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Saunders RK, Kilroe KM, Joseph TV, Caksa S, Bouxsein ML, Misra M, Mitchell DM. Total Calcium Intake Is Associated With Trabecular Bone Density in Adolescent Girls With Type 1 Diabetes. JBMR Plus 2023; 7:e10813. [PMID: 38025039 PMCID: PMC10652183 DOI: 10.1002/jbm4.10813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 12/01/2023] Open
Abstract
Type 1 diabetes (T1D) confers an increased risk of fracture and is associated with lower bone mineral density (BMD) and altered microarchitecture compared with controls. Adequate calcium (Ca) intake promotes bone mineralization, thereby increasing BMD. The objective of this analysis was to evaluate the associations of total daily Ca intake with bone outcomes among youth with T1D. This was a cross-sectional analysis of girls ages 10-16 years with (n = 62) and without (n = 60) T1D. We measured Ca intake with a validated food-frequency questionnaire and BMD, microarchitecture, and strength estimates with dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography. Total daily Ca intake did not differ between groups (950 ± 488 in T1D versus 862 ± 461 mg/d in controls, p = 0.306). Serum 25OHD was lower in T1D (26.3 ± 7.6 versus 32.6 ± 9.0 ng/mL, p = <0.001), and parathyroid hormone (PTH) was higher in T1D (38.9 ± 11 versus 33.4 ± 9.7 pg/mL, p = 0.004). Trabecular volumetric BMD and thickness at the tibia were lower in T1D (p = 0.013, p = 0.030). Ca intake correlated with trabecular BMD at the radius and tibia among T1D participants (β = 0.27, p = 0.047, and β = 0.28, p = 0.027, β = 0.28, respectively) but not among controls (pinteraction = 0.009 at the radius, pinteraction = 0.010 at the tibia). Similarly, Ca intake was associated with estimated failure load at the tibia in T1D but not control participants (p = 0.038, β = 0.18; pinteraction = 0.051). We observed the expected negative association of Ca intake with parathyroid hormone in controls (p = 0.022, β = -0.29) but not in T1D participants (pinteraction = 0.022). Average glycemia as measured by hemoglobin A1c did not influence the relationship of Ca and PTH among participants with T1D (pinteraction = 0.138). These data suggest that youth with T1D may be particularly vulnerable to dietary Ca insufficiency. Increasing Ca intake may be an effective strategy to optimize bone health in this population. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Rylee K Saunders
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Kathleen M Kilroe
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Taïsha V. Joseph
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Signe Caksa
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Mary L Bouxsein
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
- Center for Advanced Orthopaedic StudiesBeth Israel Deaconness Medical Center and Harvard Medical SchoolBostonMAUSA
| | - Madhusmita Misra
- Division of Pediatric EndocrinologyMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
- Neuroendocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Deborah M Mitchell
- Endocrine UnitMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
- Division of Pediatric EndocrinologyMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
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2
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Mangialavori IC. Commentary on Divalent metal cofactors differentially modulate RadA-mediated strand invasion and exchange in Saccharolobus solfataricus. Biosci Rep 2023:BSR20230058. [PMID: 37334574 PMCID: PMC10311128 DOI: 10.1042/bsr20230058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 06/20/2023] Open
Abstract
RecA ATPases are a family of proteins that catalyzes the exchange of complementary DNA regions via homologous recombination. They are conserved from bacteria to humans and are crucial for DNA damage repair and genetic diversity. In this work, Knadler et al. examine how ATP hydrolysis and divalent cations impact the recombinase activity of Saccharolobus solfataricus RadA protein (ssoRadA) (1). They find that the ssoRadA-mediated strand exchange depends on ATPase activity. The presence of Manganese reduces ATPase activity and enhances strand exchange, while calcium inhibits ATPase activity by preventing ATP binding to the protein, yet destabilizes the nucleoprotein ssoRadA filaments, allowing strand exchange regardless of the ATPase activity. Although RecA ATPases are highly conserved, this research offers intriguing new evidence that each member of the family requires individual evaluation.
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3
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Murashima M, Hamano T, Nishiyama T, Tsuruya K, Ogata S, Kanda E, Abe M, Masakane I, Nitta K. Performance Status Modifies the Association Between Vitamin D Receptor Activator and Mortality or Fracture: A Prospective Cohort Study on the Japanese Society for Dialysis Therapy (JSDT) Renal Data Registry. J Bone Miner Res 2022; 37:1489-1499. [PMID: 35689819 DOI: 10.1002/jbmr.4621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/10/2022] [Accepted: 06/04/2022] [Indexed: 11/12/2022]
Abstract
Immobilization osteoporosis is characterized by excess bone resorption. Vitamin D receptor activators (VDRA) might have adverse effects in immobilized patients. The objective of this study was to elucidate the impact of performance status (PS) on the associations between VDRA use and outcomes among hemodialysis patients. This is a prospective cohort study. Adults on hemodialysis in the Japanese Society for Dialysis Therapy (JSDT) Renal Data Registry were included. Exposure of interest was the use of VDRA. Outcomes were all-cause mortality and hip fracture. Associations between VDRA use and mortality or hip fractures were examined by Cox and Poisson regression analyses, respectively. Among 208,512 subjects, 128,535 were on VDRA. Poor PS was associated with higher calcium (Ca), lower parathyroid hormone, and higher alkaline phosphatase levels. The association between higher Ca levels and VDRA use was stronger among those with poor PS (p interaction 0.007). Adjusted hazard ratio (HR) (95% confidence interval [CI]) for mortality and incidence rate ratio (IRR) for hip fracture was 1.02 (95% CI, 0.99-1.05) and 0.93 (0.86-1.00) among users of VDRA, respectively. The VDRA use was associated with lower mortality and incidence of hip fractures among subjects with good PS but not among subjects with poor PS (p interaction 0.03 and 0.05). Effect modification by PS was observed for cardiovascular (CV) mortality but not for non-CV mortality. In conclusion, VDRA use was associated with better outcomes only among those with good PS. These results suggest that bone and mineral disorders among hemodialysis patients should be treated differently, depending on their performance status. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Miho Murashima
- Research Subcommittee of Japanese Renal Data Registry, Japanese Society for Dialysis Therapy, Nagoya, Japan.,Department of Nephrology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Takayuki Hamano
- Department of Nephrology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.,Renal Data Registry Committee, Japanese Society for Dialysis Therapy, Bunkyo-ku, Japan
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuhiko Tsuruya
- Department of Nephrology, Nara Medical University, Kashihara, Japan
| | - Satoshi Ogata
- Department of Clinical Nutrition, Hiroshima International University, Higashihiroshima, Japan
| | - Eiichiro Kanda
- Renal Data Registry Committee, Japanese Society for Dialysis Therapy, Bunkyo-ku, Japan.,Medical Science, Kawasaki Medical School, Kurashiki, Japan
| | - Masanori Abe
- Renal Data Registry Committee, Japanese Society for Dialysis Therapy, Bunkyo-ku, Japan.,Division of Nephrology, Hypertension, and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Itabashi, Japan
| | - Ikuto Masakane
- Renal Data Registry Committee, Japanese Society for Dialysis Therapy, Bunkyo-ku, Japan.,Department of Nephrology, Yabuki Hospital, Yamagata, Japan
| | - Kosaku Nitta
- Renal Data Registry Committee, Japanese Society for Dialysis Therapy, Bunkyo-ku, Japan.,Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan
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4
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Abstract
Calcium is required for the functioning of numerous biological processes and is essential for skeletal health. The major source of new calcium is from the diet. The central role of vitamin D in the maintenance of calcium homeostasis is to increase the absorption of ingested calcium from the intestine. The critical importance of vitamin D in this process is noted in the causal link between vitamin D deficiency and rickets, as well as in studies using genetically modified mice including mice deficient in the vitamin D receptor (Vdr null mice) or in the cytochrome P‐450 enzyme, 25‐hydroxyvitamin D3‐1α‐ hydroxylase (CYP27B1) that converts 25‐hydroxyvitamin D3 to the hormonally active form of vitamin D, 1,25‐dihydroxyvitamin D3 [1,25(OH)2D3] (Cyp27b1 null mice). When these mice are fed diets with high calcium and lactose, rickets is prevented. The studies using mouse models provide supporting evidence indicating that the major physiological function of 1,25(OH)2D3/VDR is intestinal calcium absorption. This review summarizes what is known about mechanisms involved in vitamin D‐regulated intestinal calcium absorption. Recent studies suggest that vitamin D does not affect a single entity, but that a complex network of calcium‐regulating components is involved in the process of 1,25(OH)2D3‐mediated active intestinal calcium absorption. In addition, numerous 1,25(OH)2D3 actions in the intestine have been described independent of calcium absorption. Although the translatability to humans requires further definition, an overview is presented that provides compelling evidence from the laboratory of 1,25(OH)2D3 intestinal effects, which include the regulation of adhesion molecules to enhance barrier function, the regulation of intestinal stem cell function, cellular homeostasis of other divalent cations, the regulation of drug metabolizing enzymes, and anti‐inflammatory effects. © 2021 The Author. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Sylvia Christakos
- Department of Microbiology, Biochemistry and Molecular Genetics Rutgers, the State University of New Jersey, New Jersey Medical School Newark NJ USA
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5
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Chen Y, Forgetta V, Richards JB, Zhou S. Health Effects of Calcium: Evidence From Mendelian Randomization Studies. JBMR Plus 2021; 5:e10542. [PMID: 34761146 PMCID: PMC8567492 DOI: 10.1002/jbm4.10542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 12/24/2022] Open
Abstract
Calcium is widely used in conjunction with vitamin D to prevent osteoporosis. The use of calcium supplementation is also promoted for its potential benefits in lowering the risk for metabolic syndromes and cancers. However, the causal link between calcium and various health outcomes remains unclear. This review focuses on the evidence from 24 Mendelian randomization (MR) studies that were designed to minimize bias from confounding and reverse causation. These MR studies evaluated the effect of lifelong genetically higher serum calcium levels on various health outcomes. Overall, available MR studies found no conclusive effects of serum calcium levels on bone mineral density and fracture, ischemic stroke and heart failure, cancers, type 2 diabetes, Parkinson disease, or offspring birth weight. However, a higher serum calcium concentration was reported to have estimated causal effects on increased risks for coronary artery disease (especially myocardial infarction), migraine, renal colic, allergy/adverse effect of penicillin, and reduced risks for osteoarthrosis and osteoarthritis. In conclusion, supplementation of calcium in individuals from the general population is not predicted to influence the risk of most investigated diseases to date. Moreover, long-term high serum calcium concentrations may result in adverse health outcomes. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Yiheng Chen
- Department of Human GeneticsMcGill UniversityMontréalQCCanada
- Lady Davis Institute, Jewish General HospitalMcGill UniversityMontréalQCCanada
| | - Vincenzo Forgetta
- Lady Davis Institute, Jewish General HospitalMcGill UniversityMontréalQCCanada
| | - J. Brent Richards
- Department of Human GeneticsMcGill UniversityMontréalQCCanada
- Lady Davis Institute, Jewish General HospitalMcGill UniversityMontréalQCCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQCCanada
- Department of Twin ResearchKing's College LondonLondonUK
| | - Sirui Zhou
- Lady Davis Institute, Jewish General HospitalMcGill UniversityMontréalQCCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQCCanada
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6
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Irsik DL, Bollag WB, Isales CM. Renal Contributions to Age-Related Changes in Mineral Metabolism. JBMR Plus 2021; 5:e10517. [PMID: 34693188 PMCID: PMC8520061 DOI: 10.1002/jbm4.10517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/28/2021] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
Aging results in a general decline in function in most systems. This is particularly true with respect to the skeleton and renal systems, impacting mineral homeostasis. Calcium and phosphate regulation requires tight coordination among the intestine, bone, parathyroid gland, and kidney. The role of the intestine is to absorb calcium and phosphate from the diet. The bone stores or releases calcium and phosphate depending on the body's needs. In response to low plasma ionized calcium concentration, the parathyroid gland produces parathyroid hormone, which modulates bone turnover. The kidney reabsorbs or excretes the minerals and serves as the final regulator of plasma concentration. Many hormones are involved in this process in addition to parathyroid hormone, including fibroblast growth factor 23 produced by the bone and calcitriol synthesized by the kidney. Sclerostin, calcitonin, osteoprotegerin, and receptor activator of nuclear factor‐κB ligand also contribute to tissue‐specific regulation. Changes in the function of organs due to aging or disease can perturb this balance. During aging, the intestine cannot absorb calcium efficiently due to decreased expression of key proteins. In the bone, the balance between bone formation and bone resorption tends toward the latter in older individuals. The kidney may not filter blood as efficiently in the later decades of life, and the expression of certain proteins necessary for mineral homeostasis declines with age. These changes often lead to dysregulation of organismal mineral homeostasis. This review will focus on how mineral homeostasis is impacted by aging with a particular emphasis on the kidney's role in this process. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Debra L Irsik
- Charlie Norwood VA Medical Center Augusta GA USA.,Department of Neuroscience and Regenerative Medicine Augusta University Augusta GA USA
| | - Wendy B Bollag
- Charlie Norwood VA Medical Center Augusta GA USA.,Department of Physiology Augusta University Augusta GA USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine Augusta University Augusta GA USA.,Division of Endocrinology, Department of Medicine Augusta University Augusta GA USA
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7
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Gerber C, Wang X, David V, Quaggin SE, Isakova T, Martin A. Long-Term Effects of Sglt2 Deletion on Bone and Mineral Metabolism in Mice. JBMR Plus 2021; 5:e10526. [PMID: 34368611 PMCID: PMC8328801 DOI: 10.1002/jbm4.10526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/20/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022] Open
Abstract
Sodium‐glucose cotransporter 2 (SGLT2) inhibitors improve kidney and cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM). However, bone fragility has emerged as a side effect in some but not in all human studies. Because use of SGLT2 inhibitors in humans affects mineral metabolism, we investigated the long‐term effects of genetic loss of Sglt2 function on bone and mineral metabolism in mice. Slc5a2 nonsense mutation in Sweet Pee (SP) mice results in total loss of Sglt2 function. We collected urine, serum, and bone samples from 15‐week‐old and 25‐week‐old wild‐type (WT) and SP mice fasted from food overnight. We measured parameters of renal function and mineral metabolism and we assessed bone growth, microarchitecture, and mineralization. As expected, 15‐week‐old and 25‐week‐old SP mice showed increased glucosuria, and normal kidney function compared to age‐matched WT mice. At 15 weeks, SP mice did not show alterations in mineral metabolism parameters. At 25 weeks, SP mice showed reduced fasting 24‐hour urinary calcium excretion and increased fractional excretion of phosphate, but normal serum calcium and phosphate, parathyroid hormone (PTH), vitamin D (1,25(OH)2D), and fibroblast growth factor (FGF23) levels. At 25 weeks, but not at 15 weeks, SP mice showed reduced body weight compared to WT. This was associated with reduced femur length at 25 weeks, suggesting impaired skeletal growth. SP mice did not show trabecular or cortical bone microarchitectural modifications but showed reduced cortical bone mineral density compared to WT mice at 25 weeks. These results suggest that loss of Sglt2 function in mice in the absence of T2DM does not alter regulatory hormones FGF23, PTH, and 1,25(OH)2D, but may contribute to bone fragility over the long term. Future studies are required to determine how loss of Sglt2 function impacts bone fragility in T2DM. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Claire Gerber
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Chicago IL USA
| | - Xueyan Wang
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Chicago IL USA.,Feinberg Cardiovascular and Renal Research Institute Northwestern University Chicago IL USA
| | - Valentin David
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Chicago IL USA.,Feinberg Cardiovascular and Renal Research Institute Northwestern University Chicago IL USA
| | - Susan E Quaggin
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Feinberg Cardiovascular and Renal Research Institute Northwestern University Chicago IL USA
| | - Tamara Isakova
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Chicago IL USA
| | - Aline Martin
- Division of Nephrology and Hypertension, Feinberg School of Medicine Northwestern University Chicago IL USA.,Center for Translational Metabolism and Health, Institute for Public Health and Medicine Northwestern University Chicago IL USA.,Feinberg Cardiovascular and Renal Research Institute Northwestern University Chicago IL USA
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8
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Jørgensen CU, Homøe P, Dahl M, Hitz MF. Postoperative Chronic Hypoparathyroidism and Quality of Life After Total Thyroidectomy. JBMR Plus 2021; 5:e10479. [PMID: 33869995 PMCID: PMC8046100 DOI: 10.1002/jbm4.10479] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/02/2021] [Accepted: 02/13/2021] [Indexed: 12/31/2022] Open
Abstract
Chronic hypoparathyroidism (HypoPT) is a common complication after total thyroidectomy and it impacts affected patients' quality of life (QoL). This study aimed to assess the QoL in patients with chronic HypoPT independently from their concurrent hypothyroidism and other comorbidities. For this purpose a follow‐up study was performed, including 14 patients who developed chronic HypoPT after total thyroidectomy and 28 age‐ and sex‐matched patients who had intact parathyroid function after total thyroidectomy. We used the RAND Short Form 36 Health Survey (SF‐36) to compare the QoL between patients with or without chronic HypoPT. Chronic HypoPT patients had lower QoL scores in all domains of the RAND‐SF‐36 questionnaire and significant impairment in six of eight domains after adjustment for relevant confounders. They were more often operated because of a toxic diagnosis (p = .01), often being Graves disease. Additionally adjusting for surgical indications resulted in three of eight domains being significant affected. Chronic HypoPT is associated with significantly impairment of QoL, independently of the concurrent disease of hypothyroidism, comorbidities, and prospective values of TSH and serum (se)‐ionized‐Ca++. There is a need for more focus and better treatment of patients experiencing chronic HypoPT after surgery. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Camilla Uhre Jørgensen
- Department of Otorhinolaryngology and Maxillofacial Surgery Zealand University Hospital (ZUH) Køge Denmark.,Department of Medical Endocrinology Zealand University Hospital (ZUH) Køge Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery Zealand University Hospital (ZUH) Køge Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Morten Dahl
- Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.,Department of Clinical Biochemistry Zealand University Hospital (ZUH) Køge Denmark
| | - Mette Friberg Hitz
- Department of Medical Endocrinology Zealand University Hospital (ZUH) Køge Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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9
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Shroff R, Fewtrell M, Heuser A, Kolevica A, Lalayiannis A, McAlister L, Silva S, Goodman N, Schmitt CP, Biassoni L, Rahn A, Fischer DC, Eisenhauer A. Naturally Occurring Stable Calcium Isotope Ratios in Body Compartments Provide a Novel Biomarker of Bone Mineral Balance in Children and Young Adults. J Bone Miner Res 2021; 36:133-142. [PMID: 32786145 DOI: 10.1002/jbmr.4158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/16/2022]
Abstract
Serum calcium (Ca), bone biomarkers, and radiological imaging do not allow accurate evaluation of bone mineral balance (BMB), a key determinant of bone mineral density (BMD) and fracture risk. We studied naturally occurring stable (non-radioactive) Ca isotopes in different body pools as a potential biomarker of BMB. 42 Ca and 44 Ca are absorbed from our diet and sequestered into different body compartments following kinetic principles of isotope fractionation; isotopically light 42 Ca is preferentially incorporated into bone, whereas heavier 44 Ca preferentially remains in blood and is excreted in urine and feces. Their ratio (δ44/42 Ca) in serum and urine increases during bone formation and decreases with bone resorption. In 117 healthy participants, we measured Ca isotopes, biomarkers, and BMD by dual-energy X-ray absorptiometry (DXA) and tibial peripheral quantitative CT (pQCT). 44 Ca and 42 Ca were measured by multi-collector ionization-coupled plasma mass-spectrometry in serum, urine, and feces. The relationship between bone Ca gain and loss was calculated using a compartment model. δ44/42 Caserum and δ44/42 Caurine were higher in children (n = 66, median age 13 years) compared with adults (n = 51, median age 28 years; p < 0.0001 and p = 0.008, respectively). δ44/42 Caserum increased with height in boys (p < 0.001, R2 = 0.65) and was greatest at Tanner stage 4. δ44/42 Caserum correlated positively with biomarkers of bone formation (25-hydroxyvitaminD [p < 0.0001, R2 = 0.37] and alkaline phosphatase [p = 0.009, R2 = 0.18]) and negatively with bone resorption marker parathyroid hormone (PTH; p = 0.03, R2 = 0.13). δ44/42 Caserum strongly positively correlated with tibial cortical BMD Z-score (n = 62; p < 0.001, R2 = 0.39) but not DXA. Independent predictors of tibial cortical BMD Z-score were δ44/42 Caserum (p = 0.004, β = 0.37), 25-hydroxyvitaminD (p = 0.04, β = 0.19) and PTH (p = 0.03, β = -0.13), together predicting 76% of variability. In conclusion, naturally occurring Ca isotope ratios in different body compartments may provide a novel, non-invasive method of assessing bone mineralization. Defining an accurate biomarker of BMB could form the basis of future studies investigating Ca dynamics in disease states and the impact of treatments that affect bone homeostasis. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Rukshana Shroff
- Renal Unit, UCL Great Ormond Street Hospital for Children NHS Foundation Trust and Institute of Child Health, London, UK
| | - Mary Fewtrell
- Radiology Department, UCL Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Ana Kolevica
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
| | - Alexander Lalayiannis
- Renal Unit, UCL Great Ormond Street Hospital for Children NHS Foundation Trust and Institute of Child Health, London, UK
| | - Louise McAlister
- Dietetics Department, UCL Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Selmy Silva
- Renal Unit, UCL Great Ormond Street Hospital for Children NHS Foundation Trust and Institute of Child Health, London, UK
| | - Nadine Goodman
- Renal Unit, UCL Great Ormond Street Hospital for Children NHS Foundation Trust and Institute of Child Health, London, UK
| | - Claus P Schmitt
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Lorenzo Biassoni
- Radiology Department, UCL Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anja Rahn
- Department of Pediatrics, Rostock University Medical Centre, Rostock, Germany
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10
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Pazianas M, Miller PD. The CKD-MBD Syndrome: Hysteresis in PTH Involvement and PTH Administration for Its Management. J Bone Miner Res 2020; 35:2313-2317. [PMID: 32780482 DOI: 10.1002/jbmr.4155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 01/08/2023]
Abstract
Chronic kidney disease (CKD) disturbs mineral homeostasis, leading to mineral and bone disorders (MBD). CKD-MBD is a significant problem and currently available treatment options have important limitations. Phosphate retention is thought to be the initial cause of CKD-MBD but serum phosphate remains normal until the late stages of CKD, due to elevated levels of the phosphaturic hormone fibroblast growth factor-23 (FGF-23), and parathyroid hormone (PTH). Reduction of 1,25-dihydroxy-vitamin D (1,25[OH]2 D) concentration is the next event in the adaptive response of the homeostatic system. We argue, and provide the rationale, that calcium retention which takes place concurrently with phosphate retention, could be the reason behind the hysteresis in the response of PTH. If indeed this is the case, intermittent administration of PTH in early CKD could prevent the hysteresis, which arguably leads to the development of secondary hyperparathyroidism, and provide the platform for an effective management of CKD-MBD. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michael Pazianas
- Institute of Musculoskeletal Sciences, Oxford University, Oxford, UK
| | - Paul D Miller
- University of Colorado Health Sciences Center, Denver, CO, USA.,Colorado Center for Bone Health, Lakewood, CO, USA
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11
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Bailey RL, Zou P, Wallace TC, McCabe GP, Craig BA, Jun S, Cauley JA, Weaver CM. Calcium Supplement Use Is Associated With Less Bone Mineral Density Loss, But Does Not Lessen the Risk of Bone Fracture Across the Menopause Transition: Data From the Study of Women's Health Across the Nation. JBMR Plus 2019; 4:e10246. [PMID: 31956850 PMCID: PMC6957983 DOI: 10.1002/jbm4.10246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/27/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
Diet is a modifiable factor that is related to bone mass and risk for fractures; however, the use of calcium supplements for bone health is controversial, with little scientific agreement. The purpose of this analysis was to estimate the change in lumbar spine and femoral neck BMD and the risk of bone fracture by the use of calcium supplements among the Study of Women's Health Across the Nation (SWAN) participants. SWAN is a multicenter, multiethnic, community‐based longitudinal cohort designed to examine the health of women across the menopause transition (n = 1490; aged 42 to 52 years at baseline in 1996 to 1997 and followed annually until 2006 to 2008). A mixed‐effect model for repeated measures was used to estimate annualized BMD change across time between supplement users and nonusers, unadjusted or fully adjusted (age, race, height, weight, menopausal status [pre‐, early peri‐, late peri‐, and postmenopausal], DXA scanner mode, alcohol intake, vitamin D supplement use, smoking, and physical activity) and a log‐linear model with repeated measures was used to estimate the relative risk of fracture by calcium supplement use. All models were also stratified by baseline menopausal status. In fully adjusted models, calcium supplement use was associated with less annualized loss of femoral neck BMD (−0.0032 versus −0.0040 g/cm2/year; p < .001) and lumbar spine BMD (−0.0046 versus −0.0053 g/cm2/year, p = 0.021) in the complete cohort. However, this protective association of calcium supplement use with BMD loss was significant only among premenopausal women (femoral neck: −0.0032 versus −0.0042 g/cm2/year; p = 0.002; lumbar spine: −0.0038 versus −0.0050 g/cm2/year, p = 0.001); no significant differences in BMD were observed among women who were early perimenopausal by calcium supplement use at baseline. No significant differences in the relative risk of fracture were observed, regardless of baseline menopausal status. The use of calcium supplements was associated with less BMD loss over more than a decade, but was not related to the risk of incident bone fracture across the menopause transition. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science Purdue University West Lafayette IN USA
| | - Peishan Zou
- Department of Nutrition Science Purdue University West Lafayette IN USA
| | - Taylor C Wallace
- Department of Nutrition and Food Studies George Mason University Fairfax VA USA.,Think Healthy Group, Inc. Washington, DC USA
| | - George P McCabe
- Department of Statistics Purdue University West Lafayette IN USA
| | - Bruce A Craig
- Department of Statistics Purdue University West Lafayette IN USA
| | - Shinyoung Jun
- Department of Nutrition Science Purdue University West Lafayette IN USA
| | - Jane A Cauley
- Department of Epidemiology University of Pittsburgh Pittsburgh PA USA
| | - Connie M Weaver
- Department of Nutrition Science Purdue University West Lafayette IN USA
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12
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Ryan BA, Alhani K, Sellars KB, Kirby BJ, St-Arnaud R, Kaufmann M, Jones G, Kovacs CS. Mineral Homeostasis in Murine Fetuses Is Sensitive to Maternal Calcitriol but Not to Absence of Fetal Calcitriol. J Bone Miner Res 2019; 34:669-680. [PMID: 30508318 DOI: 10.1002/jbmr.3642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D receptor (VDR) null fetuses have normal serum minerals, parathyroid hormone (PTH), skeletal morphology, and mineralization but increased serum calcitriol, placental calcium transport, and placental expression of Pthrp, Trpv6, and (as reported in this study) Pdia3. We examined Cyp27b1 null fetal mice, which do not make calcitriol, to determine if loss of calcitriol has the same consequences as loss of VDR. Cyp27b1 null and wild-type (WT) females were mated to Cyp27b1+/- males, which generated Cyp27b1 null and Cyp27b1+/- fetuses from Cyp27b1 null mothers, and Cyp27b1+/- and WT fetuses from WT mothers. Cyp27b1 null fetuses had undetectable calcitriol but normal serum calcium and phosphorus, PTH, fibroblast growth factor 23 (FGF23), skeletal mineral content, tibial lengths and morphology, placental calcium transport, and expression of Trpv6 and Pthrp; conversely, placental Pdia3 was downregulated. However, although Cyp27b1+/- and null fetuses of Cyp27b1 null mothers were indistinguishable, they had higher serum and amniotic fluid calcium, lower amniotic fluid phosphorus, lower FGF23, and higher 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D than in WT and Cyp27b1+/- fetuses of WT mothers. In summary, loss of fetal calcitriol did not alter mineral or bone homeostasis, but Cyp27b1 null mothers altered mineral homeostasis in their fetuses independent of fetal genotype. Cyp27b1 null fetuses differ from Vdr null fetuses, possibly through high levels of calcitriol acting on Pdia3 in Vdr nulls to upregulate placental calcium transport and expression of Trpv6 and Pthrp. In conclusion, maternal calcitriol influences fetal mineral metabolism, whereas loss of fetal calcitriol does not. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Brittany A Ryan
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - Kamal Alhani
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - K Berit Sellars
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - Beth J Kirby
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
| | - René St-Arnaud
- Shriners Hospitals for Children-Canada and McGill University, Montréal, Canada
| | | | | | - Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Canada
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13
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Zelt JG, Svajger BA, Quinn K, Turner ME, Laverty KJ, Shum B, Holden RM, Adams MA. Acute Tissue Mineral Deposition in Response to a Phosphate Pulse in Experimental CKD. J Bone Miner Res 2019; 34:270-281. [PMID: 30216554 DOI: 10.1002/jbmr.3572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/29/2018] [Accepted: 08/08/2018] [Indexed: 12/28/2022]
Abstract
Pathogenic accumulation of calcium (Ca) and phosphate (PO4 ) in vasculature is a sentinel of advancing cardiovascular disease in chronic kidney disease (CKD). This study sought to characterize acute distribution patterns of radiolabeled 33 PO4 and 45 Ca in cardiovascular tissues of rats with CKD (0.25% dietary adenine). The disposition of 33 PO4 and 45 Ca was assessed in blood and 36 tissues after a 10-minute intravenous infusion of one of the following: (i) PO4 pulse + tracer 33 PO4 ; (ii) PO4 pulse + tracer 45 Ca; or (iii) saline + tracer 45 Ca in CKD and non-CKD animals. After the infusion, 33 PO4 in blood was elevated (2.3× at 10 minutes, 3.5× at 30 minutes, p < 0.05) in CKD compared with non-CKD. In contrast, there was no difference in clearance of 45 Ca from the blood. Compared with controls, CKD rats had a markedly increased 33 PO4 incorporation in several tissues (skeletal muscle, 7.8×; heart, 5.5×), but accrual was most pronounced in the vasculature (24.8×). There was a significant, but smaller, increase in 45 Ca accrual in the vasculature of CKD rats (1.25×), particularly in the calcified rat, in response to the acute phosphate load. Based on the pattern of tissue uptake of 33 PO4 and 45 Ca, this study revealed that an increase in circulating PO4 is an important stimulus for the accumulation of these minerals in vascular tissue in CKD. This response is further enhanced when vascular calcification is also present. The finding of enhanced vascular mineral deposition in response to an acute PO4 pulse provides evidence of significant tissue-specific susceptibility to calcification. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jason Ge Zelt
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada.,Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Molecular Function and Imaging Program, The National Cardiac PET Centre, and the Advanced Heart Disease Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute and University of Ottawa, Ottawa, Canada
| | - Bruno A Svajger
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Kieran Quinn
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Mandy E Turner
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Kimberly J Laverty
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Bonnie Shum
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Rachel M Holden
- Department of Medicine, Queen's University, Kingston, Canada
| | - Michael A Adams
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
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14
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Hoppe S, Breves G, Klinger S. Calcium-induced chloride secretion is decreased by Resveratrol in ileal porcine tissue. BMC Res Notes 2018; 11:719. [PMID: 30309374 PMCID: PMC6182809 DOI: 10.1186/s13104-018-3825-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/08/2018] [Indexed: 11/16/2022] Open
Abstract
Objective Chloride (Cl−) secretion is crucial for intestinal fluid secretion. Therefore, effects of the polyphenol Resveratrol (RSV) on Cl− secretion have been investigated. In a previous study, we observed effects of RSV on forskolin-induced Cl− secretion in the porcine jejunum but not the ileum although RSV itself induced a transepithelial ion current that may represent Cl− secretion in the ileum. The aim of this study was to gain further insights regarding the effects of RSV on characteristics of Cl− secretion in the porcine ileum using the Ussing chamber technique (recording of short circuit currents (Isc) as a measure for epithelial net ion transfer). Results RSV increased the Isc in the porcine ileum but not in the porcine jejunum as is already known. This increase was absent in a Cl−-free buffer system, indicating that RSV indeed induces Cl− secretion. However, the carbachol-induced Isc was significantly inhibited by RSV indicating an inhibition of Ca2+-induced Cl− secretion. The cellular basis for these contradictory, segment specific results of RSV on Cl− secretion has to be subjected to further studies. The results also underline, that is difficult to generalize effects of RSV between different intestinal locations, organs, cell culture models or species. Electronic supplementary material The online version of this article (10.1186/s13104-018-3825-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susanne Hoppe
- Department of Physiology, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Gerhard Breves
- Department of Physiology, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Stefanie Klinger
- Department of Physiology, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173, Hannover, Germany.
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15
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Harvey NC, D'Angelo S, Paccou J, Curtis EM, Edwards M, Raisi‐Estabragh Z, Walker‐Bone K, Petersen SE, Cooper C. Calcium and Vitamin D Supplementation Are Not Associated With Risk of Incident Ischemic Cardiac Events or Death: Findings From the UK Biobank Cohort. J Bone Miner Res 2018; 33:803-811. [PMID: 29314248 PMCID: PMC5915292 DOI: 10.1002/jbmr.3375] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 12/20/2022]
Abstract
We investigated associations between calcium/vitamin D supplementation and incident cardiovascular events/deaths in a UK population-based cohort. UK Biobank is a large prospective cohort comprising 502,637 men and women aged 40 to 69 years at recruitment. Supplementation with calcium/vitamin D was self-reported, and information on incident hospital admission (ICD-10) for ischemic heart disease (IHD), myocardial infarction (MI), and subsequent death was obtained from linkage to national registers. Cox proportional hazards models were used to investigate longitudinal relationships between calcium/vitamin D supplementation and hospital admission for men/women, controlling for covariates. A total of 475,255 participants (median age 58 years, 55.8% women) had complete data on calcium/vitamin D supplementation. Of that number, 33,437 participants reported taking calcium supplements; 19,089 vitamin D; and 10,007 both. In crude and adjusted analyses, there were no associations between use of calcium supplements and risk of incident hospital admission with either IHD, or subsequent death. Thus, for example, in unadjusted models, the hazard ratio (HR) for admission with myocardial infarction was 0.97 (95% confidence interval [CI] 0.79-1.20, p = 0.79) among women taking calcium supplementation. Corresponding HR for men is 1.16 (95% CI 0.92-1.46, p = 0.22). After full adjustment, HR (95% CI) were 0.82 (0.62-1.07), p = 0.14 among women and 1.12 (0.85-1.48), p = 0.41 among men. Adjusted HR (95% CI) for admission with IHD were 1.05 (0.92-1.19), p = 0.50 among women and 0.97 (0.82-1.15), p = 0.77 among men. Results were similar for vitamin D and combination supplementation. There were no associations with death, and in women, further adjustment for hormone-replacement therapy use did not alter the associations. In this very large prospective cohort, there was no evidence that use of calcium/vitamin D supplementation was associated with increased risk of hospital admission or death after ischemic cardiovascular events. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Nicholas C Harvey
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Julien Paccou
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- Université Lille Nord‐de‐FranceLilleFrance
| | | | - Mark Edwards
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- Portsmouth Hospitals NHS TrustPortsmouthUK
| | - Zahra Raisi‐Estabragh
- NIHR Barts Biomedical Research CentreWilliam Harvey Research InstituteQueen Mary University of LondonLondonUK
| | - Karen Walker‐Bone
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Steffen E Petersen
- NIHR Barts Biomedical Research CentreWilliam Harvey Research InstituteQueen Mary University of LondonLondonUK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
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16
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Gillies BR, Ryan BA, Tonkin BA, Poulton IJ, Ma Y, Kirby BJ, St-Arnaud R, Sims NA, Kovacs CS. Absence of Calcitriol Causes Increased Lactational Bone Loss and Lower Milk Calcium but Does Not Impair Post-lactation Bone Recovery in Cyp27b1 Null Mice. J Bone Miner Res 2018; 33:16-26. [PMID: 28686309 DOI: 10.1002/jbmr.3217] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/26/2017] [Accepted: 07/06/2017] [Indexed: 12/14/2022]
Abstract
We hypothesized that adaptation to calcium supply demands of pregnancy and lactation do not require calcitriol. Adult Cyp27b1 null mice lack calcitriol and have hypocalcemia, hypophosphatemia, and rickets. We studied wild-type (WT) and null sister pairs raised on a calcium-, phosphorus-, and lactose-enriched "rescue" diet that prevents hypocalcemia and rickets. Bone mineral content (BMC) increased >30% in pregnant nulls, declined 30% during lactation, and increased 30% by 4 weeks post-weaning. WT showed less marked changes. Micro-CT revealed loss of trabecular bone and recovery in both genotypes. In lactating nulls, femoral cortical thickness declined >30%, whereas endocortical perimeter increased; both recovered to baseline after weaning; there were no such changes in WT. Histomorphometry revealed a profound increase in osteoid surface and thickness in lactating nulls, which recovered after weaning. By three-point bend test, nulls had a >50% decline in ultimate load to failure that recovered after weaning. Although nulls showed bone loss during lactation, their milk calcium content was 30% lower compared with WT. Serum parathyroid hormone (PTH) was markedly elevated in nulls at baseline, reduced substantially in pregnancy, but increased again during lactation and remained high post-weaning. In summary, pregnant Cyp27b1 nulls gained BMC with reduced secondary hyperparathyroidism, implying increased intestinal calcium delivery. Lactating nulls lost more bone mass and strength than WT, accompanied by increased osteoid, reduced milk calcium, and worsened secondary hyperparathyroidism. This implies suboptimal intestinal calcium absorption. Post-weaning, bone mass and strength recovered to baseline, whereas BMC exceeded baseline by 40%. In conclusion, calcitriol-independent mechanisms regulate intestinal calcium absorption and trabecular bone metabolism during pregnancy and post-weaning but not during lactation; calcitriol may protect cortical bone during lactation. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Brittany R Gillies
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Brittany A Ryan
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Brett A Tonkin
- St. Vincent's Institute of Medical Research and the Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Ingrid J Poulton
- St. Vincent's Institute of Medical Research and the Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Yue Ma
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Beth J Kirby
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - René St-Arnaud
- Shriners Hospitals for Children and Faculty of Medicine, McGill University, Montreal, Canada
| | - Natalie A Sims
- St. Vincent's Institute of Medical Research and the Department of Medicine at St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
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17
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Bertin S, Aoki-Nonaka Y, Lee J, de Jong PR, Kim P, Han T, Yu T, To K, Takahashi N, Boland BS, Chang JT, Ho SB, Herdman S, Corr M, Franco A, Sharma S, Dong H, Akopian AN, Raz E. The TRPA1 ion channel is expressed in CD4+ T cells and restrains T-cell-mediated colitis through inhibition of TRPV1. Gut 2017; 66:1584-1596. [PMID: 27325418 PMCID: PMC5173457 DOI: 10.1136/gutjnl-2015-310710] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 04/06/2016] [Accepted: 05/26/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Transient receptor potential ankyrin-1 (TRPA1) and transient receptor potential vanilloid-1 (TRPV1) are calcium (Ca2+)-permeable ion channels mostly known as pain receptors in sensory neurons. However, growing evidence suggests their crucial involvement in the pathogenesis of IBD. We explored the possible contribution of TRPA1 and TRPV1 to T-cell-mediated colitis. DESIGN We evaluated the role of Trpa1 gene deletion in two models of experimental colitis (ie, interleukin-10 knockout and T-cell-adoptive transfer models). We performed electrophysiological and Ca2+ imaging studies to analyse TRPA1 and TRPV1 functions in CD4+ T cells. We used genetic and pharmacological approaches to evaluate TRPV1 contribution to the phenotype of Trpa1-/- CD4+ T cells. We also analysed TRPA1 and TRPV1 gene expression and TRPA1+TRPV1+ T cell infiltration in colonic biopsies from patients with IBD. RESULTS We identified a protective role for TRPA1 in T-cell-mediated colitis. We demonstrated the functional expression of TRPA1 on the plasma membrane of CD4+ T cells and identified that Trpa1-/- CD4+ T cells have increased T-cell receptor-induced Ca2+ influx, activation profile and differentiation into Th1-effector cells. This phenotype was abrogated upon genetic deletion or pharmacological inhibition of the TRPV1 channel in mouse and human CD4+ T cells. Finally, we found differential regulation of TRPA1 and TRPV1 gene expression as well as increased infiltration of TRPA1+TRPV1+ T cells in the colon of patients with IBD. CONCLUSIONS Our study indicates that TRPA1 inhibits TRPV1 channel activity in CD4+ T cells, and consequently restrains CD4+ T-cell activation and colitogenic responses. These findings may therefore have therapeutic implications for human IBD.
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Affiliation(s)
- Samuel Bertin
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Yukari Aoki-Nonaka
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Jihyung Lee
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Petrus R de Jong
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Peter Kim
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Tiffany Han
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Timothy Yu
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Keith To
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Naoki Takahashi
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Brigid S Boland
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Inflammatory Bowel Disease Center, University of California San Diego, La Jolla, CA, USA
| | - John T Chang
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Inflammatory Bowel Disease Center, University of California San Diego, La Jolla, CA, USA
| | - Samuel B Ho
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.,Division of Gastroenterology, Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA
| | - Scott Herdman
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Maripat Corr
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Alessandra Franco
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | - Sonia Sharma
- La Jolla Institute for Allergy and Immunology, La Jolla, CA, USA
| | - Hui Dong
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Eyal Raz
- Division of Rheumatology, Allergy & Immunology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
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18
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Campos-Obando N, Koek WNH, Hooker ER, van der Eerden BC, Pols HA, Hofman A, van Leeuwen JP, Uitterlinden AG, Nielson CM, Zillikens MC. Serum Phosphate Is Associated With Fracture Risk: The Rotterdam Study and MrOS. J Bone Miner Res 2017; 32:1182-1193. [PMID: 28177140 PMCID: PMC5466477 DOI: 10.1002/jbmr.3094] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/26/2017] [Accepted: 02/05/2017] [Indexed: 01/31/2023]
Abstract
Extreme phosphate levels (P) have been associated with mineralization defects and increased fracture risk. Whether P within normal range is related to bone health in the general population is not well understood. To investigate the association of P with bone mineral density (BMD) and fracture risk, we assessed two population-based cohorts: the Dutch Rotterdam Study (RS-I, RS-II, RS-III; n = 6791) and the US Osteoporotic Fractures in Men (MrOS; n = 5425) study. The relationship of P with lumbar spine (LS) and femoral neck (FN) BMD was tested in all cohorts via linear models; fracture risk was tested in RS-I, RS-II, and MrOS through Cox models, after follow-up of 8.6, 6.6, and 10.9 years, respectively. Adjustments were made for age, body mass index, smoking, serum levels of calcium, potassium, 25-hydroxyvitamin D, estimated glomerular filtration rate (eGFR), FN-BMD, prevalent diabetes, and cardiovascular disease. Additional adjustments were made for phosphate intake, parathyroid hormone, and fibroblast growth factor 23 levels in MrOS. We further stratified by eGFR. Results were pooled through study-level meta-analyses. Hazard ratios (HR) and betas (β) (from meta-analyses) are expressed per 1 mg/dL P increase. P was positively associated with fracture risk in men and women from RS, and findings were replicated in MrOS (pooled HR all [95% CI]: 1.47 [1.31-1.65]). P was associated with fracture risk in subjects without chronic kidney disease (CKD): all (1.44 [1.26-1.63]) and in men with CKD (1.93 [1.42-2.62]). P was inversely related to LS-BMD in men (β: -0.06 [-0.11 to -0.02]) and not to FN-BMD in either sex. In summary, serum P was positively related to fracture risk independently from BMD and phosphate intake after adjustments for potential confounders. P and LS-BMD were negatively related in men. Our findings suggest that increased P levels even within normal range might be deleterious for bone health in the normal population. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
| | - W Nadia H Koek
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Elizabeth R Hooker
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | | | - Huibert A Pols
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Carrie M Nielson
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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Kovacs CS. The Skeleton Is a Storehouse of Mineral That Is Plundered During Lactation and (Fully?) Replenished Afterwards. J Bone Miner Res 2017; 32:676-680. [PMID: 28177150 DOI: 10.1002/jbmr.3090] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 01/23/2017] [Accepted: 01/29/2017] [Indexed: 01/08/2023]
Abstract
During lactation, mammals resorb mineral from the maternal skeleton to provide calcium to milk. Rodents lose 25% to 35% of skeletal ash weight, ash calcium content, and bone mineral content as measured by dual-energy X-ray absorptiometry (DXA), and have compromised material properties of bone as assessed by crushing vertebrae and 3-point bend tests of femora or tibias. The strength, stiffness, and toughness of vertebrae, femora, and tibias are reduced by as much as 60%. The effects of lactation are not uniform throughout the skeleton, but instead resorption is much more marked in the trabecular-rich spine than in the appendicular skeleton or whole body. Women who breastfeed exclusively lose an average of 210 mg calcium in milk each day, whereas nursing of twins or triplets can double and triple the output of calcium. Clinical data are also consistent with skeletal calcium being released during lactation to provide much of the calcium needed for milk production. Lumbar spine bone mineral density (BMD), as assessed by DXA, declines by a mean of 5% to 10% among numerous studies during 3 to 6 months of exclusive lactation, whereas largely cortical sites (hip, forearm, whole body) show half that loss or no significant changes. Micro-CT of rodents and high-resolution peripheral quantitative computed tomography (HR-pQCT) imaging of women confirm that lactation causes microarchitectural deterioration of bone. These skeletal losses occur through two pathways: upregulated osteoclast-mediated bone resorption and osteocytic osteolysis, in which osteocytes remove mineral from their lacunae and pericanalicular spaces. After weaning, the skeleton is fully restored to its prior mineral content and strength in both animal models and humans, despite persistent microarchitectural changes observed in high-resolution imaging. Osteoblasts upregulate to lay down new osteoid, while osteocytes remineralize their surroundings. The factors that stimulate this post-weaning skeletal recovery remain unclear. In most studies, a history of lactation does not increase the risk, but may protect against, low BMD and fragility fractures. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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20
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Huang W, Cane MC, Mukherjee R, Szatmary P, Zhang X, Elliott V, Ouyang Y, Chvanov M, Latawiec D, Wen L, Booth DM, Haynes AC, Petersen OH, Tepikin AV, Criddle DN, Sutton R. Caffeine protects against experimental acute pancreatitis by inhibition of inositol 1,4,5-trisphosphate receptor-mediated Ca2+ release. Gut 2017; 66:301-313. [PMID: 26642860 PMCID: PMC5284483 DOI: 10.1136/gutjnl-2015-309363] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 08/31/2015] [Accepted: 09/22/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Caffeine reduces toxic Ca2+ signals in pancreatic acinar cells via inhibition of inositol 1,4,5-trisphosphate receptor (IP3R)-mediated signalling, but effects of other xanthines have not been evaluated, nor effects of xanthines on experimental acute pancreatitis (AP). We have determined effects of caffeine and its xanthine metabolites on pancreatic acinar IP3R-mediated Ca2+ signalling and experimental AP. DESIGN Isolated pancreatic acinar cells were exposed to secretagogues, uncaged IP3 or toxins that induce AP and effects of xanthines, non-xanthine phosphodiesterase (PDE) inhibitors and cyclic adenosine monophosphate and cyclic guanosine monophosphate (cAMP/cGMP) determined. The intracellular cytosolic calcium concentration ([Ca2+]C), mitochondrial depolarisation and necrosis were assessed by confocal microscopy. Effects of xanthines were evaluated in caerulein-induced AP (CER-AP), taurolithocholic acid 3-sulfate-induced AP (TLCS-AP) or palmitoleic acid plus ethanol-induced AP (fatty acid ethyl ester AP (FAEE-AP)). Serum xanthines were measured by liquid chromatography-mass spectrometry. RESULTS Caffeine, dimethylxanthines and non-xanthine PDE inhibitors blocked IP3-mediated Ca2+ oscillations, while monomethylxanthines had little effect. Caffeine and dimethylxanthines inhibited uncaged IP3-induced Ca2+ rises, toxin-induced Ca2+ release, mitochondrial depolarisation and necrotic cell death pathway activation; cAMP/cGMP did not inhibit toxin-induced Ca2+ rises. Caffeine significantly ameliorated CER-AP with most effect at 25 mg/kg (seven injections hourly); paraxanthine or theophylline did not. Caffeine at 25 mg/kg significantly ameliorated TLCS-AP and FAEE-AP. Mean total serum levels of dimethylxanthines and trimethylxanthines peaked at >2 mM with 25 mg/kg caffeine but at <100 µM with 25 mg/kg paraxanthine or theophylline. CONCLUSIONS Caffeine and its dimethylxanthine metabolites reduced pathological IP3R-mediated pancreatic acinar Ca2+ signals but only caffeine ameliorated experimental AP. Caffeine is a suitable starting point for medicinal chemistry.
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Affiliation(s)
- Wei Huang
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK,Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Matthew C Cane
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Rajarshi Mukherjee
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Peter Szatmary
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Xiaoying Zhang
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Victoria Elliott
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
| | - Yulin Ouyang
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Michael Chvanov
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Diane Latawiec
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
| | - Li Wen
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre, West China Hospital, Sichuan University, Chengdu, China
| | - David M Booth
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Andrea C Haynes
- Immuno-Inflammation Therapeutic Area Unit, GlaxoSmithKline, Stevenage, UK
| | - Ole H Petersen
- Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - Alexei V Tepikin
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - David N Criddle
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Robert Sutton
- NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, UK
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21
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Altenhofen D, da Luz G, Frederico MJS, Venzke D, Brich M, Vigil S, Fröde TS, Linares CEB, Pizzolatti MG, Silva FRMB. Bis-Pyrano Prenyl Isoflavone Improves Glucose Homeostasis by Inhibiting Dipeptidyl Peptidase-4 in Hyperglycemic Rats. J Cell Biochem 2016; 118:92-103. [PMID: 27238050 DOI: 10.1002/jcb.25614] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/26/2016] [Indexed: 12/25/2022]
Abstract
Isoflavones widely distributed in plants prevent diabetes. This study investigated the in vivo and in vitro effect of 3',4'-dihydroxy-6″,6″,6″',6″'-tetramethylbis(pyrano[2″,3″:5,6::2″',3″':7,8]isoflavone (bis-pyrano prenyl isoflavone) on glucose homeostasis in hyperglycemic rats. The ethyl acetate fraction from aerial parts of Polygala molluginifolia that contain isoflavones was assayed on glucose tolerance, on in vitro maltase activity and on protein glycation. The isoflavone bis-pyrano prenyl isolated from this fraction was investigated on glucose homeostasis. The in vivo action of the isoflavone exhibits an anti-hyperglycemic effect by improving glucose tolerance, augmenting the liver glycogen, inhibiting maltase activity, and stimulating glucagon-like peptide-1 (GLP-1) and insulin secretion. The in vitro isoflavone inhibits dipeptidyl peptidase-4 (DPP-4) activity since the glucose tolerance was improved in the presence of the isoflavone as much as sitagliptin, an inhibitor of DPP-4. However, the co-incubation with isoflavone and sitagliptin exhibited an additive anti-hyperglycemic action. The isoflavone increased the GLP-1 faster than the positive hyperglycemic group, which shows that the intestine is a potential target. Thus, to clarify the main site of action in which isoflavone improves glucose balance, the in vitro mechanism of action of this compound was tested in intestine using calcium influx as a trigger for the signal pathways for GLP-1 secretion. The isoflavone stimulates calcium influx in intestine and its mechanism involves voltage-dependent calcium channels, phospholipase C, protein kinase C, and stored calcium contributing for GLP-1 secretion. In conclusion, the isoflavone regulates glycaemia by acting mainly in a serum target, the DPP-4 inhibitor. Furthermore, the long-term effect of isoflavone prevents protein glycation. J. Cell. Biochem. 118: 92-103, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Delsi Altenhofen
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Cx. Postal 5069, CEP: 88040-970, Florianópolis, Santa Catarina, Brazil
| | - Gabrielle da Luz
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Cx. Postal 5069, CEP: 88040-970, Florianópolis, Santa Catarina, Brazil
| | - Marisa Jádna Silva Frederico
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Cx. Postal 5069, CEP: 88040-970, Florianópolis, Santa Catarina, Brazil
| | - Dalila Venzke
- Departamento de Química, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, CEP: 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Mayara Brich
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Cx. Postal 5069, CEP: 88040-970, Florianópolis, Santa Catarina, Brazil
| | - Silvana Vigil
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, CEP: 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Tania Silvia Fröde
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, CEP: 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Carlos Eduardo Blanco Linares
- Departamento de Ciências da Saúde, Centro de Ciências da Saúde, Universidade Regional Integrada do Alto Uruguai e da Missões, Campus Frederico Westphalen, Frederico Westphalen, Rio Grande do Sul, Brazil
| | - Moacir Geraldo Pizzolatti
- Departamento de Química, Centro de Ciências Físicas e Matemáticas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, CEP: 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Fátima Regina Mena Barreto Silva
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Cx. Postal 5069, CEP: 88040-970, Florianópolis, Santa Catarina, Brazil
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22
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Piret SE, Gorvin CM, Pagnamenta AT, Howles SA, Cranston T, Rust N, Nesbit MA, Glaser B, Taylor JC, Buchs AE, Hannan FM, Thakker RV. Identification of a G-Protein Subunit-α11 Gain-of-Function Mutation, Val340Met, in a Family With Autosomal Dominant Hypocalcemia Type 2 (ADH2). J Bone Miner Res 2016; 31:1207-14. [PMID: 26818911 PMCID: PMC4915495 DOI: 10.1002/jbmr.2797] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 01/24/2023]
Abstract
Autosomal dominant hypocalcemia (ADH) is characterized by hypocalcemia, inappropriately low serum parathyroid hormone concentrations and hypercalciuria. ADH is genetically heterogeneous with ADH type 1 (ADH1), the predominant form, being caused by germline gain-of-function mutations of the G-protein coupled calcium-sensing receptor (CaSR), and ADH2 caused by germline gain-of-function mutations of G-protein subunit α-11 (Gα11 ). To date Gα11 mutations causing ADH2 have been reported in only five probands. We investigated a multigenerational nonconsanguineous family, from Iran, with ADH and keratoconus which are not known to be associated, for causative mutations by whole-exome sequencing in two individuals with hypoparathyroidism, of whom one also had keratoconus, followed by cosegregation analysis of variants. This identified a novel heterozygous germline Val340Met Gα11 mutation in both individuals, and this was also present in the other two relatives with hypocalcemia that were tested. Three-dimensional modeling revealed the Val340Met mutation to likely alter the conformation of the C-terminal α5 helix, which may affect G-protein coupled receptor binding and G-protein activation. In vitro functional expression of wild-type (Val340) and mutant (Met340) Gα11 proteins in HEK293 cells stably expressing the CaSR, demonstrated that the intracellular calcium responses following stimulation with extracellular calcium, of the mutant Met340 Gα11 led to a leftward shift of the concentration-response curve with a significantly (p < 0.0001) reduced mean half-maximal concentration (EC50 ) value of 2.44 mM (95% CI, 2.31 to 2.77 mM) when compared to the wild-type EC50 of 3.14 mM (95% CI, 3.03 to 3.26 mM), consistent with a gain-of-function mutation. A novel His403Gln variant in transforming growth factor, beta-induced (TGFBI), that may be causing keratoconus was also identified, indicating likely digenic inheritance of keratoconus and ADH2 in this family. In conclusion, our identification of a novel germline gain-of-function Gα11 mutation, Val340Met, causing ADH2 demonstrates the importance of the Gα11 C-terminal region for G-protein function and CaSR signal transduction. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sian E Piret
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
| | - Caroline M Gorvin
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
| | - Alistair T Pagnamenta
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, UK.,Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, UK
| | - Sarah A Howles
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK
| | - Treena Cranston
- Oxford University Hospitals NHS Trust, Oxford Medical Genetics Laboratories, Churchill Hospital, Oxford, UK
| | - Nigel Rust
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford, UK
| | - M Andrew Nesbit
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.,Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
| | - Ben Glaser
- Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jenny C Taylor
- Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford, UK.,Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, UK
| | - Andreas E Buchs
- Department of Medicine D, Assaf Harofe Medical Center, Zerifin, Israel
| | - Fadil M Hannan
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.,Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Rajesh V Thakker
- Academic Endocrine Unit, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.,Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, UK
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23
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ENDERLE J, TELERMAN M, CREMER M. [REPERCUSSIONS OF ELECTROLYTE DISORDERS OF THE HUMORAL MILIEU ON THE DIGITALIS ACTIVITY]. Acta Clin Belg 2016; 18:409-25. [PMID: 14104735 DOI: 10.1080/17843286.1963.11717151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Laiuppa JA, Santillán GE. Effect of Combined Action of Extracellular ATP and Elevated Calcium on Osteogenic Differentiation of Primary Cultures From Rat Calvaria. J Cell Biochem 2016; 117:2658-68. [PMID: 27038365 DOI: 10.1002/jcb.25565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/31/2016] [Indexed: 11/06/2022]
Abstract
The in vitro osteogenic differentiation has been intensively studied. However, it is not yet clear precisely how osteogenesis can be optimized. Changes in extracellular Ca(2+) concentration ([Ca(2+) ]e ), as well as modulation of purinergic receptors play an important role in the regulation of osteoblasts differentiation and bone formation. In this study, we investigated the effects of a combined treatment of ATPγ-S and high [Ca(2+) ]e (5.35 mM) on osteogenic differentiation and function of primary cell cultures from rat calvaria. Our results indicate that ATPγ-S stimulates cell transition from the G0 to S phase of cell cycle, involving the PI3K signaling pathway. Treatment with 10 or 100 µM ATPγ-S and [Ca(2+) ]e (ATP-[Ca(2+) ]e ) for 48 h increases cell number significantly above the control. ATPγ-S treatment in osteogenic medium containing [Ca(2+) ]e stimulates the gene expression of BMP-4, BMP-5, and OPN at 16, 48, and 72 h, respectively, above control. In same conditions, treatment for 6 days with 10 µM UTP or 100 µM UDP significantly increased the ALP activity respect to control. Cells grown in osteogenic medium showed a statistically significant increase in calcium deposits at 15 and 18 days, for 10 µM ATPγ-S treatment, and at 18 and 22 days, for [Ca(2+) ]e treatment, respect to control but ATP-[Ca(2+) ]e treatment shown a significant greater mineralization at 15 days respect to ATPγ-S, and at 18 days respect to both agonists. In conclusion, we demonstrated that an osteogenic medium containing 10 µM ATPγ-S and 5.35 mM [Ca(2+) ]e enhance osteogenesis and mineralization by rat primary calvarial cells cultures. J. Cell. Biochem. 117: 2658-2668, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Juan A Laiuppa
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, CONICET, San Juan 670, (B8000ICN) Bahía Blanca, Argentina
| | - Graciela E Santillán
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, CONICET, San Juan 670, (B8000ICN) Bahía Blanca, Argentina.
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Abstract
There is longstanding concern that calcium supplements might increase cardiovascular risk in patients with renal impairment. The Auckland Calcium Study suggested that the same problem occurs in older people taking these supplements for prevention of osteoporosis. Our subsequent meta-analyses, (which followed protocols finalized before the data was available) confirmed that calcium supplements, with or without vitamin D, adversely affected risk of myocardial infarction and, possibly, stroke. Several groups have re-visited these data, consistently finding an adverse effect of calcium on myocardial infarction, not always statistically significant because some meta-analyses have been under-powered. Whether or not an adverse effect of calcium plus vitamin D on myocardial infarction is found depends on whether two specific groups of subjects are included-those in the Women's Health Initiative who were already taking calcium at the time of randomization, and subjects from an open, cluster-randomized study in which baseline cardiovascular risk was different between groups. Vitamin D alone does not affect vascular risk, so it is unlikely that differences between calcium alone and calcium plus vitamin D are real, and they are more likely to result from the inclusion of studies at high risk of bias. The mechanisms of the adverse cardiovascular effects are uncertain but may be mediated by the increase in serum calcium following supplement ingestion, and the effects of this on vascular function and coagulation. Available evidence suggests the risks of calcium supplements outweigh any small benefits on fracture incidence, so the case for their use is weak.
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Affiliation(s)
- Ian R Reid
- University of Auckland, Auckland, New Zealand; Department of Endocrinology, Auckland District Health Board, New Zealand
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26
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O'Keefe JH, Bergman N, Carrera-Bastos P, Fontes-Villalba M, DiNicolantonio JJ, Cordain L. Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa. Open Heart 2016; 3:e000325. [PMID: 27042317 PMCID: PMC4809188 DOI: 10.1136/openhrt-2015-000325] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/18/2015] [Accepted: 02/02/2016] [Indexed: 12/22/2022] Open
Abstract
The focus of this paper is to explore better strategies for optimising bone strength and reducing risk of fracture, while at the same time decreasing risk of cardiovascular disease. The majority of Americans do not consume the current recommended dietary allowance for calcium, and the lifetime risk of osteoporosis is about 50%. However, traditional mononutrient calcium supplements may not be ideal. We comprehensively and systematically reviewed the scientific literature in order to determine the optimal dietary strategies and nutritional supplements for long-term skeletal health and cardiovascular health. To summarise, the following steps may be helpful for building strong bones while maintaining soft and supple arteries: (1) calcium is best obtained from dietary sources rather than supplements; (2) ensure that adequate animal protein intake is coupled with calcium intake of 1000 mg/day; (3) maintain vitamin D levels in the normal range; (4) increase intake of fruits and vegetables to alkalinise the system and promote bone health; (5) concomitantly increase potassium consumption while reducing sodium intake; (6) consider increasing the intake of foods rich in vitamins K1 and K2; (7) consider including bones in the diet; they are a rich source of calcium-hydroxyapatite and many other nutrients needed for building bone.
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Affiliation(s)
- James H O'Keefe
- Saint Luke's Mid America Heart Institute , Kansas City, Missouri , USA
| | - Nathaniel Bergman
- Cleveland Clinic Foundation , Center for Functional Medicine , Cleveland, Ohio , USA
| | - Pedro Carrera-Bastos
- Center for Primary Health Care Research , Department of Clinical Sciences, Faculty of Medicine at Lund University , Malmö , Sweden
| | - Maélan Fontes-Villalba
- Center for Primary Health Care Research , Department of Clinical Sciences, Faculty of Medicine at Lund University , Malmö , Sweden
| | | | - Loren Cordain
- Emeritus Professor of Nutritional Science , Colorado State University , Fort Collins, Colorado , USA
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27
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Al-Dujaili SA, Koh AJ, Dang M, Mi X, Chang W, Ma PX, McCauley LK. Calcium Sensing Receptor Function Supports Osteoblast Survival and Acts as a Co-Factor in PTH Anabolic Actions in Bone. J Cell Biochem 2016; 117:1556-67. [PMID: 26579618 DOI: 10.1002/jcb.25447] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 12/14/2022]
Abstract
Anabolic actions of PTH in bone involve increased deposition of mineralizing matrix. Regulatory feedback of the process may be important to maintain calcium homeostasis and, in turn, calcium may inform the process. This investigation clarified the role of calcium availability and the calcium sensing receptor (CaSR) in the anabolic actions of PTH. CaSR function promoted osteoblastic cell numbers, with lower cell numbers in post-confluent cultures of primary calvarial cells from Col1-CaSR knock-out (KO) mice, and for calvarial cells from wild-type (WT) mice treated with a calcilytic. Increased apoptosis of calvarial cells with calcilytic treatment suggested CaSR is critical for protection against stage-dependent cell death. Whole and cortical, but not trabecular, bone parameters were significantly lower in Col1-CaSR KO mice versus WT littermates. Intact Col1-CaSR KO mice had lower serum P1NP levels relative to WT. PTH treatment displayed anabolic actions in WT and, to a lesser degree, KO mice, and rescued the lower P1NP levels in KO mice. Furthermore, PTH effects on whole tibiae were inhibited by osteoblast-specific CaSR ablation. Vertebral body implants (vossicles) from untreated Col1-CaSR KO and WT mice had similar bone volumes after 4 weeks of implantation in athymic mice. These findings suggest that trabecular bone formation can occur independently of the CaSR, and that the CaSR plays a collaborative role in the PTH anabolic effects on bone. J. Cell. Biochem. 117: 1556-1567, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Saja A Al-Dujaili
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan
| | - Amy J Koh
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan
| | - Ming Dang
- Macromolecular Science and Engineering Center, University of Michigan, Ann Arbor, Michigan
| | - Xue Mi
- Macromolecular Science and Engineering Center, University of Michigan, Ann Arbor, Michigan
| | - Wenhan Chang
- Endocrine Research Unit, University of California, San Francisco, California
| | - Peter X Ma
- Macromolecular Science and Engineering Center, University of Michigan, Ann Arbor, Michigan.,Department of Biologic and Materials Sciences, University of Michigan, Ann Arbor, Michigan.,Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Laurie K McCauley
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Pathology, University of Michigan, Ann Arbor, Michigan
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28
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Takenaka T, Inoue T, Miyazaki T, Hayashi M, Suzuki H. Xeno-Klotho Inhibits Parathyroid Hormone Signaling. J Bone Miner Res 2016; 31:455-62. [PMID: 26287968 DOI: 10.1002/jbmr.2691] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/02/2015] [Accepted: 08/14/2015] [Indexed: 01/13/2023]
Abstract
Although fibroblast growth factor (FGF) 23 was recently identified as a phosphatonin that influences vitamin D metabolism, the underlying signaling mechanisms remain unclear. FGF23 elevates the renal levels of membrane-associated klotho as well as soluble klotho. Klotho is expressed on distal tubules. Upon enzymatic cleavage, soluble klotho is released into the renal interstitial space and then into the systemic circulation. The expression of 25-hydroxyvitamin D3 1α-hydroxylase (1-OH) on proximal tubular cells is controlled by parathyroid hormone (PTH). Klotho binds to various membrane proteins to alter their function. Here, the interaction between the PTH receptor and klotho was studied using various approaches, including immunoprecipitation, in vitro cell culture, and in vivo animal experiments. Immunoprecipitation studies demonstrate, for the first time, that recombinant human klotho protein interacts with human PTH receptors to inhibit the binding of human PTH. Furthermore, when applied to human proximal tubular cells, recombinant human klotho suppresses PTH-stimulated generation of inositol trisphosphate in vitro. Moreover, PTH-induced increase of cyclic AMP secretion and 1α,25-dihydroxyvitamin D3 (1,25VD) was attenuated by recombinant human klotho in vivo. In addition, recombinant human klotho inhibits the expression of 1-OH by PTH both in vitro and in vivo. These results suggest that free klotho mediates the FGF23-induced inhibition of 1,25VD synthesis.
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Affiliation(s)
- Tsuneo Takenaka
- Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, Tokyo, Japan
| | - Tsutomu Inoue
- Department of Nephrology, Saitama Medical University, Saitama, Japan
| | - Takashi Miyazaki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Matsuhiko Hayashi
- Dialysis and Blood Purification Center, Keio University, Tokyo, Japan
| | - Hiromichi Suzuki
- Department of Nephrology, Saitama Medical University, Saitama, Japan
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Abstract
Systematic reviews of randomized, controlled trials (RCTs) are considered the highest level of evidence to inform clinical practice. Meta-analyses of large RCTs of calcium and/or vitamin D supplements completed in the last 15 years provide strong evidence for clinical recommendations. These meta-analyses with data for > 50,000 older adults reported that calcium with or without vitamin D has only weak, inconsistent effects on fracture, and that vitamin D without calcium has no effect on fracture. Only one RCT of co-administered calcium and vitamin D in frail, institutionalized, elderly women with low dietary calcium intake and vitamin D levels showed significant reductions in fracture risk. These RCTs have also reported previously unrecognized adverse events of calcium supplements including kidney stones, myocardial infarction, hypercalcemia, and hospitalization with acute gastrointestinal symptoms. The small risk of these important adverse effects, together with the moderate risk of minor side-effects such as constipation, probably outweighs any benefits of calcium supplements on fracture. These data suggest the role for calcium and vitamin D supplements in osteoporosis management is very limited. Neither calcium nor vitamin D supplements should be recommended for fracture prevention in community-dwelling adults, although vitamin D should be considered for prevention of osteomalacia in at-risk individuals.
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Affiliation(s)
- M J Bolland
- a Department of Medicine , University of Auckland , Auckland , New Zealand
| | - A Grey
- a Department of Medicine , University of Auckland , Auckland , New Zealand
| | - I R Reid
- a Department of Medicine , University of Auckland , Auckland , New Zealand
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Tsunoda K, Tsujino I, Koshi R, Sugano N, Sato S, Asano M. Nicotine-Mediated Ca(2+)-Influx Induces IL-8 Secretion in Oral Squamous Cell Carcinoma Cell. J Cell Biochem 2015; 117:1009-15. [PMID: 26418512 DOI: 10.1002/jcb.25387] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 09/25/2015] [Indexed: 11/12/2022]
Abstract
Cigarette smoking is one of the most important risk factors for the development of various diseases. Nicotine is the most extensively investigated component of cigarette smoke, and a comprehensive analysis of the genes induced by nicotine stimulation revealed that interleukin-8 (IL-8) was induced in oral squamous cell carcinoma cell (OSCC). Based on this background, the signaling mechanisms of nicotine-mediated IL-8 induction in OSCC was investigated. Augmented IL-8 secretion by Ca9-22 cells was blocked by the NF-κB inhibitor L-1-4'-tosylamino-phenylethyl-chloromethyl ketone (TPCK) and the nicotinic acetylcholine receptor (nAChR)-specific inhibitor α-bungarotoxin (αBtx). The downstream signaling pathway was further examined by pre-incubating the cells with inhibitors against mitogen-activated protein kinase (MEK), protein kinase C (PKC), and Ca(2+)/calmodulin-dependent kinase II (CaMK II). Only the CaMK II inhibitor was found to exert an inhibitory effect on nicotine-mediated IL-8 secretion. Pre-treatment of the Ca9-22 cells with the Ca(2+) chelator BAPTA-AM drastically inhibited IL-8 secretion. Although nicotine stimulation induced the phosphorylation of the NF-κB p65 subunit, pre-treatment with BAPTA-AM was found to inhibit this activity significantly. CaMK II-dependent p65 phosphorylation was confirmed by pre-incubation of the cells with CaMK II inhibitor. The results from this study indicate that the binding of nicotine to nAChR induces Ca(2+) influx, which results in the activation and phosphorylation of CaMK II and NF-κB p65, respectively. Nicotine-mediated IL-8 induction should be a trigger for the initiation of various diseases.
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Affiliation(s)
- Kou Tsunoda
- Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, Tokyo, Japan
| | - Ichiro Tsujino
- Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Ryosuke Koshi
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Advanced Dental Treatment, Nihon University School of Dentistry, Tokyo, Japan
| | - Naoyuki Sugano
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Advanced Dental Treatment, Nihon University School of Dentistry, Tokyo, Japan
| | - Shuichi Sato
- Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Advanced Dental Treatment, Nihon University School of Dentistry, Tokyo, Japan
| | - Masatake Asano
- Department of Pathology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Immunology and Pathobiology, Nihon University School of Dentistry, Tokyo, Japan
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31
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Abstract
This review assesses (1) the potential role of calcium supplements in the prevention and treatment of osteoporosis and osteoporotic fractures, and (2) the safety of calcium supplements with respect to cardiovascular health as well. With regard to (1), a total calcium intake of < 800 mg/day is associated with increased loss of bone mineral density in peri- and postmenopausal women with an increase in fracture risk. Hereby, the effect of calcium supplements on fracture prevention is dependent primary on baseline calcium intake. The strongest protective effect has been reported in individuals with a calcium intake < 700 mg/day and in high-risk groups. A calcium intake of about 1000-1200 mg/day seems to be sufficient for general fracture prevention. With regard to (2), an analysis of the data based on the Hill criteria does not demonstrate convincing evidence that calcium supplements increase cardiovascular risk. In the long term, total calcium intake of 2500 mg/day (from food and supplements) continues to be classified as safe. This value should not be exceeded for an extended period of time.
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Affiliation(s)
- A Ströhle
- a Nutrition Physiology and Human Nutrition Unit, Institute of Food Science and Human Nutrition, Leibniz University of Hannover , Hannover , Germany
| | - P Hadji
- b * Department of Osteooncology , Gynecological Endocrinology and Reproductive Medicine, Krankenhaus Nordwest , Frankfurt , Germany
| | - A Hahn
- a Nutrition Physiology and Human Nutrition Unit, Institute of Food Science and Human Nutrition, Leibniz University of Hannover , Hannover , Germany
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Hsu YJ, Yang SS, Cheng CJ, Liu ST, Huang SM, Chau T, Chu P, Salter DM, Lee HS, Lin SH. Thiazide-sensitive Na+ -Cl- cotransporter (NCC) gene inactivation results in increased duodenal Ca2+ absorption, enhanced osteoblast differentiation and elevated bone mineral density. J Bone Miner Res 2015; 30:116-27. [PMID: 24984877 DOI: 10.1002/jbmr.2306] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 06/16/2014] [Accepted: 06/19/2014] [Indexed: 11/09/2022]
Abstract
Inactivation of the thiazide-sensitive sodium chloride cotransporter (NCC) due to genetic mutations in Gitelman's syndrome (GS) or pharmacological inhibition with thiazide diuretics causes hypocalciuria and increased bone mineral density (BMD) with unclear extrarenal calcium (Ca(2+) ) regulation. We investigated intestinal Ca(2+) absorption and bone Ca(2+) metabolism in nonsense Ncc Ser707X (S707X) homozygous knockin mice (Ncc(S707X/S707X) mice). Compared to wild-type and heterozygous knockin littermates, Ncc(S707X/S707X) mice had increased intestinal absorption of (45) Ca(2+) and expression of the active Ca(2+) transport machinery (transient receptor potential vanilloid 6, calbindin-D9K , and plasma membrane Ca(2+) ATPase isoform 1b). Ncc(S707X/S707X) mice had also significantly increased Ca(2+) content accompanied by greater mineral apposition rate (MAR) in their femurs and higher trabecular bone volume, cortical bone thickness, and BMD determined by μCT. Their osteoblast differentiation markers, such as bone alkaline phosphatase, procollagen I, osteocalcin, and osterix, were also significantly increased while osteoclast activity was unaffected. Analysis of marrow-derived bone cells, either treated with thiazide or directly cultured from Ncc S707X knockin mice, showed that the differentiation of osteoblasts was associated with increased phosphorylation of mechanical stress-induced focal adhesion kinase (FAK) and extracellular signal-regulated kinase (ERK). In conclusion, NCC inhibition stimulates duodenal Ca(2+) absorption as well as osteoblast differentiation and bone Ca(2+) storage, possibly through a FAK/ERK dependent mechanism.
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Affiliation(s)
- Yu-Juei Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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van Bodegraven AA, Witte BI, Lips P. Authors' response: The role of risedronate in osteopenia in Crohn's disease. Gut 2015; 64:185-6. [PMID: 24569060 DOI: 10.1136/gutjnl-2014-306746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- Ad A van Bodegraven
- Department of Gastroenterology and Hepatology, VUmc, Amsterdam, The Netherlands
| | - Birgit I Witte
- Department of Epidemiology and Biostatistics, VUmc, Amsterdam, The Netherlands
| | - Paul Lips
- Endocrine Section, Department of Internal Medicine, VUmc, Amsterdam, The Netherlands
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34
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Pines A, Langer RD. The cardiovascular safety aspects of calcium supplementations: where does the truth lie? A personal perspective. Climacteric 2014; 18:6-10. [PMID: 25318377 DOI: 10.3109/13697137.2014.947947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Clinical guidelines may change with time, as more information from topline studies emerges. Calcium plus vitamin D supplementation became routine decades ago, especially in the older population, based on the assumption that it may promote bone health and prevent fractures, and perhaps induce additional favorable health outcomes. During the past years, an ongoing debate defies this paradigm, mainly because of a potential cardiovascular risk on the one hand, and uncertainty in regard to the extent of the beneficial bone effects on the other hand. The following article summarizes the main recent developments, trying to put some order into the controversial information and opinions which have been published in the medical literature. We conclude that the best current evidence supports a primary strategy of obtaining recommended intakes of calcium and vitamin D from dietary sources. But, since most western diets are inadequate in that regard, and since there is no clear evidence of harm from modest supplementation (up to 1000 mg of elemental calcium and 400 IU of vitamin D3), supplementation is appropriate when dietary intake is inadequate.
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Affiliation(s)
- A Pines
- Sackler Faculty of Medicine, Tel-Aviv University , Israel
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35
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Schick V, Scheiber JA, Mooren FC, Turi S, Ceyhan GO, Schnekenburger J, Sendler M, Schwaiger T, Omercevic A, Brandt CVD, Fluhr G, Domschke W, Krüger B, Mayerle J, Lerch MM. Effect of magnesium supplementation and depletion on the onset and course of acute experimental pancreatitis. Gut 2014; 63:1469-80. [PMID: 24277728 DOI: 10.1136/gutjnl-2012-304274] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVE High calcium concentrations are an established risk factor for pancreatitis. We have investigated whether increasing magnesium concentrations affect pathological calcium signals and premature protease activation in pancreatic acini, and whether dietary or intraperitoneal magnesium administration affects the onset and course of experimental pancreatitis. METHODS Pancreatic acini were incubated with up to 10 mM magnesium; [Ca(2+)](i) (fura-2AM) and intracellular protease activation (fluorogenic substrates) were determined over 60 min. Wistar rats received chow either supplemented or depleted for magnesium (<300 ppm to 30 000 ppm) over two weeks before pancreatitis induction (intravenous caerulein 10 µg/kg/h/4 h); controls received 1 µg/kg/h caerulein or saline. C57BL6/J mice received four intraperitoneal doses of magnesium (NaCl, Mg(2+) 55 192 or 384 mg/kg bodyweight) over 72 h, then pancreatitis was induced by up to eight hourly supramaximal caerulein applications. Pancreatic enzyme activities, protease activation, morphological changes and the immune response were investigated. RESULTS Increasing extracellular Mg(2+) concentration significantly reduced [Ca(2+)](i) peaks and frequency of [Ca(2+)](i) oscillations as well as intracellular trypsin and elastase activity. Magnesium administration reduced pancreatic enzyme activities, oedema, tissue necrosis and inflammation and somewhat increased Foxp3-positiv T-cells during experimental pancreatitis. Protease activation was found in animals fed magnesium-deficient chow-even with low caerulein concentrations that normally cause no damage. CONCLUSIONS Magnesium supplementation significantly reduces premature protease activation and the severity of pancreatitis, and antagonises pathological [Ca(2+)](i) signals. Nutritional magnesium deficiency increases the susceptibility of the pancreas towards pathological stimuli. These data have prompted two clinical trials on the use of magnesium in patients at risk for pancreatitis.
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Affiliation(s)
- Verena Schick
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany
| | - Jonas A Scheiber
- Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Frank C Mooren
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany Department of Sports Medicine, Justus-Liebig-Universität, Giessen, Germany
| | - Stefan Turi
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Güralp O Ceyhan
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany Department of Surgery, Klinikum Rechts der Isar, Technische Universität, München, Germany
| | | | - Matthias Sendler
- Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Theresa Schwaiger
- Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Armin Omercevic
- Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | | | - Gabriele Fluhr
- Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Wolfram Domschke
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany
| | - Burkhard Krüger
- Division of Medical Biology, Universität Rostock, Rostock, Germany
| | - Julia Mayerle
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine B, Westfälische Wilhelms-Universität, Münster, Germany Department of Medicine A, Universitätsmedizin Greifswald, Greifswald, Germany
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36
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Moe SM, Chen NX, Newman CL, Gattone VH, Organ JM, Chen X, Allen MR. A comparison of calcium to zoledronic acid for improvement of cortical bone in an animal model of CKD. J Bone Miner Res 2014; 29:902-10. [PMID: 24038306 PMCID: PMC3940692 DOI: 10.1002/jbmr.2089] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 08/06/2013] [Accepted: 08/28/2013] [Indexed: 02/06/2023]
Abstract
Patients with chronic kidney disease (CKD) have increased risk of fractures, yet the optimal treatment is unknown. In secondary analyses of large randomized trials, bisphosphonates have been shown to improve bone mineral density and reduce fractures. However, bisphosphonates are currently not recommended in patients with advanced kidney disease due to concern about oversuppressing bone remodeling, which may increase the risk of developing arterial calcification. In the present study we used a naturally occurring rat model of CKD with secondary hyperparathyroidism, the Cy/+ rat, and compared the efficacy of treatment with zoledronic acid, calcium given in water to simulate a phosphate binder, and the combination of calcium and zoledronic acid. Animals were treated beginning at 25 weeks of age (approximately 30% of normal renal function) and followed for 10 weeks. The results demonstrate that both zoledronic acid and calcium improved bone volume by micro-computed tomography (µCT) and both equally suppressed the mineral apposition rate, bone formation rate, and mineralizing surface of trabecular bone. In contrast, only calcium treatment with or without zoledronic acid improved cortical porosity and cortical biomechanical properties (ultimate load and stiffness) and lowered parathyroid hormone (PTH). However, only calcium treatment led to the adverse effects of increased arterial calcification and fibroblast growth factor 23 (FGF23). These results suggest zoledronic acid may improve trabecular bone volume in CKD in the presence of secondary hyperparathyroidism, but does not benefit extraskeletal calcification or cortical biomechanical properties. Calcium effectively reduces PTH and benefits both cortical and trabecular bone yet increases the degree of extra skeletal calcification. © 2014 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sharon M Moe
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA; Richard L. Roduebush Veterans Affairs Medical Center, Indianapolis, IN, USA
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37
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Wheal BD, Beach RJ, Tanabe N, Dixon SJ, Sims SM. Subcellular elevation of cytosolic free calcium is required for osteoclast migration. J Bone Miner Res 2014; 29:725-34. [PMID: 23956003 DOI: 10.1002/jbmr.2068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 07/15/2013] [Accepted: 08/02/2013] [Indexed: 11/10/2022]
Abstract
Osteoclasts are multinucleated cells responsible for the resorption of bone and other mineralized tissues during development, physiological remodeling, and pathological bone loss. Osteoclasts have the ability to resorb substrate while concurrently migrating. However, the subcellular processes underlying migration are not well understood. It has been proposed that, in other cell types, cytosolic free Ca(2+) concentration ([Ca(2+) ]i ) regulates cell protrusion as well as retraction. Integration of these distinct events would require precise spatiotemporal patterning of subcellular Ca(2+) . The large size of osteoclasts offers a unique opportunity to monitor patterns of Ca(2+) during cell migration. We used ratiometric imaging to map [Ca(2+) ]i within rat and mouse osteoclasts. Migration was characterized by lamellipodial outgrowth at the leading edge, along with intermittent retraction of the uropod. Migrating osteoclasts displayed elevation of [Ca(2+) ]i in the uropod, that began prior to retraction. Dissipation of this [Ca(2+) ]i gradient by loading osteoclasts with the Ca(2+) chelator BAPTA abolished uropod retraction, on both glass and mineralized substrates. In contrast, elevation of [Ca(2+) ]i using ionomycin initiated prompt uropod retraction. To investigate downstream effectors, we treated cells with calpain inhibitor-1, which impaired uropod retraction. In contrast, lamellipodial outgrowth at the leading edge of osteoclasts was unaffected by any of these interventions, indicating that the signals regulating outgrowth are distinct from those triggering retraction. The large size of mature, multinucleated osteoclasts allowed us to discern a novel spatiotemporal pattern of Ca(2+) involved in cell migration. Whereas localized elevation of Ca(2+) is necessary for uropod retraction, lamellipod outgrowth is independent of Ca(2+) -a heretofore unrecognized degree of specificity underlying the regulation of osteoclast migration.
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Affiliation(s)
- Benjamin D Wheal
- Graduate Program in Neuroscience, The University of Western Ontario, London, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
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38
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Replogle RA, Li Q, Wang L, Zhang M, Fleet JC. Gene-by-diet interactions influence calcium absorption and bone density in mice. J Bone Miner Res 2014; 29:657-65. [PMID: 23955923 PMCID: PMC10591522 DOI: 10.1002/jbmr.2065] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 07/10/2013] [Accepted: 07/29/2013] [Indexed: 12/14/2022]
Abstract
Dietary calcium (Ca) intake is needed to attain peak bone mineral density (BMD). Habitual low Ca intake increases intestinal Ca absorption efficiency to protect bone mass, but the mechanism controlling, and the impact of genetics on, this adaptive response is not clear. We fed 11 genetically diverse inbred mouse lines a normal (0.5%) or low (0.25%) Ca diet from 4 to 12 weeks of age (n = 8 per diet per line) and studied the independent and interacting effects of diet and genetics on Ca and bone metabolism. Significant genetic variation was observed in all bone, renal, and intestinal phenotypes measured including Ca absorption. Also, adaptation of Ca absorption and bone parameters to low dietary Ca was significantly different among the lines. Ca absorption was positively correlated to femur BMD (r = 0.17, p = 0.02), and distal femur bone volume/tissue volume (BV/TV) (r = 0.34, p < 0.0001). Although Ca absorption was correlated to 1,25 dihydroxyvitamin D (1,25(OH)2 D) (r = 0.35, p < 0.0001), the adaptation of Ca absorption to low Ca intake did not correlate to diet-induced adaptation of 1,25(OH)2 D across the 11 lines. Several intestinal proteins have been proposed to mediate Ca absorption: claudins 2 and 12, voltage gated Ca channel v1.3 (Cav1.3), plasma membrane Ca ATPase 1b (PMCA1b), transient receptor potential vanilloid member 6 (TRPV6), and calbindin D9k (CaBPD9k). Only the mRNA levels for TRPV6, CaBPD9k, and PMCA1b were related to Ca absorption (r = 0.42, 0.43, and 0.21, respectively). However, a significant amount of the variation in Ca absorption is not explained by the current model and suggests that novel mechanisms remain to be determined. These observations lay the groundwork for discovery-focused initiatives to identify novel genetic factors controlling gene-by-diet interactions affecting Ca/bone metabolism.
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Affiliation(s)
- Rebecca A Replogle
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Yuan FL, Wang HR, Zhao MD, Yuan W, Cao L, Duan PG, Jiang YQ, Li XL, Dong J. Ovarian cancer G protein-coupled receptor 1 is involved in acid-induced apoptosis of endplate chondrocytes in intervertebral discs. J Bone Miner Res 2014; 29:67-77. [PMID: 23821474 DOI: 10.1002/jbmr.2030] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/12/2013] [Accepted: 06/25/2013] [Indexed: 11/06/2022]
Abstract
Ovarian cancer G protein-coupled receptor 1 (OGR1) has been shown to be a receptor for protons. We investigated the role of proton-sensing G protein-coupled receptors in the apoptosis of endplate chondrocytes induced by extracellular acid. The expression of proton-sensing G protein-coupled receptors was examined in rat lumbar endplate chondrocytes. Knockdown of OGR1 was achieved by transfecting chondrocytes with specific short hairpin RNA (shRNA) for OGR1. Apoptotic changes were evaluated by DNA fragmentation ELISA, electron microscopy, and flow cytometry. Intracellular calcium ([Ca(2+) ]i) was analyzed with laser scanning confocal microscopy. The mechanism of OGR1 in acid-induced apoptosis of endplate chondrocytes was also investigated. We found that OGR1 was predominantly expressed in rat endplate chondrocytes, and its expression was highly upregulated in response to acidosis. Knocking down OGR1 with shRNAs effectively attenuated acid-induced apoptosis of endplate chondrocytes and increased [Ca(2+) ]i. Blocking OGR1-mediated [Ca(2+) ]i elevation inhibited acid-induced calcium-sensitive proteases such as calpain and calcineurin, and also inhibited the activation of Bid, Bad, and Caspase 3 and cleavage of poly (ADP-ribose) polymerase (PARP). OGR1-mediated [Ca(2+) ]i elevation has a crucial role in apoptosis of endplate chondrocytes by regulating activation of calcium-sensitive proteases and their downstream signaling.
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Affiliation(s)
- Feng-Lai Yuan
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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40
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Sanfélix-Gimeno G, Sanfélix-Genovés J, Rodriguez-Bernal CL, Peiró S, Hurtado I. Prevalence, determinants, and inappropriateness of calcium supplementation among men and women in a Spanish Mediterranean area: cross-sectional data from the ESOSVAL cohort. J Bone Miner Res 2013; 28:2286-94. [PMID: 23661631 DOI: 10.1002/jbmr.1977] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/16/2013] [Accepted: 04/26/2013] [Indexed: 11/07/2022]
Abstract
Recently, safety concerns about calcium supplementation have arisen. In this situation, ensuring appropriateness of use is highly important. We aimed to describe the use of calcium and vitamin D supplements, the factors related to it, and to assess the appropriateness of calcium prescription among men and women aged 50 years or older. We performed a cross-sectional study in 2009-2010 including 11,035 adults who belong to the ESOSVAL cohort and attend 272 primary healthcare centers in the Valencia region of Spain. Criteria for the inappropriateness of calcium prescription, based on guidelines and recent evidence, were: excessive or insufficient daily total intake (diet plus supplements), excessive single doses of supplements, excessive or insufficient association with vitamin D, and overall inappropriateness. Calcium and/or vitamin D were prescribed to about 17% of the population. Older age, antiosteoporotic treatment, use of glucocorticoids, and a diagnosis of osteoporosis were related to prescription. The presence of other secondary causes of osteoporosis determined supplementation only in men. Calcium dietary intake was not related to the prescription of supplements. Among calcium users, 85.8% met at least one criterion of inappropriate prescription; 29% had an inappropriate daily total intake mainly resulting from excessive consumption (>2000 mg/day); 53.8% of patients were given calcium supplements in quantities higher than 500 mg per dose; and 38.9% of individuals receiving calcium supplements had inappropriate (absent or below 800 UI/day) vitamin D supplementation (all of them at high risk). In conclusion, we found high inappropriateness of calcium supplementation, mainly because of calcium overdosing, and also to undertreatment and underdosing of vitamin D in high-risk patients. Physicians should be encouraged to assess calcium dietary intakes before supplementation, recommending intake from food whenever possible, and to prescribe low calcium doses and high vitamin D doses when given in fixed-dose combinations, or vitamin D alone when calcium is not necessary.
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Affiliation(s)
- Gabriel Sanfélix-Gimeno
- Center for Public Health Research (CSISP), Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain
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COLLINS EB, NELSON FE, PARMELEE CE. The relation of calcium and other constituents of a defined medium to proliferation of lactic Streptococcus bacteriophage. J Bacteriol 2004; 60:533-42. [PMID: 14794619 PMCID: PMC385917 DOI: 10.1128/jb.60.5.533-542.1950] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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BAYLOR CH, VAN ALSTINE HE, KEUTMANN EH, BASSETT SH. The fate of intravenously administered calcium; effect on urinary calcium and phosphorus, fecal calcium and calcium-phosphorus balance. J Clin Invest 2004; 29:1167-76. [PMID: 14774463 PMCID: PMC436159 DOI: 10.1172/jci102354] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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