Therapeutic role and potential mechanisms of active Vitamin D in renal interstitial fibrosis

J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):491-6. doi: 10.1016/j.jsbmb.2006.11.011. Epub 2007 Jan 5.

Abstract

Vitamin D, especially its most active metabolite 1,25-dihydroxyvitamin D(3) or calcitriol, is essential in regulating a wide variety of biologic processes, such as calcium homeostasis, immune modulation, cell proliferation and differentiation. Clinical studies show that the circulating level of calcitriol is substantially reduced in patients with chronic renal insufficiency. Administration of active Vitamin D results in significant amelioration of renal dysfunction and fibrotic lesions in various experimental models of chronic kidney diseases. Active Vitamin D elicits its renal protective activity through multiple mechanisms, such as inhibiting renal inflammation, regulating renin-angiotensin system and blocking mesangial cell activation. Recent studies indicate that calcitriol induces anti-fibrotic hepatocyte growth factor expression, which in turn blocks the myofibroblastic activation and matrix production in interstitial fibroblasts. Furthermore, in vivo and in vitro studies demonstrate that active Vitamin D effectively blocks tubular epithelial to mesenchymal transition (EMT), a phenotypic conversion process that plays a central role in the evolution of renal interstitial fibrosis. Together, it is becoming increasingly clear that a high level of active Vitamin D may be obligatory in the maintenance of normal kidney structure and function. Thus, supplementation of active Vitamin D could be a rational strategy for the therapeutics of chronic kidney diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Differentiation
  • Chronic Disease
  • Epithelial Cells / cytology
  • Epithelial Cells / metabolism
  • Fibrosis / metabolism
  • Fibrosis / pathology
  • Fibrosis / therapy
  • Hepatocyte Growth Factor / metabolism
  • Humans
  • Kidney Diseases / metabolism*
  • Kidney Diseases / pathology*
  • Kidney Diseases / therapy
  • Receptors, Calcitriol / metabolism
  • Stem Cells / cytology
  • Stem Cells / metabolism
  • Vitamin D / metabolism*

Substances

  • Receptors, Calcitriol
  • Vitamin D
  • Hepatocyte Growth Factor