Mineral and electrolyte metabolism最新文献

Recent genetic studies have led to the characterization of molecular determinants contributing to the pathogenesis of hyperhomocysteinemia. In this article we summarize the current insights into the molecular genetics of severe, moderate and mild hyperhomocysteinemia. We will consider deficiencies of the trans-sulfuration enzyme cystathionine beta-synthase (gene symbol: CBS), and the disturbances of the remethylation enzymes 5, 10-methylenetetrahydrofolate reductase (gene symbol: MTHFR), methionine synthase (gene symbol: MTR), and the recently identified methionine synthase reductase (gene symbol: MTRR). Furthermore, we will focus on clinically important genetic polymorphisms which are highly prevalent and thus of potential general interest.

Hyperhomocysteinemia is a cardiovascular disease risk factor in the general population and in patients with renal failure. This article summarizes the results of recent total homocysteine-lowering intervention studies in individuals without renal failure and in patients with renal failure. Although almost all of the published studies mainly focused on the total homocysteine-lowering effect and not on cardiovascular disease outcomes of folic acid and vitamin therapy, recent work has gained important insights into this area of developing concern.

Gallium nitrate, an approved antitumor drug, has found clinical application in the treatment of cancer-related hypercalcemia and of Paget's disease; the exact mechanism of its action, however, remains unknown. The present study utilized rats in a 7-day exposure to gallium at doses similar to those used clinically. Quantitative histomorphometry and ultrastructural examination of osteoclast fine structure were carried out on specimens from animals with documented hypocalcemia. Gallium exposure produced striking changes in the osteoclast. The number of nuclei/osteoclast increased, and the ruffled borders of the osteoclasts were markedly decreased along the length of the Howship's lacunar cavity. The absence of a decrease in osteoclast number and the types of changes seen in ultrastructure suggest that the mechanism of action of gallium seen here may differ from that of calcitonin, a nontoxic, reversible antiresorbing agent. Results underscore the difficulty in assessing the toxicity of agents such as gallium on the osteoclast, a mature differentiated cell which does not divide and which does not produce a characteristic extracellular matrix component.

Background/aims: Astronauts exposed to microgravity during the course of spaceflight undergo physiologic changes that alter the urinary environment so as to increase the risk of renal stone formation. This study was undertaken to identify a simple method with which to evaluate the potential risk of renal stone development during spaceflight.

Method: We used a large database of urinary risk factors obtained from 323 astronauts before and after spaceflight to generate a mathematical model with which to predict the urinary supersaturation of calcium stone forming salts.

Result: This model, which involves the fewest possible analytical variables (urinary calcium, citrate, oxalate, phosphorus, and total volume), reliably and accurately predicted the urinary supersaturation of the calcium stone forming salts when compared to results obtained from a group of 6 astronauts who collected urine during flight.

Conclusions: The use of this model will simplify both routine medical monitoring during spaceflight as well as the evaluation of countermeasures designed to minimize renal stone development. This model also can be used for Earth-based applications in which access to analytical resources is limited.

The Na/H exchanger regulatory factor (NHE-RE), a recently cloned renal protein, is a necessary cofactor in protein kinase A-mediated inhibition of the renal brush border membrane Na/H exchanger. No studies to date, however, have examined the regulation of NHE-RF itself. The rabbit NHE-RF cDNA and an antibody to rabbit NHE-RF were used to study the effects of serum and cyclic adenosine monophosphate (cAMP) on the steady-state levels of NHE-RF mRNA and on the abundance and intracellular distribution of the protein in OK cells. Incubation of quiescent cells with serum was associated with a significant decrease in steady-state NHE-RF mRNA and protein abundance in the cytosolic and membrane fractions. Incubation of cells with cAMP for 6 h was associated with no change in NHE-mRNA at 24 h. There was, however, a 46% increase in protein abundance in the cytosolic fraction of the cell and a 43% decrease in the membrane fraction. Despite the decrease in membrane-associated NHE-RF in quiescent cells treated with serum of cAMP, there were no differences in either the basal rate of Na/H exchange transport or the inhibitory effect of the acute addition of cAMP on the transporter between experimental and control cells. These studies provide the first description of the regulation of NHE-RF. The results indicate that serum is associated with a decrease in NHE-RF mRNA and protein, while chronic exposure to cAMP is associated with an altered distribution of NHE-RF between the cytosolic and membrane fractions of OK cells.

The purpose of the present study was to investigate bone changes in the adult rat exposed to low lead levels during intake of normal dietary calcium and to contrast these findings with data from our earlier studies performed with animals receiving low dietary calcium concurrent with lead exposure. The present study exposed adult rats to 100 ppm lead via drinking water for 12 weeks and assessed bone histology, 1,25-dihydroxyvitamin D, 25(OH)vitamin D and parathyroid hormone levels. No osteopenia was evident by quantitative bone histology, and circulating levels of 1,25-dihydroxyvitamin D, 25(OH) vitamin D and parathyroid hormone were normal. Bone ash findings documented incorporation of significant amounts of lead into bone mineral. These findings document absence of interference with vitamin D metabolism, absence of secondary hyperparathyroidism and absence of osteopenia following 12 weeks of low lead exposure in the adult rat maintained on normal calcium intake. Results stress the importance of adequate calcium intake in our elderly population who may be exposed to cumulative, low-level lead exposure.

Hypophosphatemic (Hyp) mice have a reduced renal retention of phosphate. The beta-adrenergic agonist isoproterenol reverses phosphaturia induced by parathyroid hormone in the rat. This study determined whether isoproterenol could raise the renal tubular maximum transport of phosphate (TmP) in Hyp mice. Male 10- to 12-week-old normal and Hyp mice were infused with (3)H-inulin and isoproterenol (0.0, 0.25, 0.5 and 1.0 microg/kg/min) in 0.9% NaCl. Glomerular filtration rate, plasma phosphate, urinary phosphate excretion, TmP, urinary sodium excretion, and urinary cyclic adenosine monophosphate were measured. As expected, Hyp controls (0.0 dose) had a TmP which was significantly below that of normal controls: 1.15+/-(SEM) 0.6 (n = 9) versus 2.13+/-0.10 (n = 11) micromol P/ml glomerular filtrate (p<0.001). Isoproterenol at doses of 0.5 and 1.0 microg/kg/min elevated the TmP of Hyp mice to the level of normal controls: 1.94+/-0.19 (n = 7) and 1.98+/-0.10 (n = 9) micromol P/ml glomerular filtrate, respectively. These results indicate that the low tubular reabsorption of phosphate in Hyp mice is not due to a fixed low level of phosphate transport, but to decreased stimulation of phosphate transporters, since Hyp mouse kidneys increase phosphate reabsorption with suitable stimulus.

Epidermal growth factor (EGF) inhibits amiloride-sensitive Na(+) conductance in the apical membrane of the isolated rabbit cortical collecting duct. However, there is no information on the relationship between electrolyte transport and tyrosine kinase. We examined the effect of EGF on transport of potassium and chloride as well as sodium and the roles of tyrosine kinases in the rabbit cortical collecting duct using in vitro isolated tubular microperfusion. Basolateral EGF depolarized the transepithelial voltage in a dose-dependent manner within a concentration range of 10(-10) in 10(-8) M. Basolateral ouabain and luminal amiloride completely abolished EGF-induced depolarization. However, luminal BaCl(2) did not abolish its depolarization. To confirm the mechanism, sodium, potassium, and chloride fluxes were measured in the presence of 10(-10) M EGF. EGF significantly decreased the lumen-to-bath isotope flux of sodium and chloride from 93.6+/-12.5 to 61.1+/-9.6 pmol/mm/min (n = 5, p<0.05) and from 86.6+/-10.0 to 54. 8+/-9.7 pmol/mm/min (n = 10, p<0.01), respectively. EGF also decreased net potassium secretion from -27.7+/-5.9 to -7.8+/-1.5 pmol/mm/min (n = 6, p<0.01). To examine whether EGF-induced depolarization is mediated by tyrosine kinase, tyrosine kinase inhibitors were applied from the basolateral side. Pretreatment with 1 microg/ml herbimycin A for 120 min completely abolished EGF-induced depolarization (90.9+/-5.4%, n = 4; NS). Herbimycin A itself also did not change the lumen-to-bath isotope flux of sodium and completely abolished the inhibition of Na(+) absorption on EGF action (control 65.4+/-6.8, herbimycin A 61.8+/-6.3, EGF with herbimycin A 60.0+/-4.4 pmol/min/mm, n = 5; NS). In conclusion, EGF depolarizes transepithelial voltage by inhibiting sodium transport primarily and potassium and chloride transport secondarily. These effects were blocked by nonspecific tyrosine kinase inhibitors.

To determine whether environmental factors influence racial differences in calcium metabolism, the authors evaluated the influence of three factors (season, length of sunlight exposure, and diet) on calciotropic hormones, renal calcium excretion, and markers of bone turnover in an ambulatory population aged 25-36 years. Included were 109 black men, 114 white men, 95 black women, and 84 white women. Compared with white subjects, black subjects of both genders showed lower levels of serum 25-hydroxyvitamin D (25-OHD) and higher levels of serum 1,25-dihydroxyvitamin D [1,25(OH)(2)D]. The mean winter levels of 25-OHD were 19 to 29% lower than the summer levels in all groups. The urinary calcium excretion was 26% lower in black men than in white men and was 36% lower in black women than in white women. The parathyroid hormone levels were 29% higher in black women than in white women, but no statistically significant racial differences in parathyroid hormone levels were seen in men. Bone turnover markers (serum osteocalcin, bone-specific alkaline phosphatase, urinary pyridinoline cross-link excretion) did not show consistent racial differences. Racial and gender differences in calcium excretion did not significantly correlate with differences in lifestyle or with levels of the calciotropic hormones. Environmental factors such as diet and sunlight exposure do not appear to influence racial differences in the levels of the calciotropic hormones or renal calcium excretion.