High-salt diet promotes crystal deposition through hypertension in Dahl salt-sensitive rat model.

OBJECTIVES: To study the promotive effect of salt-induced hypertension on crystal deposition and urolithiasis using a salt-sensitive rat hypertension model. METHODS: Hyperoxaluria and hypercalciuria were induced in male Dahl salt-sensitive rats with administration of ethylene glycol and alfacalcidol. Hypertension was induced by a high-salt diet. Eplerenone, a selective mineralocorticoid receptor antagonist, was given. Blood and urine were collected to evaluate renal function, electrolytes and the blood renin-angiotensin-aldosterone system. Renal calcium content was also evaluated. Histological examination, transcriptome analysis with DNA microarray and semiquantitative reverse transcriptase polymerase chain reaction were carried out. RESULTS: A high-salt diet increased crystal deposition in Dahl salt-sensitive rats with hypertension, and eplerenone administration significantly suppressed it. The mRNA expression profile was associated with crystal formation, growth, adhesion and cellular injury, and it was regulated in the group exposed to a high-salt diet and ethylene glycol. CONCLUSIONS: A high-salt diet has a promotive effect on salt-sensitive hypertension and urolithiasis. This promotive effect can be prevented by eplerenone administration. Hence, salt-sensitive hypertension has promotive effects on crystal deposition in Dahl salt-sensitive rats.

Receptor activator of NF-kappa B ligand inhibition suppresses bone resorption and hypercalcemia but does not affect host immune responses to influenza infection.

Receptor activator of NF-kappaB (RANK) and its ligand (RANKL) are essential for osteoclast formation, function, and survival. Osteoprotegerin (OPG) inhibits RANK signaling by sequestering RANKL. This study evaluated the antiosteoclast and immunoregulatory effects of mouse rRANK-Fc, which, similar to OPG, can bind RANKL. The effect of RANKL inhibition by RANK-Fc on osteoclast function was determined by inhibition of vitamin D(3) (1,25(OH)(2)D(3))-induced hypercalcemia. Mice were injected with a single dose of 0, 10, 100, 500, or 1000 microg of RANK-Fc; 100 microg of OPG-Fc; or 5 microg of zoledronate 2 h before 1,25(OH)(2)D(3) challenge on day 0, and sacrificed on days 1, 2, 4, 6, 8, 12, 16, and 20. RANK-Fc doses of 100 or 500 microg were tested in a mouse respiratory influenza virus host-resistance model. A single dose of RANK-Fc > or =100 microg suppressed elevation of serum calcium levels and suppressed the bone turnover marker serum pyridinoline at day 4 and later time points, similar to those observed with OPG-Fc and zoledronate (p < or = 0.01 vs controls). By day 6, both immature and mature osteoclasts were depleted by high doses of RANK-Fc (500 and 1000 microg) or 100 microg of OPG-Fc. RANK-Fc doses of 100 or 500 microg had no detectable effect on immune responses to influenza infection, as measured by activation of cytotoxic T cell activity, influenza-specific IgG response, and virus clearance. RANK-Fc inhibition of RANKL has antiosteoclast activity at doses that have no detectable immunoregulatory activity, suggesting that RANKL inhibitors be further studied for their potential to treat excess bone loss.

1alpha-hydroxyvitamin D2 is less toxic but not bone selective relative to 1alpha-hydroxyvitamin D3 in ovariectomized rats.

Identification of bone selective vitamin D analogues would provide an interesting substance class for the treatment of osteoporosis. The synthetic prodrug 1alpha-hydroxyvitamin D2 [1alpha(OH)D2] has been shown to combine equal bone-preserving activity with distinctly reduced calcemic effects relative to 1alpha-hydroxyvitamin D3 [1alpha(OH)D3] in 3-month-old ovariectomized (OVX) rats. Therefore, 1alpha(OH)D2 may be a bone-selective compound. The aim of this study was to compare the bone protective and the calcemic activities of chronically administered 1alpha(OH)D2 and 1alpha(OH)D3 in 6-month-old OVX rats over a broad dose range from ineffective to toxic doses. Ninety-six female 6-month-old Fischer-344 rats were used for this experiment. Eighty rats were bilaterally OVX, 8 rats were sham-operated (SHAM), and 8 rats were killed at the time of surgery as a baseline control. Groups of OVX rats received vehicle alone (n = 16) or daily doses in the diet of 0.025, 0.05, 0.1, and 0.2 microg of 1alpha(OH)D2 or 1alpha(OH)D3 per kg body weight (BW) per day (n = 8 each). After calcein double-labeling, all animals were killed 3 months post-OVX. Orally administered 1alpha(OH)D2 was significantly less toxic compared with 1alpha(OH)D3 in terms of BW gain and kidney calcium content. The effects of 1alpha(OH)D2 and 1alpha(OH)D3 on serum calcium and urinary calcium excretion were generally similar at all doses in this study. Both 1alpha(OH)D2 and 1alpha(OH)D3 prevented the estrogen deficiency-induced bone loss in OVX rats, and induced profound bone anabolic effects at high dosages. 1alpha(OH)D3 and 1alpha(OH)D2 also dose-dependently increased total bone mineral density (BMD), cortical area, and cortical thickness in the tibial diaphysis of OVX rats. Bone resorption as assessed by osteoclast numbers (Oc.Ns) in vertebral cancellous bone and urinary excretion of deoxypyridinoline (DPD) was dose-dependently suppressed by 1alpha(OH)D2 and 1alpha(OH)D3. These data show that although 1alpha(OH)D2 was slightly but significantly less toxic compared with 1alpha(OH)D3, it did not have increased skeletal effects at any dose. Taken together, our findings argue against selective metabolic activation of 1alpha(OH)D2 in bone.

Alendronate distributed on bone surfaces inhibits osteoclastic bone resorption in vitro and in experimental hypercalcemia models.

Alendronate is an aminobisphosphonate that acts as a potent inhibitor of osteoclastic bone resorption. To understand the mechanism of action of alendronate in vivo, in this study we investigated the relationship between distribution of [14C]-alendronate in rat bone and its effects on bone resorption in vitro or in rat hypercalcemic models. A single IV dose of 0.05 approximately 1.25 mg/kg inhibited the increase in plasma calcium level induced by bovine PTH or 1 alpha(OH)D3. The minimal effective dose of pamidronate (1.25 mg/kg) and etidronate (over 31.25 mg/kg) were at least 5 times and 25 times, respectively, higher than the dose of alendronate in the rat hypercalcemic model prepared by 1 alpha(OH)D3. The relative potencies of compounds in the hypercalcemic rat models reflected those of inhibitory effects on bone resorption in vitro. We conducted the ivory-slice assay under two conditions: (a) addition of a given bisphosphonate after adherence of the osteoclasts; and (b) preincubation of the ivory slices with a given bisphosphonate. The inhibitory IC50 values of alendronate under condition (b) were similar to those under condition (a). To evaluate the interaction between osteoclasts and alendronate in bone, we investigated the localization of [14C]-alendronate in the tibia of growing rats (4-day-old rats). Alendronate did not distribute uniformly in the tibia. At 1 day after injection (0.05 mg SC), dense labeling was seen primarily under osteoclasts. We injected 0.05 mg/kg of [14C]-alendronate (single i.v.) into rats [14C]-alendronate was rapidly eliminated from plasma, and mainly distributed to the bone in rats. These data suggest that alendronate which distributed on bone surface mainly contributed to the antihypercalcemic action in vivo.

Alphacalcidol and renal function in normal subjects.

Sixteen young healthy adults were treated for 3 weeks with alphacalcidol (1 alpha OHD3), 1 microgram orally per day, and renal function tests were performed before, at the end and 3 weeks after termination of the drug. No significant changes occurred in the serum concentrations of calcium or phosphate, whereas the serum calcium-phosphorus product and the urinary excretion of calcium increased significantly. Serum creatinine and the urinary excretion of creatinine showed no significant changes. Inulin clearance decreased by 4% (p = 0.11). The total plasma clearance rate of 51Cr-EDTA and the 24-hour endogenous creatinine clearance both decreased by 4% during the treatment (p less than 0.05). It is concluded that treatment of normal subjects with 1 alpha OHD3, in a modest dose causing no significant change in serum calcium, is associated with a small but reversible decrease in renal function.

The comparative toxicity of vitamin D metabolites in the weanling mouse.

The potential toxicity of vitamin D, alpha-calcidol [1 alpha(OH)D3], and calcitriol [1,25(OH)2D3] was studied by administration of these compounds at three different doses to weanling C57BL/6J mice over a 4-week period. Drug effects on calcium were monitored by serum calcium and urine calcium/creatinine ratio determinations. Tests of renal function included serum creatinine, 24-h urine volume, urinary protein, and glucose excretion, and histological evaluation of renal tissue. At 2 weeks, serum calcium was significantly elevated in animals receiving the higher doses of alpha-calcidol (2.78 +/- 0.25 at 50 ng/kg and 3.45 +/- 0.13 at 250 ng/kg body wt vs 2.14 +/- 0.06 mmol/l in controls, respectively). A similar effect was seen in the urinary calcium/creatinine ratio but serum creatinine remained unchanged. By 4 weeks, all animals receiving alpha-calcidol had significantly higher serum calcium and urinary calcium/creatinine ratios than other groups. Severe nephrocalcinosis was observed in the high-dose alpha-calcidol group only. We conclude that alpha-calcidol is more toxic than calcitriol in the mouse and suggest that the degree of toxicity is correlated to the degree of hypercalcemia and to the vitamin D metabolite used.

[Comparative study of the toxicity of 1 alpha-hydroxyvitamin D3 and 24,25 (RS)-dihydroxyvitamin D3 in rats]. / Sravnitel'noe izuchenie toksichnosti 1 al'fa-oksivitimina D3 i 24,25 (RS)-dioksivitamina D3 u krys.

The toxic effects of 1 alpha (OH)D3 and 24,25 (OH)2D3 administered in doses of 0.25, 2.5 and 25 micrograms per animal a day were compared in rats weighing initially 230-260 g and fed an artificial diet containing 0.65 and 0.50% of Ca and P, respectively. After 5 days of administering different doses of 1 alpha (OH) D3 hypercalcemia and hyperphosphatemia developed whatever the dose, the animals' weight and density of the osseous tissue dropped starting with a dose of 2.5 micrograms, together with a high death rate and Ca accumulation by soft tissues at a dose of 25 micrograms per animal. Unlike 1 alpha (OH)D3, 24,25 (OH)2D3 did not exert any hypercalcemic or hyperphosphatemic action when given in a high dose (25 micrograms). On the contrary, it promote the decrease of the Ca and P blood levels. 24,25 (OH)2D3 did not bring about Ca accumulation by the organs or reduction of the osseous tissue density whatever the dose applied. In addition, the metabolite administered in a dose of 25 micrograms arrested the animals' growth. Thus, when given in comparable doses (the physiologic requirement of 1 alpha (OH)D3 and 24,25 (OH)2D3 for rats are 0.025 and 0.25 micrograms/day, respectively), 24,25 (OH)2D3 was at least one order of magnitude less active as regards its capacity to increase the Ca and P blood levels and to resorb the osseous tissue. The data obtained and the inhibitory effect on the growth of the 100-fold dose of 24,25 (OH)2D3 point to the feasibility of the short-term use of the metabolite in doses that do not exceed more than 10-fold the physiologic dose.

[Experimental and clinical studies on calcium urolithiasis: (I) Animal model for calcium oxalate urolithiasis using ethylene glycol and 1-alpha (OH) D3].

As calcium oxalate stones are the most important component in urolithiasis, an experimental model has to be designed to clarify the pathogenesis and aid in their prevention. Hyperoxaluria as well as hypercalciuria were produced in rats by administering ethylene glycol (0.5%, in drinking water administered ad libitum) and 1-alpha (OH) D3 (0.5 micrograms/rat given every other day), respectively, for three to four weeks. Neither drug alone produced stones efficiently as did the combination regimen of these two compounds. The occurrence of stones was 77.3%, and with only a moderate degree of renal functional impairment. Biochemical and histological data were obtained using this model.

1 alpha-Hydroxyvitamin D2 is less toxic than 1 alpha-hydroxyvitamin D3 in the rat.

An LD50 of 0.2 mg/kg body wt has been determined for 1 alpha-hydroxyvitamin D3 in the rat. In comparison, the LD50 for 1 alpha-hydroxyvitamin D2 is between 3.5 and 6.5 mg/kg. In terms of chronic toxicity, 1 alpha-hydroxyvitamin D3 at a dose of 5 micrograms/kg/day causes death of one-half the animals in a 4-week period. On the other hand, 20 micrograms/kg/day of 1 alpha-hydroxyvitamin D2 is required to induce similar toxicity. The body weight record and renal calcium accumulation during chronic treatment support the above conclusion. It therefore appears that 1 alpha-hydroxyvitamin D2 is between 5 and 15 times less toxic than 1 alpha-hydroxyvitamin D3. This surprising result prompted a reexamination of the relative biological activity of 1 alpha-hydroxyvitamin D2 and 1 alpha-hydroxyvitamin D3. Both compounds are equally potent in the stimulation of intestinal calcium transport, bone calcium mobilization, in the elevation of serum phosphorus, and in the healing of rickets in the rat. The reason for lower toxicity of 1 alpha-hydroxyvitamin D2 is unknown. The results suggest that 1 alpha-hydroxyvitamin D2 might represent a therapeutically superior compound.

Parathyroid morphology in rats after administration of active vitamin D3.

The morphology of the parathyroid gland was examined in rats treated for one month with an active vitamin D3, 1 alpha-hydroxyvitamin D3. On continuous administration of 12.5 micrograms/kg/day of 1 alpha-hydroxyvitamin D3, the first histological change of the parathyroid gland, seen on day 10, was atrophy of the chief cells with marked accumulation of prosecretory granules. Replacement of the parenchyma by small or large cysts was evident on days 20 and 30. The remaining portion of the parathyroid parenchyma showed various histological changes: widened intercellular spaces intermingled with many cytoplasmic processes, shrinkage of the cytoplasm of the chief cells, and the presence of a few ghost cells in cysts. The appearance of cysts may be caused by suppression of parathyroid hormone secretion and is a characteristic lesion in hypervitaminosis in rats induced by treatment with active vitamin D3.

Toxicity of a vitamin D steroid to laying hens.

Two experiments were conducted with 56-week-old or 104-week-old Leghorn hens to determine if feeding vitamin D steroids in excess of requirement levels caused any marked affects on eggshell quality. In the first experiment caged hens had reduced feed consumption, egg shell quality, and egg production as early as 6 weeks after initially consuming a basal diet supplemented with 6.8 micrograms 1 alpha-hydroxycholecalciferol (1 alpha-OH-D3)/kg. The second experiment confirmed the previous results and showed that extensive weight loss occurred with continued feeding of 10 or 15 micrograms 1 alpha-OH-D3/kg diet. No adverse affects were observed in either experiment when the level of 1 alpha-OH-D3 supplementation was 5.0 micrograms/kg diet or less. No toxic effects were observed when the hormone precursor 25-OH-D3 was supplemented to diets at 6 or 12 micrograms/kg. It is suggested that the pathological effects observed are related to the potent calcium homeostatic properties of 1 alpha-OH-D3 that at elevated levels may cause aberrations in circulating calcium.

The ultrastructure of nephrocalcinosis induced in chicks by Cestrum diurnum leaves.

Powdered Cestrum diurnum leaves, mixed with two diets differing in calcium and phosphorus contents, produced nephrocalcinosis in young chicks regardless of serum calcium elevation. The calcific deposits, found in both proximal and distal portions of cortical tubules, began either in the cytoplasm or in lysosomal bodies as a unilaminar spheroid structure containing apatite crystals. The ultrastructural characteristics of intraluminal concretions suggested that they were formed intracellularly but later were extruded into the lumen. The extent of calcific deposits increased with duration and with hypercalcemia. Although Cestrum contains an analog of 1,25-dihydroxycholecalciferol, neither mitochondria nor basal lamina contained calcific deposits described in nephrocalcinosis secondary to hypervitaminosis D.

Effects of excess 1,25-dihydroxycholecalciferol in young rats.

The oral administration for 5 days of excess 1 alpha,25-dihydroxycholecalciferol [1,25(OH)2D3] at doses of 1, 5, and 25 micrograms/kg to rats, beginning at the age of 2 or 10 days, produced dose-dependent reductions in weight development and additional calcification near the skeleton. Alizarin red S stained skeleton revealed calcific deposits near the bones of the head, near the neural arches, between the ribs, along the bones both of the fore limbs and, to a lesser extent, of the hind limbs. Histologically, the deposits appeared to be localized primarily in the sub-epithelial connective tissues. Starting treatment with 1,25(OH)2D3 (25 micrograms/kg for 5 days) at the age of 20 days produced additional calcification in 1 of 8 rats at only 1 location (lower jaw). Additional calcification as described above could no longer be induced by 1,25(OH)2D3 in 30-day-old rats using doses up to 25 micrograms/kg and 10 daily treatments. We conclude that the sensitivity of young rats to 1,25(OH)2D3-induced additional calcification, which differs in localization from that observed in adult rats, decreases with the maturation of the animals.

An investigation of the toxicity of 1alpha-hydroxycholecalciferol to calves.

Two calves were treated with 15 micrograms/kg body weight of 1alpha-hydroxycholecalciferol by intramuscular injection on four occasions at seven-day intervals. Anorexia and reduced water consumption persisted for 48 h after each treatment. No clinical signs of iridocyclitis or any other lesions of the eyes were present at any time either macroscopically or microscopically. After the first treatment serum GOT and GD activities increased, serum AP activity fell, serum concentrations of calcium and inorganic phosphate increased, and magnesium concentrations decreased. The reduced serum magnesium concentrations and increased calcium and inorganic phosphate concentrations were maintained for the duration of the experiment, but there was no evidence of a cumulative effect of successive treatments. Blood urea concentrations increased after the third treatment. The gross pathology at post mortem examination was similar to that reported after vitamin D3 supplementation.

[Comparative study of the biological activity and toxic effect of 1alpha-hydroxycholecalciferol and ergocalciferol in rats]. / Sravnitel'noe izuchenie biologicheskoi aktivnosti i toksicheskogo deistviia 1alpha-oksikholekal'tsiferola i érgokal'tsiferola na krysakh.

Single administration of 0.25 microgram of sunthetic Ialpha-hydroxycholecalciferol (IalphaOHD3) into nephrectomized rats, maintained at D-avitaminous diet, improved the active transport of calcium ions against the concentration gradient in small intestine of these animals, whereas ergocalciferol was biologically inactive under the same conditions. Administration of IalphaOHD3 during 5 days at a dose 0.025 microgram normalized calcium content in blood serum of rats with D-avitaminosis, Increased doses of IalphaOHD3, administered into intact animals, caused transient hyperphosphatemia, hypercalcemia, calcinosis of internal tissues (kidney heart, aorta) as well as death of some animals. IalphaOHD3 exceeded 400-fold the hypercalcemic and calcinose effects of ergocalciferol. LD50 for IalphaOHD3 was equal to 100 microgram/kg, if it was administered during 5 days per os. Tissue calcinosis was developed after administration of a daily dose 10 microgram/kg, moderate hypercalcemia was caused by a daily dose 1 microgram/kg or 0.25 microgram per an animal; this amount is only 10-fold higher as compared with the physiologic requirement. Ergocalciferol caused hypercalcemia and metastatic calcification only at a dose 4000 microgram/kg. Clinical use of IalphaOHD3 at doses, exceeding the physiologic requirements, has to be prohibited due to high activity of the preparation and to toxicity of its increased doses.