Stephen Strugnell

Insights into Vitamin D metabolism using cyp24 over-expression and knockout systems in conjunction with liquid chromatography/mass spectrometry (LC/MS).

The development of novel gene expression systems for cytochrome P450s (CYPs) together with a revolution in analytical mass spectrometry with the emergence of liquid chromatography/mass spectrometry (LC/MS) has opened the door to answering some long-standing questions in Vitamin D metabolism. Our studies focused on: (1) elucidating the role of CYP24 in 25-OH-D3 and 1alpha,25-(OH)2D3 metabolism; (2) exploring how DBP influences this process; (3) measuring 25-OH-D3 metabolism in CYP24-knockout (CYP24-XO) cells and; (4) comparing 1alpha-OH-D2 metabolism in the CYP24-XO mouse in vivo and in vitro. Methodology employed CYP24 over-expression and knockout systems in conjunction with state-of-the-art analytical LC/MS, diode array, and radioisotopic detection methods. We found that CYP24 metabolizes 25-OH-D3 and 1alpha,25-(OH)2D3 at similar rates in vitro, but that for 25-OH-D3 but not 1alpha,25-(OH)2D3, this rate is strongly influenced by the concentration of DBP. Unlike their wild type littermates, the administration of 25-OH-D3 to CYP24-XO mice results in no measurable 24,25-(OH)2D3 production. When neonatal murine keratinocytes are prepared from wild type and CYP24-XO mice there was no measurable production of 24,25-(OH)2D3 or 1alpha,24,25-(OH)2D3 in CYP24-XO mice. Similar experiments using the same wild type and CYP24-XO animals and cells and [3H] 1alpha-OH-D2 resulted in the apparent paradox that the Vitamin D prodrug was 25-hydroxylated in vivo but 24-hydroxylated in vitro.

Metabolism of a cyclopropane-ring-containing analog of 1α-hydroxyvitamin D3 in a hepatocyte cell model: Identification of 24-oxidized metabolites

MC969 is an analog of the calcemic drug 1 alpha-hydroxyvitamin D3 (1 alpha-OH-D3) in which carbons 25,26, and 27 in the side chain are incorporated into a cyclopropane ring. Metabolites of MC 969 were generated in an in vitro human hepatocyte cell model, Hep 3B. The identity of the metabolites was established by comigration on HPLC with authentic standards, and by mass spectrometry of native and chemically modified metabolites. Unequivocal identification of the 24-keto- and the two epimeric 24-alcohol metabolites is provided. No 25-hydroxylated metabolites were detected. In competition studies, MC 969 was able to inhibit 25-hydroxylation of tritiated vitamin D3 more effectively than 1 alpha-OH-D3 itself, indicating that the vitamin D3-25-hydroxylase may be responsible for generation of one or more of the metabolites observed.

The seleno-acetal route to 1α-hydroxy-vitamin D analogues: synthesis of 24-oxa-1α-hydroxy-vitamin D3, a useful vitamin D metabolism probe

Abstract Alkylation of the lithio-demethylseleno-derivative of seleno-acetal 11 with chloromethyl isopropyl ether [shown by NMR to give the (22 S )-methylseleno-compound 13a as the major diastereoisomer] is the key reaction in the synthesis of the 24-oxa analogue (MC 1090, 8 ) of 1α-hydroxyvitamin D 3 ( 4 ). The metabolism of 8 to calcitroic acid ( 7 ) is demonstrated in vitro in a hepatocyte cell (Hep 3B) model. This supports the hypothesis that 8 can undergo enzymatic 25-hydroxylation analogous to the activation of 4 , or a similar side chain hydroxylation, but then short cuts the target cell side chain cleavage pathway taking 1α,25-dihydroxyvitamin D 3 to 7 .

Use of vitamin D4 analogs to investigate differences in hepatic and target cell metabolism of vitamins D2 and D3

In this study, we used molecules with either of the structural differences in the side chains of vitamin D(2) and vitamin D(3) to investigate which feature is responsible for the significant differences in their respective metabolism, pharmacokinetics and toxicity. We used two cell model systems-HepG2 and HPK1A-ras-to study hepatic and target cell metabolism, respectively. Studies with HepG2 revealed that the pattern of 24- and 26-hydroxylation of the side chain reported for 1alpha-hydroxyvitamin D(2) (1alpha-OH-D(2)) but not for 1alpha-OH-D(3) is also observed in both 1alpha-OH-D(4) and Delta(22)-1alpha-OH-D(3) metabolism. This suggests that the structural feature responsible for targeting the enzyme to the C24 or C26 site could be either the C24 methyl group or the 22-23 double bond. In HPK1A-ras cells, the pattern of metabolism observed for the 24-methylated derivative, 1alpha,25-(OH)(2)D(4), was the same pattern of multiple hydroxylations at C24, C26 and C28 seen for vitamin D(2) compounds without evidence of side chain cleavage observed for vitamin D(3) derivatives, suggesting that the C24 methyl group plays a major role in this difference in target cell metabolism of D(2) and D(3) compounds. Novel vitamin D(4) compounds were tested and found to be active in a variety of in vitro biological assays. We conclude that vitamin D(4) analogs and their metabolites offer valuable insights into vitamin D analog design, metabolic enzymes and maybe useful clinically.

Extended-release calcifediol for secondary hyperparathyroidism in stage 3-4 chronic kidney disease

ABSTRACT Introduction: Extended-release calcifediol (ERC) 30 µg capsules were recently approved as Rayaldee® by the United States Food and Drug Administration (FDA) for the treatment of secondary hyperparathyroidism (SHPT) in adults with stage 3–4 (not 5) chronic kidney disease (CKD) and vitamin D insufficiency (serum total 25-hydroxyvitamin D < 30 ng/mL). Calcifediol is 25-hydroxyvitamin D3, a prohormone of calcitriol (1,25-dihydroxyvitamin D3), the endogenous active vitamin D hormone. ERC capsules have a lipophilic fill which gradually releases calcifediol, corrects vitamin D insufficiency and increases serum calcitriol and thereby suppresses production of parathyroid hormone (PTH) in CKD patients without perturbing normal vitamin D and mineral metabolism. Areas covered: This review focuses on the chemical, pharmacokinetic, pharmacodynamic and clinical profiles of ERC and describes the product’s utility relative to other current treatment options for SHPT. Expert commentary: Randomized clinical trials (RCTs) have demonstrated that nutritional vitamin D is ineffective for treating SHPT whereas vitamin D receptor activators can correct elevated PTH but with increased risk of hypercalcemia and hyperphosphatemia. ERC offers healthcare professionals a new treatment option that has been demonstrated in RCTs to be safe and effective for controlling SHPT without meaningfully increasing serum concentrations of calcium or phosphorus.