Spectrally and Time-Resolved Fluorescence Imaging of 22-NBD-Cholesterol in Human Peripheral Blood Mononuclear Cells in Chronic Kidney Disease Patients.

The interaction of the fluorescent probe 22-NBD-cholesterol with membranes of human peripheral blood mononuclear cells (PBMC) was tested by time- and spectrally resolved fluorescence imaging to monitor the disturbance of lipid metabolism in chronic kidney disease (CKD) and its treatment with statins. Blood samples from healthy volunteers (HV) and CKD patients, either treated or untreated with statins, were compared. Spectral imaging was done using confocal microscopy at 16 spectral channels in response to 458 nm excitation. Time-resolved imaging was achieved by time-correlated single photon counting (TCSPC) following excitation at 475 nm. The fluorescence of 22-NBD-cholesterol was mostly integrated into plasmatic membrane and/or intracellular membrane but was missing from the nuclear region. The presence of two distinct spectral forms of 22-NBD-cholesterol was uncovered, with significant variations between studied groups. In addition, two fluorescence lifetime components were unmasked, changing in CKD patients treated with statins. The gathered results indicate that 22-NBD-cholesterol may serve as a tool to study changes in the lipid metabolism of patients with CKD to monitor the effect of statin treatment.

[Vitamin D3 supplementation and cellular calcium homeostasis in patients with chronic kidney disease]. / Suplementácia vitamínu D3 a bunková homeostáza vápnika u pacientov pri chronickej chorobe obliciek.

Mini review summarizes the results of our studies focused on elucidation of the pathophysiological mechanisms of altered calcium homeostasis in nonexcitable cells from patients with early stages of chronic kidney disease (CKD), as well as on determining the effect of vitamin D3 supplementation on these mechanisms. The basic mechanisms of calcium entry to and removal of the cell are already changed in early stages of CKD. These disturbances cause an increased the concentration of cytosolic free calcium ([Ca2+]i), which may change a number of cellular processes, and the expression of various signaling molecules. Vitamin D3 supplementation is a standard procedure of vitamin D insufficiency/ deficiency correction in these patients. The pleiotropic effects of vitamin D may be involved in the modulation of cellular calcium homeostasis. Vitamin D3 supplementation resulted in a reduction in [Ca2+]i by affecting of specific transport systems of calcium cations entry to and removal of the cell. The normalization [Ca2+]i can have a beneficial effect on intracellular signalling, and thus positively influence the functioning of cells, tissues or organs.Key words: cellular calcium homeostasis - chronic kidney disease - intracellular calcium - vitamin D.

The Impact of Vitamin D3 Supplementation on Mechanisms of Cell Calcium Signaling in Chronic Kidney Disease.

Intracellular calcium concentration in peripheral blood mononuclear cells (PBMCs) of patients with chronic kidney disease (CKD) is significantly increased, and the regulatory mechanisms maintaining cellular calcium homeostasis are impaired. The purpose of this study was to examine the effect of vitamin D3 on predominant regulatory mechanisms of cell calcium homeostasis. The study involved 16 CKD stages 2-3 patients with vitamin D deficiency treated with cholecalciferol 7000-14000 IU/week for 6 months. The regulatory mechanisms of calcium signaling were studied in PBMCs and red blood cells. After vitamin D3 supplementation, serum concentration of 25(OH)D3 increased (P < 0.001) and [Ca(2+)]i decreased (P < 0.001). The differences in [Ca(2+)]i were inversely related to differences in 25(OH)D3 concentration (P < 0.01). Vitamin D3 supplementation decreased the calcium entry through calcium release activated calcium (CRAC) channels and purinergic P2X7 channels. The function of P2X7 receptors was changed in comparison with their baseline status, and the expression of these receptors was reduced. There was no effect of vitamin D3 on P2X7 pores and activity of plasma membrane Ca(2+)-ATPases. Vitamin D3 supplementation had a beneficial effect on [Ca(2+)]i decreasing calcium entry via CRAC and P2X7 channels and reducing P2X7 receptors expression.

Purinergic P2X7 receptors participate in disturbed intracellular calcium homeostasis in peripheral blood mononuclear cells of patients with chronic kidney disease.

BACKGROUND: P2X(7) receptors intervene with lymphocyte activation and are responsible for multiple processes, including calcium influx. Here, we studied the participation of P2X(7) receptors in disturbed intracellular calcium homeostasis regulation in early-stage chronic kidney disease (CKD). METHODS: The study involved 20 healthy volunteers and 20 CKD stage 2-3 patients. The free cytosolic calcium concentration ([Ca(2+)](i)) was measured using fluorimetry. The P2X(7) pore function was evaluated by the fluorescent dye ethidium bromide. RESULTS: In peripheral blood mononuclear cells (PBMCs) of patients, [Ca(2+)](i), intracellular calcium stores and the capacitative calcium entry were increased when compared with healthy subjects. The agonist of P2X(7) receptor BzATP caused a sustained increase in [Ca(2+)](i) in both groups, but the effect was smaller in patients. The antagonist at the P2X(7) receptor KN-62 reduced [Ca(2+)](i) in patients, but had no effect in healthy subjects. In patients, the permeability of ethidium bromide through P2X(7) pores, as well as through BzATP-activated and KN-62-inhibited pores, was distinct from permeability in healthy volunteers. CONCLUSIONS: These results demonstrate that the calcium signaling pathway in PBMCs of CKD patients is defective already in CKD stage 2-3, and the pore-forming P2X(7) receptors are involved in these pathophysiological processes.

Intracellular calcium homeostasis in patients with early stages of chronic kidney disease: effects of vitamin D3 supplementation.

BACKGROUND: Chronic renal failure has been referred to as a state of cellular calcium toxicity. The aim of this study was to investigate the status of free cytosolic calcium ([Ca(2+)](i)), intracellular calcium reserves and the capacitative calcium entry in peripheral blood mononuclear cells (PBMCs) of early-stage chronic kidney disease (CKD) patients, and to determine the effect of vitamin D(3) supplementation on these parameters. METHODS: The study involved 44 patients with CKD stages 2-3; 27 of them were treated with cholecalciferol (5000 IU/week) for 12 months. [Ca(2+)](i) was measured using Fluo-3 AM fluorimetry. Intracellular calcium reserves were emptied by the application of thapsigargin (Tg), a specific inhibitor of endoplasmic reticulum Ca(2+)-ATPase. 2-Aminoethyl-diphenyl borate (2APB) was used to examine the capacitative calcium entry. RESULTS: [Ca(2+)](i) of CKD patients was substantially higher in comparison with healthy subjects: 123 (115-127) versus 102 (98-103) nmol/l, P < 0.001. The calcium concentration of Tg-sensitive stores and the capacitative calcium entry were also significantly increased in CKD patients. After the 12-month vitamin D(3) supplementation, there was a marked decrease in [Ca(2+)](i) [105 (103-112) nmol/l, P < 0.001 versus baseline], independently of the increase in 25(OH)D(3) or the decrease in PTH levels. No significant changes in intracellular calcium reserves and the capacitative calcium entry were found. CONCLUSIONS: Our results demonstrate that (1) [Ca(2+)](i), intracellular calcium stores and the capacitative calcium entry were significantly increased already in early stages of CKD; (2) long-term vitamin D(3) supplementation normalized [Ca(2+)](i) without any effect on intracellular calcium reserves or the capacitative calcium entry.

Effects of long-term cholecalciferol supplementation on mineral metabolism and calciotropic hormones in chronic kidney disease.

BACKGROUND: Data on the efficacy and safety of long-term vitamin D supplementation in chronic kidney disease (CKD) are scarce. We assessed the effects of the 12-month vitamin D(3) treatment on mineral metabolism and calciotropic hormones in patients with CKD stages 2-4. METHODS: Eighty-seven patients (mean age 66 years, men/women 33/54) were randomized to cholecalciferol treatment with either 5,000 or 20,000 IU/week. Serum calcium, phosphate, 25(OH)D(3), 1,25(OH)(2)D(3), PTH and urinary mineral concentrations were obtained at baseline and after 4, 8 and 12 months. RESULTS: The median serum mineral concentrations were normal and not changed throughout the study. The number of hypercalciuric patients slightly increased with higher dose, but no sustained rise in calciuria was present. Vitamin D insufficiency/deficiency was revealed in 72 (83%) patients at baseline and 37 (43%) at month 12. The 25(OH)D(3) levels increased more with higher dose; a rise in 1,25(OH)(2)D(3) was less impressive. The parathyroid hormone (PTH) concentrations were reduced, but the number of subjects with PTH below the lower limit for CKD stage 3 increased equally with both doses. CONCLUSIONS: Vitamin D insufficiency/deficiency in CKD significantly improved after the 12-month cholecalciferol treatment, with higher dose being more effective and equally safe. Further studies of vitamin D(3) effects on bone metabolism are warranted.

Rapid effects of 1alpha,25(OH)2D3 in resting human peripheral blood mononuclear cells.

The steroid hormone 1alpha,25(OH)2D3 produces biological responses via both genomic and nongenomic mechanisms. Stimulation of rapid, nongenomic responses by 1alpha,25(OH)2D3 has been postulated to result from interaction of the ligand with cell membrane 1alpha,25(OH)2D3 receptors and to involve membrane receptors. We examined the rapid effects of 1alpha,25(OH)2D3 on calcium mobilization and calcium entry into resting human peripheral blood mononuclear cells isolated from healthy volunteers. We also investigated the possible involvement of purinergic receptors in this action. 1alpha,25(OH)2D3 induced a time-dependent increase in intracellular calcium concentration ([Ca2+]i). The initial 1alpha,25(OH)2D3-stimulated calcium increment was sensitive to thapsigargin (Tg), indicating its origins in calcium release from intracellular stores. 2-Aminoethyldiphenyl borate (2APB), an inhibitor of capacitative calcium entry, caused a significant [Ca2+]i decrease in human cells treated with 1alpha,25(OH)2D3. Furthermore, in contrast to observations in osteoblasts and skeletal muscle cells, nifedipine had no effect on 1alpha,25(OH)2D3-induced calcium entry, suggesting that L-type calcium channels were not implicated in this action. Besides, 1alpha,25(OH)(2)D3 prevented the calcium entry induced by 3'-O-(4-benzoyl)benzoyl-adenosine 5'-triphosphate (BzATP), a specific agonist of purinergic P2X7 receptors. This finding was further confirmed by 1alpha,25(OH)2D3-induced reduction of BzATP- and 4-aminopyridine (4AP)-stimulated ethidium bromide fluorescence. The presented results demonstrate, for the first time in healthy, resting human peripheral blood mononuclear cells that 1alpha,25(OH)2D3 is capable of exerting a rapid, nongenomic effect on [Ca2+]i, while inhibiting of the P2X7 channel permeability.

4-Aminopyridine activates calcium influx through modulation of the pore-forming purinergic receptor in human peripheral blood mononuclear cells.

We investigated whether 4-aminopyridine (4AP), a drug recently linked to calcium influx and apoptosis, also affected purinergic receptor channels that are known to play an important role in the activation of T lymphocytes. The application of 4AP induced a rise in [Ca2+]i that was sensitive to nickel. This action was also observed in cells in which calcium reserves were emptied using thapsigargin (Tg). However, it was not present in the absence of extracellular Ca2+, despite full internal reserves. Adenosine trisphosphate (ATP), a partial agonist and a physiological activator of purinergic receptors, also stimulated Ca2+ entry independently of the calcium release from internal compartments. The effects of 4AP and ATP were not additive when studied on the same population of cells. KN-62 inhibited an increase in calcium entry induced by 4AP, while brilliant blue G (BBG) prevented it, supporting the hypothesis that purinergic P2X7 receptors are involved in this action. Furthermore, 4AP allowed entry of ethidium bromide (314 Da) but not propidium iodide (415 Da) into the cell, also corroborating the involvement of P2X7 pores. The presented results demonstrate, for the first time in human mononuclear cells isolated from healthy volunteers, that the P2X7 channel pore is involved in the action of 4AP and intervenes in the sustained calcium entry induced in response to 4AP.