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Calreticulin Inhibits Vitamin D’s Action on the PTH Gene in Vitro and May Prevent Vitamin D’s Effect in Vivo in Hypocalcemic Rats

Minerva Center for Calcium and Bone Metabolism (A.S-B., T.N-M, J.S.) Nephrology Services Hadassah University Hospital and Hebrew University Medical School Jerusalem, Israel 91120
Department of Medicine (J.R.) Albert Einstein College of Medicine Bronx, New York 10461
Department of Medicine (N.J.K.) University of Kentucky Medical School Lexington, Kentucky 40536
Molecular Biology of Membranes Research Group (M.M.) University of Alberta Edmonton, Alberta T6G 2S2, Canada

1,25-dihydroxyvitaminD₃ [1,25-(OH)₂D₃] and PTH both act to increase serum calcium. In addition, 1,25-(OH)₂D₃ decreases PTH gene transcription, which is relevant both to the physiology of calcium homeostasis and to the management of the secondary hyperparathyroidism of patients with chronic renal failure. In chronic hypocalcemia there is secondary hyperparathyroidism with increased levels of PTH mRNA and serum PTH despite markedly increased levels of 1,25-(OH)₂D₃. We have studied the role of calreticulin in this resistance to 1,25-(OH)₂D₃. Weanling rats fed a low-calcium diet were hypocalcemic and had increased PTH mRNA levels despite high serum 1,25-(OH)₂D₃ levels. 1,25-(OH)₂D₃ given by continuous minipump infusion to normal rats led to the expected decrease in PTH mRNA. The hypocalcemic rats had an increased concentration of calreticulin in the nuclear fraction of their parathyroids, but not in other tissues. Gel shift assays showed that a purified vitamin D receptor and retinoid X receptor-ß bound to the PTH promoter’s chicken and rat vitamin D response element (VDRE), and this binding was inhibited by added pure calreticulin. Transfection studies with a PTH VDRE-chloramphenicol acetyltransferase (CAT) construct showed that 1,25-(OH)₂D₃ decreased CAT transcription. Cotransfection of PTH VDRE-CAT with a calreticulin expression vector in the sense orientation prevented the transcriptional effect of 1,25-(OH)₂D₃, but a calreticulin vector in the antisense orientation had no effect. These results show that calreticulin prevents the binding of vitamin D receptor-retinoid X receptor-ß to the PTH VDRE in gel retardation assays and prevents the transcriptional effect of 1,25-(OH)₂D₃ on the PTH gene. This is the first report of calreticulin inhibiting a down-regulatory function of a sterol hormone and may help explain the refractoriness of the secondary hyperparathyroidism of many chronic renal failure patients to 1,25-(OH)₂D₃.

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