Vitamin D
The enzyme _________ catalyzes the conversion of 25-OH D to 1,25-(OH)D3
1α -hydroxylase
UVB radiation-> Vitamin D precursor in your skin-> _______ -> ________ -> active vitamin D
25- OH D 1.25- OH D
Metabolized to ______ in liver
25-OH D
______ secreted into blood, transported by DBP
25-OH D
With usual physiological intake, most vitamin D is converted to ______ and released into the blood; with supraphysiological intake, it is stored in the ______ tissue and released slowly.
25-OH D adipose
Ergocalciferol & cholecalciferol have a ______ with one ring broken Known as ______
3 ring structure Secosterioids
Structure of both Ergosterol & 7- dehydrocholesterol :
4-ring structure, characteristic of steroid
________ decreases the amount of calcium and phosphate in the blood.
Calcitonin
______ enables phosphorous absorption in the intestine
Calcitriol
_______ is loosely bound to DBPs for transport and then easy release into the tissues.
Calcitrol
Vitamin D reaching the liver either by way of ______ or by _____ must be hydroxylated by ________ to begin the generation of vitamin D's active form
Chylomicron remenants DBP cytochrome P-450 hydroxylases
_______ 25-OH D reflects Vit D status
Circulating
Most supplements provide Vit D as ______. Why?
D3 D3 is more potent than D2 form
______ known as vitamin D2 or calciferol, found in food and as dietary supplement
Ergocalciferol
Does dietary vitamin D require digestion?
No its absorbed from micelle by passive diffusion with help from bile salts and fat
From the blood, 25-OH D is taken up by tissues mostly the kidney in response to increase _____ concentrations.
PTH
A ______ is a substance added to a solid catalyst to improve its performance in a chemical reaction. By itself, the promoter has little or no catalytic effect. Some promoters interact with active components of catalysts and thereby alter their ______.
Promoter chemical effect on the catalyzed substance.
2 main function of Vit D
Serum Calcium Homeostasis Calcitrol synthesis Phosphorous homeostasis
Cutaneous vitamin D production is affected by time, pollution, latitude, sunscreen use, age, cloud cover, skin pigmentation. T of F
True
Sources of Vit D?
UV light, Animal foods fortified milk/dairy/margarine
First, Vit D activity requires an interaction with a ________.
Vitamin D Receptor (VDR)
Vitamin D exerts most of its effects via binding to a ______ that interacts with DNA. The vitamin D receptor is a member of the superfamily of _________ that regulate gene expression.
Vitamin D receptor (VDR) Nuclear receptors
Vit D deficiency
Widespread worldwide Rickets & Osteomalacia
Who needs supplementation?
breast-fed infants & other impaired absorption
The 1,25-(OH)D3 will be released to the blood and target the small intestinal cells to stimulate the production of ______, which is a calcium uptake protein. Collectively, all of these reactions will raise blood calcium levels to a normal physiological range.
calbindin
D3 is
cholecalciferol
Once within the enterocyte, vit D is incorporated into ______ that reach the systemic circulation via the _____ circulation. Some of the vit D is actually transferred from plasma chylomicrons to circulating ______
chylomicrons lymph vitamin D-binding proteins (DBP).
1α -hydroxylase is part of the enzyme systems associated with _________
cytochrome p450
D2 is
ergocalciferol
D3: Double bonds present at the ____ and _____ carbons in the B ring structure are necessary for this conversion, which in essence, opens up the B ring
fifth & seventh
Vit D carried aboard chylomicrons will be taken into _______ as chylomicrons remnants are removed. Meanwhile, the vitamin D transported by _____ can be delivered to extrahepatic tissue, such as skeletal muscle and adipocytes.
hepatocytes DBP
Both the liver and the kidneys add a ________ group to the vitamin D structure.
hydroxyl
Most absorbed in _______
jejunum
Vitamin D becomes incorporated into micelles in the small intestine and enters mucosal enterocytes by ________
passive diffusion
Low blood calcium increases secretion of _____. PTH stimulates (1) calcium release from bone; (2) 1 α-hydroxylase to produce 1,25 (OH)2D3 and (3) the reabsorption of calcium by the kidney tubules. 1,25 (OH)2 will enhance calcium absorption by stimulating small intestinal cells to produce the calcium uptake protein, calbindin. These series of reactions maintain calcium levels within a normal range.
PTH
Hypocalcemia (low blood calcium levels <8.5 mg/dL) will trigger _____
PTH release.
Role of ________ in the homeostatic control of calcium through interaction with vitamin D metabolism
Parathyroid hormone
Vit D toxicity Upper limit?
UL- 50 mg (4000 IU) most likely of all vitamins to cause toxicity excessive exposure to sun does not result in over production
The _______ may regulate the differentiation of hair follicles and skin epidermal cells.
VDR/1,25-dihydroxycholecalciferol
_______ are short sequences of DNA and are found in DNA regions associated with 1,25-dihydroxycholecalciferol-activated genes., such as ________, ________(expressed in osteoblasts), _______ (found in osteoclasts and macrophages) ______, and ______ (kidney).
VDREs Osteocalcin osteopontin β3 integrin 24-OHase calbindin D
Vitamin D binds to ____ & ___ complexes with ____ ____ influence gene expression/repression
VRD, VDR RXR VDRE's
In humans, ______ is created photochemically as UV light converts the precursor sterol 7-dehydrocholeserol to cholecalciferol. That reaction takes place as _______ glands secret 7-dehydrocholesterol onto the skins surface. Cholecalciferol can then be reabsorbed to varying depths within the skin.
Vitamin D3 Sebaceous
Osteomalacia
adults failure to mineralize already formed bone Results from decreased calcium and phosphate absorption
Why Vit D is still deemed essential
bc its recommended to avoid sun exposure to decrease risk of skin cancer
Vitamin D also called
calciferol
Parathyroid hormone stimulates ______ production in the kidney by increasing the synthesis of ______.
calcitrol 1-α hydroxylase.
PTH release will stimulate the release of ______ from bone.
calcium
The production of the vitamin D hormone is tightly feedback regulated directly or indirectly by _____ and ______ levels of the plasma
calcium & phosphorus
Whats major contributor of Vit D in human diet?
fortified milk and dairy products
Why is vitamin D questionable as a "vitamin"? What makes it unique...
*it can be synthesized* adequately in body with sufficient exposure to sunlight and organ function & it functions more like a *hormone* bc its activity is dependent on first interacting with a receptor
_______ min cutaneous exposure (Caucasian wearing a bathing suit) to UVB between 10 am -3 pm during spring, summer, fall produces ~10,000 - 20,000 IU (250-500 ug) of vitamin D3. About ______ times more than vitamin D found in fortified foods.
15-30 100
The most potent metabolite of vitamin D. This enzyme is found in renal cells lining the proximal tubule.
1a-hydroxylase
________ enables humans to manufacture vit D3 from UV light.
7-dehydrocholesterol
Provitamin is
7-dehydrocholesterol found in skin & breast milk
This vitamin D hormone functions in the intestine, bone, and kidney to stimulate transport of calcium and phosphorus into the extracellular fluid compartment upon demand.
Calcitriol (D3)
_______ maintains serum calcium levels by increasing calcium absorption in the gastrointestinal tract
Calcitrol
_______ acts on cells in the gastrointestinal tract to increase the production of calcium transport proteins, termed ________, which results in increased uptake of calcium from the gut into the body. This is the only mechanism by which the body can increase its calcium _____.
Calcitrol calbindin-D protein stores
______ is stimulated in response to changes in serum calcium concentrations and release of pTH
Calcitrol synthesis
PTH stimulates (1) _____ release from bone; (2) 1 α-hydroxylase to produce ________. (3) the reabsorption of calcium by the _______.
Calcium 1,25 (OH)2D3 Kidney tubules
Rickets Result?
Children Failure of bone to mineralize.As the epiphyseal cartilage continues to grow, it is not properly replaced with matrix and hydroxyapatite. Results in bowing of long, weight-bearing bones
_______ known as vitamin D3, made by the skin when exposed to light
Cholecalciferol
After hepatic synthesis, most 25-OH D is excreted from the liver and transported in the blood by _____. The blood is the major storage site of 25-OH D, which has a half-life of about 2-3 weeks
DBP
Upon reaching the liver, either by chylomicron remnant removal or by transport by ______, vitamin is hydroxylated at carbon 25 by ________. The status of existing active vitamin D is fundamental for the efficiency of this enzyme: when vit D status is low, efficiency increases. Vitamin D is converted to 25-hydrocholecalciferol, or more simply_______.
DBP 25 hydroxylase 25-OH D
Cytochrome P450 is involved in protein processing and transport (______) and the energy-producing centers of cells (_______)
ER mitochondria
______ converted to Vit D2 when irradiated with UV light
Ergosterol
These _______ are collectively referred to as mixed-function oxidases (the enzymes reduce one atom of molecular oxygen to water and one to the hydroxyl group) They are abbreviated by ____ followed by numbers/letters
Hydrolases CYP
Two medical conditions absorption can be compromised/decreased by ?
resection of jejunum fat malabsorption
The vitamin D receptor (VDR) acts in partnership with the_______ and binds to nucleotide base pairs called the _______ to control gene expression.
retinoic acid receptors (RXR) vitamin D-responsive elements (VDRE)
Direct exposure to UVB photons penetrate into the epidermis and dermis, allowing 7-dehydrocholesterol in the plasma membranes of skin cells to absorb the photons; this event causes the B ring to open, forming previtamin D3 (precholecalciferol). The unstable double bonds in previtamin D3 are rearranged through a process called ________.
thermal isomerization -atoms have diff arrangement
The efficiency of vitamin D binding is tremendously increased after ________ to its molecular form
two hydroxylations
Converted to 1,25-OH2 D (calcitriol) in kidneys Calcitrol released into _____
1,25-OH2 D blood
PTH will have two effects on the kidneys: 1) it will stimulate 1α -hydroxylase to produce ______ 2) it will stimulate the reabsorption of Ca by the _______
1,25-(OH)D3 kidney tubules
______ also picks up cholecalciferol created in the skin. About 40% circulating vit D is transported by ______, 60% by _____.
DBP chylomicrons DBP
Older adults produce less ______ and therefore produce up to ____ less Vit D.
DHCR7 75%
*Cis-retinoic acid* and *1,25-dihydroxycholecalciferol* are _____ that must be present to control gene expression.
Ligands
the activity of 1a- hydroxylase is enhanced by _____ & ______ and inhibited by ______ & ______
PTH & IGF-1 Calcium & phosphorous
Vitamin D _____ and ______ signaling pathways. ______ binds to its nuclear receptor (VDR) which, after heterodimerisation with ____, induces genomic responses.
genomic & nongenomic 1,25-(OH)2D RXR
In the kidneys, 25-OH D is _______at position 1 to form the vitamin's active form _______. Other tissues are also able to use _______ to make their own calcitriol.
hydroxylated *1,25-(OH)2* 25-OH D
Darker skin individuals require ______ sun exposure to generate the vitamin as melanin blocks some of the UVB rays.
longer
Incorporated into chylomicron for: -transport into ______, then _____ -transferred to ________ to skeletal muscle and adipocytes
lymphatic system, blood vitamin D binding proteins (DBP)
Vitamin D helps the small intestine and the kidney to reabsorb ______ back into the bloodstream. The _______ is believed to increase the brush border ______, which increases the availability of phosphorous for absorption by cleaving phosphate esters bonds with other molecules.
phosphate VDR/1,25-dihydroxycholecalciferol complex alkaline phosphatase
Calcitriol promotes reabsorption of ________ out of the bone and into the blood
phosphorous
Vitamin D Functions:
vitamin D receptor mediation regulation of gene expression differentiation of stem cells in bone tissue, hair follicles, and skin cells Possible roles in bone metabolism and/or bone formation and cancer -prevention and treatment Multiple sclerosis, type 1 diabetes, IBD and rheumatoid arthritis Thought to prevent heart disease of various types