21/10/2024
25-hydroxyvitamin D₃ (25(OH)D₃), also known as calcidiol, is a crucial intermediate in the vitamin D metabolic pathway. It is a more active form of vitamin D compared to the parent vitamin D₃ (cholecalciferol) and plays an essential role in calcium and phosphorus homeostasis, bone health, and other physiological processes. Here is its mode of action:
Conversion in the Liver: Vitamin D₃, either obtained from diet or synthesized in the skin through sunlight exposure, is transported to the liver, where it undergoes hydroxylation by the enzyme 25-hydroxylase to form 25-hydroxyvitamin D₃ (25(OH)D₃).
Circulation in Blood: 25(OH)D₃ is the major circulating form of vitamin D and is considered a good indicator of overall vitamin D status because of its relatively long half-life (2-3 weeks). It is transported in the bloodstream bound to the vitamin D-binding protein (DBP).
Activation in the Kidneys: In the kidneys, 25(OH)D₃ is converted by the enzyme 1α-hydroxylase into the active form of vitamin D, 1,25-dihydroxyvitamin D₃ (1,25(OH)₂D₃), also known as calcitriol. This is the biologically active form that exerts most of the effects of vitamin D.
Binding to Vitamin D Receptor (VDR): Calcitriol binds to the vitamin D receptor (VDR), a nuclear receptor found in various cells, especially in the intestines, bones, kidneys, and parathyroid glands. Upon binding, the VDR forms a complex with the retinoid X receptor (RXR).
Gene Regulation: The VDR-RXR complex binds to specific DNA sequences called vitamin D response elements (VDREs) in the promoter regions of target genes, modulating the transcription of these genes. These genes are involved in various biological processes such as:
Calcium and Phosphorus Absorption: Calcitriol enhances the absorption of calcium and phosphorus in the intestines, promoting bone mineralization.
Bone Remodeling: By regulating osteoblast and osteoclast activity, vitamin D supports bone formation and resorption.
Immune Function: Vitamin D modulates the immune system, supporting both innate and adaptive immune responses.
Feedback Regulation: Levels of 25(OH)D₃ and calcitriol are tightly regulated by feedback loops involving calcium levels, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23). When calcium levels are low, PTH increases the conversion of 25(OH)D₃ to calcitriol, whereas high levels of calcium or calcitriol reduce PTH secretion, thus reducing 25(OH)D₃ conversion.
This mechanism ensures proper calcium and phosphorus balance, which is critical for maintaining bone density and overall health.