Human articular chondrocytes acquire 1,25-(OH)2 vitamin D-3 receptors in culture

Evaluation and comparison of Vitamin D receptors in periodontal ligament tissue of Vitamin D-deficient chronic periodontitis patients before and after supplementation of Vitamin D3

Background:

Vitamin D, an important hormone required by the body, exerts its biological effects through Vitamin D receptors (VDRs) present on target cells. Vitamin D is ineffective in tissues which lack VDR. Various tissues show the presence of VDRs. However, evidence for the presence of VDRs in human periodontal ligament tissue in fully erupted teeth in adults is lacking. The present study intends to evaluate the presence of VDRs in periodontal ligament (PDL) tissue and assess their response to serum Vitamin D3 levels in chronic periodontic patients.

Materials and Methods:

A total of 19 chronic periodontitis patients were enrolled in the study and tested for serum 25(OH)D3 levels. Deficient patients were supplemented with Vitamin D3. PDL tissue of these patients was isolated after tooth extraction before and after supplementation of Vitamin D3 and analyzed for the presence of VDR in PDL tissue by using enzyme-linked immunosorbent assay.

Results:

All the chronic periodontitis patients were found to be deficient in Vitamin D3. The mean serum 25(OH)D3 level before supplementation was 13.96 ng/mL which significantly increased to 35.12 ng/mL after supplementation of Vitamin D3 for 6 weeks. VDR analysis determined mean VDR conc. in PDL tissue to be -1.443 ng/mL, which increased to 2.38 ng/mL after supplementation. A concentration dependent correlation was seen between serum 25(OH)D3 levels and VDR conc. in PDL tissue after supplementation.

Conclusions:

The study determined Vitamin D Receptors (VDR) in PDL tissue after supplementation of Vitamin D. Thus in addition to the standard treatment modalities, Vitamin D3 supplementation would be an important factor for generation of adequate immune response.

Recovery after unilateral knee replacement due to severe osteoarthritis and progression in the contralateral knee: a randomised clinical trial comparing daily 2000 IU versus 800 IU vitamin D

Objective

To test whether daily high-dose vitamin D improves recovery after unilateral total knee replacement.

Methods

Data come from a 24-month randomised, double-blind clinical trial. Adults aged 60 and older undergoing unilateral joint replacement due to severe knee osteoarthritis were 6-8 weeks after surgery randomly assigned to receive daily high-dose (2000 IU) or standard-dose (800 IU) vitamin D₃. The primary endpoints were symptoms (Western Ontario and McMaster Universities Arthritis Index pain and function scores) assessed at baseline, 6, 12, 18 and 24 months in both knees, and the rate of falls over 24 months. The secondary outcomes were sit-to-stand performance, gait speed, physical activity and radiographic progression in the contralateral knee.

Results

We recruited 273 participants, 137 were randomised to receive 2000 IU and 136 were randomised to receive 800 IU vitamin D per day. 2000 IU vitamin D increased 25-hydroxyvitamin D levels to 45.6 ng/mL and 800 IU vitamin D to 37.1 ng/mL at month 24 (p<0.0001). While symptoms improved significantly in the operated knee and remained stable in the contralateral knee over time, none of the primary or secondary endpoints differed by treatment group over time. The rate of falls over 24 months was 1.05 with 2000 IU and 1.07 with 800 IU (p=0.84). 30.5% of participants in the 2000 IU and 31.3% of participants in the 800 IU group had radiographic progression in the contralateral knee over 24 months (p=0.88).

Conclusions

Our findings suggest that a 24-month treatment with daily 2000 IU vitamin D did not show greater benefits or harm than a daily standard dose of 800 IU among older adults undergoing unilateral total knee replacement.

Co-expression of 1α-hydroxylase and vitamin D receptor in human articular chondrocytes

BACKGROUND

The aim was to investigate whether resident chondrocytes in human articular cartilage and in subculture express vitamin D receptor (VDR) and the enzyme that hydroxylates the prohormone 25(OH)D₃ to the active hormone 1α,25(OH)₂D₃, namely 1α-hydroxylase (CYP27B1). Any putative effects of vitamin D on chondrocytes were also explored.

METHODS

Cartilage from human osteoarthritic knee joints, cultured chondrocytes and cells grown in 3D spheroids were examined for the expression of VDR and 1α-hydroxylase by PCR, Western blots and immunolabelling. Receptor engagement was judged by visualizing nuclear translocation. The effects of 25(OH)D₃ and 1α,25(OH)₂D₃ on chondrocyte functions were assessed in proliferation-, chondrogenesis- and cartilage signature-gene expression assays. The capability of chondrocytes to hydroxylate 25(OH)D₃ was determined by measuring the concentration of metabolites. Finally, a putative regulation of receptor and enzyme expression by 1α,25(OH)₂D₃ or interleukin (IL)-1β, was investigated by Western blot.

RESULTS

Gene expression was positive for VDR in freshly isolated cells from native cartilage, cells subcultured in monolayers and in spheroids, whereas protein expression, otherwise judged low, was apparent in monolayers. Nuclear translocation of VDR occurred upon 1α,25(OH)₂D₃ treatment. Transcripts for 1α-hydroxylase were detected in freshly isolated cells, cultured cells and spheroids. Western blots and immunolabelling detected 1α-hydroxylase protein in all materials, while staining of tissue appeared confined to cells at the superficial layer. A dose-dependent 1α,25(OH)₂D₃ production was measured when the enzyme substrate was supplied to cell cultures. Western blots revealed that the VDR, but not 1α-hydroxylase, was induced by IL-1β treatment in adherent cells. Proliferation in monolayers was enhanced by both 25(OH)D₃ and 1α,25(OH)₂D₃, and both compounds had negative effects on chondrogenesis and cartilage-matrix genes.

CONCLUSIONS

VDR expression in resident cartilage chondrocytes, generally considered differentiated cells, is elusive. A similar pattern applies for redifferentiated chondrocytes in spheroid cultures, whereas dedifferentiated cells, established in monolayers, stably express VDR. Both 25(OH)D₃ and 1α,25(OH)₂D₃ are able to potentiate cell proliferation but have a negative impact in proteoglycan synthesis. Chondrocytes express 1α-hydroxylase and may contribute to the production of 1α,25(OH)₂D₃ into the joint environment. Effects of vitamin D could be unfavourable in the context of cartilage matrix synthesis.

Vitamin D in liver disease: Current evidence and potential directions

Consistent with its multifaceted nature, growing evidence links vitamin D with hepatic disease. In this review, we summarise the roles of vitamin D in different liver pathologies and explore the clinical utility of vitamin D-based treatments in hepatology. We find that the small number of clinical trials coupled with the profound heterogeneity of study protocols limits the strength of evidence needed to ascribe definite clinical value to the hormone in liver disease. Nevertheless, the experimental data is promising and further bench and bedside studies will likely define a clearer role in hepatic therapeutics.

Vitamin D, muscle and bone: Integrating effects in development, aging and injury

Beyond the established effects of muscle loading on bone, a complex network of hormones and growth factors integrates these adjacent tissues. One such hormone, vitamin D, exerts broad-ranging effects in muscle and bone calcium handling, differentiation and development. Vitamin D also modulates muscle and bone-derived hormones, potentially facilitating cross-talk between these tissues. In the clinical setting, vitamin D deficiency or mutations of the vitamin D receptor result in generalized atrophy of muscle and bone, suggesting coordinated effects of vitamin D at these sites. In this review, we discuss emerging evidence that vitamin D exerts specific effects throughout the life of the musculoskeletal system - in development, aging and injury. From this holistic viewpoint, we offer new insights into an old debate: whether vitamin D's effects in the musculoskeletal system are direct via local VDR signals or indirect via its systemic effects in calcium and phosphate homeostasis.

The vitamin D receptor (VDR) is expressed in skeletal muscle of male mice and modulates 25-hydroxyvitamin D (25OHD) uptake in myofibers

Vitamin D deficiency is associated with a range of muscle disorders, including myalgia, muscle weakness, and falls. In humans, polymorphisms of the vitamin D receptor (VDR) gene are associated with variations in muscle strength, and in mice, genetic ablation of VDR results in muscle fiber atrophy and motor deficits. However, mechanisms by which VDR regulates muscle function and morphology remain unclear. A crucial question is whether VDR is expressed in skeletal muscle and directly alters muscle physiology. Using PCR, Western blotting, and immunohistochemistry (VDR-D6 antibody), we detected VDR in murine quadriceps muscle. Detection by Western blotting was dependent on the use of hyperosmolar lysis buffer. Levels of VDR in muscle were low compared with duodenum and dropped progressively with age. Two in vitro models, C2C12 and primary myotubes, displayed dose- and time-dependent increases in expression of both VDR and its target gene CYP24A1 after 1,25(OH)2D (1,25 dihydroxyvitamin D) treatment. Primary myotubes also expressed functional CYP27B1 as demonstrated by luciferase reporter studies, supporting an autoregulatory vitamin D-endocrine system in muscle. Myofibers isolated from mice retained tritiated 25-hydroxyvitamin D3, and this increased after 3 hours of pretreatment with 1,25(OH)2D (0.1 nM). No such response was seen in myofibers from VDR knockout mice. In summary, VDR is expressed in skeletal muscle, and vitamin D regulates gene expression and modulates ligand-dependent uptake of 25-hydroxyvitamin D3 in primary myofibers.

Where is the vitamin D receptor?

The vitamin D receptor (VDR) is a member of the nuclear receptor superfamily and plays a central role in the biological actions of vitamin D. VDR regulates the expression of numerous genes involved in calcium/phosphate homeostasis, cellular proliferation and differentiation, and immune response, largely in a ligand-dependent manner. To understand the global function of the vitamin D system in physiopathological processes, great effort has been devoted to the detection of VDR in various tissues and cells, many of which have been identified as vitamin D targets. This review focuses on the tissue- and cell type-specific distribution of VDR throughout the body.

Osteoarthritis and osteoporosis in postmenopausal women: clinical similarities and differences

Osteoarthritis and osteoporosis are two major health problems affecting more than 60% of post-menopausal women in the United States. The promotion of healthy aging and the prevention and reduction of morbidity and mortality is a main concern for healthcare providers. The similarities and differences in pathophysiology, diagnosis, and treatment for osteoarthritis and osteoporosis are often not clear for clinicians. Some osteoporosis treatments, including bisphosphonates and vitamin D, seem to have a beneficial effect on osteoarthritis as well. A review of these two conditions in terms of bone mineral density, bone turnover, hormonal effects, and treatment options will be discussed.

The role of bone metabolism in osteoarthritis

Bone is not structurally normal in osteoarthritis (OA). Periarticular bone in OA has increased turnover, decreased bone mineral content and stiffness, and decreased trabecular numbers. The increased turnover of collagen, in particular, may affect the biomechanical competence of bone and is driven by a number of processes, including osteoblast phenotypic expression, chondrocyte apoptosis, matrix metalloproteinases, and growth factors. This turnover is reflected in alterations in biomarkers and bone mineral density (BMD). High BMD at non-joint sites is associated with an increased risk of OA; however, low BMD and high bone turnover appears to be associated with more rapid progression. These alterations in bone turnover offer new therapeutic opportunities.

Comparative morphological and biochemical analysis of hypertrophic, non-hypertrophic and 1,25(OH)2D3 treated non-hypertrophic chondrocytes

A comparative study of Type X collagen expression, chondrocyte morphology, and the expression of two genes controlling chondrocyte morphology (beta-actin and fibronectin) was carried out on chondrocytes derived from a tissue that remains as permanent hyaline cartilage in vivo (embryonic chicken caudal sterna), from a tissue that undergoes endochondral replacement (embryonic chicken ventral vertebrae) and caudal sternal chondrocytes treated with 1,25(OH)2D3. Under identical in vitro growth conditions and times, sternal chondrocytes grew as rounded non-adherent cells, and vertebral chondrocytes grew as adherent polygonal cells. Upon treatment with 10(-8) M 1,25(OH)2D3 over a twelve day period the sternal chondrocytes showed complete adherence and took on an identical appearance as the vertebral chondrocytes. Cellular adherence of both vertebral and 1,25(OH)2D3 treated sternal chondrocytes was associated with 10 X increased beta-actin, fibronectin and their corresponding mRNA's. Changes in connective tissue expression were observed with altered cellular morphology. Total collagen synthesis was 35-50% lower in both hormone treated and vertebral chondrocytes. Type II collagen was the major collagen type produced by all chondrocyte cultures; however, in both vertebral and 1,25(OH)2D3 treated sternal chondrocytes, a 60 kD collagenous protein was identified. This short chain collagen was determined to be Type X collagen based on its molecular weight and its CNBr peptide maps. Analysis of Type X mRNA levels using a 33 base pair anti sense oligonucleotide sequence to Type X, demonstrated that vertebral cells showed six to seven times more mRNA than sternal chondrocytes. However, the low mRNA levels of type X mRNA in sternal chondrocytes were increased two to three times by 1,25(OH)2D3 treatment. These studies demonstrate that the steroid hormone 1,25(OH)2 vitamin D3 induced morphological, biochemical and molecular changes indicative of chondrocyte maturation from a hyaline to a more hypertrophic phenotype.