The roles of vitamin D and growth factors in the pathogenesis of renal osteodystrophy

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To clarify the pathophysiologic roles of vitamin D in the renal osteodystrophy, the expression of vitamin D receptor (VDR) gene in parathyroid gland was examined. Decreased expression of VDR was confirmed by immunostaining and in situ hybridization methods. From these results in hands, we next turned to examine the VDR gene polymorphism in renal failure, because Eisman et al.suggested that VDR gene polymorphism might determine VDR mRNA stability. Namely, the genotype which contains Bsml and Apal cutting sites in intron 8 (referred to as B and A respectively), and does not contain Taql cutting site (t) in exon 9 might be unstable. In chronic renal failure patients, the patients who had B,A,t genotype showed more sever from of secondary hyperparathyroidism. Therefore, the severities of secondary hyperparathyroidism may be forecasted by the analysis of VDR gene polymorphism.