BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcome...BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcomes”clinical practice guidelines recommend PTH levels be maintained in the range of two to nine times of the upper normal limit.Maintaining this balance is critical to prevent renal osteodystrophy.When the severity of hyperparathyroidism exceeds the recommended limits,vitamin D receptor agonists may be used for lowering PTH levels.Paricalcitol,as a biologically active vitamin D analog,is a selective activator of vitamin D responsive pathways.Both calcitriol and paricalcitol can be used as PTHlowering agents.There is conflicting data about their comparative effectiveness for controlling hyperparathyroidism in patients undergoing hemodialysis and a meta-analysis revealed no differences between the two.AIM To give real world data comparing paricalcitol and calcitriol as PTH-lowering agents in patients undergoing hemodialysis.METHODS Patients undergoing hemodialysis whose PTH levels exceeded nine times of the upper normal limit were enrolled in the study.Depending on patient preferences,they were either given calcitriol or paricalcitol.Intravenous calcitriol was given 2μg at the end of each dialysis sessions,and intravenous paricalcitol was administered as 5μg twice per week.Demographic data,calcium-phosphorus levels,change in PTH levels in 6 months,and ratios of 25%and 50%reductions in PTH levels were compared between the two groups.RESULTS A total of 21 patients were enrolled in this comparative study,eight patients received paricalcitol and 13 were prescribed calcitriol.A 50%reduction in PTH levels could be achieved in five patients in the paricalcitol group(62.5%);only one patient in the calcitriol group achieved the same reduction(7.6%).The difference was statistically significant(P=0.014).However,there was no difference in the ratio of patients who had a 25%reduction in PTH levels(87.5%vs 38.4%;P=0.067).PTH levels could be maintained in the targeted range in 87.5%of the patients in the paricalcitol group and in 69.2%of the patients in the calcitriol group(P=0.36).However,PTH could be better suppressed under paricalcitol.Clinically important hyperphosphatemia or hypercalcemia was not observed in either the paricalcitol or the calcitriol groups.CONCLUSION Although the PTH lowering effect of paricalcitol is stronger than calcitriol,both may help maintain PTH levels in the targeted range.Paricalcitol may be preferred for patients who have very high levels of PTH because it seems to cause a faster decline.Calcitriol may be preferred for a slower and limited decline.Prospective further studies with larger samples may be needed for a better comparison.展开更多
Objective:To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism(SHPT).Methods:Eighty-nine patients with SHPT who visited t...Objective:To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism(SHPT).Methods:Eighty-nine patients with SHPT who visited the hospital from February 2023 to February 2025 were included in the study.They were divided into an observation group(n=45)and a control group(n=44)using a random number table method.The observation group received calcitriol combined with low-calcium dialysate treatment,while the control group received calcitriol combined with conventional dialysate treatment.The differences in intact parathyroid hormone(iPTH),calcium and phosphorus metabolism indicators,renal function indicators,and adverse reaction rates were compared and evaluated before and after treatment between the two groups.Results:Compared with before treatment,the levels of iPTH,serum phosphorus,and calcium-phosphorus product were significantly reduced in both groups after treatment,and the observation group had lower levels than the control group(P<0.05).Additionally,the blood calcium levels in both groups increased compared to before treatment,and the observation group had higher levels than the control group(P<0.05).After intervention,there was no statistically significant difference in renal function indicators between the two groups(P>0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The combination of calcitriol and low-calcium dialysate for the treatment of SHPT can effectively reduce the levels of iPTH,serum phosphorus,and calcium-phosphorus product,increase blood calcium levels,and has a low incidence of adverse reactions.It has no significant effect on renal function and is a safe and effective treatment method.展开更多
AIM: To investigate the effects of ZK1916784, a low calcemic analog of calcitriol on intestinal inflammation. METHODS: Acute and chronic colitis was induced by dextran sodium sulfate (DSS) according to standard proced...AIM: To investigate the effects of ZK1916784, a low calcemic analog of calcitriol on intestinal inflammation. METHODS: Acute and chronic colitis was induced by dextran sodium sulfate (DSS) according to standard procedures. Mice were treated intraperitoneally with ZK1916784 or placebo and colonic inflammation was evaluated. Cytokine production by mesenterial lymph node (MLN) cells was measured by ELISA. Immunohistochemistry was performed to detect intestinal dendritic cells (DCs) within the colonic tissue, and the effect of the calcitriol analog on DCs was investigated. RESULTS: Treatment with ZK191784 resulted in significant amelioration of disease with a reduced histological score in acute and chronic intestinal inflammation. In animals with acute DSS colitis, down- regulation of colonic inflammation was associated with a dramatic reduction in the secretion of the proinflammatory cytokine interferon (IFN)-γ and a significant increase in intereleukin (IL)-10 by MLN cells. Similarly, in chronic colitis, IL-10 expression in colonic tissue increased 1.4-fold when mice were treated with ZK191784, whereas expression of the Th1-specific transcription factor T-beta decreased by 81.6%. Lower numbers of infiltrating activated CD11c+ DCs were found in the colon in ZK191784-treated mice with acute DSScolitis, and secretion of proinflammatory cytokines by primary mucosal DCs was inhibited in the presence of the calcitriol analog. CONCLUSION: The calcitriol analog ZK191784 demonstrated significant anti-inflammatory properties in experimental colitis that were at least partially mediated by the immunosuppressive effects of the derivate on mucosal DCs.展开更多
Solid dispersion of calcitriol with lipophilic surfactants and triglycerides was developed by melt-mixing method to modify the release and enhance stability of the drug.The solid dispersions were characterized by diff...Solid dispersion of calcitriol with lipophilic surfactants and triglycerides was developed by melt-mixing method to modify the release and enhance stability of the drug.The solid dispersions were characterized by differential scanning calorimetry(DSC),hot stage polarized optical microscopy(HSPM),infrared spectroscopy(FTIR)and stability studies.The solid dispersion significantly enhanced the stability of calcitriol,which could be attributed to the high antioxidant activity of the solid lipid dispersion.The rapid dissolution rate from the solid dispersion was attributed to the amorphous or solid solution state of drug with improved specific surface area and wettability than the drug crystals.Therefore,solid dispersion of calcitriol with D-a-tocopheryl polyethylene glycol 1000 succinate(TPGS)offers a good approach to modify the release and enhance stability of calcitriol.The influence of lipophilic solid dispersion on drug bioavailability needs further investigation.展开更多
Back ground: There are no published clinical data in hemodialysis (HD) patients with mineral bone disorder (CKD-MBD) regarding the effect of sevelamer hydrochloride on the absorption of the oral calcitriol. Objectives...Back ground: There are no published clinical data in hemodialysis (HD) patients with mineral bone disorder (CKD-MBD) regarding the effect of sevelamer hydrochloride on the absorption of the oral calcitriol. Objectives: The aim of the present study was to determine the association of the sevelamer hydrochloride and serum 1-25(OH)2D concentration during oral calcitriol therapy. Methods: This was a before-and-after study in HD patients. Forty-six patients co-administered with phosphate-binder and calcitriol for CKD-MBD therapy took lanthanum carbonate (LC) and sevelamer hydrochloride (SH) for 4 weeks, respectively with calcitriol. The serum 1-25(OH)2D concentration was assessed after each period. Results: Serum 1-25(OH)2D concentration was significantly reduced with co-administration of SH compared to LH (mean, calcitriol with LC→SH: 19.9 pg/ml → 14.2 pg/ml, p 2D concentrations after oral calcitriol administration compared to LH in HD patients. When we use SH as a phosphate binder with calcitriol for HD patients with CKD-MBD, we should consider the inhibitory effect of SH on oral calcitriol absorption.展开更多
BACKGROUND Hepatic fibrosis is a serious condition,and the development of hepatic fibrosis can lead to a series of complications.However,the pathogenesis of hepatic fibrosis remains unclear,and effective therapy optio...BACKGROUND Hepatic fibrosis is a serious condition,and the development of hepatic fibrosis can lead to a series of complications.However,the pathogenesis of hepatic fibrosis remains unclear,and effective therapy options are still lacking.Our group identified hepatitis C virus nonstructural protein 3-transactivated protein 1(NS3TP1) by suppressive subtractive hybridization and bioinformatics analysis,but its role in diseases including hepatic fibrosis remains undefined.Therefore,additional studies on the function of NS3TP1 in hepatic fibrosis are urgently needed to provide new targets for treatment.AIM To elucidate the mechanism of NS3TP1 in hepatic fibrosis and the regulatory effects of calcitriol on NS3TP1.METHODS Twenty-four male C57BL/6 mice were randomized and separated into three groups,comprising the normal,fibrosis,and calcitriol treatment groups,and liver fibrosis was modeled by carbon tetrachloride(CCl4).To evaluate the level of hepatic fibrosis in every group,serological and pathological examinations of the liver were conducted.TGF-β1 was administered to boost the in vitro cultivation of LX-2 cells.NS3TP1,α-smooth muscle actin(α-SMA),collagen I,and collagen Ⅲ in every group were examined using a Western blot and real-time quantitative polymerase chain reaction.The activity of the transforming growth factor beta 1(TGFβ1)/Smad3 and NF-κB signaling pathways in each group of cells transfected with pcDNA-NS3TP1 or siRNA-NS3TP1 was detected.The statistical analysis of the data was performed using the Student’s t test.RESULTS NS3TP1 promoted the activation,proliferation,and differentiation of hepatic stellate cells(HSCs)and enhanced hepatic fibrosis via the TGFβ1/Smad3 and NF-κB signaling pathways,as evidenced by the presence of α-SMA,collagen I,collagen Ⅲ,p-smad3,and p-p65 in LX-2 cells,which were upregulated after NS3TP1 overexpression and downregulated after NS3TP1 interference.The proliferation of HSCs was lowered after NS3TP1 interference and elevated after NS3TP1 overexpression,as shown by the luciferase assay.NS3TP1 inhibited the apoptosis of HSCs.Moreover,both Smad3 and p65 could bind to NS3TP1,and p65 increased the promoter activity of NS3TP1,while NS3TP1 increased the promoter activity of TGFβ1 receptor I,as indicated by coimmunoprecipitation and luciferase assay results.Both in vivo and in vitro,treatment with calcitriol dramatically reduced the expression of NS3TP1.Calcitriol therapy-controlled HSCs activation,proliferation,and differentiation and substantially suppressed CCl4-induced hepatic fibrosis in mice.Furthermore,calcitriol modulated the activities of the above signaling pathways via downregulation of NS3TP1.CONCLUSION Our results suggest that calcitriol may be employed as an adjuvant therapy for hepatic fibrosis and that NS3TP1 is a unique,prospective therapeutic target in hepatic fibrosis.展开更多
Background:Capacitation is a set of physiological changes sperms undergo to acquire fertilizing capacity.In vivo,this process is directly associated with high calcium levels in sperm cytoplasm.Calcitriol,the vitamin D...Background:Capacitation is a set of physiological changes sperms undergo to acquire fertilizing capacity.In vivo,this process is directly associated with high calcium levels in sperm cytoplasm.Calcitriol,the vitamin D hypercalcemic metabolite,is related to human sperm motility,capacitation,and acrosome reaction.This work aimed to study the effect of calcitriol on bull sperm quality parameters and capacitation.Methods:One million freezethawed spermatozoa were obtained from different bulls and treated with 20 nM of calcitriol for 30 min.Untreated cells(negative control)and treated ones with calcitriol or heparin(100μg/mL,positive capacitation control)were evaluated for motility,viability,and functional parameters.Menadione(70μM,30 min)treatment was included as a reactive oxygen species(ROS)positive sperm agent.Results:The results elucidated that sperm exposed to 20 nM calcitriol showed higher viability,vigor,and capacitation than their positive and negative controls.The percentage of sperm with intact plasma and acrosome membranes,mitochondrial membrane potential(ΔΨm),and phosphatidylserine externalization was similar in all the conditions evaluated,while ROS production was higher with heparin and menadione-treated groups than the calcitriol group or negative control.Conclusion:Our results indicate that calcitriol induces the capacitation of thawed bull spermatozoa and maintains acceptable values of progressive motility,viability,and vigor without altering key biological parameters such as redox status,ΔΨm,and cell death.展开更多
BACKGROUND Calcitriol-induced hypercalcemia has been rarely reported in cases of lung cancer;however,it is frequently reported in cases of lymphoid malignancy and granulomatous disease.We present a rare case of hyperc...BACKGROUND Calcitriol-induced hypercalcemia has been rarely reported in cases of lung cancer;however,it is frequently reported in cases of lymphoid malignancy and granulomatous disease.We present a rare case of hypercalcemia associated with squamous cell cancer of the lung with elevated calcitriol level.CASE SUMMARY A 61-year-old Caucasian female with severe hypercalcemia of 15 mg/dL,which led to a new diagnosis of metastatic lung cancer.Since the parathyroid hormonerelated peptide(PTHrP)level was minimally elevated at 2.1 pmol/L,we believe excessive calcitriol production by tumor cells was the underlying mechanism for hypercalcemia.Calcitriol was significantly elevated at 130 pg/mL with a low 25-hydroxyvitamin D level of 25.9 ng/mL and suppressed PTH level of 8 pg/mL.Corticosteroids are generally used to treat calcitriol-induced hypercalcemia,but we successfully treated our patient with bisphosphonate,highlighting the further utility of bisphosphonates in hypercalcemia treatment.CONCLUSION We believe that the underlying cause of hypercalcemia,in this case of metastatic squamous cell lung carcinoma,was elevated calcitriol,which was likely produced by the tumor cells.In addition to PTHrP,calcitriol levels should be included in the workup for hypercalcemia in cases of lung cancer.However,the pathophysiology and prognostic significance of dysregulated calcitriol production in solid tumors remain unclear and warrant further research.Bisphosphonate may be used as a steroid-sparing therapy even in cases of calcitriol-induced hypercalcemia and warrants further investigation.展开更多
Objective:To investigate calcitriol, cinacalcet plus comprehensive intervention on maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT) calcium (Ca), phosphorus (P) metabolism and parathyr...Objective:To investigate calcitriol, cinacalcet plus comprehensive intervention on maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT) calcium (Ca), phosphorus (P) metabolism and parathyroid hormone (PTH) effect.Methods: A total of 80 cases of patients with SHPT from January 2014 to January 2016 in our hospital were randomly divided into observation group and control group, control group to eat the whole piece of cinacalcet hydrochloride oral tablets, the initial dose of 25 mg/d, every 2 to 4 weeks, according to Ca×P, parathyroid hormone (iPTH) test results adjust the dose, the maximum dose of not more than 75 mg/d, the observation group in the control group on the basis of oral administration of Calcitriol Soft Capsules 0.25 g/d, 3 times/week, 2 groups were given comprehensive intervention measures, to evaluate the curative effect after 3 months of treatment. The 2 groups before and after treatment collected fasting peripheral venous blood, the determination of Ca, P and alkaline phosphatase by colorimetric method (ALP), Ca, P product calculation (Ca×P), to detect the level of iPTH before and after treatment by ELISA method;TY-6858-HI type ultrasound instrument, measuring length, width and thickness of the parathyroid glands, and calculate the parathyroid gland volume.Results:in the observation group after treatment, Ca, Ca×P increased degree, P, ALP, iPTH lower than the control group, the size of the parathyroid gland was better than the control group.Conclusion:calcitriol, cinacalcet combined intervention therapy has good clinical effect in patients with MHD SHPT, Ca, P can effectively improve the metabolism, reduce the level of iPTH, reduce the parathyroid gland volume is worthy of promotion.展开更多
Background:Colorectal cancer(CRC)is one of the most malignant tumorswith high incidence,yet its molecular mechanism is not fully understood,hindering the development of targeted therapy.Metabolic abnormalities are a h...Background:Colorectal cancer(CRC)is one of the most malignant tumorswith high incidence,yet its molecular mechanism is not fully understood,hindering the development of targeted therapy.Metabolic abnormalities are a hallmark of cancer.Targeting dysregulated metabolic features has become an important direction for modern anticancer therapy.In this study,we aimed to identify a new metabolic enzyme that promotes proliferation of CRC and to examine the related molecular mechanisms.Methods:We performed RNA sequencing and tissue microarray analyses of human CRC samples to identify new genes involved in CRC.Squalene epoxidase(SQLE)was identified to be highly upregulated in CRC patients.The regulatory function of SQLE in CRC progression and the therapeutic effect of SQLE inhibitors were determined by measuring CRC cell viability,colony and organoid formation,intracellular cholesterol concentration and xenograft tumor growth.Themolecularmechanism of SQLE functionwas explored by combining transcriptome and untargeted metabolomics analysis.Western blotting and realtime PCR were used to assess MAPK signaling activation by SQLE.Results:SQLE-related control of cholesterol biosynthesis was highly upregulated in CRC patients and associated with poor prognosis.SQLE promoted CRC growth in vitro and in vivo.Inhibition of SQLE reduced the levels of calcitriol(active form of vitamin D3)and CYP24A1,followed by an increase in intracellular Ca2+concentration.Subsequently,MAPK signaling was suppressed,resulting in the inhibition of CRC cell growth.Consistently,terbinafine,an SQLE inhibitor,suppressed CRC cell proliferation and organoid and xenograft tumor growth.Conclusions:Our findings demonstrate that SQLE promotes CRC through the accumulation of calcitriol and stimulation of CYP24A1-mediated MAPK signaling,highlighting SQLE as a potential therapeutic target for CRC treatment.展开更多
This study was aimed to investigate the effects of dietary calcitriol or quercetin supplementation on eggshell and bone quality of laying hens.In trial 1,72 Hy-Line Brown layers(80-week-old)with weak-shelled strength(...This study was aimed to investigate the effects of dietary calcitriol or quercetin supplementation on eggshell and bone quality of laying hens.In trial 1,72 Hy-Line Brown layers(80-week-old)with weak-shelled strength(25 to 30 N)were assigned into 4 dietary treatments with 6 replicates of 3 birds and fed a basal diet(4%calcium level)or basal diets supplemented with 0.5%calcium,5μg/kg calcitriol or 500 mg/kg quercetin for 4 weeks.In trial 2,360 Hy-Line Brown layers(60-week-old)were divided into 3 groups with 8 replicates of 15 birds:control group(basal diet),calcitriol group(basal diet+5μg/kg calcitriol),and quercetin group(basal diet+500 mg/kg quercetin).This trial lasted for 12 weeks.The results showed that dietary calcitriol or quercetin improved eggshell quality in both trials(P<0.05).In trial 2,compared with the control group,both calcitriol and quercetin supplementations improved femoral bone quality,calcium retention of hens and calcium content in uterine fluid at 18.5 h post-oviposition(PO)(P<0.05),along with enhancing uterine morphology.Compared to the control group,supplemental calcitriol or quercetin up-regulated the relative mRNA expression levels of uterine transient receptor potential cation channel,subfamily V,member 6(TRPV6)at 8.5 h PO and plasma membrane calcium-ATPase(PMCA),vitamin D receptor(VDR),estrogen receptor alpha(ERα)at 18.5 h PO(P<0.05),but down-regulated the uterine caspase 3(CASP3)relative mRNA expression level at 8.5 h PO(P<0.05).Meanwhile,the femoral relative mRNA expression levels of tartrate-resistant acid phosphatase(TRAP)(up-regulated at 8.5 and 18.5 h PO)and alkaline phosphatase(ALP)(up-regulated at 8.5 h PO but down-regulated at 18.5 h PO)were also affected by calcitriol or quercetin supplementation(P<0.05).Compared to the calcitriol,quercetin increased hen-day egg production and femoral medullary bone volume/bone tissue volume but reduced femoral stiffness(P<0.05),which were accompanied by increased relative mRNA expression levels of uterine TRPV6,estrogen receptor beta(ERβ)at 18.5 h PO(P<0.05).Overall,both dietary calcitriol and quercetin could improve eggshell and bone quality by modulating calcium metabolism of aged layers.Compared to calcitriol,dietary quercetin up-regulated the expression of uterine calcium transporters,without affecting eggshell quality.展开更多
Background:Tuberculosis is a leading cause of morbidity and mortality in humans worldwide.There is an urgent need for new and effective drugs to treat tuberculosis and shorten the duration of tuberculosis therapy.1,25...Background:Tuberculosis is a leading cause of morbidity and mortality in humans worldwide.There is an urgent need for new and effective drugs to treat tuberculosis and shorten the duration of tuberculosis therapy.1,25-dihydroxy vitamin D3(1,25(OH)2D3)has been reported to have a synergistic effect with pyrazinamide(PZA)in killing tubercle bacilli in vitro.The addition of 1,25(OH)2D3 to standard tuberculosis treatment should benefit patients if the adjunctive drug has a synergistic effect in vivo.Thus,in this study,calcitriol(bioactive 1,25(OH)2D3)was administered to mice undergoing treatment for Mycobacterium tuberculosis(M.tb)infection with PZA,a first-line anti-tuberculosis drug,to determine whether vitamin D3 enhances the therapeutic effect.Methods:C57BL/6 female mice were infected with the M.tb H37Rv strain through aerosol exposure.Calcitriol and PZA,either alone or in combination,were orally administered to the M.tb infected mice.The effect of calcitriol on PZA activity was determined by evaluating the bacterial burden and analyzing the histopathological lesions in the lungs and spleen.To investigate the expression of inflammatory cytokines and anti-microbial peptide genes,we determined the transcriptional levels of interferon-γ(IFN-γ),interleukin-4(IL-4),mouseβ-defensin-2(mBD2),and cathelicidin LL-37 through real-time quantitative polymerase chain reaction.The protein levels of IFN-γwere detected by enzyme-linked immunosorbent assay.Differences between groups were analyzed with independent samples t-test or one-way analysis of variance.Results:Calcitriol alone had little effect on tuberculosis infection,whereas PZA,compared with saline control treatment,decreased the bacterial burden(spleens:PZA vs.saline,4.82±0.22 vs.5.22±0.40 Log10 colony-forming units[CFU]/gram,t=2.13,P<0.05;lungs:PZA vs.saline,5.55±0.15 vs.6.83±0.46 Log10 CFU/gram,t=6.56,P<0.01)and pathological lesions in the lungs.Simultaneous administration of calcitriol with PZA,compared with PZA alone,decreased the bacterial load(spleen:calcitriol+PZA vs.PZA,4.37±0.13 vs.4.82±0.22 Log10 CFU/gram,t=4.36,P<0.01;lung:calcitriol+PZA vs.PZA,5.03±0.32 vs.5.55±0.15 Log10 CFU/gram,t=3.58,P<0.01)and attenuated the lung lesions(gross pathological score:calcitriol+PZA vs.PZA,3.25±0.50 vs.2.50±0.58,t=1.96,P<0.05;affected area of total lung area:calcitriol+PZA vs.PZA,30.75%±6.50%vs.21.55%±2.99%,t=2.66,P<0.05).Further studies demonstrated calcitriol significantly increased the expression of anti-inflammatory cytokine IL-4 but suppressed production of the pro-inflammatory cytokine IFN-γ(IL-4:calcitriol vs.saline,5.69±0.50 vs.2.80±0.56 fold of control,t=6.74,P<0.01;IFN-γ:calcitriol vs.saline,1.36±0.11 vs.4.13±0.83 fold of control,t=5.77,P<0.01).In addition,calcitriol alone or in combination with PZA significantly enhanced the transcriptional level of anti-microbial peptides(cathelicidin LL-37:calcitriol vs.saline,10.59±1.03 vs.2.80±0.90 fold of control,t=9.85,P<0.01;mBD2:calcitriol vs.saline,7.92±0.62 vs.1.79±0.45 fold of control,t=13.82,P<0.01),whereas PZA exerted a negative effect on anti-microbial peptide gene expression.Conclusions:Calcitriol as adjunctive treatment can result in beneficial treatment outcomes in M.tb infection by suppressing the inflammatory response and up-regulating the expression of anti-microbial peptides.These results indicate the feasibility of using calcitriol adjunctively with standard chemotherapy for the treatment of M.tb infection.展开更多
文摘BACKGROUND Parathyroid hormone(PTH)levels may fluctuate in patients undergoing hemodialysis because of changes in calcium,phosphorus,and vitamin D levels.For these patients,the“Kidney Disease:Improving Global Outcomes”clinical practice guidelines recommend PTH levels be maintained in the range of two to nine times of the upper normal limit.Maintaining this balance is critical to prevent renal osteodystrophy.When the severity of hyperparathyroidism exceeds the recommended limits,vitamin D receptor agonists may be used for lowering PTH levels.Paricalcitol,as a biologically active vitamin D analog,is a selective activator of vitamin D responsive pathways.Both calcitriol and paricalcitol can be used as PTHlowering agents.There is conflicting data about their comparative effectiveness for controlling hyperparathyroidism in patients undergoing hemodialysis and a meta-analysis revealed no differences between the two.AIM To give real world data comparing paricalcitol and calcitriol as PTH-lowering agents in patients undergoing hemodialysis.METHODS Patients undergoing hemodialysis whose PTH levels exceeded nine times of the upper normal limit were enrolled in the study.Depending on patient preferences,they were either given calcitriol or paricalcitol.Intravenous calcitriol was given 2μg at the end of each dialysis sessions,and intravenous paricalcitol was administered as 5μg twice per week.Demographic data,calcium-phosphorus levels,change in PTH levels in 6 months,and ratios of 25%and 50%reductions in PTH levels were compared between the two groups.RESULTS A total of 21 patients were enrolled in this comparative study,eight patients received paricalcitol and 13 were prescribed calcitriol.A 50%reduction in PTH levels could be achieved in five patients in the paricalcitol group(62.5%);only one patient in the calcitriol group achieved the same reduction(7.6%).The difference was statistically significant(P=0.014).However,there was no difference in the ratio of patients who had a 25%reduction in PTH levels(87.5%vs 38.4%;P=0.067).PTH levels could be maintained in the targeted range in 87.5%of the patients in the paricalcitol group and in 69.2%of the patients in the calcitriol group(P=0.36).However,PTH could be better suppressed under paricalcitol.Clinically important hyperphosphatemia or hypercalcemia was not observed in either the paricalcitol or the calcitriol groups.CONCLUSION Although the PTH lowering effect of paricalcitol is stronger than calcitriol,both may help maintain PTH levels in the targeted range.Paricalcitol may be preferred for patients who have very high levels of PTH because it seems to cause a faster decline.Calcitriol may be preferred for a slower and limited decline.Prospective further studies with larger samples may be needed for a better comparison.
文摘Objective:To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism(SHPT).Methods:Eighty-nine patients with SHPT who visited the hospital from February 2023 to February 2025 were included in the study.They were divided into an observation group(n=45)and a control group(n=44)using a random number table method.The observation group received calcitriol combined with low-calcium dialysate treatment,while the control group received calcitriol combined with conventional dialysate treatment.The differences in intact parathyroid hormone(iPTH),calcium and phosphorus metabolism indicators,renal function indicators,and adverse reaction rates were compared and evaluated before and after treatment between the two groups.Results:Compared with before treatment,the levels of iPTH,serum phosphorus,and calcium-phosphorus product were significantly reduced in both groups after treatment,and the observation group had lower levels than the control group(P<0.05).Additionally,the blood calcium levels in both groups increased compared to before treatment,and the observation group had higher levels than the control group(P<0.05).After intervention,there was no statistically significant difference in renal function indicators between the two groups(P>0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The combination of calcitriol and low-calcium dialysate for the treatment of SHPT can effectively reduce the levels of iPTH,serum phosphorus,and calcium-phosphorus product,increase blood calcium levels,and has a low incidence of adverse reactions.It has no significant effect on renal function and is a safe and effective treatment method.
基金Supported by Grants from the German Research Foundation DFG (UGS, HCR)as well as research grants from the University of Regensburg, Germany, as part of the ReForM-program (UGS, FO)
文摘AIM: To investigate the effects of ZK1916784, a low calcemic analog of calcitriol on intestinal inflammation. METHODS: Acute and chronic colitis was induced by dextran sodium sulfate (DSS) according to standard procedures. Mice were treated intraperitoneally with ZK1916784 or placebo and colonic inflammation was evaluated. Cytokine production by mesenterial lymph node (MLN) cells was measured by ELISA. Immunohistochemistry was performed to detect intestinal dendritic cells (DCs) within the colonic tissue, and the effect of the calcitriol analog on DCs was investigated. RESULTS: Treatment with ZK191784 resulted in significant amelioration of disease with a reduced histological score in acute and chronic intestinal inflammation. In animals with acute DSS colitis, down- regulation of colonic inflammation was associated with a dramatic reduction in the secretion of the proinflammatory cytokine interferon (IFN)-γ and a significant increase in intereleukin (IL)-10 by MLN cells. Similarly, in chronic colitis, IL-10 expression in colonic tissue increased 1.4-fold when mice were treated with ZK191784, whereas expression of the Th1-specific transcription factor T-beta decreased by 81.6%. Lower numbers of infiltrating activated CD11c+ DCs were found in the colon in ZK191784-treated mice with acute DSScolitis, and secretion of proinflammatory cytokines by primary mucosal DCs was inhibited in the presence of the calcitriol analog. CONCLUSION: The calcitriol analog ZK191784 demonstrated significant anti-inflammatory properties in experimental colitis that were at least partially mediated by the immunosuppressive effects of the derivate on mucosal DCs.
基金The work was supported by the National Natural Science Foundation of China(No 81173002)National Science and Technology Support Program(No 2012BAI35B02)International Science and Technology Cooperation and Exchange Projects(No 2008DFA31080).
文摘Solid dispersion of calcitriol with lipophilic surfactants and triglycerides was developed by melt-mixing method to modify the release and enhance stability of the drug.The solid dispersions were characterized by differential scanning calorimetry(DSC),hot stage polarized optical microscopy(HSPM),infrared spectroscopy(FTIR)and stability studies.The solid dispersion significantly enhanced the stability of calcitriol,which could be attributed to the high antioxidant activity of the solid lipid dispersion.The rapid dissolution rate from the solid dispersion was attributed to the amorphous or solid solution state of drug with improved specific surface area and wettability than the drug crystals.Therefore,solid dispersion of calcitriol with D-a-tocopheryl polyethylene glycol 1000 succinate(TPGS)offers a good approach to modify the release and enhance stability of calcitriol.The influence of lipophilic solid dispersion on drug bioavailability needs further investigation.
文摘Back ground: There are no published clinical data in hemodialysis (HD) patients with mineral bone disorder (CKD-MBD) regarding the effect of sevelamer hydrochloride on the absorption of the oral calcitriol. Objectives: The aim of the present study was to determine the association of the sevelamer hydrochloride and serum 1-25(OH)2D concentration during oral calcitriol therapy. Methods: This was a before-and-after study in HD patients. Forty-six patients co-administered with phosphate-binder and calcitriol for CKD-MBD therapy took lanthanum carbonate (LC) and sevelamer hydrochloride (SH) for 4 weeks, respectively with calcitriol. The serum 1-25(OH)2D concentration was assessed after each period. Results: Serum 1-25(OH)2D concentration was significantly reduced with co-administration of SH compared to LH (mean, calcitriol with LC→SH: 19.9 pg/ml → 14.2 pg/ml, p 2D concentrations after oral calcitriol administration compared to LH in HD patients. When we use SH as a phosphate binder with calcitriol for HD patients with CKD-MBD, we should consider the inhibitory effect of SH on oral calcitriol absorption.
基金the National Key Research and Development Program of China,No.2017YFC0908104National Science and Technology Projects,No.2017ZX10203201,No.2017ZX10201201,and No.2017ZX10202202.
文摘BACKGROUND Hepatic fibrosis is a serious condition,and the development of hepatic fibrosis can lead to a series of complications.However,the pathogenesis of hepatic fibrosis remains unclear,and effective therapy options are still lacking.Our group identified hepatitis C virus nonstructural protein 3-transactivated protein 1(NS3TP1) by suppressive subtractive hybridization and bioinformatics analysis,but its role in diseases including hepatic fibrosis remains undefined.Therefore,additional studies on the function of NS3TP1 in hepatic fibrosis are urgently needed to provide new targets for treatment.AIM To elucidate the mechanism of NS3TP1 in hepatic fibrosis and the regulatory effects of calcitriol on NS3TP1.METHODS Twenty-four male C57BL/6 mice were randomized and separated into three groups,comprising the normal,fibrosis,and calcitriol treatment groups,and liver fibrosis was modeled by carbon tetrachloride(CCl4).To evaluate the level of hepatic fibrosis in every group,serological and pathological examinations of the liver were conducted.TGF-β1 was administered to boost the in vitro cultivation of LX-2 cells.NS3TP1,α-smooth muscle actin(α-SMA),collagen I,and collagen Ⅲ in every group were examined using a Western blot and real-time quantitative polymerase chain reaction.The activity of the transforming growth factor beta 1(TGFβ1)/Smad3 and NF-κB signaling pathways in each group of cells transfected with pcDNA-NS3TP1 or siRNA-NS3TP1 was detected.The statistical analysis of the data was performed using the Student’s t test.RESULTS NS3TP1 promoted the activation,proliferation,and differentiation of hepatic stellate cells(HSCs)and enhanced hepatic fibrosis via the TGFβ1/Smad3 and NF-κB signaling pathways,as evidenced by the presence of α-SMA,collagen I,collagen Ⅲ,p-smad3,and p-p65 in LX-2 cells,which were upregulated after NS3TP1 overexpression and downregulated after NS3TP1 interference.The proliferation of HSCs was lowered after NS3TP1 interference and elevated after NS3TP1 overexpression,as shown by the luciferase assay.NS3TP1 inhibited the apoptosis of HSCs.Moreover,both Smad3 and p65 could bind to NS3TP1,and p65 increased the promoter activity of NS3TP1,while NS3TP1 increased the promoter activity of TGFβ1 receptor I,as indicated by coimmunoprecipitation and luciferase assay results.Both in vivo and in vitro,treatment with calcitriol dramatically reduced the expression of NS3TP1.Calcitriol therapy-controlled HSCs activation,proliferation,and differentiation and substantially suppressed CCl4-induced hepatic fibrosis in mice.Furthermore,calcitriol modulated the activities of the above signaling pathways via downregulation of NS3TP1.CONCLUSION Our results suggest that calcitriol may be employed as an adjuvant therapy for hepatic fibrosis and that NS3TP1 is a unique,prospective therapeutic target in hepatic fibrosis.
基金Research was funded by grants from National University of Río Cuarto(UNRC)through the Secretary of Science and Technology(SECYT,PPI 2020-2022,Res 083).
文摘Background:Capacitation is a set of physiological changes sperms undergo to acquire fertilizing capacity.In vivo,this process is directly associated with high calcium levels in sperm cytoplasm.Calcitriol,the vitamin D hypercalcemic metabolite,is related to human sperm motility,capacitation,and acrosome reaction.This work aimed to study the effect of calcitriol on bull sperm quality parameters and capacitation.Methods:One million freezethawed spermatozoa were obtained from different bulls and treated with 20 nM of calcitriol for 30 min.Untreated cells(negative control)and treated ones with calcitriol or heparin(100μg/mL,positive capacitation control)were evaluated for motility,viability,and functional parameters.Menadione(70μM,30 min)treatment was included as a reactive oxygen species(ROS)positive sperm agent.Results:The results elucidated that sperm exposed to 20 nM calcitriol showed higher viability,vigor,and capacitation than their positive and negative controls.The percentage of sperm with intact plasma and acrosome membranes,mitochondrial membrane potential(ΔΨm),and phosphatidylserine externalization was similar in all the conditions evaluated,while ROS production was higher with heparin and menadione-treated groups than the calcitriol group or negative control.Conclusion:Our results indicate that calcitriol induces the capacitation of thawed bull spermatozoa and maintains acceptable values of progressive motility,viability,and vigor without altering key biological parameters such as redox status,ΔΨm,and cell death.
文摘BACKGROUND Calcitriol-induced hypercalcemia has been rarely reported in cases of lung cancer;however,it is frequently reported in cases of lymphoid malignancy and granulomatous disease.We present a rare case of hypercalcemia associated with squamous cell cancer of the lung with elevated calcitriol level.CASE SUMMARY A 61-year-old Caucasian female with severe hypercalcemia of 15 mg/dL,which led to a new diagnosis of metastatic lung cancer.Since the parathyroid hormonerelated peptide(PTHrP)level was minimally elevated at 2.1 pmol/L,we believe excessive calcitriol production by tumor cells was the underlying mechanism for hypercalcemia.Calcitriol was significantly elevated at 130 pg/mL with a low 25-hydroxyvitamin D level of 25.9 ng/mL and suppressed PTH level of 8 pg/mL.Corticosteroids are generally used to treat calcitriol-induced hypercalcemia,but we successfully treated our patient with bisphosphonate,highlighting the further utility of bisphosphonates in hypercalcemia treatment.CONCLUSION We believe that the underlying cause of hypercalcemia,in this case of metastatic squamous cell lung carcinoma,was elevated calcitriol,which was likely produced by the tumor cells.In addition to PTHrP,calcitriol levels should be included in the workup for hypercalcemia in cases of lung cancer.However,the pathophysiology and prognostic significance of dysregulated calcitriol production in solid tumors remain unclear and warrant further research.Bisphosphonate may be used as a steroid-sparing therapy even in cases of calcitriol-induced hypercalcemia and warrants further investigation.
文摘Objective:To investigate calcitriol, cinacalcet plus comprehensive intervention on maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT) calcium (Ca), phosphorus (P) metabolism and parathyroid hormone (PTH) effect.Methods: A total of 80 cases of patients with SHPT from January 2014 to January 2016 in our hospital were randomly divided into observation group and control group, control group to eat the whole piece of cinacalcet hydrochloride oral tablets, the initial dose of 25 mg/d, every 2 to 4 weeks, according to Ca×P, parathyroid hormone (iPTH) test results adjust the dose, the maximum dose of not more than 75 mg/d, the observation group in the control group on the basis of oral administration of Calcitriol Soft Capsules 0.25 g/d, 3 times/week, 2 groups were given comprehensive intervention measures, to evaluate the curative effect after 3 months of treatment. The 2 groups before and after treatment collected fasting peripheral venous blood, the determination of Ca, P and alkaline phosphatase by colorimetric method (ALP), Ca, P product calculation (Ca×P), to detect the level of iPTH before and after treatment by ELISA method;TY-6858-HI type ultrasound instrument, measuring length, width and thickness of the parathyroid glands, and calculate the parathyroid gland volume.Results:in the observation group after treatment, Ca, Ca×P increased degree, P, ALP, iPTH lower than the control group, the size of the parathyroid gland was better than the control group.Conclusion:calcitriol, cinacalcet combined intervention therapy has good clinical effect in patients with MHD SHPT, Ca, P can effectively improve the metabolism, reduce the level of iPTH, reduce the parathyroid gland volume is worthy of promotion.
基金National Natural Science Foundation of China,Grant/Award Numbers:31630047,81874201,81725014Natural Science Foundation of Shanghai,Grant/AwardNumber:20ZR1452300+1 种基金Shanghai Municipal Health Bureau,Grant/Award Number:201840359The National Key Research and Development Program of China,Grant/Award Numbers:2020YFA0509000,2017YFA0503600。
文摘Background:Colorectal cancer(CRC)is one of the most malignant tumorswith high incidence,yet its molecular mechanism is not fully understood,hindering the development of targeted therapy.Metabolic abnormalities are a hallmark of cancer.Targeting dysregulated metabolic features has become an important direction for modern anticancer therapy.In this study,we aimed to identify a new metabolic enzyme that promotes proliferation of CRC and to examine the related molecular mechanisms.Methods:We performed RNA sequencing and tissue microarray analyses of human CRC samples to identify new genes involved in CRC.Squalene epoxidase(SQLE)was identified to be highly upregulated in CRC patients.The regulatory function of SQLE in CRC progression and the therapeutic effect of SQLE inhibitors were determined by measuring CRC cell viability,colony and organoid formation,intracellular cholesterol concentration and xenograft tumor growth.Themolecularmechanism of SQLE functionwas explored by combining transcriptome and untargeted metabolomics analysis.Western blotting and realtime PCR were used to assess MAPK signaling activation by SQLE.Results:SQLE-related control of cholesterol biosynthesis was highly upregulated in CRC patients and associated with poor prognosis.SQLE promoted CRC growth in vitro and in vivo.Inhibition of SQLE reduced the levels of calcitriol(active form of vitamin D3)and CYP24A1,followed by an increase in intracellular Ca2+concentration.Subsequently,MAPK signaling was suppressed,resulting in the inhibition of CRC cell growth.Consistently,terbinafine,an SQLE inhibitor,suppressed CRC cell proliferation and organoid and xenograft tumor growth.Conclusions:Our findings demonstrate that SQLE promotes CRC through the accumulation of calcitriol and stimulation of CYP24A1-mediated MAPK signaling,highlighting SQLE as a potential therapeutic target for CRC treatment.
基金supported by the National Natural Science Foundation of China (32172743)the eammarked fund for China Agriculture Research Systems (CARS-40)the Agricultural Science and Tec hnology Innovation Program (ASTIP)of CAAS.
文摘This study was aimed to investigate the effects of dietary calcitriol or quercetin supplementation on eggshell and bone quality of laying hens.In trial 1,72 Hy-Line Brown layers(80-week-old)with weak-shelled strength(25 to 30 N)were assigned into 4 dietary treatments with 6 replicates of 3 birds and fed a basal diet(4%calcium level)or basal diets supplemented with 0.5%calcium,5μg/kg calcitriol or 500 mg/kg quercetin for 4 weeks.In trial 2,360 Hy-Line Brown layers(60-week-old)were divided into 3 groups with 8 replicates of 15 birds:control group(basal diet),calcitriol group(basal diet+5μg/kg calcitriol),and quercetin group(basal diet+500 mg/kg quercetin).This trial lasted for 12 weeks.The results showed that dietary calcitriol or quercetin improved eggshell quality in both trials(P<0.05).In trial 2,compared with the control group,both calcitriol and quercetin supplementations improved femoral bone quality,calcium retention of hens and calcium content in uterine fluid at 18.5 h post-oviposition(PO)(P<0.05),along with enhancing uterine morphology.Compared to the control group,supplemental calcitriol or quercetin up-regulated the relative mRNA expression levels of uterine transient receptor potential cation channel,subfamily V,member 6(TRPV6)at 8.5 h PO and plasma membrane calcium-ATPase(PMCA),vitamin D receptor(VDR),estrogen receptor alpha(ERα)at 18.5 h PO(P<0.05),but down-regulated the uterine caspase 3(CASP3)relative mRNA expression level at 8.5 h PO(P<0.05).Meanwhile,the femoral relative mRNA expression levels of tartrate-resistant acid phosphatase(TRAP)(up-regulated at 8.5 and 18.5 h PO)and alkaline phosphatase(ALP)(up-regulated at 8.5 h PO but down-regulated at 18.5 h PO)were also affected by calcitriol or quercetin supplementation(P<0.05).Compared to the calcitriol,quercetin increased hen-day egg production and femoral medullary bone volume/bone tissue volume but reduced femoral stiffness(P<0.05),which were accompanied by increased relative mRNA expression levels of uterine TRPV6,estrogen receptor beta(ERβ)at 18.5 h PO(P<0.05).Overall,both dietary calcitriol and quercetin could improve eggshell and bone quality by modulating calcium metabolism of aged layers.Compared to calcitriol,dietary quercetin up-regulated the expression of uterine calcium transporters,without affecting eggshell quality.
基金supported by a grant from the National Natural Sciences Foundation of China(No.81201261).
文摘Background:Tuberculosis is a leading cause of morbidity and mortality in humans worldwide.There is an urgent need for new and effective drugs to treat tuberculosis and shorten the duration of tuberculosis therapy.1,25-dihydroxy vitamin D3(1,25(OH)2D3)has been reported to have a synergistic effect with pyrazinamide(PZA)in killing tubercle bacilli in vitro.The addition of 1,25(OH)2D3 to standard tuberculosis treatment should benefit patients if the adjunctive drug has a synergistic effect in vivo.Thus,in this study,calcitriol(bioactive 1,25(OH)2D3)was administered to mice undergoing treatment for Mycobacterium tuberculosis(M.tb)infection with PZA,a first-line anti-tuberculosis drug,to determine whether vitamin D3 enhances the therapeutic effect.Methods:C57BL/6 female mice were infected with the M.tb H37Rv strain through aerosol exposure.Calcitriol and PZA,either alone or in combination,were orally administered to the M.tb infected mice.The effect of calcitriol on PZA activity was determined by evaluating the bacterial burden and analyzing the histopathological lesions in the lungs and spleen.To investigate the expression of inflammatory cytokines and anti-microbial peptide genes,we determined the transcriptional levels of interferon-γ(IFN-γ),interleukin-4(IL-4),mouseβ-defensin-2(mBD2),and cathelicidin LL-37 through real-time quantitative polymerase chain reaction.The protein levels of IFN-γwere detected by enzyme-linked immunosorbent assay.Differences between groups were analyzed with independent samples t-test or one-way analysis of variance.Results:Calcitriol alone had little effect on tuberculosis infection,whereas PZA,compared with saline control treatment,decreased the bacterial burden(spleens:PZA vs.saline,4.82±0.22 vs.5.22±0.40 Log10 colony-forming units[CFU]/gram,t=2.13,P<0.05;lungs:PZA vs.saline,5.55±0.15 vs.6.83±0.46 Log10 CFU/gram,t=6.56,P<0.01)and pathological lesions in the lungs.Simultaneous administration of calcitriol with PZA,compared with PZA alone,decreased the bacterial load(spleen:calcitriol+PZA vs.PZA,4.37±0.13 vs.4.82±0.22 Log10 CFU/gram,t=4.36,P<0.01;lung:calcitriol+PZA vs.PZA,5.03±0.32 vs.5.55±0.15 Log10 CFU/gram,t=3.58,P<0.01)and attenuated the lung lesions(gross pathological score:calcitriol+PZA vs.PZA,3.25±0.50 vs.2.50±0.58,t=1.96,P<0.05;affected area of total lung area:calcitriol+PZA vs.PZA,30.75%±6.50%vs.21.55%±2.99%,t=2.66,P<0.05).Further studies demonstrated calcitriol significantly increased the expression of anti-inflammatory cytokine IL-4 but suppressed production of the pro-inflammatory cytokine IFN-γ(IL-4:calcitriol vs.saline,5.69±0.50 vs.2.80±0.56 fold of control,t=6.74,P<0.01;IFN-γ:calcitriol vs.saline,1.36±0.11 vs.4.13±0.83 fold of control,t=5.77,P<0.01).In addition,calcitriol alone or in combination with PZA significantly enhanced the transcriptional level of anti-microbial peptides(cathelicidin LL-37:calcitriol vs.saline,10.59±1.03 vs.2.80±0.90 fold of control,t=9.85,P<0.01;mBD2:calcitriol vs.saline,7.92±0.62 vs.1.79±0.45 fold of control,t=13.82,P<0.01),whereas PZA exerted a negative effect on anti-microbial peptide gene expression.Conclusions:Calcitriol as adjunctive treatment can result in beneficial treatment outcomes in M.tb infection by suppressing the inflammatory response and up-regulating the expression of anti-microbial peptides.These results indicate the feasibility of using calcitriol adjunctively with standard chemotherapy for the treatment of M.tb infection.
