Calcium calciferol
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Calcium and Calciferol: Therapeutic Applications and Mechanisms
Calcium and Calciferol in Familial Adenomatous Polyposis (FAP)
A study comparing the effects of sulindac versus calcium and calciferol on upper gastrointestinal polyps in patients with familial adenomatous polyposis (FAP) found that while sulindac reduced the crypt proliferation index in the gastric epithelium, calcium and calciferol did not have any significant effect on the crypt proliferation index in these patients1.
Calcitriol and Doxercalciferol in Secondary Hyperparathyroidism
Research comparing calcitriol and doxercalciferol, both combined with either calcium carbonate or sevelamer, demonstrated that both treatments effectively controlled bone turnover and suppressed parathyroid hormone (PTH) levels in patients with secondary hyperparathyroidism. However, doxercalciferol showed a greater improvement in eroded bone surface compared to calcitriol. Both treatments led to a significant increase in fibroblast growth factor-23 (FGF-23) levels, regardless of the phosphate binder used2.
Calciferol's Role in Nephrectomized Rats
In nephrectomized rats, calciferol was shown to maintain serum calcium levels postoperatively. This suggests that calciferol plays a crucial role in calcium homeostasis even after significant surgical interventions like thyroparathyroidectomy and nephrectomy3.
Dietary Calcium and 1,25-Dihydroxycholecalciferol in Autoimmune Encephalomyelitis
Studies on mice with experimental autoimmune encephalomyelitis (EAE) revealed that 1,25-dihydroxycholecalciferol, an active form of vitamin D, combined with a high-calcium diet, significantly suppressed the incidence and severity of EAE. The treatment also resulted in decreased lymphocyte numbers in lymph nodes and increased levels of IL-4 and TGF-beta1 mRNA, indicating an immune-modulating effect4.
Calcium and Calciferol in Osteoporotic Backache
A clinical trial involving postmenopausal women with osteoporotic backache showed that a combination of sodium fluoride, calcium, and calciferol significantly improved pain, infirmity, and reduced the consumption of analgesics compared to placebo5.
Mechanism of Calciferol in Calcium Uptake
Research on the intestinal transport of calcium in chicks indicated that calciferol enhances calcium uptake in the intestinal mucosa. The study found that calciferol supplementation increased the efficiency of calcium transport, suggesting that calciferol plays a critical role in the active transport of calcium across the intestinal epithelial cells6.
Impact of Oral Calcium and Calciferol on Serum Calcium Levels
In both young and elderly subjects, large oral doses of calcium carbonate significantly increased serum calcium levels. Pretreatment with calciferol further enhanced this effect, suggesting that calciferol supplementation can improve calcium absorption and potentially benefit osteoporosis treatment7.
Comparison of Dihydrotachysterol and Calciferol
Dihydrotachysterol (DHT) was found to be more potent than calciferol in increasing plasma calcium levels, particularly on a calcium-free diet. This suggests that DHT primarily enhances bone resorption, whereas calciferol mainly augments calcium absorption from the gut8.
Effects of Calciferol on Electrolyte Transport
Administering high doses of calciferol to dogs resulted in marked hypercalcemia and altered electrolyte concentrations in various tissues. This indicates that calciferol significantly influences calcium and magnesium metabolism, as well as the distribution and transport of other electrolytes9.
Calcium and Calciferol in Allergic Bronchial Asthma
In patients with allergic bronchial asthma, oral administration of calcium combined with calciferol significantly reduced airway resistance and intrathoracic gas volume, while increasing forced expiratory and inspiratory volumes. This suggests a potential therapeutic role for calcium and calciferol in managing airway obstruction in asthma10.
Conclusion
Calcium and calciferol exhibit diverse therapeutic effects across various conditions, including familial adenomatous polyposis, secondary hyperparathyroidism, autoimmune diseases, osteoporosis, and allergic bronchial asthma. Their roles in calcium homeostasis, bone metabolism, and immune modulation highlight their importance in clinical applications. Further research is needed to fully understand their mechanisms and optimize their therapeutic use.
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Most relevant research papers on this topic
Prospective randomized study of sulindac versus calcium and calciferol for upper gastrointestinal polyps in familial adenomatous polyposis
Sulindac effectively reduces gastric crypt proliferation in patients with familial adenomatous polyposis, while calcium and calciferol show no significant effects on crypt proliferation index.
RCTCalcitriol and doxercalciferol are equivalent in controlling bone turnover, suppressing parathyroid hormone, and increasing fibroblast growth factor-23 in secondary hyperparathyroidism.
Doxercalciferol is as effective as calcitriol in controlling serum parathyroid hormone levels and suppressing bone formation rate in patients with secondary hyperparathyroidism, with sevelamer allowing higher doses of vitamin D.
RCT
Rigorous Journal
Highly CitedON THE MODE OF ACTION OF CALCIFEROL IN THE NEPHRECTOMIZED RAT
Calciferol effectively maintains serum calcium levels in rats after thyroparathyroidectomy and bilateral nephrectomy, providing a potential therapeutic strategy for maintaining calcium levels in patients with kidney disease.
Non-RCT
Animal StudyDietary calcium is a major factor in 1,25-dihydroxycholecalciferol suppression of experimental autoimmune encephalomyelitis in mice.
Dietary calcium and 1,25-dihydroxycholecalciferol both play a role in preventing experimental autoimmune encephalomyelitis in mice.
Non-RCTAnimal StudyHighly CitedRelief of osteoporotic backache with fluoride, calcium, and calciferol.
Fluoride, calcium, and calciferol therapy significantly improves osteoporotic backache in postmenopausal women with crush fractures.
RCTStudies on the mechanism of action of calciferol. VIII. The effects of dietary vitamin D and the polyene antibiotic, filipin, in vitro, on the intestinal cellular uptake of calcium.
Calciferol-mediated calcium uptake is not the rate-limiting step in intestinal calcium transport, and filipin stimulates calcium uptake across the mucosal membrane in both +D3 and minus D3 systems.
In Vitro StudyEffect of single large doses of oral calcium on serum calcium levels in the young and the elderly.
Orally induced hypercalcemia combined with physiologic calciferol supplementation may provide benefits in osteoporosis treatment, potentially benefiting elderly individuals with subclinical vitamin D deficiency.
Non-RCTComparison of dihydrotachysterol and calciferol.
Dihydrotachysterol (DHT) is more potent in normal rats than calciferol, acting predominantly on bone resorption whereas calciferol mainly augments calcium absorption from the gut.
Effect of Vitamin D on Tissue Distribution and Transport of Electrolytes, 47Ca and 28Mg
Calciferol administration in dogs leads to hypercalcemia and decreases in plasma concentrations of sodium, potassium, magnesium, and chloride, with increased calcium uptake and magnesium concentrations.
Non-RCTAnimal Study