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Intestinal Cyp24a1 regulates vitamin D locally independent of systemic regulation by renal Cyp24a1 in mice
Michaela A.A. Fuchs, … , Tomokazu Souma, Myles Wolf
Michaela A.A. Fuchs, … , Tomokazu Souma, Myles Wolf
Published December 17, 2024
Citation Information: J Clin Invest. 2025;135(4):e179882. https://doi.org/10.1172/JCI179882.
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Research Article Metabolism Nephrology

Intestinal Cyp24a1 regulates vitamin D locally independent of systemic regulation by renal Cyp24a1 in mice

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Abstract

Vitamin D regulates mineral homeostasis. The most biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25D), is synthesized by CYP27B1 from 25-dihydroxyvitamin D (25D) and is inactivated by CYP24A1. Human monogenic diseases and genome-wide association studies support a critical role for CYP24A1 in regulation of mineral homeostasis, but little is known about its tissue-specific effects. Here, we describe the responses of mice with inducible global deletion, kidney-specific, and intestine-specific deletion of Cyp24a1 to dietary calcium challenge and chronic kidney disease (CKD). Global and kidney-specific Cyp24a1 deletion caused similar syndromes of systemic vitamin D intoxication: elevated circulating 1,25D, 25D, and fibroblast growth factor 23 (FGF23), activation of vitamin D target genes in the kidney and intestine, hypercalcemia, and suppressed parathyroid hormone (PTH). In contrast, mice with intestine-specific Cyp24a1 deletion demonstrated activation of vitamin D target genes exclusively in the intestine, despite no changes in systemic vitamin D levels. In response to a high calcium diet, PTH was suppressed, despite normal serum calcium. In mice with CKD, intestinal Cyp24a1 deletion decreased PTH and FGF23 without precipitating hypercalcemia. These results implicate kidney CYP24A1 in systemic vitamin D regulation while independent local effects of intestinal CYP24A1 could be targeted to treat secondary hyperparathyroidism in CKD.

Authors

Michaela A.A. Fuchs, Alexander Grabner, Melody Shi, Susan L. Murray, Emily J. Burke, Nejla Latic, Venkataramana Thiriveedi, Jatin Roper, Shintaro Ide, Koki Abe, Hiroki Kitai, Tomokazu Souma, Myles Wolf

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Figure 8

Tissue-specific effects of Cyp24a1 deletion in health and in CKD.

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Tissue-specific effects of Cyp24a1 deletion in health and in CKD.
(A) Ki...
(A) Kidney-specific deletion of Cyp24a1 increased systemic 1,25D levels and 1,25D-VDR activity, which caused hypercalcemia, increased FGF23, and suppressed PTH. In contrast, mice with intestine-specific deletion of Cyp24a1 demonstrated no change in circulating 1,25D levels, yet 1,25D-VDR activity increased locally in the intestines. As a result, augmented intestinal calcium absorption suppressed PTH without causing hypercalcemia and only mildly increased FGF23. (B) Secondary hyperparathyroidism is a common complication of CKD that is characterized by low 1,25D effects. In a model of CKD, intestinal Cyp24a1 deletion potentiated 1,25D effects locally in the intestine, resulting in increased calcium absorption and significantly decreased PTH and FGF23 levels. These findings support intestinal Cyp24a1 as a potential target for the treatment of secondary hyperparathyroidism in patients with CKD.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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