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Copyright © 2005, The National Academy of Sciences Biochemistry Parathyroid hormone decreases renal vitamin D receptor expression in vivo Department of Biochemistry, University of Wisconsin, Madison, WI 53706 * To whom correspondence should be addressed. E-mail: deluca/at/biochem.wisc.edu. Contributed by Hector F. DeLuca, February 16, 2005 Abstract The vitamin D receptor (VDR) is a nuclear transcription factor responsible for mediating the biological activities of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. Renal and parathyroid gland VDR content is an important factor in calcium homeostasis, vitamin D metabolism, and the treatment of secondary hyperparathyroidism and renal osteodystrophy. In these tissues, VDR expression is highly regulated by the calcium and vitamin D status. Although 1,25(OH)2D3 up-regulates VDR expression, hypocalcemia and vitamin D deficiency result in drastically reduced expression of the receptor. The generation of 25-hydroxyvitamin D3-1α-hydroxylase-null mice, which are incapable of endogenously producing 1,25(OH)2D3, has allowed us to investigate the influence of parathyroid hormone (PTH) on VDR expression independent of PTH-mediated increases in 1,25(OH)2D3. Administration of human PTH (1-34) (110 μg/kg per day) for 48 h reduced renal VDR levels from 515 to 435 fmol/mg protein (15%, P < 0.03) in wild-type mice. In the 25-hydroxyvitamin D3-1α-hydroxylase-null mice, PTH administration strongly reduced renal VDR levels, from 555 to 394 fmol/mg protein (29%, P < 0.001). These results demonstrate that PTH is a potent down-regulator of VDR expression in vivo. Keywords: 1,25-dihydroxyvitamin D3; 1α-hydroxylase-null; 25-hydroxyvitamin D3-1α-hydroxylase; renal failure; vitamin D resistance Parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], the vitamin D hormone, are responsible for maintaining serum calcium values at sufficient levels for many physiological events, including proper neuromuscular function and bone mineralization. Their coordinated activities depend on several metabolic and functional interactions. In conditions of low serum calcium, the calcium-sensing receptor of the parathyroid gland stimulates PTH secretion (1). PTH increases circulating levels of 1,25(OH)2D3 by increasing expression of the renal 25-hydroxyvitamin D3-1α-hydroxylase (1α-hydroxylase) gene (2, 3), which encodes the enzyme responsible for the production of the vitamin D hormone. 1,25(OH)2D3 exerts the biological actions of vitamin D by binding to the vitamin D receptor (VDR), a steroid/thyroid hormone nuclear receptor, and regulating the transcription of target genes. Through this mechanism, 1,25(OH)2D3 stimulates the intestinal absorption of calcium while 1,25(OH)2D3 and PTH act in concert to increase bone resorption and renal reabsorption of calcium (4). As a form of negative feedback regulation, 1,25(OH)2D3 decreases PTH expression by negatively regulating the PTH gene (5). The biological response to 1,25(OH)2D3 is directly related to the VDR content of target tissues (6, 7). Thus, the regulation of receptor expression is a critical determinant of hormone activity. The VDR has been shown to be developmentally regulated, expressed in a tissue-specific manner, and regulated by a variety of physiological factors and hormones (8). It is well established that 1,25(OH)2D3 can stimulate receptor expression in the kidney and parathyroid gland while having minimal influence on intestinal VDR expression (9-13). Several studies also have noted a positive correlation between calcium and VDR expression. Hypocalcemia induced by dietary calcium restriction dramatically reduces renal VDR levels and prevents 1,25(OH)2D3 from increasing VDR expression (14-16). Reduced dietary calcium also has been associated with diminished VDR mRNA in avian and rat parathyroid gland (11, 12). If left untreated, renal failure with subsequent vitamin D deficiency and hypocalcemia will lead to a decrease in parathyroid gland VDR content and the development of vitamin D resistance (17, 18). The molecular trigger responsible for the hypocalcemia-mediated decline in renal and parathyroid gland VDR content is hereto-fore unknown. PTH expression is inversely related to serum calcium values (19). Because hypocalcemic animals have high circulating levels of PTH and reduced renal and parathyroid gland VDR expression, we hypothesized that PTH may down-regulate VDR expression. Previous investigations into PTH-mediated regulation of VDR expression yielded mixed results. A PTH-mediated increase of VDR and VDR mRNA was reported in osteoblast-like UMR-106 cells (20, 21), whereas a PTH-mediated decrease in VDR and its transcript was reported in ROS 17/2.8 osteoblast cells (22). In vivo, osmotic PTH administration to rats nearly doubled renal VDR levels (23). However, these in vivo results were complicated by the PTH-mediated activation of the 1α-hydroxylase gene and the increase in circulating levels of 1,25(OH)2D3. Recently, our laboratory and others have generated 1α-hydroxylase-null (1α-hydroxylase-/-) mice that are incapable of endogenously producing 1,25(OH)2D3 (24, 25). We have used these null mice to directly assess the effect of PTH on VDR expression, and from these studies, we have uncovered an additional functional interaction between PTH and the vitamin D endocrine system that is of both physiological and clinical significance. Materials and Methods Chemicals. 1,25(OH)2D3 was purchased from Tetrionics (Madison, WI). Human PTH (1-34) was obtained from Bachem. Mice. Null mice were generated in-house (J.L.V., J.M.P., C. Kimmel-Jehan, M. Mendelsohn, E. W. Danielson, K.D.H., and H.F.D., unpublished data) and maintained on a C57BL/6 background. The majority of the 1α-hydroxylase gene coding region is obliterated in these mice, and no 1α-hydroxylase transcript is detectable by real-time RT-PCR of total kidney RNA. The mice grow, develop, and reproduce normally when maintained on a balanced diet supplemented with 1,25(OH)2D3 but quickly become rachitic when fed a diet devoid of 1,25(OH)2D3 and phosphorus. Administration of 1,25(OH)2D3 effectively reverses the rachitic condition; its biological precursor, 25-hydroxyvitamin D3, is ineffective as a cure. For this study, wild-type (1α-hydroxylase+/+) and 1α-hydroxylase-/- offspring of 1α-hydroxylase heterozygotes were weaned onto a diet containing fat-soluble vitamins A, E, and K, with 0.47% calcium and 4 ng of 1,25(OH)2D3 per mouse per day (26). At 7 weeks of age, mice were transferred onto a 20% lactose/2.0% calcium/1.25% phosphorus diet supplemented with 1 ng of 1,25(OH)2D3 per mouse per day (27). One week later, mice were implanted with Alzet microosmotic pumps delivering either human PTH (1-34) (110 μg/kg per day) or a 97.9% saline/2.0% heat-inactivated serum/0.1% 1 N HCl vehicle. Mice were euthanized by using CO2 48 h later. Experimental protocols were reviewed and approved by the Research Animal Resources Center (University of Wisconsin). Serum Analysis. After CO2 euthanasia, blood was collected and centrifuged to obtain serum. For serum calcium analysis, serum was diluted 1:40 in 0.1% LaCl3, and serum calcium was measured by using an atomic absorption spectrometer (model 3110, Perkin-Elmer). Serum phosphorus was quantified with a colorimetric assay by using malachite green (28). Kidney Homogenate Preparation. Kidney whole-cell extract was prepared by using a modified method of Pierce et al. (29) and Sandgren and DeLuca (14). All steps were performed on ice or at 4°C. Kidneys were minced with a razor blade and washed twice with Tris·HCl EDTA DTT (TED)Na150 containing a panel of protease inhibitors. The buffer was decanted and replaced with 1 vol (vol/vol) of TED plus inhibitors. After homogenization with a Tissue-Tearor (BioSpec Products, Bartlesville, OK), 1 vol of TEDK600Mg20 was added, and homogenization was repeated. Samples were centrifuged at 20,000 × g for 1 h. Supernatant was divided into aliquots, frozen under liquid nitrogen, and stored at -80°C until analysis. The buffers contained 50 mM Tris·HCl (pH 7.4), 1.5 mM EDTA, and 5 mM DTT. Either 150 mM NaCl or 600 mM KCl/20 mM MgCl2 was added where appropriate. The panel of protease inhibitors (Sigma) consisted of 150 μM aprotinin, 130 μM bestatin, 10 μM leupeptin, 1 μM pepstatin A, and 1 mM phenylmethylsulfonyl fluoride. Analysis of Kidney Homogenate. VDR content was determined by using an ELISA developed in this laboratory (30). The protein concentration of the homogenates was determined by the method of Bradford (31), using BSA as a standard. RNA Isolation. Total RNA was isolated from mouse kidney with Tri Reagent (Molecular Research Center, Cincinnati) according to the manufacturer's protocol. Quantitative RT-PCR. RNA was DNase-treated (RQ-1 RNase-Free DNase, Promega) and then reverse-transcribed by using a first-strand synthesis system for RT-PCR (SuperScript, Invitrogen). Real-time PCR was performed in a LightCycler (Roche Diagnostics) according to the manufacturer's recommendations. SYBR green dye (Roche Applied Science) was used for quantification of double-stranded DNA after every cycle. The following primer sequences were used: β-actin, (forward) 5′-TGGAATCCTGTGGCATCCATGAAAC-3′ and (reverse) 5′-TAAAACGCAGCTCAGTAACAGTCCG-3′; 1α-hydroxylase, (forward) 5′-CCGCGGGCTATGCTGGAAC-3′ and (reverse) 5′-CTCTGGGCAAAGGCAAACATCTGA-3′; and VDR, (forward) 5′-CTCCTCGATGCCCACCACAAGACCTACG-3′ and (reverse) 5′-GTGGGGCAGCATGGAGAGCGGAGACAG-3′. All amplicons were 200-500 bp in length and were sequenced to confirm specificity of amplification. Throughout real-time PCR analysis, product identities were confirmed by melting curve analysis. The quantification of each gene was relative to a standard curve generated from a serially diluted sample. The relative amount of each experimental gene was then normalized to the abundance of the housekeeping gene β-actin. These values were standardized such that a maximum value of 1.0 was assigned to the group with the highest gene expression. Statistical Analysis. The two-tailed Student t test was used to quantify statistical differences between experimental groups. Results are expressed as the mean ± SE. Results PTH Increases Serum Calcium and Decreases Serum Phosphorus. To investigate the effect of PTH on VDR expression, 1α-hydroxylase+/+ and 1α-hydroxylase-/- mice were implanted with an osmotic pump that delivered human PTH (110 μg/kg per day) for 48 h. Mice were maintained on a high-calcium diet to minimize circulating levels of endogenous PTH. Osmotic PTH administration dramatically increased the serum calcium levels in both the wild-type and null mice (Fig. 1A
PTH Dramatically Up-Regulates 1α-Hydroxylase mRNA in Wild-Type Mice. The ability of PTH to stimulate 1,25(OH)2D3 production was demonstrated by Garabedian et al. in 1972 (2). Since then, the mechanism by which PTH activates 1α-hydroxylase gene expression to stimulate production of the vitamin D hormone has been delineated (3, 33). To monitor the bioactivity of the administered PTH on transcriptional regulation and verify the absence of the 1α-hydroxylase gene product in the null mice, we quantified renal 1α-hydroxylase mRNA levels. As shown in Fig. 2
PTH Reduces Renal VDR Levels in Vivo. After 48 h of continuous PTH administration, renal VDR levels were quantified with an ELISA assay. PTH caused a modest (15%) yet significant (P < 0.03) drop in the renal VDR levels of the wild-type mice (Fig. 3
Renal VDR Transcript Levels Are Modestly Decreased by PTH. As an initial investigation into the mechanism by which PTH decreases renal VDR levels, real-time PCR was performed to quantify the renal VDR transcript levels. Although the differences were not statistically significant, PTH administration resulted in a trend of reduced VDR mRNA levels both in wild-type and null mice (Fig. 4
Discussion Hypocalcemia as a result of dietary calcium restriction or vitamin D deficiency results in a reduction of renal and parathyroid gland VDR (14, 17). Because serum calcium levels are inversely proportional to serum PTH, we hypothesized that PTH may suppress VDR expression in vivo. Previous investigations into the PTH regulation of receptor content were complicated by the PTH-mediated activation of the 1α-hydroxylase gene and subsequent increase in circulating levels of 1,25(OH)2D3, a known up-regulator of VDR expression. The development of transgenic mice with targeted ablation of the 1α-hydroxylase gene has allowed us to separate the effects of PTH and 1,25(OH)2D3 and investigate the in vivo effect of PTH administration on VDR content. PTH administration by osmotic pump for 48 h resulted in the anticipated increase in serum calcium and decrease in serum phosphorus (Fig. 1 The hypocalcemia and PTH-mediated decrease in VDR expression is of physiological and medical significance. The kidney is an important tissue for the regulation of the metabolism of 1,25(OH)2D3, because both the anabolic 1α-hydroxylase and the catabolic 25-hydroxyvitamin D3-24-hydroxylase (24-hydroxylase) are expressed in the renal proximal tubular cells. The PTH-mediated down-regulation of renal VDR may be a protective measure to block 1,25(OH)2D3-mediated suppression of the 1α-hydroxylase and induction of the 24-hydroxylase, resulting in a net increase in serum 1,25(OH)2D3 levels that would be beneficial to a hypocalcemic animal (34). In advanced renal failure, treatment with calcitriol or vitamin D analogs is used to prevent secondary hyperparathyroidism and renal osteodystrophy (35). Without early intervention, hypocalcemia and parathyroid hyperplasia preface a reduction in parathyroid gland VDR content and vitamin D resistance (18). The mechanism established in this report, PTH-mediated suppression of VDR expression, is likely responsible for this reduction of parathyroid gland VDR content. Our findings emphasize the importance of early treatment with vitamin D compounds in renal failure patients to prevent vitamin D resistance. Although parathyroid gland and renal receptor content is diminished in hypocalcemic conditions, studies on rats and mice have concluded that intestinal VDR expression is not significantly affected (10, 13). This constitutive VDR expression may reflect important noncalcemic actions of intestinal VDR, such as the receptor-mediated bile acid detoxification recently suggested by Makishima et al. (36). The tissue specificity of hypocalcemia-mediated suppression of VDR expression may be related to PTH responsiveness; the lack of PTH receptor in intestinal cells may allow them to escape regulation by PTH and constitutively express VDR. Notably, Meyer et al. (37) reported that a low-calcium diet repressed intestinal VDR mRNA expression in chickens, suggesting that a factor other than PTH may be repressing VDR expression in this model. In addition to its classical role in regulating calcium homeostasis, 1,25(OH)2D3 also inhibits cellular proliferation, stimulates cell differentiation, and influences the immune response (38). The immunosuppressive properties of 1,25(OH)2D3 are being investigated for therapeutic intervention in several autoimmune diseases. Interestingly, dietary calcium restriction drastically reduced the effectiveness of 1,25(OH)2D3 in preventing disease onset in experimental autoimmune encephalomyelitis (39) and in reducing diabetes incidence in the nonobese diabetic mouse (J. B. Zella and H.F.D., unpublished data). The influence of PTH and calcium status on lymphocyte VDR expression merits investigation. The mechanism by which PTH down-regulates VDR expression is not clear. Although we observed a trend toward reduced VDR mRNA expression in PTH-treated mice, the reductions were not statistically significant (Fig. 4 Acknowledgments We thank Prof. Terrence F. Meehan (The Scripps Research Institute, La Jolla, CA) for his assistance with the osmotic pumps, Eric Danielson for his aid in genotyping, and Wendy Hellwig for her help in the quantification of serum calcium. This work was supported in part by funds from the Wisconsin Alumni Research Foundation. Notes Author contributions: K.D.H. and H.F.D. designed research; K.D.H., J.L.V., and J.M.P. performed research; K.D.H. and H.F.D. analyzed data; and K.D.H. wrote the paper. Abbreviations: PTH, parathyroid hormone; VDR, vitamin D receptor; (1,25(OH)2D3), 1,25-dihydroxyvitamin D3; 1α-hydroxylase, 25-hydroxyvitamin D3-1α-hydroxylase; 24-hydroxylase, 25-hydroxyvitamin D3-24-hydroxylase. References 1. Nemeth, E. F. & Scarpa, A. (1987. ) J. Biol. Chem. 262, 5188-5196. [PubMed] 2. Garabedian, M., Holick, M. F., Deluca, H. F. & Boyle, I. T. (1972. ) Proc. Natl. Acad. Sci. USA 69, 1673-1676. [PubMed] 3. Brenza, H. L., Kimmel-Jehan, C., Jehan, F., Shinki, T., Wakino, S., Anazawa, H., Suda, T. & DeLuca, H. F. (1998. ) Proc. Natl. Acad. Sci. USA 95, 1387-1391. [PubMed] 4. DeLuca, H. F. & Zierold, C. (1998. ) Nutr. Rev. 56, S4-S10; discussion S54-S75. [PubMed] 5. Demay, M. B., Kiernan, M. S., DeLuca, H. F. & Kronenberg, H. M. (1992. ) Proc. Natl. Acad. Sci. USA 89, 8097-8101. [PubMed] 6. 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[J Biol Chem. 1987]Proc Natl Acad Sci U S A. 1972 Jul; 69(7):1673-6.
[Proc Natl Acad Sci U S A. 1972]Proc Natl Acad Sci U S A. 1998 Feb 17; 95(4):1387-91.
[Proc Natl Acad Sci U S A. 1998]Nutr Rev. 1998 Feb; 56(2 Pt 2):S4-10; discussion S 54-75.
[Nutr Rev. 1998]Proc Natl Acad Sci U S A. 1992 Sep 1; 89(17):8097-101.
[Proc Natl Acad Sci U S A. 1992]J Biol Chem. 1981 Jul 25; 256(14):7338-42.
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[Biochem Biophys Res Commun. 1986]Arch Biochem Biophys. 2005 Jan 15; 433(2):466-73.
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[Biochem Biophys Res Commun. 1988]Biochem Biophys Res Commun. 1992 Jun 30; 185(3):881-6.
[Biochem Biophys Res Commun. 1992]Endocrinology. 1995 Sep; 136(9):3735-42.
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[J Nutr. 1970]Endocrinology. 1998 Oct; 139(10):4391-6.
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[J Biol Chem. 1987]Proc Natl Acad Sci U S A. 1990 Jun; 87(11):4312-4.
[Proc Natl Acad Sci U S A. 1990]J Bone Miner Res. 1996 Dec; 11(12):1921-5.
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[Endocrinology. 1974]Proc Natl Acad Sci U S A. 1972 Jul; 69(7):1673-6.
[Proc Natl Acad Sci U S A. 1972]Proc Natl Acad Sci U S A. 1998 Feb 17; 95(4):1387-91.
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[Biochim Biophys Acta. 1993]Proc Natl Acad Sci U S A. 2003 Aug 19; 100(17):9733-7.
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[Arch Biochem Biophys. 2005]Proc Natl Acad Sci U S A. 2003 Aug 19; 100(17):9733-7.
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