A biochemical model for the ionic control of 25-hydroxyvitamin D3 1alpha-hydroxylase

Simulated acidosis does not impair 1,25-dihydroxyvitamin D3 production by cultured kidney cells

Cultured mouse kidney cells grown in serum-free medium were used to assess the metabolism of 25-hydroxyvitamin D3 in the presence of simulated metabolic acidosis. Kidney epithelial cells isolated from 4-6 week old mice were grown to confluence in a defined serum-free medium at pH 7.4. The confluent monolayers were incubated with tritiated 25-hydroxyvitamin D3 for 6 hours, the samples were extracted, and vitamin D metabolites were separated and quantitated by high pressure liquid chromatography (HPLC). The pH of the incubation medium was set at 6.9, 7.1, 7.4, or 7.7 by adjusting the bicarbonate concentration, using chloride as the balancing anion at constant Pco2. When pH was altered at the beginning of the 6 hour assay, production of 1,25-dihydroxyvitamin D3 was the same at each pH. More prolonged pH perturbation for a total of 30 hours likewise had no influence on 1,25-dihydroxyvitamin D3 production. These results confirm that intact mammalian kidney cells in serum-free culture possess an active 25-hydroxyvitamin D3-1-hydroxylase and that the activity of the enzyme is unaffected by pH over the range 6.8-7.7. In experiments where acidosis has been shown to alter 1,25-dihydroxyvitamin D3 production, the mechanism was probably indirect.

Effect of dietary acid and calcium on 25-hydroxyvitamin D metabolism by chick kidney

Studies of the effects of acidosis and dietary calcium on 25-hydroxyvitamin D3 (25OHD3) metabolism were conducted utilizing assays of mitochondrial 1-hydroxylase and 24-hydroxylase activity following 96 hours of acid loading. The results showed decreased 1-hydroxylase (206 +/- 6 vs. 132 +/- 22 fmol min-1 mg/mitochondrial protein-1, p less than 0.01), augmented 24-hydroxylase (48 +/- 14 vs. 180 +/- 30 fmol min-1 mg-1, p less than 0.001) and increments in plasma calcium and phosphate following acidosis. High calcium diet also increased 24-hydroxylase activity (48 +/- 14 vs. 160 +/- 24 fmol min-1 mg-1, p less than 0.001) and plasma calcium, but decreased plasma phosphate. The extramitochondrial concentrations of calcium, potassium, and phosphate which maximally stimulated the hydroxylases in vitro were not altered by the in vivo dietary perturbations. The increments in 1-hydroxylase and 24-hydroxylase resulting from the presence of calcium, potassium, or phosphate in optimal concentrations (10(-5) M, 100 mM, and 100 mM, respectively) were changed by both acid loading and high calcium diet, decreasing in the case of 1-hydroxylase and increasing in that of 24-hydroxylase. The data indicate that the suppression of 1-hydroxylase and augmentation of 24-hydroxylase following these dietary perturbations may depend on both changed total enzyme capacity and altered enzyme sensitivity to extramitochondrial ions and are consistent with mediation by calcium of the effects of acidosis.

Metabolic degradation and synthesis of calcitriol in spontaneously hypertensive rat

Plasma calcitriol concentration is unexpectedly low in spontaneously hypertensive rats (SHR) compared with normotensive Wistar-Kyoto rats (WKY) in view of previous findings of low plasma ionized calcium, hypophosphatemia, and hyperparathyroidism in SHR. Also, parathyroid hormone (PTH) and other exogenous stimuli cause a smaller increment in plasma calcitriol in SHR than in WKY. We investigated whether these differences in plasma calcitriol levels were due to decreased production rate (PR) or increased metabolic clearance rate (MCR) in SHR using the continuous infusion-isotope equilibration technique. In the basal state, MCR was 0.306 +/- 0.048 ml X min-1 X kg-1 in SHR and 0.284 +/- 0.026 ml X min-1 X kg-1 in WKY (P = NS). Estimated PR was lower in SHR (22.7 vs. 33.7 ng X day-1 X kg-1). With PTH infusion (3 U X h-1 X 100 g-1 for 20 h), MCR was 0.220 +/- 0.011 ml X min-1 X kg-1 in SHR and 0.256 +/- 0.017 ml X min-1 X kg-1 in WKY (P = NS). Measured PR was markedly lower in SHR (154 +/- 24 vs. 262 +/- 27 ng X day-1 X kg-1; P less than 0.02). Basal plasma PTH, total plasma calcium, and plasma inorganic phosphate were not different between SHR and WKY. Thus, SHR show diminished calcitriol production under basal condition and with PTH stimulation. MCR is not increased in SHR and does not appear to be influenced by PTH or the accompanying elevation in plasma calcium and calcitriol.

Uniformity and diversity of calcium metabolism in hypertension. A conceptual framework

Calcium metabolism plays an important role in blood pressure homeostasis, although it remains unclear to what extent calcium contributes to or, alternatively, protects against clinical hypertension. To resolve this confusion, hypertensive subgroups were first defined by plasma renin activity, dietary salt sensitivity, sensitivity to calcium channel blockade, and calcium metabolic indices. Using these classification schemes, different patterns of calcium metabolism emerged, each predictive of divergent clinical responses. Patients with low plasma renin activity, low serum ionized calcium levels, and dietary salt sensitivity, such as black and elderly hypertensive patients, may preferentially benefit from calcium supplementation. It is postulated that calcium-regulating hormones and the renin-angiotensin-aldosterone system coordinately monitor dietary mineral intake, and transduce these environmental signals at the cellular level by altering cellular calcium uptake and disposition. Analysis of these hormonal systems is useful diagnostically in defining those patients who would most benefit from non-pharmacologic dietary forms of treatment.

Calcium metabolism, renin activity, and the antihypertensive effects of calcium channel blockade

Although abnormalities of calcium metabolism have been described in various hypertensive states, the specific manner in which these abnormalities contribute to the increased pressure remains unclear. Our own group, in attempting to resolve the seemingly contradictory evidence thus far obtained, has adopted an approach emphasizing the clinical as well as biochemical heterogeneity among hypertensive subjects. We have observed the following: broad-based deviations of calcium ionic and hormonal indices in patients with essential hypertension; these deviations are linked with concurrent deviations in the renin-aldosterone system. Thus, low-renin subjects exhibit a calcium ionic and hormonal profile suggestive of calcium deficiency, whereas high-renin subjects have an opposite metabolic profile suggestive of calcium excess; blood pressure responses to dietary salt loading may also differ among renin subgroups of essential hypertension and may be mediated by salt-induced alterations of calcium metabolism. In the absence of these alterations, dietary salt intake results in little or no change in blood pressure; and calcium as a dietary supplement may itself possess antihypertensive properties in targeted subgroups of essential hypertensive patients, preferentially in low-renin, lower ionized calcium subjects. Interestingly, calcium channel blockade also preferentially lowers pressure in low-renin, lower serum ionized calcium forms of hypertension and may define those subjects whose elevated pressure is most dependent on extracellular calcium. Conversely, renin profiling or serum ionized calcium measurements may be used clinically to help target subjects most likely to benefit from calcium channel antagonists. Lastly, unlike other antihypertensive drug classes, high salt intake does not blunt, and may even enhance, the hypotensive effects of calcium channel blockade, lessening the need for stringent dietary recommendations. Altogether, these heterogeneous alterations of calcium metabolism in essential hypertension suggest that the linkage between the regulation of calcium metabolism, renin system activity, and blood pressure in essential hypertension is of pathophysiologic as well as therapeutic relevance.

Vitamin D and skeletal tissues

It is now accepted that vitamin D is an integral part of a complex endocrine system, one with far-reaching implications in mineral metabolism. Reviews of the sources, functions and metabolism of vitamin D, as currently understood, are presented as a prelude to discussions of the role of vitamin D in calcium and phosphorous homeostatis and possible specific roles for vitamin D in mineralized tissues. Data describing a possible regulatory function for vitamin D in bone and bone protein metabolism are presented. Some of the controversy which presently exists regarding the biochemical mechanism of the action of this vitamin is discussed. Finally, the possible relationship of vitamin D and disorders of skeletal tissues is described.

Studies of the chick renal mitochondrial 25-hydroxyvitamin D-3 24-hydroxylase

The vitamin D metabolite, 24,25-dihydroxyvitamin D-3, is made from 25-hydroxyvitamin D-3 by an enzyme (25-hydroxyvitamin D-3 24-hydroxylase) located in the renal mitochondria of vitamin D and calcium-replete chicks. The apparent Km for 25-hydroxyvitamin D-3 for this reaction was found to be 3 x 10(-7) M, although simple Michaelis-Menten kinetics were not observed at the higher substrate concentrations. Enzymatic activity was reduced by the mitochondrial metabolic inhibitors, antimycin A and dinitrophenol, as well as the inhibitors of mixed function oxidases, 2,4-dichloro-6-phenylphenoxyethylamine, 2-diethylaminoethyl-2,2-diphenylvalerate and metyrapone. Increasing the calcium concentration from 0 to 1 x 10(-5) M or the potassium concentration from 0 to 50 mM stimulated enzymatic activity 4- to 8-fold. Increasing the phosphate or acetate concentration from 0 to 50 mM stimulated enzymatic activity 6-fold. Raising the CO2/HCO3(-) content from 0/0 to 10%/10 mM stimulated enzymatic activity 5-fold. The effects of the cations were additive to those of the anions except in the presence of 50 mM phosphate or acetate. The effect of ions on 24,25-hydroxyvitamin D-3 production by renal mitochondria from vitamin D-replete chicks resembles the effect of these ions on production of 1,25-dihydroxyvitamin D-3 by renal mitochondria from vitamin D-deficient chicks, suggesting that the same mechanisms may be utilized.