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Lee JY, Moon J, Hu HJ, Ryu CS, Ko EJ, Ahn EH, Kim YR, Kim JH, Kim NK. Discovery of Pathogenic Variants Associated with Idiopathic Recurrent Pregnancy Loss Using Whole-Exome Sequencing. Int J Mol Sci 2024; 25:5447. [PMID: 38791485 PMCID: PMC11121708 DOI: 10.3390/ijms25105447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Idiopathic recurrent pregnancy loss (RPL) is defined as at least two pregnancy losses before 20 weeks of gestation. Approximately 5% of pregnant couples experience idiopathic RPL, which is a heterogeneous disease with various causes including hormonal, chromosomal, and intrauterine abnormalities. Although how pregnancy loss occurs is still unknown, numerous biological factors are associated with the incidence of pregnancy loss, including genetic variants. Whole-exome sequencing (WES) was conducted on blood samples from 56 Korean patients with RPL and 40 healthy controls. The WES data were aligned by means of bioinformatic analysis, and the detected variants were annotated using machine learning tools to predict the pathogenicity of protein alterations. Each indicated variant was confirmed using Sanger sequencing. A replication study was also conducted in 112 patients and 114 controls. The Variant Effect Scoring Tool, Combined Annotation Dependent Depletion tool, Sorting Intolerant from Tolerant annotation tool, and various databases detected 10 potential variants previously associated with spontaneous abortion genes in patients by means of a bioinformatic analysis of WES data. Several variants were detected in more than one patient. Interestingly, several of the detected genes were functionally clustered, including some with a secretory function (mucin 4; MUC4; rs200737893 G>A and hyaluronan-binding protein 2; HABP2; rs542838125 G>T), in which growth arrest-specific 2 Like 2 (GAS2L2; rs140842796 C>T) and dynamin 2 (DNM2; rs763894364 G>A) are functionally associated with cell protrusion and the cytoskeleton. ATP Binding Cassette Subfamily C Member 6 (ABCC6) was the only gene with two variants. HABP2 (rs542838125 G>T), MUC4 (rs200737893 G>A), and GAS2L2 (rs140842796 C>T) were detected in only the patient group in the replication study. The combination of WES and machine learning tools is a useful method to detect potential variants associated with RPL. Using bioinformatic tools, we found 10 potential variants in 9 genes. WES data from patients are needed to better understand the causes of RPL.
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Affiliation(s)
- Jeong Yong Lee
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Republic of Korea; (J.Y.L.); (C.S.R.); (E.J.K.)
| | - JaeWoo Moon
- Endomics, Inc., Seongnam-si 13595, Republic of Korea; (J.M.); (H.-J.H.)
| | - Hae-Jin Hu
- Endomics, Inc., Seongnam-si 13595, Republic of Korea; (J.M.); (H.-J.H.)
| | - Chang Soo Ryu
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Republic of Korea; (J.Y.L.); (C.S.R.); (E.J.K.)
| | - Eun Ju Ko
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Republic of Korea; (J.Y.L.); (C.S.R.); (E.J.K.)
| | - Eun Hee Ahn
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13596, Republic of Korea; (E.H.A.); (Y.R.K.)
| | - Young Ran Kim
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13596, Republic of Korea; (E.H.A.); (Y.R.K.)
| | - Ji Hyang Kim
- Department of Obstetrics and Gynecology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13596, Republic of Korea; (E.H.A.); (Y.R.K.)
| | - Nam Keun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Republic of Korea; (J.Y.L.); (C.S.R.); (E.J.K.)
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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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Leszczyńska D, Szatko A, Latocha J, Kochman M, Duchnowska M, Wójcicka A, Misiorowski W, Zgliczyníski W, Glinicki P. Persistent hypercalcaemia associated with two pathogenic variants in the CYP24A1 gene and a parathyroid adenoma-a case report and review. Front Endocrinol (Lausanne) 2024; 15:1355916. [PMID: 38665259 PMCID: PMC11043563 DOI: 10.3389/fendo.2024.1355916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction 24-Hydroxylase, encoded by the CYP24A1 gene, is a crucial enzyme involved in the catabolism of vitamin D. Loss-of-function mutations in CYP24A1 result in PTH-independent hypercalcaemia with high levels of 1,25(OH)2D3. The variety of clinical manifestations depends on age, and underlying genetic predisposition mutations can lead to fatal infantile hypercalcaemia among neonates, whereas adult symptoms are usually mild. Aim of the study We report a rare case of an adult with primary hyperparathyroidism and loss-of-function mutations in the CYP24A1 gene and a review of similar cases. Case presentation We report the case of a 58-year-old woman diagnosed initially with primary hyperparathyroidism. Preoperatively, the suspected mass adjoining the upper pole of the left lobe of the thyroid gland was found via ultrasonography and confirmed by 99mTc scintigraphy and biopsy as the parathyroid gland. The patient underwent parathyroidectomy (a histopathology report revealed parathyroid adenoma), which led to normocalcaemia. After 10 months, vitamin D supplementation was introduced due to deficiency, and the calcium level remained within the reference range. Two years later, biochemical tests showed recurrence of hypercalcaemia with suppressed parathyroid hormone levels and elevated 1,25(OH)2D3 concentrations. Further investigation excluded the most common causes of PTH-independent hypercalcaemia, such as granulomatous disease, malignancy, and vitamin D intoxication. Subsequently, vitamin D metabolites were measured using LC-MS/MS, which revealed high levels of 25(OH)D3, low levels of 24,25(OH)2D3 and elevated 25(OH)2D3/24,25(OH)2D3 ratios, suggesting a defect in vitamin D catabolism. Molecular analysis of the CYP24A1 gene using the NGS technique revealed two pathogenic variants: p.(Arg396Trp) and p.(Glu143del) (rs114368325 and rs777676129, respectively). Conclusions The diagnostic process for hypercalcaemia becomes complicated when multiple causes of hypercalcaemia coexist. The measurement of vitamin D metabolites using LC-MS/MS may help to identify carriers of CYP24A1 mutations. Subsequent molecular testing may contribute to establishing the exact frequency of pathogenic variants of the CYP24A1 gene and introducing personalized treatment.
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Affiliation(s)
- Dorota Leszczyńska
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Alicja Szatko
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
- EndoLab Laboratory, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Julia Latocha
- Students’ Scientific Group Affiliated with the Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Magdalena Kochman
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Maria Duchnowska
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Anna Wójcicka
- Warsaw Genomics, Warsaw, Poland
- Fundacja Wiedzieć Więcej, Warsaw, Poland
| | - Waldemar Misiorowski
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Wojciech Zgliczyníski
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Piotr Glinicki
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland
- EndoLab Laboratory, Centre of Postgraduate Medical Education, Warsaw, Poland
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Gefen AM, Zaritsky JJ. Review of childhood genetic nephrolithiasis and nephrocalcinosis. Front Genet 2024; 15:1381174. [PMID: 38606357 PMCID: PMC11007102 DOI: 10.3389/fgene.2024.1381174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Nephrolithiasis (NL) is a common condition worldwide. The incidence of NL and nephrocalcinosis (NC) has been increasing, along with their associated morbidity and economic burden. The etiology of NL and NC is multifactorial and includes both environmental components and genetic components, with multiple studies showing high heritability. Causative gene variants have been detected in up to 32% of children with NL and NC. Children with NL and NC are genotypically heterogenous, but often phenotypically relatively homogenous, and there are subsequently little data on the predictors of genetic childhood NL and NC. Most genetic diseases associated with NL and NC are secondary to hypercalciuria, including those secondary to hypercalcemia, renal phosphate wasting, renal magnesium wasting, distal renal tubular acidosis (RTA), proximal tubulopathies, mixed or variable tubulopathies, Bartter syndrome, hyperaldosteronism and pseudohyperaldosteronism, and hyperparathyroidism and hypoparathyroidism. The remaining minority of genetic diseases associated with NL and NC are secondary to hyperoxaluria, cystinuria, hyperuricosuria, xanthinuria, other metabolic disorders, and multifactorial etiologies. Genome-wide association studies (GWAS) in adults have identified multiple polygenic traits associated with NL and NC, often involving genes that are involved in calcium, phosphorus, magnesium, and vitamin D homeostasis. Compared to adults, there is a relative paucity of studies in children with NL and NC. This review aims to focus on the genetic component of NL and NC in children.
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Affiliation(s)
- Ashley M. Gefen
- Phoenix Children’s Hospital, Department of Pediatrics, Division of Nephrology, Phoenix, AZ, United States
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Brancatella A, Cappellani D, Pierotti L, Dinoi E, Sardella C, Borsari S, Piaggi P, Baldinotti F, Caligo MA, Marcocci C, Cetani F. When to suspect infantile hypercalcemia-1? J Endocrinol Invest 2024:10.1007/s40618-024-02312-7. [PMID: 38329607 DOI: 10.1007/s40618-024-02312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE The screening test to suspect infantile hypercalcemia-1 (HCINF1) is the measure of 25(OH)D3/24,25(OH)2D3 ratio at mass spectroscopy (MS). When the ratio is > 80, the gold standard for the diagnosis is genetic analysis. Given its limited availability, MS may not represent a screening test and most cases of HCINF1 remain undiagnosed. Aim of the study is to identify cut-offs of serum calcium and PTH useful to suspect patients with HCINF1. METHODS We compared the levels of total serum calcium and PTH of 6 patients with HCINF1 harboring biallelic CYP24A1 pathogenic variants with 3 different control groups: (1) 12 subjects wild type for CYP24A1; (2) 12 subjects matched for age and sex; (3) 12 subjects matched for vitamin D levels. We validated the cut-offs, testing the number of adult patients affected by HCINF1 reported in the literature that could be identified using these cut-offs. RESULTS A serum calcium level > 9.6 mg/dL showed the highest sensitivity (100%) and specificity (91%) in the comparison between homozygous and wild-type subjects. A serum PTH index < 0.315 showed the highest sensitivity (100%) and specificity (83.3%). A serum calcium level > 9.6 mg/dL was able to identify all adult HCINF1 patients whereas a PTH ratio < 0.315 identified 89.8% of the cases. Superimposable results were obtained using the other control groups. CONCLUSION Patients with serum calcium levels higher than 9.6 mg/dL and a PTH index lower than 0.315 are likely to be affected by HCINF1. Their diagnosis may be confirmed using MS and genetic analysis.
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Affiliation(s)
- A Brancatella
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - D Cappellani
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - L Pierotti
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - E Dinoi
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - C Sardella
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - S Borsari
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - P Piaggi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - F Baldinotti
- Endocrine Unit 2, Laboratory of Molecular Genetics, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - M A Caligo
- Endocrine Unit 2, Laboratory of Molecular Genetics, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - C Marcocci
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - F Cetani
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy.
- Endocrine Unit, University Hospital of Pisa, Pisa, Italy.
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Fu L, Wong BYL, Li Z, Horst RL, Williams R, Lee B, Miller J, Carpenter TO, Cole DEC. Genetic variants in the vitamin D pathway and their association with vitamin D metabolite levels: Detailed studies of an inner-city pediatric population suggest a modest but significant effect in early childhood. J Steroid Biochem Mol Biol 2023; 233:106369. [PMID: 37490983 DOI: 10.1016/j.jsbmb.2023.106369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/17/2023] [Accepted: 07/22/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES In a large cohort of healthy infants and toddlers 6-36 months of age (n = 776), we have been exploring the potential role of genetic variation in predisposition to vitamin D insufficiency. The genes encoding the key cytochrome P450 hydroxylases (CYP2R1, CYP24A1, and CYP27B1) harbour recurrent mutations of uncertain effect. This study was undertaken to look for biochemically relevant associations of these variants with inter-individual differences in vitamin D metabolism in an at-risk pediatric population. METHODS Genotyping for CYP2R1-CT (c.-1127 C>T, rs10741657), CYP24A1-AG (c.-686A>G, rs111622401), and CYP27B1-CA (c.-1261 C>A, rs10877012) mutations were performed using SNaPshot assay, followed by Sanger sequencing confirmation. Vitamin D metabolites and vitamin D binding protein (DBP) were measured by established methods. RESULTS In a multivariate regression model, with corrections for co-variates, subjects with the homozygous CYP2R1-TT variant had significantly higher concentrations of 25(OH)D, free 25(OH)D, and 24,25(OH)2D levels. In subjects with the CYP24A1-AG mutation, concentrations of 25(OH)D were significantly higher. CONCLUSIONS The CYP2R1-TT and CYP24A1-AG variants have measurable effects on the vitamin D pathway. It seems unlikely that they will be clinically relevant in isolation, but they may be members of the large pool of infrequent mutations contributing to different risks for the vitamin D deficiency phenotype.
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Affiliation(s)
- Lei Fu
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Departments of Laboratory Medicine and Pathobiology, Toronto, ON, Canada
| | - Betty Y L Wong
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Zhenyu Li
- Departments of Laboratory Medicine and Pathobiology, Toronto, ON, Canada
| | | | - Rashida Williams
- Departments of Laboratory Medicine and Pathobiology, Toronto, ON, Canada
| | - Bonnie Lee
- Departments of Laboratory Medicine and Pathobiology, Toronto, ON, Canada
| | - Jessica Miller
- Departments of Laboratory Medicine and Pathobiology, Toronto, ON, Canada
| | - Thomas O Carpenter
- Departments of Pediatrics (Endocrinology), Yale University School of Medicine, New Haven, CT, USA; Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
| | - David E C Cole
- Pediatrics (Genetics), Toronto, ON, Canada; Medicine, University of Toronto, Toronto, ON, Canada.
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Hou X, Ke J, Chen X, Ai T, Liu X, Qian L, Xiang W, Wang J, Wang C. Changes in the liver of Tinca tinca under successive domestication using an integrated multi-omics approach. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. PART D, GENOMICS & PROTEOMICS 2023; 47:101107. [PMID: 37354750 DOI: 10.1016/j.cbd.2023.101107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
Domestication is the process of modifying the phenotype of a population through anthropic selection from human perspectives. Successive generations of domestication have influenced the physiological characteristics of tench Tinca tinca. In current study, we investigated gene and protein expression alterations in the liver of fifth-generation (F5). A total of 420 genes were found to be upregulated and 351 genes were downregulated, while 410 proteins were upregulated and 279 proteins were downregulated in domesticated T. tinca (DT). The integrated analysis of omics data revealed a total of 55 genes/proteins exhibiting consistent upregulation and 12 genes/proteins displaying consistent downregulation in DT. The upregulated genes/proteins in DT, such as SSR1, DERLIN2, OS9, DNAJB11, and HYOU1, exhibit enrichment in the protein processing in the endoplasmic reticulum pathway. Additionally, upregulated genes/proteins such as IL2RB, F13B, and IRF3 are associated with immune response. Conversely, downregulated genes/proteins in DT, including HSD11B1, CYP24A1, and COMT, play roles in hormone metabolism. These findings indicate that domestication can have a substantial impact on the physiological modifications related to protein processing, immune response, and hormone metabolism in DT. These adaptations potentially enhance their ability to thrive in artificial aquaculture environments, leading to improved growth and development. The exploration of genetic changes in DT will not only improve aquaculture practices but also provide significant insights into the broader process of domestication and its effects on physiological functions.
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Affiliation(s)
- Xin Hou
- Key Laboratory of Freshwater Aquatic Genetic Resources, Ministry of Agriculture/National Demonstration Center for Experimental Fisheries Science Education/Shanghai Engineering Research Center of Aquaculture, Shanghai Ocean University, Shanghai, China
| | - Jing Ke
- Key Laboratory of Freshwater Aquatic Genetic Resources, Ministry of Agriculture/National Demonstration Center for Experimental Fisheries Science Education/Shanghai Engineering Research Center of Aquaculture, Shanghai Ocean University, Shanghai, China
| | - Xiaowen Chen
- Key Laboratory of Freshwater Aquatic Genetic Resources, Ministry of Agriculture/National Demonstration Center for Experimental Fisheries Science Education/Shanghai Engineering Research Center of Aquaculture, Shanghai Ocean University, Shanghai, China
| | - Tao Ai
- Fisheries Technology Extension Station, Xinjiang Production and Construction Corps, Urumqi, Xinjiang, China
| | - Xiaochen Liu
- Agricultural Technology Extension Station of the 10th Division, Xinjiang Production and Construction Corps, Beitun, Xinjiang, China
| | - Long Qian
- Fisheries Technology Extension Station, Xinjiang Production and Construction Corps, Urumqi, Xinjiang, China
| | - Wei Xiang
- Fisheries Technology Extension Station, Xinjiang Production and Construction Corps, Urumqi, Xinjiang, China
| | - Jun Wang
- Key Laboratory of Freshwater Aquatic Genetic Resources, Ministry of Agriculture/National Demonstration Center for Experimental Fisheries Science Education/Shanghai Engineering Research Center of Aquaculture, Shanghai Ocean University, Shanghai, China.
| | - Chenghui Wang
- Key Laboratory of Freshwater Aquatic Genetic Resources, Ministry of Agriculture/National Demonstration Center for Experimental Fisheries Science Education/Shanghai Engineering Research Center of Aquaculture, Shanghai Ocean University, Shanghai, China.
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Liu J, Angelos P, Barhoum M, Jain R. Severe Hypercalcemia Due to Primary Hyperparathyroidism and Heterozygous Pathogenic Variant of CYP24A1. JCEM CASE REPORTS 2023; 1:luad071. [PMID: 37909006 PMCID: PMC10578407 DOI: 10.1210/jcemcr/luad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 11/02/2023]
Abstract
Pathogenic variants of CYP24A1 are associated with hypercalcemia due to disruptions in the ability of 24-hydroxylase to break down 1,25-dihydroxyvitamin D (1,25-DHVD). A case involving a heterozygous pathogenic variant of CYP24A1 and primary hyperparathyroidism leading to severe hypercalcemia has not been previously reported. A 23-year-old woman presented with fatigue and was found to be hypercalcemic at 13.8 mg/dL [reference range, 8.4-10.2 pg/mL]. Her parathyroid hormone (PTH) was 62 pg/mL [reference range, 19-88 pg/mL] and 1,25-DHVD was elevated to 242.7 pg/mL [reference range, 18-72 pg/mL]. Other laboratory workup was unrevealing. She had a bone scan, whole body CT scan, and thyroid ultrasound that were normal. Her 25-hydroxy-vitamin D to 24,25-dihydroxy-vitamin D ratio was elevated at 25.18 (normal, < 25). Because of concern for primary hyperparathyroidism, she was referred to an endocrine surgeon and underwent a parathyroidectomy with the removal of a 3.5-gram adenoma. Pathology showed a parafibromin-deficient parathyroid neoplasm. Genetic testing demonstrated a heterozygous pathogenic variant in CYP24A1. Three weeks after surgery, PTH was 14 pg/mL (1.48 pmol/L), calcium and 1,25-DHVD normalized. In summary, we report a case where a patient with severe symptomatic hypercalcemia was found to have primary hyperparathyroidism exacerbated by an underlying heterozygous pathogenic variant in CYP24A1.
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Affiliation(s)
- Jannel Liu
- Department of Endocrinology, Diabetes, and Metabolism, University of Chicago Medicine, Chicago, IL 60637, USA
| | - Peter Angelos
- Department of Endocrine Surgery, University of Chicago Medicine, Chicago, IL 60637, USA
| | - Maan Barhoum
- Advanced Diabetes & Endocrine Center, Libertyville, IL 60048, USA
| | - Rajesh Jain
- Department of Endocrinology, Diabetes, and Metabolism, University of Chicago Medicine, Chicago, IL 60637, USA
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Brunerova L, Remes O, Zoubkova V, Votypka P. Case report: Two heterozygous pathogenic variants of CYP24A1: A novel cause of hypercalcemia and nephrocalcinosis in adulthood. Front Med (Lausanne) 2023; 9:1020096. [PMID: 36703897 PMCID: PMC9871448 DOI: 10.3389/fmed.2022.1020096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Background and aims Vitamin D 24-hydroxylase is an enzyme encoded by the CYP24A1 gene, which inhibits the activation of vitamin D to form inactive metabolites. More than 20 currently described pathogenic variants (usually biallelic) of this gene are responsible for idiopathic infantile hypercalcemia manifested typically in childhood (often in newborns) with hypercalcemia, hypercalciuria, and nephrocalcinosis. However, a few patients (mostly with monoallelic heterozygous pathogenic variants) can develop mild symptoms in adulthood. Case description We present the case of a 43-year-old male patient with hypertension and heterozygous Leiden mutation, with mural thrombi in the common iliac artery, who was sent by a nephrologist to endocrinological examination due to hypoparathyroidism, progressive hypercalcemia, hypercalciuria, and CKDG2A1. Complete laboratory and imaging methods (including PET-CT) excluded PTH-related peptide-mediated hypercalcemia and granulomatosis. Finally, the genetic analysis of the CYP24A1 gene revealed the presence of a novel combination of two heterozygous pathogenic variants: CYP24A1: c. 443T>C p.(Leu148Pro) and c.1186C>T p.(Arg396Trp). Conclusion Differential diagnosis of patients with hypercalciuria, nephrocalcinosis, and hypercalcemia related to vitamin D exposure should include the CYP24A1 gene mutation. To the best of our knowledge, this is the first case of the novel combination of two heterozygous pathogenic variants of CYP24A1.
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Affiliation(s)
- Ludmila Brunerova
- Department of Internal Medicine, Faculty Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague, Czechia,*Correspondence: Ludmila Brunerova ✉
| | - Ondrej Remes
- Department of Internal Medicine, Faculty Hospital Kralovske Vinohrady and 3rd Faculty of Medicine, Charles University, Prague, Czechia,Nefromed, Prague, Czechia
| | - Veronika Zoubkova
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Pavel Votypka
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
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Effects of CYP24A1 polymorphisms on premature ejaculation: a case–control study. J Genet 2022. [DOI: 10.1007/s12041-022-01378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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11
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Brancatella A, Cappellani D, Kaufmann M, Semeraro A, Borsari S, Sardella C, Baldinotti F, Caligo MA, Jones G, Marcocci C, Cetani F. Long-term Efficacy and Safety of Rifampin in the Treatment of a Patient Carrying a CYP24A1 Loss-of-Function Variant. J Clin Endocrinol Metab 2022; 107:e3159-e3166. [PMID: 35569070 DOI: 10.1210/clinem/dgac315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pharmacological therapy may be useful in the treatment of moderate to severe hypercalcemia in patients with infantile hypercalcemia-1 (HCINF1) due to pathogenic variants in the cytochrome P450 24 subfamily A member 1 (CYP24A1). Rifampin is an antituberculosis drug that is a potent inducer of cytochrome P450 3 subfamily A member 4, which is involved in an alternative catabolic pathway of vitamin D. The efficacy of rifampin in improving hypercalcemia was previously reported, but many questions remain on the long-term efficacy and safety. The aim of the study is to test the long-term efficacy and safety of rifampin in a patient with HCINF1. METHODS We report clinical, biochemical, and imaging features of a 23-year-old man affected by HCINF1 with moderate hypercalcemia (12.9 mg/dL), symptomatic nephrolithiasis, nephrocalcinosis, and impaired kidney function [estimated glomerular filtration rate (eGFR) 60 mL/min/1.73 m2] treated with rifampin for an overall period of 24 months. Kidney, liver, and adrenal function were evaluated at every follow-up visit. RESULTS In 2 months, rifampin induced a normalization of serum calcium (9.6 mg/dL) associated with an improvement of kidney function (eGFR 92 mL/min/1.73 m2) stable during the treatment. After 15 months, rifampin was temporally withdrawn because of asthenia, unrelated to impairment of adrenal function. After 3 months, the timing of drug administration was shifted from the morning to the evening, obtaining the remission of asthenia. At the end of follow-up, the nephrolithiasis disappeared and the nephrocalcinosis was stable. CONCLUSIONS Rifampin could represent an effective choice to induce a stable reduction of calcium levels in patients with HCINF1, with a good safety profile.
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Affiliation(s)
| | - Daniele Cappellani
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martin Kaufmann
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Antonella Semeraro
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simona Borsari
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Fulvia Baldinotti
- Laboratory of Molecular Genetics, University Hospital of Pisa, Pisa, Italy
| | | | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- University Hospital of Pisa, Endocrine Unit, Pisa, Italy
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12
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Hypercalcemia in Pregnancy Due to CYP24A1 Mutations: Case Report and Review of the Literature. Nutrients 2022; 14:nu14122518. [PMID: 35745247 PMCID: PMC9229801 DOI: 10.3390/nu14122518] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 02/06/2023] Open
Abstract
Pathogenic mutations of CYP24A1 lead to an impaired catabolism of vitamin D metabolites and should be considered in the differential diagnosis of hypercalcemia with low parathyroid hormone concentrations. Diagnosis is based on a reduced 24,25-dihydroxyvitamin D to 25-hydroxyvitamin D ratio and confirmed by genetic analyses. Pregnancy is associated with an upregulation of the active vitamin D hormone calcitriol and may thus particularly trigger hypercalcemia in affected patients. We present a case report and a narrative review of pregnant women with CYP24A1 mutations (13 women with 29 pregnancies) outlining the laboratory and clinical characteristics during pregnancy and postpartum and the applied treatment approaches. In general, pregnancy triggered hypercalcemia in the affected women and obstetric complications were frequently reported. Conclusions on drugs to treat hypercalcemia during pregnancy are extremely limited and do not show clear evidence of efficacy. Strictly avoiding vitamin D supplementation seems to be effective in preventing or reducing the degree of hypercalcemia. Our case of a 24-year-old woman who presented with hypercalcemia in the 24th gestational week delivered a healthy baby and hypercalcemia resolved while breastfeeding. Pathogenic mutations of CYP24A1 mutations are rare but should be considered in the context of vitamin D supplementation during pregnancy.
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13
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Xu QH, Muyayalo KP, Zhang YJ, Wang H, Lin XX, Liao AH. Altered vitamin D metabolism is involved in the dysregulation of γδT cell function and their crosstalk with trophoblasts in recurrent pregnancy loss. Am J Reprod Immunol 2022; 89:e13581. [PMID: 35704547 DOI: 10.1111/aji.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/23/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Recurrent pregnancy loss (RPL) is a common disease characterized by immune dysfunction and vitamin D deficiency. This study aimed to investigate vitamin D metabolism and γδT cell phenotypes at the maternal-fetal interface in women with early normal pregnancy (NP) and RPL and to determine the effects of vitamin D on the functions of γδT cells and their crosstalk with trophoblasts. METHODS The levels of 25-(OH)VD3 , the expression of vitamin D metabolic enzymes in the villi, and the proportion of γδT cells in the decidua were detected in women with NP and RPL. After treatment with different concentrations of vitamin D, the mRNA expression of the vitamin D receptor (VDR), cytokines, and transcription factors was detected in Vδ2+ γδT cells. In addition, the proliferation, migration, and invasion of HTR-8/SVneo trophoblasts were determined by co-culturing them with vitamin D-treated Vδ2+ γδT cells and their supernatants. RESULTS In women with RPL, the level of 25-(OH)VD3 in the villi was increased; however, that of CYP27B1 (enzyme converting 25-(OH)VD3 into 1,25-(OH)2 VD3 ) was decreased. In addition, the proportion of Vδ2+ γδT cells increased, whereas that of Foxp3+ Vδ2+ γδT cells decreased in the decidua of women with RPL. An in vitro study showed that vitamin D increased the expression of VDR mRNA and Foxp3, but decreased the expression of IFN-γ mRNA, in Vδ2+ γδT cells. Finally, vitamin D-treated Vδ2+ γδT cells promoted trophoblast migration and invasion. CONCLUSIONS Abnormal vitamin D metabolism and γδT cell proportions were present at the maternal-fetal interface in women with RPL. Under normal pregnancy conditions, vitamin D can induce the differentiation of decidual Vδ2+ γδT cells toward an anti-inflammatory phenotype (Treg-like γδT cells) and modulate the crosstalk between Vδ2+ γδT cells and trophoblasts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Qian-Han Xu
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Kahindo P Muyayalo
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Yu-Jing Zhang
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Huan Wang
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xin-Xiu Lin
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ai-Hua Liao
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
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14
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Rousseau-Nepton I, Jones G, Schlingmann K, Kaufmann M, Zuijdwijk CS, Khatchadourian K, Gupta IR, Pacaud D, Pinsk MN, Mokashi A, Nour MA, Alexander RT, Rodd CJ. CYP24A1 and SLC34A1 Pathogenic Variants Are Uncommon in a Canadian Cohort of Children with Hypercalcemia or Hypercalciuria. Horm Res Paediatr 2022; 94:124-132. [PMID: 34320495 DOI: 10.1159/000517548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Biallelic pathogenic variants in CYPA24A1 and SLC34A1 are causes of idiopathic infantile hypercalcemia. Pathogenic variants in both may also give rise to hypercalciuria with nephrocalcinosis or nephrolithiasis without previous hypercalcemia (renal group). Our objective was to examine the frequency of CYP24A1 or SLC34A1 variants in children with early hypercalcemia or late-onset hypercalciuria. METHOD Forty-one children from 7 centers across Canada were recruited. Local investigations were undertaken. The serum was evaluated by liquid chromatography tandem-mass spectrometry for the ratio of 25-hydroxyvitamin D3 to 24,25-dihydroxyvitamin D3, (25-OH-D3:24,25-(OH)2D3), an elevation pathognomonic for the loss of function of the CYP24A1 enzyme. Mutational analyses were undertaken. Family cascade screening was performed if pathogenic variants were detected in probands. RESULTS Twenty-nine children had early-onset hypercalcemia; none had elevated 25-OH-D3:24,25-(OH)2D3 or variants. Interestingly, 2 of 12 in the renal group had elevated 25-OH-D3:24,25-(OH)2D3 and presented as preadolescents. In case 1, cascade testing revealed a sibling and parent with asymptomatic pathogenic variants in CYP24A1. Four CYP24A1 pathogenic variants were identified in these 2 probands: 3 have been described in European populations, and 1 is a rare variant in exon 7 (c931delC) that is likely pathogenic. No SLC34A1 pathogenic variants were detected. CONCLUSION In Canada, pathogenic variants in CYP24A1 appear to manifest with late-onset hypercalciuria and its sequelae. The 25-OH-D3:24,25-(OH)2D3 ratio is an excellent tool for screening for biallelic pathogenic variants in CYP24A1. We confirm that cascade testing is important for these variants.
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Affiliation(s)
| | - Glenville Jones
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Karlpiet Schlingmann
- Department of General Pediatrics, University Children's Hospital, University of Münster, Münster, Germany
| | - Martin Kaufmann
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | | | | | - Indra R Gupta
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Danièle Pacaud
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Maury N Pinsk
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Arati Mokashi
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Munier A Nour
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - R Todd Alexander
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Celia J Rodd
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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15
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Lenherr-Taube N, Young EJ, Furman M, Elia Y, Assor E, Chitayat D, Uster T, Kirwin S, Robbins K, Vinette KMB, Daneman A, Marshall CR, Collins C, Thummel K, Sochett E, Levine MA. Mild Idiopathic Infantile Hypercalcemia-Part 1: Biochemical and Genetic Findings. J Clin Endocrinol Metab 2021; 106:2915-2937. [PMID: 34125233 PMCID: PMC8475208 DOI: 10.1210/clinem/dgab431] [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: 12/09/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Idiopathic infantile hypercalcemia (IIH), an uncommon disorder characterized by elevated serum concentrations of 1,25 dihydroxyvitamin D (1,25(OH)2D) and low parathyroid hormone (PTH) levels, may present with mild to severe hypercalcemia during the first months of life. Biallelic variants in the CYP24A1 or SLC34A1 genes are associated with severe IIH. Little is known about milder forms. OBJECTIVE This work aims to characterize the genetic associations and biochemical profile of mild IIH. METHODS This is a cross-sectional study including children between age 6 months and 17 years with IIH who were followed in the Calcium Clinic at the Hospital for Sick Children (SickKids), Toronto, Canada. Twenty children with mild IIH on calcium-restricted diets were evaluated. We performed a dietary assessment and analyzed biochemical measures including vitamin D metabolites and performed a stepwise molecular genetic analysis. Complementary biochemical assessments and renal ultrasounds were offered to first-degree family members of positive probands. RESULTS The median age was 16 months. Median serum levels of calcium (2.69 mmol/L), urinary calcium:creatinine ratio (0.72 mmol/mmol), and 1,25(OH)2D (209 pmol/L) were elevated, whereas intact PTH was low normal (22.5 ng/L). Mean 1,25(OH)2D/PTH and 1,25(OH)2D/25(OH)D ratios were increased by comparison to healthy controls. Eleven individuals (55%) had renal calcification. Genetic variants were common (65%), with the majority being heterozygous variants in SLC34A1 and SLC34A3, while a minority showed variants of CYP24A1 and other genes related to hypercalciuria. CONCLUSION The milder form of IIH has a distinctive vitamin D metabolite profile and is primarily associated with heterozygous SLC34A1 and SLC34A3 variants.
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Affiliation(s)
- Nina Lenherr-Taube
- Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Edwin J Young
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, M5G 1X8 Toronto, Ontario, Canada
| | - Michelle Furman
- Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Yesmino Elia
- Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Esther Assor
- Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - David Chitayat
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
- Department of Pediatrics, Division of Clinical Genetics and Metabolism, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Tami Uster
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Susan Kirwin
- Nemours Molecular Diagnostics Laboratory, Nemours Children’s Health System, Wilmington, Delaware 19802, USA
| | - Katherine Robbins
- Nemours Molecular Diagnostics Laboratory, Nemours Children’s Health System, Wilmington, Delaware 19802, USA
| | - Kathleen M B Vinette
- Nemours Molecular Diagnostics Laboratory, Nemours Children’s Health System, Wilmington, Delaware 19802, USA
| | - Alan Daneman
- Department of Diagnostic Imaging, Division of General Radiology and Body Imaging, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Christian R Marshall
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, M5G 1X8 Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, M5S 1A8 Toronto, Ontario, Canada
| | - Carol Collins
- Department of Pharmaceutics, University of Washington, Seattle, Washington 98195, USA
| | - Kenneth Thummel
- Department of Pharmaceutics, University of Washington, Seattle, Washington 98195, USA
| | - Etienne Sochett
- Department of Pediatrics, Division of Endocrinology, The Hospital for Sick Children, University of Toronto, M5G 1X8 Toronto, Ontario, Canada
| | - Michael A Levine
- Division of Endocrinology and Diabetes and Center for Bone Health, Children’s Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104, USA
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16
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A Mendelian randomization study on the role of serum parathyroid hormone and 25-hydroxyvitamin D in osteoarthritis. Osteoarthritis Cartilage 2021; 29:1282-1290. [PMID: 33975017 DOI: 10.1016/j.joca.2021.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] have been demonstrated to be associated with pathogenesis and progression of osteoarthritis (OA). This study aimed to determine the potential causal relationship between serum PTH and 25(OH)D levels and risk of OA. DESIGN We applied the two-sample Mendelian randomization (MR) approach to estimate the causal roles of serum PTH and 25(OH)D on OA. The instrumental variables for serum PTH and 25(OH)D were derived from two large genome-wide association studies (GWAS), which included 29,155 and 79,366 individuals, respectively. Summary-level data for overall, hip and knee OA were extracted from a GWAS meta-analysis, including 455,221 individuals. All participants included in this study were from the European population. RESULTS An inverse association was observed between serum PTH levels and risk of OA (random-effects: Effect = 0.71; 95% CI: 0.54 to 0.92; fixed-effects: Effect = 0.71; 95% CI: 0.61 to 0.82). Stratified by site, serum PTH levels were found to be inversely associated with knee OA (random-effects: Effect = 0.53; 95% CI: 0.41 to 0.68; fixed-effects: Effect = 0.53; 95% CI: 0.41 to 0.68). However, there was no evidence of the causal effect of serum 25(OH)D levels on OA. CONCLUSIONS The present study indicates an inverse causal relationship between serum PTH concentrations and development of OA. Moreover, a site-specific association was also observed between serum PTH levels and knee OA. The potential mechanisms by which serum PTH affects OA need to be further investigated.
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McCartney DM, O'Shea PM, Faul JL, Healy MJ, Byrne G, Griffin TP, Walsh JB, Byrne DG, Kenny RA. Vitamin D and SARS-CoV-2 infection-evolution of evidence supporting clinical practice and policy development : A position statement from the Covit-D Consortium. Ir J Med Sci 2021; 190:1253-1265. [PMID: 33219912 PMCID: PMC7679797 DOI: 10.1007/s11845-020-02427-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Daniel M McCartney
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland.
| | - Paula M O'Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - John L Faul
- James Connolly Memorial Asthma Research Centre, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin 15, Ireland
| | - Martin J Healy
- Biochemistry Department, St. James's Hospital, Dublin 8, Ireland
| | - Greg Byrne
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland
| | - Tomás P Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
- Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals, Galway, Ireland
| | - James Bernard Walsh
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Declan G Byrne
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Medicine Directorate, St. James's Hospital, Dublin 8, Ireland
| | - Rose Anne Kenny
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
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18
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Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature. Biomedicines 2021; 9:biomedicines9050475. [PMID: 33925967 PMCID: PMC8145477 DOI: 10.3390/biomedicines9050475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 12/27/2022] Open
Abstract
Pregnancy and lactation are characterized by sophisticated adaptations of calcium homeostasis, aiming to meet fetal, neonatal, and maternal calcium requirements. Pregnancy is primarily characterized by an enhancement of intestinal calcium absorption, whereas during lactation additional calcium is obtained through resorption from the maternal skeleton, a process which leads to bone loss but is reversible following weaning. These maternal adaptations during pregnancy and lactation may influence or confound the presentation, diagnosis, and management of parathyroid disorders such as primary hyperparathyroidism or hypoparathyroidism. Parathyroid diseases are uncommon in these settings but can be severe when they occur and may affect both maternal and fetal health. This review aims to delineate the changes in calcium physiology that occur with pregnancy and lactation, describe the disorders of calcium and parathyroid physiology that can occur, and outline treatment strategies for these diseases in the above settings.
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Duplex high resolution melting analysis (dHRMA) to detect two hot spot CYP24A1 pathogenic variants (PVs) associated to idiopathic infantile hypercalcemia (IIH). Mol Biol Rep 2021; 48:3303-3311. [PMID: 33864587 PMCID: PMC8172411 DOI: 10.1007/s11033-021-06324-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/27/2021] [Indexed: 11/06/2022]
Abstract
Pathogenic variants (PVs) in CYP24A1 gene are associated with Idiopathic Infantile Hypercalcemia disease (IIH). The identification of CYP24A1 PVs can be a useful tool for the improvement of target therapeutic strategies. Aim of this study is to set up a rapid and inexpensive High Resolution Melting Analysis (HRMA)-based method for the simultaneous genotyping of two hot spot PVs in CYP24A1 gene, involved in IIH. A duplex-HRMA (dHRMA) was designed in order to detect simultaneously CYP24A1 c.428_430delAAG, p.(Glu143del) (rs777676129) and c.1186C > T, p.(Arg396Trp) (rs114368325), in peculiar cases addressed to our Laboratory. dHRMA was able to identify clearly and simultaneously both hot spot CYP24A1 PVs evaluating melting curve shape and melting temperature (Tm). This is the first dHRMA approach to rapidly screen the two most frequent CYP24A1 PVs in peculiar case, providing useful information for diagnosis and patient management in IIH disease.
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Makris K, Bhattoa HP, Cavalier E, Phinney K, Sempos CT, Ulmer CZ, Vasikaran SD, Vesper H, Heijboer AC. Recommendations on the measurement and the clinical use of vitamin D metabolites and vitamin D binding protein - A position paper from the IFCC Committee on bone metabolism. Clin Chim Acta 2021; 517:171-197. [PMID: 33713690 DOI: 10.1016/j.cca.2021.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/10/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Vitamin D, an important hormone with a central role in calcium and phosphate homeostasis, is required for bone and muscle development as well as preservation of musculoskeletal function. The most abundant vitamin D metabolite is 25-hydroxyvitamin D [25(OH)D], which is currently considered the best marker to evaluate overall vitamin D status. 25(OH)D is therefore the most commonly measured metabolite in clinical practice. However, several other metabolites, although not broadly measured, are useful in certain clinical situations. Vitamin D and all its metabolites are circulating in blood bound to vitamin D binding protein, (VDBP). This highly polymorphic protein is not only the major transport protein which, along with albumin, binds over 99% of the circulating vitamin D metabolites, but also participates in the transport of the 25(OH)D into the cell via a megalin/cubilin complex. The accurate measurement of 25(OH)D has proved a difficult task. Although a reference method and standardization program are available for 25(OH)D, the other vitamin D metabolites still lack this. Interpretation of results, creation of clinical supplementation, and generation of therapeutic guidelines require not only accurate measurements of vitamin D metabolites, but also the accurate measurements of several other "molecules" related with bone metabolism. IFCC understood this priority and a committee has been established with the task to support and continue the standardization processes of vitamin D metabolites along with other bone-related biomarkers. In this review, we present the position of this IFCC Committee on Bone Metabolism on the latest developments concerning the measurement and standardization of vitamin D metabolites and its binding protein, as well as clinical indications for their measurement and interpretation of the results.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece.
| | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - Karen Phinney
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Christopher T Sempos
- Coordinator, Vitamin D Standardization Program (VDSP), Havre de Grace, MD 21078, USA
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samuel D Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Hubert Vesper
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology Endocrinology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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21
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Brancatella A, Cappellani D, Kaufmann M, Borsari S, Piaggi P, Baldinotti F, Caligo MA, Jones G, Marcocci C, Cetani F. Do the Heterozygous Carriers of a CYP24A1 Mutation Display a Different Biochemical Phenotype Than Wild Types? J Clin Endocrinol Metab 2021; 106:708-717. [PMID: 33249478 DOI: 10.1210/clinem/dgaa876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 01/07/2023]
Abstract
CONTEXT Human cytochrome P450 24 subfamily A member 1 (CYP24A1) loss-of-function mutations result in impaired activity of the 24-hydroxylase involved in vitamin D catabolism, thus inducing a vitamin D-dependent hypercalcemia. Homozygotes often present an overt clinical phenotype named idiopathic infantile hypercalcemia (IIH), whereas it is debated whether heterozygotes display an abnormal phenotype. OBJECTIVE To compare the clinical and biochemical features of heterozygous carriers of CYP24A1 variant and healthy wild-type controls sharing the same genetic and environmental exposure. METHODS A large family harboring the nonsense c.667A>T, p.Arg223* pathogenic variant in the CYP24A1 gene was evaluated. All subjects underwent clinical and biochemical evaluation and complete analysis of vitamin D metabolites using mass spectroscopy including 1,24,25(OH)3D3. Subjects were divided into 2 groups according to their genotype: heterozygotes and wild-type for the CYP24A1 variant. RESULTS The proband, a 40-year-old man, homozygous for p.Arg223* pathogenic variant, had a history of mild hypercalcemia with a seasonal trend, recurrent nephrolithiasis, and no episodes of acute hypercalcemia. He showed the highest serum levels of fibroblast growth factor 23, the highest 25(OH)D3/24,25(OH)2D3 ratio and undetectable levels of 1,24,25(OH)3D3, which represent indicators of a loss-of-function CYP24A1. Compared with the wild-types, heterozygotes had higher serum calcium and 25(OH)D3 concentrations (P = .017 and P = .025, respectively), without any difference in the other biochemical parameters and in the rate of nephrolithiasis. CONCLUSION Heterozygotes exhibit a biochemical phenotype different from that of wild-type subjects. In clinical practice, these individuals might require surveillance because of the potential risk of developing hypercalcemia and related clinical manifestations if exposed to triggering factors.
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Affiliation(s)
- Alessandro Brancatella
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - Daniele Cappellani
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - Martin Kaufmann
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Simona Borsari
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | | | | | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
| | - Filomena Cetani
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Pisa, Italy
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22
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Rovito D, Belorusova AY, Chalhoub S, Rerra AI, Guiot E, Molin A, Linglart A, Rochel N, Laverny G, Metzger D. Cytosolic sequestration of the vitamin D receptor as a therapeutic option for vitamin D-induced hypercalcemia. Nat Commun 2020; 11:6249. [PMID: 33288743 PMCID: PMC7721737 DOI: 10.1038/s41467-020-20069-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 11/12/2020] [Indexed: 11/09/2022] Open
Abstract
The bioactive vitamin D3, 1α,25(OH)2D3, plays a central role in calcium homeostasis by controlling the activity of the vitamin D receptor (VDR) in various tissues. Hypercalcemia secondary to high circulating levels of vitamin D3 leads to hypercalciuria, nephrocalcinosis and renal dysfunctions. Current therapeutic strategies aim at limiting calcium intake, absorption and resorption, or 1α,25(OH)2D3 synthesis, but are poorly efficient. In this study, we identify WBP4 as a new VDR interactant, and demonstrate that it controls VDR subcellular localization. Moreover, we show that the vitamin D analogue ZK168281 enhances the interaction between VDR and WBP4 in the cytosol, and normalizes the expression of VDR target genes and serum calcium levels in 1α,25(OH)2D3-intoxicated mice. As ZK168281 also blunts 1α,25(OH)2D3-induced VDR signaling in fibroblasts of a patient with impaired vitamin D degradation, this VDR antagonist represents a promising therapeutic option for 1α,25(OH)2D3-induced hypercalcemia. Current therapeutic strategies for vitamin D-induced hypercalcemia are poorly efficient. Here the authors identify a new interaction between the vitamin D receptor (VDR) and WBP4 controlling the subcellular localization of VDR and show that ZK168281, a VDR antagonist, enhances the interaction between VDR and WBP4 blunting VDR signalling and normalizing calcium levels in vitamin D-intoxicated mice.
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Affiliation(s)
- Daniela Rovito
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France.,Université de Strasbourg, Illkirch, France
| | - Anna Y Belorusova
- Medicinal Chemistry, Respiratory, Inflammation and Autoimmunity, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Sandra Chalhoub
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France.,Université de Strasbourg, Illkirch, France
| | - Anna-Isavella Rerra
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France.,Université de Strasbourg, Illkirch, France
| | - Elvire Guiot
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France.,Université de Strasbourg, Illkirch, France
| | - Arnaud Molin
- Université de Normandie, UNICAEN, CHU de Caen Normandie, Service de Génétique, EA 7450 BIOTARGEN, Caen, France.,Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism (OSCAR), Paris, France
| | - Agnès Linglart
- Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism (OSCAR), Paris, France.,Université de Paris Saclay, AP-HP, Hôpital Bicêtre, DMU SEA, INSERM, U1185, Le Kremlin Bicêtre, France
| | - Natacha Rochel
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France.,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France.,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France.,Université de Strasbourg, Illkirch, France
| | - Gilles Laverny
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France. .,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France. .,Université de Strasbourg, Illkirch, France.
| | - Daniel Metzger
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France. .,Centre National de la Recherche Scientifique, UMR7104, Illkirch, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM), U1258, Illkirch, France. .,Université de Strasbourg, Illkirch, France.
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23
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Lundquist AL, Pelletier RC, Leonard CE, Williams WW, Armstrong KA, Rehm HL, Rhee EP. From Theory to Reality: Establishing a Successful Kidney Genetics Clinic in the Outpatient Setting. KIDNEY360 2020; 1:1099-1106. [PMID: 35368791 DOI: 10.34067/kid.0004262020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/12/2020] [Indexed: 02/06/2023]
Abstract
Background Genetic testing in nephrology is increasingly described in the literature and several groups have suggested significant clinical benefit. However, studies to date have described experience from established genetic testing centers or from externally funded research programs. Methods We established a de novo kidney genetics clinic within an academic adult general nephrology practice. Key features of this effort included a pipeline for internal referrals, flexible scheduling, close coordination between the nephrologist and a genetic counselor, and utilization of commercial panel-based testing. Over the first year, we examined the outcomes of genetic testing, the time to return of genetic testing, and out-of-pocket cost to patients. Results Thirty patients were referred and 23 were evaluated over the course of five clinic sessions. Nineteen patients underwent genetic testing with new diagnoses in nine patients (47%), inconclusive results in three patients (16%), and clearance for kidney donation in two patients (11%). On average, return of genetic results occurred 55 days (range 9-174 days) from the day of sample submission and the average out-of-pocket cost to patients was $155 (range $0-$1623). Conclusions We established a kidney genetics clinic, without a pre-existing genetics infrastructure or dedicated research funding, that identified a new diagnosis in approximately 50% of patients tested. This study provides a clinical practice model for successfully incorporating genetic testing into ambulatory nephrology care with minimal capital investment and limited financial effect on patients.
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Affiliation(s)
- Andrew L Lundquist
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Renee C Pelletier
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Courtney E Leonard
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Winfred W Williams
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Katrina A Armstrong
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Heidi L Rehm
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Department of Pathology, Harvard Medical School, Harvard, University, Boston, Massachusetts
| | - Eugene P Rhee
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
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24
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De Paolis E, Scaglione GL, De Bonis M, Minucci A, Capoluongo E. CYP24A1 and SLC34A1 genetic defects associated with idiopathic infantile hypercalcemia: from genotype to phenotype. Clin Chem Lab Med 2020; 57:1650-1667. [PMID: 31188746 DOI: 10.1515/cclm-2018-1208] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023]
Abstract
Loss of function mutations in the CYP24A1 gene, involved in vitamin D catabolism and in calcium homeostasis, are known to be the genetic drivers of both idiopathic infantile hypercalcemia (IIH) and adult renal stone disease. Recently, also defects in the SLC34A1 gene, encoding for the renal sodium-phosphate transporter NaPi-IIa, were associated with the disease. IIH typically affects infants and pediatric patients with a syndrome characterized by severe hypercalcemia, hypercalciuria, suppressed parathyroid hormone level and nephrolithiasis. In SLC34A1 mutated carriers, hypophosphatemia is also a typical biochemical tract. IIH may also persist undiagnosed into adulthood, causing an increased risk of nephrocalcinosis and renal complication. To note, a clinical heterogeneity characterizes IIH manifestation, principally due to the controversial gene-dose effect and, to the strong influence of environmental factors. The present review is aimed to provide an overview of the current molecular findings on the IIH disorder, giving a comprehensive description of the association between genotype and biochemical and clinical phenotype of the affected patients. We also underline that patients may benefit from genetic testing into a targeted diagnostic and therapeutic workflow.
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Affiliation(s)
- Elisa De Paolis
- Laboratory of Molecular Diagnostics and Genomics, Teaching and Research Hospital "Fondazione Policlinico Agostino Gemelli" - IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Giovanni Luca Scaglione
- Laboratory of Molecular Oncology, "Fondazione Giovanni Paolo II", Catholic University of Sacred Heart, Campobasso, Italy
| | - Maria De Bonis
- Laboratory of Molecular Diagnostics and Genomics, Teaching and Research Hospital "Fondazione Policlinico Agostino Gemelli" - IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Angelo Minucci
- Laboratory of Molecular Diagnostics and Genomics, Teaching and Research Hospital "Fondazione Policlinico Agostino Gemelli" - IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Ettore Capoluongo
- Laboratory of Molecular Diagnostics and Genomics, Teaching and Research Hospital "Fondazione Policlinico Agostino Gemelli" - IRCCS, Catholic University of the Sacred Heart, Rome, Italy
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25
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites part II-the measurement of the various vitamin D metabolites. Hormones (Athens) 2020; 19:97-107. [PMID: 32221839 DOI: 10.1007/s42000-020-00188-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Abstract
Today, the possibility exists to measure a number of different vitamin D metabolites with accurate and precise methods. The most abundant vitamin D metabolite, 25(OH)D, is considered the best marker for estimating vitamin D status and is therefore the most commonly measured in clinical practice. There is no consensus on the added value of measuring other metabolites beyond 25-hydroxyvitamin D, although, in some special clinical scenarios and complicated cases, these metabolites may provide just the information needed for an accurate diagnosis. The problem this review addresses is which metabolite to measure and when and how to measure it.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 2 Nikis Str., 14561, Kifissia, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Belgium
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26
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Bao Q, Wang D, Zhang Y, Bao L, Jia H. The Impact of CYP24A1 Polymorphisms on Hypertension Susceptibility. Kidney Blood Press Res 2020; 45:28-37. [PMID: 31918428 DOI: 10.1159/000503925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/04/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypertension is one of the leading causes of human death and disability. CYP24A1 regulates vitamin D activity and is closely linked to hypertension. However, the relationship between CYP24A1polymorphisms and hypertension risk remains unclear. METHODS This case-control study included 503 hypertensive patients and 498 healthy controls from the Chinese Han population. The genotypes of CYP24A1polymorphisms were detected using the Agena MassARRAY method. The association between genetic variations of CYP24A1and hypertension risk was evaluated with odds ratios (OR) and 95% confidence intervals (CI) in genetic models. RESULTS We found that rs56229249 of CYP24A1significantlydecreased the hypertension risk in homozygote (OR 0.51, 95% CI 0.29-0.91, p = 0.022) and recessive models (OR 0.51, 95% CI 0.29-0.91, p = 0.023). Further stratification analyses indicated that hypertension risk is related to age and sex, rs2762934 polymorphism increases hypertension risk among younger subjects (<61 years), and rs1977297 influences the risk of hypertension among older subjects (≥61 years). In addition, rs2762940 is related to hypertension risk in men, and rs56229249 is a protective factor against hypertension in women. CONCLUSIONS Our study suggests that genetic variations of the CYP24A1gene were significantly associated with susceptibility to hypertension in the Chinese population.
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Affiliation(s)
- Qiuhong Bao
- Gerontological Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Dan Wang
- Gerontological Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yong Zhang
- Gerontological Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Lili Bao
- Gerontological Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Haiyu Jia
- Gerontological Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China,
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27
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Cai H, Jiao Y, Li Y, Yang Z, He M, Liu Y. Low CYP24A1 mRNA expression and its role in prognosis of breast cancer. Sci Rep 2019; 9:13714. [PMID: 31548577 PMCID: PMC6757028 DOI: 10.1038/s41598-019-50214-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/09/2019] [Indexed: 01/09/2023] Open
Abstract
Breast cancer is the most common malignant cancer in women. CYP24A1 expression regulates cellular response to vitamin D, which has antitumor effects against breast cancer. This study aimed to identify the correlation between CYP24A1 mRNA expression and prognosis of breast cancer. This study enrolled 1102 patients, including 1090 females and 12 males, from TCGA-BRCA cohort. The Cancer Genome Atlas database was used to study CYP24A1 mRNA expression in breast cancer, and Chi-squared tests were performed to test the correlation between clinical features and CYP24A1 expression. The prognostic value of CYP24A1 in breast cancer was assessed using Kaplan–Meier curves and Cox analysis. Low CYP24A1 expression was associated with age, molecular subtype, ER, PR, HER2, menopause status, N classification, vital status, overall survial and relapse-free survival. CYP24A1 presented a moderate diagnostic ability in breast cancer. Furthermore, low CYP24A1 expression was correlated with poor prognosis. CYP24A1 was an independent risk factor for breast cancer. CYP24A1 plays an important role in prognosis of breast cancer. CYP24A1 has the potential to be a biomarker, especially in predicting prognosis.
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Affiliation(s)
- Hongqiao Cai
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Yan Jiao
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Yanqing Li
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Zhaoying Yang
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130033, P. R. China.
| | - Miao He
- Department of Anesthesia, The Second Hospital of Jilin University, Changchun, 130022, P. R. China
| | - Yahui Liu
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, 130021, P.R. China.
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28
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Hosadurg D, Srirangalingam U. Response to 'Seasonal hypercalcaemia'. QJM 2019; 112:395. [PMID: 30418655 DOI: 10.1093/qjmed/hcy266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Hosadurg
- Department of Endocrinology, University College London Medical School and University College London Hospital, London, UK
| | - U Srirangalingam
- Department of Endocrinology, University College London Medical School and University College London Hospital, London, UK
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29
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Grant DJ, Manichaikul A, Alberg AJ, Bandera EV, Barnholtz‐Sloan J, Bondy M, Cote ML, Funkhouser E, Moorman PG, Peres LC, Peters ES, Schwartz AG, Terry PD, Wang X, Keku TO, Hoyo C, Berchuck A, Sandler DP, Taylor JA, O’Brien KM, Velez Edwards DR, Edwards TL, Beeghly‐Fadiel A, Wentzensen N, Pearce CL, Wu AH, Whittemore AS, McGuire V, Sieh W, Rothstein JH, Modugno F, Ness R, Moysich K, Rossing MA, Doherty JA, Sellers TA, Permuth‐Way JB, Monteiro AN, Levine DA, Setiawan VW, Haiman CA, LeMarchand L, Wilkens LR, Karlan BY, Menon U, Ramus S, Gayther S, Gentry‐Maharaj A, Terry KL, Cramer DW, Goode EL, Larson MC, Kaufmann SH, Cannioto R, Odunsi K, Etter JL, Huang R, Bernardini MQ, Tone AA, May T, Goodman MT, Thompson PJ, Carney ME, Tworoger SS, Poole EM, Lambrechts D, Vergote I, Vanderstichele A, Van Nieuwenhuysen E, Anton‐Culver H, Ziogas A, Brenton JD, Bjorge L, Salvensen HB, Kiemeney LA, Massuger LFAG, Pejovic T, Bruegl A, Moffitt M, Cook L, Le ND, Brooks‐Wilson A, Kelemen LE, Pharoah PD, Song H, Campbell I, Eccles D, DeFazio A, Kennedy CJ, Schildkraut JM. Evaluation of vitamin D biosynthesis and pathway target genes reveals UGT2A1/2 and EGFR polymorphisms associated with epithelial ovarian cancer in African American Women. Cancer Med 2019; 8:2503-2513. [PMID: 31001917 PMCID: PMC6536963 DOI: 10.1002/cam4.1996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/03/2018] [Accepted: 01/08/2019] [Indexed: 02/02/2023] Open
Abstract
An association between genetic variants in the vitamin D receptor (VDR) gene and epithelial ovarian cancer (EOC) was previously reported in women of African ancestry (AA). We sought to examine associations between genetic variants in VDR and additional genes from vitamin D biosynthesis and pathway targets (EGFR, UGT1A, UGT2A1/2, UGT2B, CYP3A4/5, CYP2R1, CYP27B1, CYP24A1, CYP11A1, and GC). Genotyping was performed using the custom-designed 533,631 SNP Illumina OncoArray with imputation to the 1,000 Genomes Phase 3 v5 reference set in 755 EOC cases, including 537 high-grade serous (HGSOC), and 1,235 controls. All subjects are of African ancestry (AA). Logistic regression was performed to estimate odds ratios (OR) and 95% confidence intervals (CI). We further evaluated statistical significance of selected SNPs using the Bayesian False Discovery Probability (BFDP). A significant association with EOC was identified in the UGT2A1/2 region for the SNP rs10017134 (per allele OR = 1.4, 95% CI = 1.2-1.7, P = 1.2 × 10-6 , BFDP = 0.02); and an association with HGSOC was identified in the EGFR region for the SNP rs114972508 (per allele OR = 2.3, 95% CI = 1.6-3.4, P = 1.6 × 10-5 , BFDP = 0.29) and in the UGT2A1/2 region again for rs1017134 (per allele OR = 1.4, 95% CI = 1.2-1.7, P = 2.3 × 10-5 , BFDP = 0.23). Genetic variants in the EGFR and UGT2A1/2 may increase susceptibility of EOC in AA women. Future studies to validate these findings are warranted. Alterations in EGFR and UGT2A1/2 could perturb enzyme efficacy, proliferation in ovaries, impact and mark susceptibility to EOC.
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Affiliation(s)
- Delores J. Grant
- Department of Biological and Biomedical Sciences, Cancer Research ProgramJLC‐Biomedical/Biotechnology Research Institute, North Carolina Central UniversityDurhamNorth Carolina
| | - Ani Manichaikul
- Center for Public Health GenomicsUniversity of VirginiaCharlottesvilleVirginia
| | - Anthony J. Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth Carolina
| | - Elisa V. Bandera
- Department of Population ScienceRutgers Cancer Institute of New JerseyNew BrunswickNew Jersey
| | - Jill Barnholtz‐Sloan
- Case Comprehensive Cancer CenterCase Western Reserve University School of MedicineClevelandOhio
| | - Melissa Bondy
- Cancer Prevention and Population Sciences ProgramBaylor College of MedicineHoustonTexas
| | - Michele L. Cote
- Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research ProgramWayne State University School of MedicineDetroitMichigan
| | - Ellen Funkhouser
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Patricia G. Moorman
- Department of Community and Family MedicineDuke University Medical CenterDurhamNorth Carolina
| | - Lauren C. Peres
- Center for Public Health GenomicsUniversity of VirginiaCharlottesvilleVirginia
| | - Edward S. Peters
- Epidemiology ProgramLouisiana State University Health Sciences Center School of Public HealthNew OrleansLouisisana
| | - Ann G. Schwartz
- Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research ProgramWayne State University School of MedicineDetroitMichigan
| | - Paul D. Terry
- Department of MedicineUniversity of Tennessee Medical Center – KnoxvilleKnoxvilleTennessee
| | - Xin‐Qun Wang
- Department of Public Health SciencesUniversity of VirginiaCharlottesvilleVirginia
| | - Temitope O. Keku
- Departments of Medicine and Nutrition, Division of Gastroenterology and HepatologyUniversity of North Carolina at Chapel HillChapel HillNorth Carolina
| | - Cathrine Hoyo
- Department of Biological SciencesNorth Carolina State UniversityRaleighNorth Carolina
| | - Andrew Berchuck
- Department of Obstetrics and GynecologyDuke University Medical CenterDurhamNorth Carolina
| | - Dale P. Sandler
- Epidemiology Branch, Division of Intramural ResearchNational Institute of Environmental Health Sciences, National Institutes of HealthResearch Triangle ParkNorth Carolina
| | - Jack A. Taylor
- Epidemiology Branch, Division of Intramural ResearchNational Institute of Environmental Health Sciences, National Institutes of HealthResearch Triangle ParkNorth Carolina
| | - Katie M. O’Brien
- Epidemiology Branch, Division of Intramural ResearchNational Institute of Environmental Health Sciences, National Institutes of HealthResearch Triangle ParkNorth Carolina
| | - Digna R. Velez Edwards
- Vanderbilt Epidemiology Center, Center for Human Genetics Research, Department of Obstetrics and GynecologyVanderbilt University Medical CenterNashvilleTennessee
| | - Todd L. Edwards
- Division of Epidemiology, Center for Human Genetics Research, Department of MedicineVanderbilt University Medical CenterNashvilleTennessee
| | - Alicia Beeghly‐Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology CenterInstitute for Medicine and Public Health, Vanderbilt University Medical CenterNashvilleTennessee
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMaryland
| | - Celeste Leigh Pearce
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichigan
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCalifornia
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCalifornia
| | - Alice S. Whittemore
- Department of Health Research and PolicyStanford University School of MedicineStanfordCalifornia
- Department of Biomedical Data ScienceStanford University School of MedicineStanfordCalifornia
| | - Valerie McGuire
- Department of Health Research and PolicyStanford University School of MedicineStanfordCalifornia
| | - Weiva Sieh
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew York
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - Joseph H. Rothstein
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew York
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew York
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
- Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPennsylvania
- Ovarian Cancer Center of Excellence, Womens Cancer Research ProgramMagee‐Womens Research Institute and University of Pittsburgh Cancer InstitutePittsburghPennsylvania
| | - Roberta Ness
- The University of Texas School of Public HealthHoustonTexas
| | - Kirsten Moysich
- Department of Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloNew York
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashington
- Department of EpidemiologyUniversity of WashingtonSeattleWashington
| | - Jennifer A. Doherty
- Department of Population Health SciencesHuntsman Cancer Institute, University of UtahSalt Lake City, Utah
| | | | | | | | - Douglas A. Levine
- Gynecology Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkNew York
- Gynecologic Oncology, Laura and Isaac Pearlmutter Cancer CenterNew York University Langone Medical CenterNew YorkNew York
| | | | - Christopher A. Haiman
- University of Southern California Norris Comprehensive Cancer CenterLos AngelesCalifornia
| | | | - Lynne R. Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHawaii
| | - Beth Y. Karlan
- Women's Cancer ProgramSamuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCalifornia
| | - Usha Menon
- MRC CTU at UCL, Institute of Clinical Trials and MethodologyUniversity College LondonLondonUK
| | - Susan Ramus
- School of Women's and Children's HealthUniversity of New South WalesNew South WalesAustralia
- The Kinghorn Cancer CentreGarvan Institute of Medical ResearchDarlinghurstNew South WalesAustralia
| | - Simon Gayther
- Center for Cancer Prevention and Translational GenomicsSamuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCalifornia
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCalifornia
| | | | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology CenterBrigham and Women's HospitalBostonMassachusetts
- Harvard T. H. Chan School of Public HealthBostonMassauchusetts
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology CenterBrigham and Women's HospitalBostonMassachusetts
- Harvard T. H. Chan School of Public HealthBostonMassauchusetts
| | - Ellen L. Goode
- Department of Health Science Research, Division of EpidemiologyMayo ClinicRochesterMinnesota
| | - Melissa C. Larson
- Department of Health Science Research, Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMinnesota
| | - Scott H. Kaufmann
- Departments of Medicine and PharmacologyMayo ClinicRochesterMinnesota
| | - Rikki Cannioto
- Cancer Pathology & Prevention, Division of Cancer Prevention and Population SciencesRoswell Park Cancer InstituteBuffaloNew York
| | - Kunle Odunsi
- Department of Gynecological OncologyRoswell Park Cancer InstituteBuffaloNew York
| | - John L. Etter
- Department of Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloNew York
| | - Ruea‐Yea Huang
- Center For ImmunotherapyRoswell Park Cancer InstituteBuffaloNew York
| | - Marcus Q. Bernardini
- Division of Gynecologic OncologyPrincess Margaret Hospital, University Health NetworkTorontoOntarioCanada
| | - Alicia A. Tone
- Division of Gynecologic OncologyPrincess Margaret Hospital, University Health NetworkTorontoOntarioCanada
| | - Taymaa May
- Division of Gynecologic OncologyPrincess Margaret Hospital, University Health NetworkTorontoOntarioCanada
| | - Marc T. Goodman
- Cancer Prevention and ControlSamuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCalifornia
- Department of Biomedical SciencesCommunity and Population Health Research Institute, Cedars‐Sinai Medical CenterLos AngelesCalifornia
| | - Pamela J. Thompson
- Cancer Prevention and ControlSamuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCalifornia
| | - Michael E. Carney
- Department of Obstetrics and GynecologyJohn A. Burns School of Medicine, University of HawaiiHonoluluHawaii
| | - Shelley S. Tworoger
- Channing Division of Network MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | | | - Diether Lambrechts
- Vesalius Research Center, VIBLeuvenBelgium
- Laboratory for Translational Genetics, Department of OncologyUniversity of LeuvenBelgium
| | - Ignace Vergote
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer InstituteUniversity Hospitals LeuvenLeuvenBelgium
| | - Adriaan Vanderstichele
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer InstituteUniversity Hospitals LeuvenLeuvenBelgium
| | - Els Van Nieuwenhuysen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology and Leuven Cancer InstituteUniversity Hospitals LeuvenLeuvenBelgium
| | - Hoda Anton‐Culver
- Department of Epidemiology, Director of Genetic Epidemiology Research Institute, Center for Cancer Genetics Research & Prevention, School of MedicineUniversity of California IrvineIrvineCalifornia
| | - Argyrios Ziogas
- Department of EpidemiologyUniversity of California IrvineIrvineCalifornia
| | - James D. Brenton
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUK
| | - Line Bjorge
- Department of Gynecology and ObstetricsHaukeland University HospitalBergenNorway
- Centre for Cancer Biomarkers, Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Helga B. Salvensen
- Department of Gynecology and ObstetricsHaukeland University HospitalBergenNorway
- Centre for Cancer Biomarkers, Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Lambertus A. Kiemeney
- Radboud University Medical CenterRadboud Institute for Health SciencesNijmegenNetherlands
| | - Leon F. A. G. Massuger
- Department of Gynaecology, Radboud University Medical CenterRadboud Institute for Molecular Life sciencesNijmegenThe Netherlands
| | - Tanja Pejovic
- Department of Obstetrics & GynecologyOregon Health & Science UniversityPortlandOregon
- Knight Cancer Institute, Oregon Health & Science UniversityPortlandOregon
| | - Amanda Bruegl
- Department of Obstetrics & GynecologyOregon Health & Science UniversityPortlandOregon
- Knight Cancer Institute, Oregon Health & Science UniversityPortlandOregon
| | - Melissa Moffitt
- Department of Obstetrics & GynecologyOregon Health & Science UniversityPortlandOregon
- Knight Cancer Institute, Oregon Health & Science UniversityPortlandOregon
| | - Linda Cook
- Division of Epidemiology and Biostatistics, Department of Internal MedicineUniversity of New MexicoAlbuquerqueNew Mexico
| | - Nhu D. Le
- Cancer Control Research, British Columbia Cancer AgencyVancouverBritish ColumbiaCanada
| | - Angela Brooks‐Wilson
- Canada's Michael Smith Genome Sciences CentreBritish Columbia Cancer AgencyVancouverBritish ColumbiaCanada
- Department of Biomedical Physiology and KinesiologySimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Linda E. Kelemen
- Hollings Cancer Center and Department of Public Health SciencesMedical University of South CarolinaCharlestonSouth Carolina
| | - Paul D.P. Pharoah
- Strangeways Research laboratory, Department of Oncology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Honglin Song
- Strangeways Research Laboratory, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Ian Campbell
- Cancer Genetics Laboratory, Research DivisionPeter MacCallum Cancer CentreVictoriaAustralia
- Department of PathologyUniversity of MelbourneParkvilleVictoriaAustralia
| | - Diana Eccles
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Anna DeFazio
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, The University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
| | - Catherine J. Kennedy
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, The University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
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Hereditary Hypercalcemia Caused by a Homozygous Pathogenic Variant in the CYP24A1 Gene: A Case Report and Review of the Literature. Case Rep Endocrinol 2019; 2019:4982621. [PMID: 31089432 PMCID: PMC6476011 DOI: 10.1155/2019/4982621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/26/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction Loss of function mutations of CYP24A1 gene, which is involved in vitamin D catabolism, cause vitamin D-mediated PTH-independent hypercalcemia. The phenotype varies from life-threatening forms in the infancy to milder forms in the adulthood. Case Presentation We report a case of a 17-year-old woman with a history of nephrolithiasis, mild PTH-independent hypercalcemia (10,5mg/dL), and high serum 1,25(OH)2D concentrations (107pg/mL). Other causes of hypercalcemia associated with the above biochemical signature were excluded. Family history revealed nephrolithiasis in the sister. Blood testing in first-degree relatives showed serum PTH in the low-normal range and 1,25(OH)2D at the upper normal limit or slightly elevated. The CYP24A1 gene analysis revealed a known homozygous loss-of-function pathogenic variant (c.428_430delAAG, rs777676129, p.Glu143del). The panel of vitamin D metabolites evaluated by liquid chromatography showed the typical profile of CYP24A1 mutations, namely, low 24,25(OH)2D3, elevated 25(OH)D3:24,25(OH)2D3 ratio, and undetectable 1,24,25(OH)3D3. The parents and both the siblings harbored the same variant in heterozygosis. We decided for a watchful waiting approach and the patient remained clinically and biochemically stable over a 24-month followup. Conclusion CYP24A1 gene mutations should be considered in cases of PTH-independent hypercalcemia, once that more common causes (hypercalcemia of malignancy, granulomatous diseases, and vitamin D intoxication) have been ruled out.
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31
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O'Brien KO, Abrams SA. Using stable isotope tracers to study bone metabolism in children. J Physiol 2018; 597:1311-1319. [PMID: 29869788 DOI: 10.1113/jp275452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/08/2018] [Indexed: 11/08/2022] Open
Abstract
Skeletal mineralization is initiated in utero and continues throughout childhood and adolescence. During these key periods of the life cycle, calcium retention must increase significantly to provide sufficient mineral for bone deposition and skeletal growth. Stable calcium isotopes have served as a fundamental tool to non-invasively characterize the dynamic changes in calcium physiology that occur from infancy through adolescence. These approaches have helped define the dynamics of calcium absorption and utilization in healthy children and in children with chronic diseases. As data in this area have accumulated, new areas of emphasis are beginning to characterize the determinants of variability in mineral retention, the genetic determinants of bone turnover and calcium flux and the impact of the gut microbiome on whole body and niche specific calcium dynamics. Advances in these areas will help define calcium utilization in paediatric populations and provide information that may be useful in maximizing bone acquisition across this critical phase of the life cycle.
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Affiliation(s)
| | - Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, TX, 78723, USA
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Best CM, Pressman EK, Queenan RA, Cooper E, Vermeylen F, O'Brien KO. Gestational Age and Maternal Serum 25-hydroxyvitamin D Concentration Interact to Affect the 24,25-dihydroxyvitamin D Concentration in Pregnant Adolescents. J Nutr 2018; 148:868-875. [PMID: 29796622 PMCID: PMC6014295 DOI: 10.1093/jn/nxy043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/13/2018] [Indexed: 11/13/2022] Open
Abstract
Background Interpretation of serum vitamin D biomarkers across pregnancy is complex due to limited understanding of pregnancy adaptations in vitamin D metabolism. During pregnancy, both gestational age and serum 25-hydroxyvitamin D [25(OH)D] concentrations may influence the concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D], 24,25-dihydroxyvitamin D [24,25(OH)2D], and parathyroid hormone (PTH). Objective We aimed to identify predictors of change in serum 25(OH)D across gestation in pregnant adolescents and to assess the contribution made by cholecalciferol (vitamin D3) supplementation. We sought to determine whether gestational age and 25(OH)D concentration interacted to affect serum 1,25(OH)2D, 24,25(OH)2D, or PTH. Methods Pregnant adolescents (n = 78, 59% African American, mean ± SD age: 17 ± 1 y) living in Rochester, NY (latitude 43°N) were supplemented with 200 IU or 2000 IU vitamin D3/d and allowed to continue their daily prenatal supplement that contained 400 IU vitamin D3. Serum was collected at study entry (18 ± 5 wk of gestation), halfway through study participation, and at delivery (40 ± 2 wk). Serum concentrations of the biochemical markers were modeled with linear mixed-effects regression models. Results Vitamin D3 supplement intake and season of delivery determined change in 25(OH)D across pregnancy. Fall-winter delivery was associated with a decline in 25(OH)D unless vitamin D3 supplement intake was >872 IU/d. The interaction of gestational age and 25(OH)D affected 24,25(OH)2D concentrations. For a given 25(OH)D concentration, model-predicted serum 24,25(OH)2D increased across gestation except when 25(OH)D was <13 ng/mL. Below this threshold, 24,25(OH)2D was predicted to decline over time. Mean serum 1,25(OH)2D was elevated (>100 pg/mL) throughout the study. Conclusion Our results suggest that when maternal serum 25(OH)D was low, its catabolism into 24,25(OH)2D decreased or remained stable as pregnancy progressed in order to maintain persistently elevated serum 1,25(OH)2D. Furthermore, in adolescents living at latitude 43°N, standard prenatal supplementation did not prevent a seasonal decline in 25(OH)D during pregnancy. This study was registered at clinicaltrials.gov as NCT01815047.
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Affiliation(s)
- Cora M Best
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Eva K Pressman
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ruth Anne Queenan
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Elizabeth Cooper
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, NY,Address correspondence to KOO (e-mail: )
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De Paolis E, Minucci A, De Bonis M, Scaglione GL, Gervasoni J, Primiano A, Ferraro PM, Cappellani D, Marcocci C, Gambaro G, Capoluongo E. A rapid screening of a recurrent CYP24A1 pathogenic variant opens the way to molecular testing for Idiopathic Infantile Hypercalcemia (IIH). Clin Chim Acta 2018; 482:8-13. [PMID: 29574006 DOI: 10.1016/j.cca.2018.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/09/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Loss-of-function mutations in cytochrome P450 family 24 subfamily A member 1 (CYP24A1) gene are associated with Idiopathic Infantile Hypercalcemia (IIH) and adult kidney stone disease. The enzyme deficiency leads to an impaired vitamin D catabolism pathway, resulting in a syndrome characterized by recurrent hypercalcemia, hypercalciuria and suppressed parathyroid hormone (PTH) levels. In these patients, the genetic evaluation of CYP24A1 is an important diagnostic tool, allowing the definitive diagnosis of IIH. METHODS A rapid CYP24A1 gene testing based on High Resolution Melting Analysis (HRMA) was designed in order to detect the CYP24A1 c.428_430delAAG (p.Glu143del), a recurrent IIH-associated variant. RESULTS HRMA method was able to identify c.428_430delAAG genotypes evaluating melting curve shape and melting temperature (Tm). Heterozygous samples exhibited a typical melting profile while homozygous samples showed a specific Tm shift. CONCLUSIONS We provide evidence about application of HRMA in unambiguous genotyping of the CYP24A1 c.428_430delAAG variant, making this method useful in clinical molecular diagnostics. This approach opens the way to a helpful molecular analysis of CYP24A1 gene in IIH diagnosis, to an improved pharmacological treatment strategy and to a reduced risk of recurrent stones and worsening nephrocalcinosis.
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Affiliation(s)
- Elisa De Paolis
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Angelo Minucci
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Maria De Bonis
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Giovanni Luca Scaglione
- Laboratory of Molecular Oncology, "Giovanni Paolo II" Foundation, Catholic University of Sacred Heart, Campobasso, Italy
| | - Jacopo Gervasoni
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Aniello Primiano
- Polo Scienze delle Immagini, di Laboratorio ed Infettivologiche, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Pietro Manuel Ferraro
- Polo di Scienze Reumatologiche, Dermatologiche, Immuno-Allergologiche, Urologiche e Nefrologiche, Istituto di Medicina Interna e Geriatria. Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Daniele Cappellani
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Pisa, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Pisa, Italy
| | - Giovanni Gambaro
- Polo di Scienze Reumatologiche, Dermatologiche, Immuno-Allergologiche, Urologiche e Nefrologiche, Istituto di Medicina Interna e Geriatria. Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy
| | - Ettore Capoluongo
- Laboratory of Clinical Pathology and Advanced Molecular Diagnostics, Istituto Dermopatico dell'Immacolata -IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Roma, Italy.
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Messa P, Regalia A, Alfieri CM. Nutritional Vitamin D in Renal Transplant Patients: Speculations and Reality. Nutrients 2017; 9:nu9060550. [PMID: 28554998 PMCID: PMC5490529 DOI: 10.3390/nu9060550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/14/2022] Open
Abstract
Reduced levels of nutritional vitamin D are commonly observed in most chronic kidney disease (CKD) patients and particularly in patients who have received a kidney transplant (KTx). In the complex clinical scenario characterizing the recipients of a renal graft, nutritional vitamin D deficiency has been put in relation not only to the changes of mineral and bone metabolism (MBM) after KTx, but also to most of the medical complications which burden KTx patients. In fact, referring to its alleged pleiotropic (non-MBM related) activities, vitamin D has been claimed to play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic and infectious complications commonly observed in KTx recipients. Furthermore, low nutritional vitamin D levels have also been connected with graft dysfunction occurrence and progression. In this review, we will discuss the purported and the demonstrated effects of native vitamin D deficiency/insufficiency in most of the above mentioned fields, dealing separately with the MBM-related and the pleiotropic effects.
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Affiliation(s)
- Piergiorgio Messa
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
- via Festa del Perdono, Università degli Studi di Milano, Milano 20122, Italy.
| | - Anna Regalia
- via Festa del Perdono, Università degli Studi di Milano, Milano 20122, Italy.
| | - Carlo Maria Alfieri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
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Hu H, Zhang J, Lu Y, Zhang Z, Qin B, Gao H, Wang Y, Zhu J, Wang Q, Zhu Y, Xun Y, Wang S. Association between Circulating Vitamin D Level and Urolithiasis: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:nu9030301. [PMID: 28335477 PMCID: PMC5372964 DOI: 10.3390/nu9030301] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 12/20/2022] Open
Abstract
Many studies compared the serum/plasma 1,25 dihydroxyvitamin D₃ (1,25(OH)₂D) and 25 hydroxyvitamin D₃ (25(OH)D) between people with and without nephrolithiasis, and their results were conflicting. After systematically searching PubMed, Web of Science, The Cochrane Library, CNKI, and the Wanfang Database, we conducted a meta-analysis. Thirty-two observational studies involving 23,228 participants were included. Meta-analysis of these studies showed that of stone formers (SFs), calcium SFs had significantly higher concentrations of 1,25(OH)₂D (weighted mean difference (WMD), 10.19 pg/mL; 95% confidence interval (CI), 4.31-16.07; p = 0.0007 and WMD, 11.28 pg/mL; 95% CI, 4.07-18.50; p = 0.002, respectively) than non-stone formers, while the levels of 25(OH)D (WMD, 0.88 ng/mL; 95% CI, -1.04-2.80; p = 0.37 and WMD, -0.63 ng/mL; 95% CI, -2.72-1.47; p = 0.56, respectively) are similar. Compared with controls and normocalciuria SFs, hypercalciuria SFs had increased circulating 1,25(OH)₂D (WMD, 9.41 pg/mL; 95% CI, 0.15-18.67; p = 0.05 and WMD, 2.75 pg/mL; 95% CI, -0.20-5.69; p = 0.07, respectively) and markedly higher 25(OH)D (WMD, 5.02 ng/mL; 95% CI, 0.99-9.06; p = 0.01 and WMD, 5.02 ng/mL; 95% CI, 2.14-7.90; p = 0.0006, respectively). Normocalciuria SFs had elevated 1,25(OH)₂D level (WMD, 6.85 pg/mL; 95% CI, -5.00-18.71; p = 0.26) and comparable 25(OH)D (WMD, 0.94 ng/mL; 95% CI, -3.55-5.43; p = 0.68). Sensitivity analysis generated similar results. Current evidence suggests that increased circulating 1,25(OH)₂D is associated with urinary stones and a higher level of circulating 25(OH)D is significantly associated with hypercalciuria urolithiasis. Further studies are still needed to reconfirm and clarify the role of vitamin D in the pathogenesis of stones.
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Affiliation(s)
- Henglong Hu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Jiaqiao Zhang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yuchao Lu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Zongbiao Zhang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Baolong Qin
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Hongbin Gao
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yufeng Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Jianning Zhu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Qing Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yunpeng Zhu
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Yang Xun
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
| | - Shaogang Wang
- Department and Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, China.
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