在5/6肾切除术后4个月,动物每周接受3次治疗,持续3个月,治疗药物分别为赋形剂、1,25 - 二羟基维生素D3[1,25(OH)2D3]、1,25(OH)2D3 + 24,25 - 二羟基维生素D3[24,25(OH)2D3]、1,25(OH)2D3 + 降钙素(CT)或1,25(OH)2D3 + 24,25(OH)2D3 + CT。在研究结束时,分析了临床化学指标、股骨的化学成分和力学性能、颅骨甲状旁腺激素(PTH)诱导的腺苷酸环化酶(AC)和磷脂酶C(PL - C)活性、股骨横截面积以及骨组织形态计量学指标。主要研究结果如下:1,25(OH)2D3 ± 24,25(OH)2D3治疗增强了股骨近端干骺端的弹性以及骨折时间。CT增强了1,25(OH)2D3 ± 24,25(OH)2D3治疗所带来的弹性增加。仅给予24,25(OH)2D3可纠正尿毒症骨中PTH刺激的AC异常升高,仅给予1,25(OH)2D3可使CT诱导的AC降低恢复正常。所有药物治疗方案均可使尿毒症骨中消失的PTH敏感PL - C完全恢复正常。尿毒症可使股骨干内侧区直径增大,但所有药物治疗均可使其恢复正常。对于异常减小的外侧和内侧区宽度,药物治疗也有同样的效果。组织形态计量学分析表明,给予1,25(OH)2D3可减少侵蚀面和类骨质表面。最显著的是,辅助给予24,25(OH)2D3或CT可增强1,25(OH)2D3对纤维化和骨软化的有益作用。我们认为维生素D3治疗可显著逆转肾性骨营养不良的发展,而CT可增强维生素D3的作用。