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Hartery SA, Kirby BJ, Walker EC, Kaufmann M, Jones G, St-Arnaud R, Sims NA, Kovacs CS. Loss of maternal calcitriol reversibly alters early offspring growth and skeletal development in mice. J Bone Miner Res 2024; 39:595-610. [PMID: 38477809 DOI: 10.1093/jbmr/zjae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Ablation of Cyp27b1 eliminates calcitriol but does not disturb fetal mineral homeostasis or skeletal development. However, independent of fetal genotypes, maternal loss of Cyp27b1 altered fetal mineral and hormonal levels compared to offspring of WT dams. We hypothesized that these maternal influences would alter postnatal skeletal development. Cyp27b1 null and WT females were mated to bear only Cyp27b1+/- offspring. Forty-eight hours after birth, pups were cross-fostered to dams of the same or opposite genotype that bore them. Maternal and offspring samples were collected on days 21 (weaning) and 42. Offspring measurements included minerals and hormones, BMC by DXA, ash weight and mineral content, gene expression, 3-point bending tests, and microCT. Maternal lactational behavior was evaluated. Milk was analyzed for nutritional content. At day 21, offspring fostered by nulls, independent of birth dam, had ~20% lower weight, BMC, ash weight, and ash calcium than pups fostered by WT dams. Adjustment for body weight accounted for the lower BMC but not the lower ash weight and ash calcium. Hormones and serum/urine minerals did not differ across offspring groups. Offspring fostered by nulls had shorter femurs and lower cortical thickness, mean polar moment of inertia, cortical area, trabecular bone volume, and trabecular number. Dam lactational behaviors and milk nutritional content did not differ between groups. At day 42, body weight, ash weight, lengths, BMC, and tibial bone strength were no longer different between pups fostered by null vs WT dams. In summary, pups fostered by Cyp27b1 nulls, regardless of birth dam, have proportionately smaller skeletons at 21 d, impaired microstructure, but normal mineral homeostasis. The skeletal effects are largely recovered by day 42 (3 wk after weaning). In conclusion, maternal loss of calcitriol impairs early postnatal cortical bone growth and trabecular bone mass, but affected offspring catch up after weaning.
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Affiliation(s)
- Sarah A Hartery
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, A1B 3V6, Canada
| | - Beth J Kirby
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, A1B 3V6, Canada
| | - Emma C Walker
- St. Vincent's Institute of Medical Research, the University of Melbourne, Melbourne, 3065, Australia
| | - Martin Kaufmann
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - René St-Arnaud
- Shriners Hospitals for Children - Canada and McGill University, Montréal, Quebec, H4A 0A9, Canada
| | - Natalie A Sims
- St. Vincent's Institute of Medical Research, the University of Melbourne, Melbourne, 3065, Australia
| | - Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, A1B 3V6, Canada
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Bennin D, Hartery SA, Kirby BJ, Maekawa AS, St-Arnaud R, Kovacs CS. Loss of 24-hydroxylated catabolism increases calcitriol and fibroblast growth factor 23 and alters calcium and phosphate metabolism in fetal mice. JBMR Plus 2024; 8:ziae012. [PMID: 38577520 PMCID: PMC10993470 DOI: 10.1093/jbmrpl/ziae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/23/2024] [Accepted: 01/18/2024] [Indexed: 04/06/2024] Open
Abstract
Calcitriol circulates at low levels in normal human and rodent fetuses, in part due to increased 24-hydroxylation of calcitriol and 25-hydroxyvitamin D by 24-hydroxylase (CYP24A1). Inactivating mutations of CYP24A1 cause high postnatal levels of calcitriol and the human condition of infantile hypercalcemia type 1, but whether the fetus is disturbed by the loss of CYP24A1 is unknown. We hypothesized that loss of Cyp24a1 in fetal mice will cause high calcitriol, hypercalcemia, and increased placental calcium transport. The Cyp24a1+/- mice were mated to create pregnancies with wildtype, Cyp24a1+/-, and Cyp24a1 null fetuses. The null fetuses were hypercalcemic, modestly hypophosphatemic (compared to Cyp24a1+/- fetuses only), with 3.5-fold increased calcitriol, 4-fold increased fibroblast growth factor 23 (FGF23), and unchanged parathyroid hormone. The quantitative RT-PCR confirmed the absence of Cyp24a1 and 2-fold increases in S100g, sodium-calcium exchanger type 1, and calcium-sensing receptor in null placentas but not in fetal kidneys; these changes predicted an increase in placental calcium transport. However, placental 45Ca and 32P transport were unchanged in null fetuses. Fetal ash weight and mineral content, placental weight, crown-rump length, and skeletal morphology did not differ among the genotypes. Serum procollagen 1 intact N-terminal propeptide and bone expression of sclerostin and Blgap were reduced while calcitonin receptor was increased in nulls. In conclusion, loss of Cyp24a1 in fetal mice causes hypercalcemia, modest hypophosphatemia, and increased FGF23, but no alteration in skeletal development. Reduced incorporation of calcium into bone may contribute to the hypercalcemia without causing a detectable decrease in the skeletal mineral content. The results predict that human fetuses bearing homozygous or compound heterozygous inactivating mutations of CYP24A1 will also be hypercalcemic in utero but with normal skeletal development.
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Affiliation(s)
- David Bennin
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, A1B 3V6, Canada
| | - Sarah A Hartery
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, A1B 3V6, Canada
| | - Beth J Kirby
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, A1B 3V6, Canada
| | - Alexandre S Maekawa
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, A1B 3V6, Canada
| | - René St-Arnaud
- Shriners Hospitals for Children–Canada and McGill University, Montréal, Quebec, H4A 0A9, Canada
| | - Christopher S Kovacs
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, A1B 3V6, Canada
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Percival MA, Anderson KB, Pasco JA, Hosking SM, Williams LJ, Holloway-Kew KL, Wark JD, Hyde NK. Gestational vitamin D and offspring fracture risk: do associations persist into mid adolescence? Eur J Clin Nutr 2024:10.1038/s41430-024-01421-z. [PMID: 38429375 DOI: 10.1038/s41430-024-01421-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Previous studies report that maternal vitamin D exposure during pregnancy is associated with offspring later-life bone health. A study in the Vitamin D in Pregnancy (VIP) cohort reported sexually dimorphic effects of maternal 25-hydroxyvitamin-D (25(OH)D) and offspring fracture profiles at 10 years of age. We, therefore, aimed to determine associations between maternal 25(OH)D status and offspring fracture risk at 16 years of age in this cohort. METHODS In total, 475 mother-child pairs were recruited to the VIP study in southeastern Australia. Maternal serum samples were obtained at recruitment (<16 weeks' gestation) and/or 28-32 weeks' gestation and analysed for 25(OH)D. Radiologically-confirmed incident fractures in children were ascertained from date of birth (2002-2004) until July 16, 2019. Cox proportional hazard models were used to determine associations between maternal 25(OH)D and childhood fracture risk, and final models included maternal age at recruitment, offspring sex, birth weight, gestation length and season of 25(OH)D sample. RESULTS Data were available for 400 children (mean age 16.1 years). There were 122 (30.5%) children who sustained at least one fracture. Higher maternal 25(OH)D (per 10 nmol/L) in early gestation was associated with a decreased fracture risk in boys (HR 0.87; 95% CI: 0.77, 0.99); the pattern was reversed in girls (HR 1.10; 95% CI 1.00, 1.22). At late gestation, higher maternal 25(OH)D was associated with an increased fracture risk in girls (HR 1.14; 95% CI: 1.04, 1.24). CONCLUSIONS While our findings must be interpreted within the constraints of our limitations, we report that the contradictory risk profiles observed at early childhood in this cohort remain in adolescence.
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Affiliation(s)
- Mia A Percival
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia.
| | - Kara B Anderson
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Julie A Pasco
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
- Barwon Health, Geelong, VIC, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, 3021, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, 3181, Australia
| | - Sarah M Hosking
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Lana J Williams
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Kara L Holloway-Kew
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - John D Wark
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3050, Australia
- Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
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Curtis EM, Parsons C, Maslin K, D'Angelo S, Moon RJ, Crozier SR, Gossiel F, Bishop NJ, Kennedy SH, Papageorghiou AT, Fraser R, Gandhi SV, Prentice A, Inskip HM, Godfrey KM, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey NC. Bone turnover in pregnancy, measured by urinary CTX, is influenced by vitamin D supplementation and is associated with maternal bone health: findings from the Maternal Vitamin D Osteoporosis Study (MAVIDOS) trial. Am J Clin Nutr 2021; 114:1600-1611. [PMID: 34297067 PMCID: PMC8574710 DOI: 10.1093/ajcn/nqab264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The pattern of change in maternal bone turnover throughout pregnancy is poorly characterized. OBJECTIVES We investigated changes across pregnancy in a marker of maternal bone resorption, urinary C-terminal telopeptide of type I collagen (CTX), the influence of gestational vitamin D supplementation, and associations between CTX and maternal postnatal bone indices. METHODS MAVIDOS (the Maternal Vitamin D Osteoporosis Study) is a randomized, double-blind, placebo-controlled trial of 1000 IU cholecalciferol/d compared with placebo from 14 weeks of gestation to birth. Maternal second-void urinary α- and β-CTX were measured (ELISA) at 14 and 34 weeks of gestation; DXA was performed within 2 wk postpartum. The Mann-Whitney Rank Sum test, Spearman's rank correlation, and linear regression were used to compare median CTX values within and between groups from early to late pregnancy, and associations with maternal bone outcomes. RESULTS In total, 372 women had CTX and 25-hydroxyvitamin D [25(OH)D] measured in early and late pregnancy. CTX at 14 and 34 weeks of gestation were correlated in both placebo (r = 0.31) and cholecalciferol (r = 0.45) groups (P < 0.0001). Median CTX increased from 14 to 34 weeks of gestation in both groups (n = 372 total) [placebo (n = 188): from 223.6 to 449.7 μg/mmol creatinine; cholecalciferol (n = 184): from 222.3 to 419.3 μg/mmol creatinine; P = 0.03 for placebo compared with cholecalciferol difference in CTX at 34 weeks of gestation]. The conditional mean ± SD increase in CTX [z-score (SD)] from early to late pregnancy was greater in the placebo group (n = 188) than in the cholecalciferol group (n = 184) (placebo: 0.16 ± 0.92; cholecalciferol: -0.16 ± 1.06; P-difference < 0.01). Higher CTX at 34 weeks of gestation was associated, similarly in both groups, with lower maternal total hip and lumbar spine bone mineral content and bone mineral density (BMD) (e.g., lumbar spine BMD: β = -0.02 g · cm-2 · SD-1 increase in CTX; 95% CI: -0.027, -0.002 g · cm-2 · SD-1; P = 0.02, n = 283). CONCLUSIONS Maternal urinary CTX, a bone resorption marker, rises through pregnancy, although to a lesser degree with gestational cholecalciferol supplementation, and is inversely associated with maternal bone mass postpartum.This trial was registered at www.isrctn.com as ISRCTN 82927713 and eudract.ema.europa.eu as EudraCT 2007-001716-23.
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Affiliation(s)
- Elizabeth M Curtis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Camille Parsons
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Kate Maslin
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom
| | - Stefania D'Angelo
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Rebecca J Moon
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Paediatric Endocrinology, University Hospitals Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Sarah R Crozier
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Fatma Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Nicholas J Bishop
- Academic Unit of Child Health, Sheffield Children's Hospital, University of Sheffield, Sheffield, United Kingdom
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service Trust, University of Sheffield, Sheffield, United Kingdom
| | - Saurabh V Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service Trust, University of Sheffield, Sheffield, United Kingdom
| | - Ann Prentice
- Medical Research Council Nutrition and Bone Health, University of Cambridge, Cambridge, United Kingdom
| | - Hazel M Inskip
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - M Kassim Javaid
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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Romašovs A, Jaunozola L, Berga-Švītiņa E, Daneberga Z, Miklaševičs E, Pīrāgs V. Hypercalcemia and CYP24A1 Gene Mutation Diagnosed in the 2nd Trimester of a Twin Pregnancy: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931116. [PMID: 34662328 PMCID: PMC8532071 DOI: 10.12659/ajcr.931116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Patient: Female, 33-year-old
Final Diagnosis: Hypercalcemic crisis • pregnancy
Symptoms: Hypercalcemia • hypertension • hypertensive crisis • pregnancy
Medication: —
Clinical Procedure: —
Specialty: Genetics
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Affiliation(s)
- Andris Romašovs
- Department of Internal Medicine, Pauls Stradiņš Clinical University Hospital, Riga, Latvia.,University of Latvia, Riga, Latvia
| | - Lauma Jaunozola
- Department of Internal Medicine, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | | | - Zanda Daneberga
- Institute of Oncology, Riga Stradins University, Riga, Latvia
| | | | - Valdis Pīrāgs
- Department of Internal Medicine, Pauls Stradins Clinical University Hospital, Riga, Latvia.,University of Latvia, Riga, Latvia
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Kovacs CS, Chaussain C, Osdoby P, Brandi ML, Clarke B, Thakker RV. The role of biomineralization in disorders of skeletal development and tooth formation. Nat Rev Endocrinol 2021; 17:336-349. [PMID: 33948016 DOI: 10.1038/s41574-021-00488-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 02/03/2023]
Abstract
The major mineralized tissues are bone and teeth, which share several mechanisms governing their development and mineralization. This crossover includes the hormones that regulate circulating calcium and phosphate concentrations, and the genes that regulate the differentiation and transdifferentiation of cells. In developing endochondral bone and in developing teeth, parathyroid hormone-related protein (PTHrP) acts in chondrocytes to delay terminal differentiation, thereby increasing the pool of precursor cells. Chondrocytes and (in specific circumstances) pre-odontoblasts can also transdifferentiate into osteoblasts. Moreover, bone and teeth share outcomes when affected by systemic disorders of mineral homeostasis or of the extracellular matrix, and by adverse effects of treatments such as bisphosphonates and fluoride. Unlike bone, teeth have more permanent effects from systemic disorders because they are not remodelled after they are formed. This Review discusses the normal processes of bone and tooth development, followed by disorders that have effects on both bone and teeth, versus disorders that have effects in one without affecting the other. The takeaway message is that bone specialists should know when to screen for dental disorders, just as dental specialists should recognize when a tooth disorder should raise suspicions about a possible underlying bone disorder.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada.
| | | | - Philip Osdoby
- Department of Biology, Washington University, St. Louis, MO, USA
| | - Maria Luisa Brandi
- Department of Biochemical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Bart Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Arnold A, Dennison E, Kovacs CS, Mannstadt M, Rizzoli R, Brandi ML, Clarke B, Thakker RV. Hormonal regulation of biomineralization. Nat Rev Endocrinol 2021; 17:261-275. [PMID: 33727709 DOI: 10.1038/s41574-021-00477-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 01/31/2023]
Abstract
Biomineralization is the process by which organisms produce mineralized tissues. This crucial process makes possible the rigidity and flexibility that the skeleton needs for ambulation and protection of vital organs, and the hardness that teeth require to tear and grind food. The skeleton also serves as a source of mineral in times of short supply, and the intestines absorb and the kidneys reclaim or excrete minerals as needed. This Review focuses on physiological and pathological aspects of the hormonal regulation of biomineralization. We discuss the roles of calcium and inorganic phosphate, dietary intake of minerals and the delicate balance between activators and inhibitors of mineralization. We also highlight the importance of tight regulation of serum concentrations of calcium and phosphate, and the major regulators of biomineralization: parathyroid hormone (PTH), the vitamin D system, vitamin K, fibroblast growth factor 23 (FGF23) and phosphatase enzymes. Finally, we summarize how developmental stresses in the fetus and neonate, and in the mother during pregnancy and lactation, invoke alternative hormonal regulatory pathways to control mineral delivery, skeletal metabolism and biomineralization.
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Affiliation(s)
- Andrew Arnold
- Division of Endocrinology & Metabolism and Center for Molecular Oncology, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michael Mannstadt
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Luisa Brandi
- Department of Biochemical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Bart Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Ryan BA, Kovacs CS. Maternal and fetal vitamin D and their roles in mineral homeostasis and fetal bone development. J Endocrinol Invest 2021; 44:643-659. [PMID: 32772256 DOI: 10.1007/s40618-020-01387-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/02/2020] [Indexed: 01/11/2023]
Abstract
During pregnancy, female physiology adapts to meet the additional mineral demands of the developing fetus. Meanwhile, the fetus actively transports minerals across the placenta and maintains high circulating levels to mineralize the rapidly developing skeleton. Most of this mineral is accreted during the last trimester, including 30 g of calcium, 20 g of phosphate and 0.8 g of magnesium. Given the dependence of calcium homeostasis on vitamin D and calcitriol in the adult and child, it may be expected that vitamin D sufficiency would be even more critical during pregnancy and fetal development. However, the pregnant mother and fetus appear to meet their mineral needs independent of vitamin D. Adaptations in maternal mineral and bone metabolism during pregnancy appear to be invoked independent of maternal vitamin D, while fetal mineral metabolism and skeletal development appear to be protected from vitamin D deficiency and genetic disorders of vitamin D physiology. This review discusses key data from both animal models and human studies to address our current knowledge on the role of vitamin D and calcitriol during pregnancy and fetal development.
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Affiliation(s)
- B A Ryan
- Faculty of Medicine - Endocrinology, Health Sciences Centre, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - C S Kovacs
- Faculty of Medicine - Endocrinology, Health Sciences Centre, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
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9
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Sellars KB, Ryan BA, Hartery SA, Kirby BJ, Kovacs CS. Murine Fetal Serum Phosphorus is Set Independent of FGF23 and PTH, Except in the Presence of Maternal Phosphate Loading. Endocrinology 2021; 162:5956315. [PMID: 33150413 PMCID: PMC7737482 DOI: 10.1210/endocr/bqaa202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 01/03/2023]
Abstract
Fibroblast growth factor 23 (FGF23) appears to play no role until after birth, given unaltered phosphate and bone metabolism in Fgf23- and Klotho-null fetuses. However, in those studies maternal serum phosphorus was normal. We studied whether maternal phosphate loading alters fetal serum phosphorus and invokes a fetal FGF23 or parathyroid hormone (PTH) response. C57BL/6 wild-type (WT) female mice received low (0.3%), normal (0.7%), or high (1.65%) phosphate diets beginning 1 week prior to mating to WT males. Fgf23+/- female mice received the normal or high-phosphate diets 1 week before mating to Fgf23+/- males. One day before expected birth, we harvested maternal and fetal blood, intact fetuses, placentas, and fetal kidneys. Increasing phosphate intake in WT resulted in progressively higher maternal serum phosphorus and FGF23 during pregnancy, while PTH remained undetectable. Fetal serum phosphorus was independent of the maternal phosphorus and PTH remained low, but FGF23 showed a small nonsignificant increase with high maternal serum phosphorus. There were no differences in fetal ash weight and mineral content, or placental gene expression. High phosphate intake in Fgf23+/- mice also increased maternal serum phosphorus and FGF23, but there was no change in PTH. WT fetuses remained unaffected by maternal high-phosphate intake, while Fgf23-null fetuses became hyperphosphatemic but had no change in PTH, skeletal ash weight or mineral content. In conclusion, fetal phosphate metabolism is generally regulated independently of maternal serum phosphorus and fetal FGF23 or PTH. However, maternal phosphate loading reveals that fetal FGF23 can defend against the development of fetal hyperphosphatemia.
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Affiliation(s)
- K Berit Sellars
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Brittany A Ryan
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Sarah A Hartery
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Beth J Kirby
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Christopher S Kovacs
- Faculty of Medicine – Endocrinology, Memorial University of Newfoundland, St. John’s, NL, Canada
- Correspondence: Dr Christopher Kovacs, Health Sciences Centre, 300 Prince Philip Drive, St. John’s, Newfoundland, A1B 3V6, Canada. E-mail:
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The Influence of Maternal Levels of Vitamin D and Adiponectin on Anthropometrical Measures and Bone Health in Offspring. ACTA ACUST UNITED AC 2020; 40:91-98. [PMID: 32109213 DOI: 10.2478/prilozi-2020-0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND From the conception onward, certain parameters associated with maternal health may affect foetal body composition, growth and bone mineral content. The objective of the study was to determine the association between maternal vitamin D and adiponectin status with the anthropometrical measures of newborns, and bone health status measured by Quantitative Ultrasound (QUS) at birth. METHODS Circulating 25OHD and adiponectin concentration were measured in 73 pregnant women. Correlations with the anthropometrical measures and bone health status in their infants were studied. Bone health was evaluated using QUS with the measurements of speed of sound (SOS, in m/s) and Z score on the right tibia. RESULTS There was no significant association between maternal 25OHD and newborn's anthropometrical measures at birth (weight p=0.35, length p=0.59 and head circumference p=0.47). There was a significant negative correlation between a maternal serum adiponectin and a) weight of infants at birth (R= -0.37, p=0.002); b) birth length (R= -0.31, p=0.008) and c) head circumference (R= -0.29, p=0.014). There was no significant correlation between maternal 25OHD blood levels during pregnancy and SOS in newborns (p=0.48). Additionally, a correlation between maternal adiponectin concentration during pregnancy and SOS in newborns was not significant (p=0.82). CONCLUSION Although a high prevalence of low 25OHD level among pregnant women was found, maternal vitamin D status did not influence growth and bone health of their offspring at birth. Maternal adiponectin levels in plasma showed an inverse relationship with anthropometrical measures of infants at birth, while no correlation with the newborn's bone health was found.
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Ryan BA, Kovacs CS. Calciotropic and phosphotropic hormones in fetal and neonatal bone development. Semin Fetal Neonatal Med 2020; 25:101062. [PMID: 31786156 DOI: 10.1016/j.siny.2019.101062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
There are remarkable differences in bone and mineral metabolism between the fetus and adult. The fetal mineral supply is from active transport across the placenta. Calcium, phosphorus, and magnesium circulate at higher levels in the fetus compared to the mother. These high concentrations enable the skeleton to accrete required minerals before birth. Known key regulators in the adult include parathyroid hormone (PTH), calcitriol, fibroblast growth factor-23, calcitonin, and the sex steroids. But during fetal life, PTH plays a lesser role while the others appear to be unimportant. Instead, PTH-related protein (PTHrP) plays a critical role. After birth, serum calcium falls and phosphorus rises, which trigger an increase in PTH and a subsequent rise in calcitriol. The intestines become the main source of mineral supply while the kidneys reabsorb filtered minerals. This striking developmental switch is triggered by loss of the placenta, onset of breathing, and the drop in serum calcium.
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Affiliation(s)
- Brittany A Ryan
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada.
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Ryan BA, Alhani K, Sellars KB, Kirby BJ, St-Arnaud R, Kaufmann M, Jones G, Kovacs CS. Mineral Homeostasis in Murine Fetuses Is Sensitive to Maternal Calcitriol but Not to Absence of Fetal Calcitriol. J Bone Miner Res 2019; 34:669-680. [PMID: 30508318 DOI: 10.1002/jbmr.3642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D receptor (VDR) null fetuses have normal serum minerals, parathyroid hormone (PTH), skeletal morphology, and mineralization but increased serum calcitriol, placental calcium transport, and placental expression of Pthrp, Trpv6, and (as reported in this study) Pdia3. We examined Cyp27b1 null fetal mice, which do not make calcitriol, to determine if loss of calcitriol has the same consequences as loss of VDR. Cyp27b1 null and wild-type (WT) females were mated to Cyp27b1+/- males, which generated Cyp27b1 null and Cyp27b1+/- fetuses from Cyp27b1 null mothers, and Cyp27b1+/- and WT fetuses from WT mothers. Cyp27b1 null fetuses had undetectable calcitriol but normal serum calcium and phosphorus, PTH, fibroblast growth factor 23 (FGF23), skeletal mineral content, tibial lengths and morphology, placental calcium transport, and expression of Trpv6 and Pthrp; conversely, placental Pdia3 was downregulated. However, although Cyp27b1+/- and null fetuses of Cyp27b1 null mothers were indistinguishable, they had higher serum and amniotic fluid calcium, lower amniotic fluid phosphorus, lower FGF23, and higher 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D than in WT and Cyp27b1+/- fetuses of WT mothers. In summary, loss of fetal calcitriol did not alter mineral or bone homeostasis, but Cyp27b1 null mothers altered mineral homeostasis in their fetuses independent of fetal genotype. Cyp27b1 null fetuses differ from Vdr null fetuses, possibly through high levels of calcitriol acting on Pdia3 in Vdr nulls to upregulate placental calcium transport and expression of Trpv6 and Pthrp. In conclusion, maternal calcitriol influences fetal mineral metabolism, whereas loss of fetal calcitriol does not. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Brittany A Ryan
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - Kamal Alhani
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - K Berit Sellars
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - Beth J Kirby
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - René St-Arnaud
- Shriners Hospitals for Children-Canada and McGill University, Montréal, Canada
| | | | | | - Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
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Hauta-Alus HH, Kajantie E, Holmlund-Suila EM, Rosendahl J, Valkama SM, Enlund-Cerullo M, Helve OM, Hytinantti TK, Viljakainen H, Andersson S, Mäkitie O. High Pregnancy, Cord Blood, and Infant Vitamin D Concentrations May Predict Slower Infant Growth. J Clin Endocrinol Metab 2019; 104:397-407. [PMID: 30247704 DOI: 10.1210/jc.2018-00602] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 09/17/2018] [Indexed: 12/13/2022]
Abstract
CONTEXT The relationship of maternal and infant 25-hydroxyvitamin D concentration [25(OH)D] with infant growth is unclear. OBJECTIVE Our objective was to explore whether 25(OH)D in pregnancy, umbilical cord blood (UCB), or in infancy was associated with infant growth. DESIGN This study involved 798 healthy infants and their mothers in Finland. We assessed 25(OH)D during pregnancy, from UCB at birth, and from the infant at the age of 12 months. MAIN OUTCOME MEASURES Infant length, weight, length-adjusted weight, and head circumference at 6 and 12 months and midupper-arm circumference at 12 months. RESULTS Of the mothers and infants, 96% and 99% were vitamin D sufficient [25(OH)D ≥50 nmol/L], respectively. Mothers with pregnancy 25(OH)D >125 nmol/L had the shortest, lightest (in weight), and thinnest (in length-adjusted weight) infants at 6 months (P for all < 0.05). For each 10 nmol/L higher UCB 25(OH)D, the infants were 0.03 SD score (SDS) shorter at 6 months (95% CI -0.05 to -0.01), adjusted for birth size, infant 25(OH)D, and parental height. Higher UCB 25(OH)D associated with smaller head circumference at 6 and 12 months (P for all <0.05) but attenuated after adjustments. Mothers with pregnancy 25(OH)D >125 nmol/L had the thinnest infants at 12 months (P = 0.021). For each 10 nmol/L higher infant 25(OH)D, the infants were 0.03 SDS lighter (-0.05 to -0.01) and 0.03 SDS thinner (-0.05 to 0.00) at 12 months. CONCLUSIONS Our results suggest that high pregnancy, cord blood, and infant vitamin D concentration may have disadvantageous effects on infant growth.
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Affiliation(s)
- Helena H Hauta-Alus
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, Me Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elisa M Holmlund-Suila
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jenni Rosendahl
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saara M Valkama
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Otto M Helve
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo K Hytinantti
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heli Viljakainen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Clinical Genetics, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
- Folkhälsan Institute of Genetics, Helsinki, Finland
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Yang L, Dong Y, Luo W, Zhu T, Li Q, Zhang L, Kong J, Yuan Z, Zhao Q. Calbindin‐D28K mediates 25(OH)D3/VDR‐regulated bone formation through MMP13 and DMP1. J Cell Biochem 2018; 119:8035-8047. [PMID: 29377305 DOI: 10.1002/jcb.26722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 01/24/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Li‐Ping Yang
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Ya‐Ping Dong
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Wen‐Ting Luo
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Tong Zhu
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Qi‐Wei Li
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Li‐Jun Zhang
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Juan Kong
- Department of Clinical NutritionShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Zheng‐Wei Yuan
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
| | - Qun Zhao
- Department of Pediatric OrthopedicShengjing Hospital of China Medical UniversityShenyangLiaoningChina
- Key Laboratory of Congenital MalformationMinistry of HealthShengjing Hospital of China Medical UniversityShenyangLiaoningChina
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Intra-Amniotic Administration (Gallus gallus) of Cicer arietinum and Lens culinaris Prebiotics Extracts and Duck Egg White Peptides Affects Calcium Status and Intestinal Functionality. Nutrients 2017; 9:nu9070785. [PMID: 28754012 PMCID: PMC5537899 DOI: 10.3390/nu9070785] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/29/2017] [Accepted: 07/19/2017] [Indexed: 12/13/2022] Open
Abstract
Calcium (Ca) is one of the most abundant inorganic elements in the human body and has many important physiological roles. Prebiotics and bioactive peptides are two important substances used to promote calcium uptake. However, the difference in mechanisms of the calcium uptake from these two supplements is not clear. By using the Gallus gallus model and the intra-amniotic administration procedure, the aim of this study was to investigate whether Ca status, intestinal functionality, and health-promoting bacterial populations were affected by prebiotics extracted from chickpea and lentil, and duck egg white peptides (DPs). Eleven groups (non-injected; 18 MΩ H2O; 4 mmol/L CaCl2; 50 mg/mL chickpea + 4 mmol/L CaCl2; 50 mg/mL lentil + 4 mmol/L CaCl2; 40 mg/mL DPs + 4 mmol/L CaCl2; 5 mg/mL Val-Ser-Glu-Glu (VSEE) + 4 mmol/L CaCl2; 50 mg/mL chickpea; 50 mg/mL lentil; 40 mg/mL DPs; 5 mg/mL VSEE) were utilized. Upon hatch, blood, cecum, small intestine, liver and bone were collected for assessment of serum bone alkaline phosphate level (BALP), the relative abundance of intestinal microflora, expression of Ca-related genes, brush border membrane (BBM) functional genes, and liver and bone mineral levels, respectively. The BALP level increased in the presence of lentil, DPs and VSEE (p < 0.05). The relative abundance of probiotics increased significantly (p < 0.05) by VSEE + Ca and chickpea. The expression of CalbindinD9k (Ca transporter) increased (p < 0.05) in Ca, chickpea + Ca and lentil + Ca groups. In addition, the brush border membrane functionality genes expressions increased (p < 0.05) by the chickpea or lentil extracts. Prebiotics and DPs beneficially affected the intestinal microflora and duodenal villus surface area. This research expands the understanding of the prebiotics’ properties of chickpea and lentil extracts, and peptides’ effects on calcium metabolism and gut health.
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Ma Y, Kirby BJ, Fairbridge NA, Karaplis AC, Lanske B, Kovacs CS. FGF23 Is Not Required to Regulate Fetal Phosphorus Metabolism but Exerts Effects Within 12 Hours After Birth. Endocrinology 2017; 158:252-263. [PMID: 27929669 PMCID: PMC5413075 DOI: 10.1210/en.2016-1369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/07/2016] [Indexed: 01/01/2023]
Abstract
Loss of fibroblast growth factor-23 (FGF23) causes hyperphosphatemia, extraskeletal calcifications, and early mortality; excess FGF23 causes hypophosphatemia with rickets or osteomalacia. However, FGF23 may not be important during fetal development. FGF23 deficiency (Fgf23 null) and FGF23 excess (Phex null) did not alter fetal phosphorus or skeletal parameters. In this study, we further tested our hypothesis that FGF23 is not essential for fetal phosphorus regulation but becomes important after birth. Although coreceptor Klotho null adults have extremely high FGF23 concentrations, intact FGF23 was normal in Klotho null fetuses, as were fetal phosphorus and skeletal parameters and placental and renal expression of FGF23 target genes. Pth/Fgf23 double mutants had the same elevation in serum phosphorus as Pth null fetuses, as compared with normal serum phosphorus in Fgf23 nulls. We examined the postnatal time courses of Fgf23 null, Klotho null, and Phex null mice. Fgf23 nulls and Klotho nulls were normal at birth, but developed hyperphosphatemia, increased renal expression of NaPi2a and NaPi2c, and reduced renal phosphorus excretion between 5 and 7 days after birth. Parathyroid hormone remained normal. In contrast, excess FGF23 exerted effects in Phex null males within 12 hours after birth, with the development of hypophosphatemia, reduced renal expression of NaPi2a and NaPi2c, and increased renal phosphorus excretion. In conclusion, although FGF23 is present in the fetal circulation at levels that may equal adult values, and there is robust expression of FGF23 target genes in placenta and fetal kidneys, FGF23 itself is not an important regulator of fetal phosphorous metabolism.
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Affiliation(s)
- Yue Ma
- Faculty of Medicine–Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland A1B 3V6, Canada;
| | - Beth J. Kirby
- Faculty of Medicine–Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland A1B 3V6, Canada;
| | - Nicholas A. Fairbridge
- Faculty of Medicine–Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland A1B 3V6, Canada;
| | - Andrew C. Karaplis
- McGill University and Jewish General Hospital, Montréal, Quebec H3T 1E2, Canada; and
| | - Beate Lanske
- Division of Bone and Mineral Research, Harvard School of Dental Medicine, Boston, Massachusetts 02115
| | - Christopher S. Kovacs
- Faculty of Medicine–Endocrinology, Memorial University of Newfoundland, St. John’s, Newfoundland A1B 3V6, Canada;
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Lykkedegn S, Sorensen GL, Beck-Nielsen SS, Pilecki B, Duelund L, Marcussen N, Christesen HT. Vitamin D Depletion in Pregnancy Decreases Survival Time, Oxygen Saturation, Lung Weight and Body Weight in Preterm Rat Offspring. PLoS One 2016; 11:e0155203. [PMID: 27571350 PMCID: PMC5003352 DOI: 10.1371/journal.pone.0155203] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 07/28/2016] [Indexed: 01/20/2023] Open
Abstract
Animal studies suggest a role of vitamin D in fetal lung development although not studied in preterm animals. We tested the hypothesis that vitamin D depletion aggravates respiratory insufficiency in preterm rat offspring. Furthermore, the effects of vitamin D depletion on growth and lung surfactant were investigated. Female Sprague-Dawley rats were randomly assigned low vitamin D (VDL) or control diet before mating and followed with serum 25-hydroxyvitamin D (s-25(OH)D) determinations. After cesarean section at gestational day 19 (E19) or day 22 (E22), placental weight, birth weight, crown-rump-length (CRL), oxygenation (SaO2) at 30 min and survival time were recorded. The pup lungs were analyzed for phospholipid levels, surfactant protein A-D mRNA and the expression of the vitamin D receptor (VDR). S-25(OH)D was significantly lower in the VDL group at cesarean section (12 vs. 30nmol/L, p<0.0001). Compared to the controls, E19 VDL pups had lower birth weight (2.13 vs. 2.29g, p<0.001), lung weight (0.09 vs. 0.10g, p = 0.002), SaO2(54% vs. 69%, p = 0.002) as well as reduced survival time (0.50 vs. 1.25h, p<0.0001). At E22, the VDL-induced pulmonary differences were leveled out, but VDL pups had lower CRL (4.0 vs. 4.5cm, p<0.0001). The phospholipid levels and the surfactant protein mRNA expression did not differ between the dietary groups. In conclusion, Vitamin D depletion led to lower oxygenation and reduced survival time in the preterm offspring, associated with reduced lung weight and birth weight. Further studies of vitamin D depletion in respiratory insufficiency in preterm neonates are warranted.
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Affiliation(s)
- Sine Lykkedegn
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Grith Lykke Sorensen
- Institute of Molecular Medicine, Department of Cancer and Inflammation, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Signe Sparre Beck-Nielsen
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Bartosz Pilecki
- Institute of Molecular Medicine, Department of Cancer and Inflammation, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lars Duelund
- MEMPHYS, University of Southern Denmark, Odense, Denmark
| | - Niels Marcussen
- Institute of Pathology, Odense University Hospital, Odense, Denmark
| | - Henrik Thybo Christesen
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- * E-mail:
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Sun J, Sun B, Wang W, Han X, Liu H, Du J, Feng W, Liu B, Amizuka N, Li M. Histochemical examination of the effects of high-dose 1,25(OH)2D3 on bone remodeling in young growing rats. J Mol Histol 2016; 47:389-99. [PMID: 27255234 DOI: 10.1007/s10735-016-9681-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/26/2016] [Indexed: 12/17/2022]
Abstract
Vitamin D has an anabolic effect on bone developmental processes and is involved in maintaining skeletal integrity. In recent years, pediatric cases of vitamin D intoxication have attracted attention. Therefore, the aim of this study was to investigate the influence of long-term administration of physiologically-high-dose calcitriol (1,25(OH)2D3) on bone remodeling in young developing rats. Neonatal rats received once-daily subcutaneous injection of calcitriol (250 ng/kg body weight), or PBS only as a control, for 3 weeks. At 1, 2 and 4 weeks' post-administration, rats were sacrificed and fixed by transcardial perfusion with 4 % paraformaldehyde, following which tibiae were extracted for histochemical analysis. Compared with the control group, the number of tartrate-resistant acid phosphatase- and Cathepsin K-positive osteoclasts were significantly increased, and the expression of alkaline phosphatase in osteoblasts was decreased in trabecular bone of rats administered high-dose 1,25(OH)2D3, leading to decreased trabecular bone volume. In addition, the expression of receptor activator of nuclear factor kappa-B ligand (RANKL) was increased, while that of osteoprotegerin was weaker in osteoblasts in the experimental group compared with the control group. Moreover, there was weaker immunoreactivity for EphrinB2 in osteoclasts and EphB4 in osteoblasts of trabecular bone in the experimental group compared with the control group. These findings suggest that long-term use of physiologically-high dose calcitriol may result in bone loss through RANKL/RANK/osteoprotegerin and EphrinB2-EphB4 signaling pathways, and that these negative effects could continue after drug withdrawal. Therefore, optimal limits for vitamin D administration need to be established for children and adolescents.
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Affiliation(s)
- Jing Sun
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Bao Sun
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Wei Wang
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Xiuchun Han
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Hongrui Liu
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Juan Du
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Wei Feng
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Bo Liu
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China
| | - Norio Amizuka
- Department of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Minqi Li
- Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Wenhua West Road 44-1, 250012, Jinan, China.
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Towards in vitro DT/DNT testing: Assaying chemical susceptibility in early differentiating NT2 cells. Toxicology 2015; 338:69-76. [PMID: 26498558 DOI: 10.1016/j.tox.2015.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/15/2015] [Accepted: 10/15/2015] [Indexed: 11/21/2022]
Abstract
Human pluripotent embryonal carcinoma (NT2) cells are increasingly considered as a suitable model for in vitro toxicity testing, e.g. developmental toxicity and neurotoxicity (DT/DNT) studies, as they undergo neuronal differentiation upon stimulation with retinoic acid (RA) and permit toxicity testing at different stages of maturation. NT2 cells have recently been reported to show specific changes in dielectric resistance profiles during differentiation which can be observed as early as 24h upon RA-stimulation. These observations suggest altered susceptibility to chemicals at an early stage of differentiation. However, chemical susceptibility of early differentiating NT cells has not yet been studied. To address this question, we have established a cell fitness screening assay based on the analysis of intracellular ATP levels and we applied the assay in a large-scale drug screening experiment in NT2 stem cells and early differentiating NT2 cells. Subsequent analysis of ranked fitness phenotypes revealed 19 chemicals with differential toxicity profile in early differentiating NT2 cells. To evaluate whether any of the identified drugs have previously been associated with DT/DNT, we conducted a literature search on the identified molecules and quantified the fraction of chemicals assigned to the FDA (Food and Drug Administration) pregnancy risk categories (PRC) N, A, B, C, D, and X in the hit list and the small molecule library. While the fractions of the categories N and B were decreased (0.81 and 0.35-fold), the classes C, D and X were increased (1.35, 1.47 and 3.27-fold) in the hit list compared to the chemical library. From these data as well as from the literature review, identifying large fractions of chemicals being directly (∼42%) and indirectly associated with DT/DNT (∼32%), we conclude that our method may be beneficial to systematic in vitro-based primary screening for developmental toxicants and neurotoxicants and we propose cell fitness screening in early differentiating NT2 cells as a strategy for evaluating chemical susceptibility at different stages of differentiation to reduce animal testing in the context of the 3Rs.
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Pérez-López FR, Pasupuleti V, Mezones-Holguin E, Benites-Zapata VA, Thota P, Deshpande A, Hernandez AV. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril 2015; 103:1278-88.e4. [PMID: 25813278 DOI: 10.1016/j.fertnstert.2015.02.019] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 02/11/2015] [Accepted: 02/12/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital, Zaragoza, Spain.
| | - Vinay Pasupuleti
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Edward Mezones-Holguin
- Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru; School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Vicente A Benites-Zapata
- Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru
| | - Priyaleela Thota
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Abhishek Deshpande
- Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio
| | - Adrian V Hernandez
- School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru; Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
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Hoffman MB, Farhangian M, Feldman SR. Psoriasis during pregnancy: characteristics and important management recommendations. Expert Rev Clin Immunol 2015; 11:709-20. [DOI: 10.1586/1744666x.2015.1037742] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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22
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Sanz-Salvador L, García-Pérez MÁ, Tarín JJ, Cano A. Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture. Eur J Endocrinol 2015; 172:R53-65. [PMID: 25209679 DOI: 10.1530/eje-14-0424] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Changes in bone density and bone markers suggest that pregnancy is associated with deterioration of bone mass in the mother. The metabolism of calcium resets to allow for the needs imposed by the building of the fetal skeleton. The fetus contributes to the process through the output of regulators from the placenta. Understanding of the whole process is limited, but some changes are unambiguous. There is an increase in the circulating levels of vitamin D, but its functional impact is unclear. Fetal parathyroid hormone (PTH) and PTH-related peptide (PTHrp) play an indirect role through support of a calcium gradient that creates hypercalcemia in the fetus. Placental GH, which increases up to the end of pregnancy, may exert some anabolic effects, either directly or through the regulation of the IGF1 production. Other key regulators of bone metabolism, such as estrogens or prolactin, are elevated during pregnancy, but their role is uncertain. An increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL) to osteoprotegerin (OPG) acts as an additional pro-resorbing factor in bone. The increase in bone resorption may lead to osteoporosis and fragility fracture, which have been diagnosed, although rarely. However, the condition is transitory as long-term studies do not link the number of pregnancies with osteoporosis. Prevention is limited by the lack of identifiable risk factors. When fractures are diagnosed, rest, analgesics, or, when indicated, orthopedic intervention have demonstrated efficacy. Systemic treatment with anti-osteoporotic drugs is effective, but the potential harm to the fetus imposes caution in their use.
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Affiliation(s)
- Lucía Sanz-Salvador
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Miguel Ángel García-Pérez
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Juan J Tarín
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Antonio Cano
- Fundación para la Investigación Sanitaria y Biomédica (FISABIO)Juan de Garay 21, 46017 Valencia, SpainDepartment of GeneticsUniversity of Valencia and Research Foundation, INCLIVA, Avenida Blasco Ibáñez 15, 46010 Valencia, SpainDepartment of Functional Biology and Physical AnthropologySchool of Biological Sciences, University of Valencia, Burjasot Campus, Valencia, SpainDepartment of PediatricsObstetrics and Gynecology, Facultad de Medicina, University Hospital Dr Peset, University of Valencia, Avenida Blasco Ibáñez 15, 46010 Valencia, Spain
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23
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Kovacs CS. Bone development and mineral homeostasis in the fetus and neonate: roles of the calciotropic and phosphotropic hormones. Physiol Rev 2014; 94:1143-218. [PMID: 25287862 DOI: 10.1152/physrev.00014.2014] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Mineral and bone metabolism are regulated differently in utero compared with the adult. The fetal kidneys, intestines, and skeleton are not dominant sources of mineral supply for the fetus. Instead, the placenta meets the fetal need for mineral by actively transporting calcium, phosphorus, and magnesium from the maternal circulation. These minerals are maintained in the fetal circulation at higher concentrations than in the mother and normal adult, and such high levels appear necessary for the developing skeleton to accrete a normal amount of mineral by term. Parathyroid hormone (PTH) and calcitriol circulate at low concentrations in the fetal circulation. Fetal bone development and the regulation of serum minerals are critically dependent on PTH and PTH-related protein, but not vitamin D/calcitriol, fibroblast growth factor-23, calcitonin, or the sex steroids. After birth, the serum calcium falls and phosphorus rises before gradually reaching adult values over the subsequent 24-48 h. The intestines are the main source of mineral for the neonate, while the kidneys reabsorb mineral, and bone turnover contributes mineral to the circulation. This switch in the regulation of mineral homeostasis is triggered by loss of the placenta and a postnatal fall in serum calcium, and is followed in sequence by a rise in PTH and then an increase in calcitriol. Intestinal calcium absorption is initially a passive process facilitated by lactose, but later becomes active and calcitriol-dependent. However, calcitriol's role can be bypassed by increasing the calcium content of the diet, or by parenteral administration of calcium.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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24
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Eisman JA, Bouillon R. Vitamin D: direct effects of vitamin D metabolites on bone: lessons from genetically modified mice. BONEKEY REPORTS 2014; 3:499. [PMID: 24605216 PMCID: PMC3944130 DOI: 10.1038/bonekey.2013.233] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/26/2013] [Indexed: 12/14/2022]
Abstract
The vitamin D endocrine system has clear beneficial effects on bone as demonstrated by prevention of rickets in children and by reducing the risk of osteomalacia or osteoporosis in adults or elderly subjects. Depending on the design of the study of genetically modified animals, however, 1,25(OH)2D and the vitamin D receptor (VDR) may have no effect, beneficial or even deleterious direct effects on bone. We present here a comprehensive model of the direct effects of vitamin D on bone. In case of sufficient calcium supply, vitamin D and its metabolites can improve the calcium balance and facilitate mineral deposition in bone matrix largely without direct effects on bone cells, although some beneficial effects may occur via mature osteoblasts, as demonstrated in mice with osteoblast-specific overexpression of VDR or 1α-hydroxylase. In case of calcium deficiency, however, 1,25(OH)2D enhances bone resorption, whereas simultaneously inhibiting bone mineralization, so as to defend serum calcium homeostasis at the expense of bone mass. This dual role probably provides a survival benefit for land vertebrates living in a calcium-poor environment.
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Affiliation(s)
- John A Eisman
- Clinical Excellence and Research, School of Medicine Sydney, UNDA, Sydney, NSW, Australia
- Clinical Translation and Advanced Education, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent's Hospital, Sydney, NSW, Australia
- University of New South Wales, Randwick, NSW, Australia
- CAPHRI - School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Roger Bouillon
- Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
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