NONCALCEMIC ACTIONS OF 1,25-DIHYDROXYVITAMIN D-3 AND CLINICAL-APPLICATIONS
NONCALCEMIC ACTIONS OF 1,25-DIHYDROXYVITAMIN D-3 AND CLINICAL-APPLICATIONS
复制标题
DOI：
10.1016/8756-3282(95)00195-j
复制
发表时间：
1995-08-01
期刊：
影响因子：
4.1
通讯作者：
HOLICK, MF
中科院分区：
文献类型：
--
作者：
HOLICK, MF
维生素D对于保持健康的骨骼是绝对必要的，如果没有维生素D，儿童会患软骨病，成年人会加剧他们的骨质疏松症和骨软化症，随意暴露在阳光下是大多数人维生素D的主要来源，在阳光照射下，紫外线B光子会光解皮肤储存的7-脱氢胆固醇来预防维生素D-3。维生素D-3前体热异构化形成维生素D-3。皮肤色素沉着的增加，纬度的变化，一天中时间的变化，防晒霜的使用和衰老都会对皮肤产生维生素D-3产生显著的影响，一旦维生素D-3在皮肤中形成或在饮食中摄入，它必须在肝脏和肾脏中被羟化为1，25-二羟基维生素D-3[1，25(OH)(2)D-3]。现在已经认识到，与钙代谢相关和与钙代谢无关的各种组织和细胞都是1，25(OH)(2)D-3的靶点。1，25(OH)(2)D-3刺激肠道钙吸收，动员干细胞动员骨钙库，拥有1，25(OH)(2)D-3受体的非钙化组织以多种方式对激素作出反应，人们非常感兴趣的是1，25(OH)(2)D-3是一种有效的抗增殖和促分化介质，因此，1，25(OH)(2)D-3及其类似物在各种临床疾病中有广泛的临床应用，如类风湿性和银屑病关节炎；1型糖尿病；高血压；心律失常；癫痫；乳腺癌、前列腺癌和结肠癌；一些白血病和骨髓增生性疾病；化疗导致的脱发；皮肤再生以及牛皮癣和鱼鳞病等皮肤病。
Vitamin D is absolutely essential for the maintenance of a healthy skeleton, Without vitamin D, children develop rickets and adults exacerbate their osteoporosis and develop osteomalacia, Casual exposure to sunlight is the major source of vitamin D for most people, During exposure to sunlight, ultraviolet B photons photolyze cutaneous stores of 7-dehydrocholesterol to previtamin D-3. Previtamin D-3 undergoes a thermal isomerization to form vitamin D-3. Increased skin pigmentation, changes in latitude, time of day, sunscreen use, and aging can have a marked influence on the cutaneous production of vitamin D-3, Once vitamin D-3 is formed in the skin or ingested in the diet, it must be hydroxylated in the liver and kidney to 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3]. It is now recognized that a wide variety of tissues and cells, both related to calcium metabolism and unrelated to calcium metabolism, are target sites for 1,25(OH)(2)D-3. 1,25(OH)(2)D-3 stimulates intestinal calcium absorption and mobilizes stem cells to mobilize calcium stores from bone, Noncalcemic tissues that possess receptors for 1,25(OH)(2)D-3 respond to the hormone in a variety of ways, Of great interest is that 1,25(OH)(2)D-3 is a potent antiproliferative and prodifferentiation mediator, As a result, 1,25(OH)(2)D-3 and its analogs have wide clinical application in such diverse clinical disorders as rheumatoid and psoriatic arthritis; diabetes mellitus type I; hypertension; cardiac arrhythmias; seizure disorders; cancers of the breast, prostate, and colon; some leukemias and myeloproliferative disorders; chemotherapy-induced hair loss; and skin rejuvenation as well as skin diseases like psoriasis and ichthyosis.