腎と骨代謝 Vol.27 No.3(4)


特集名 骨カルシウム代謝調節最前線
題名 核内レセプターの新規機能解析と構造情報に基づいた腎線維化疾患治療法
発刊年月 2014年 07月
著者 伊藤 一明 Department of Internal Medicine, University of Texas Medical Branch
【 要旨 】 核内レセプターであるビタミンD受容体(VDR)はさまざまな臓器で発現しており,カルシウム恒常性以外にも多面的な生理調節機能をもつ.ビタミンDやその代謝物がVDRに作用するメカニズムの解明は,各種疾患に対する治療薬の開発につながる.本稿ではVDRの分子調節メカニズムについて概説し,治療薬としてのビタミンDアナログ開発の新たなアプローチを提案する.
Theme Regulation and disorders of calcium and phosphate metabolism
Title Development of drugs to treat renal fibrosis by specifically stimulating nonclassical nuclear receptor pathway
Author Ichiaki Ito Department of Internal Medicine, University of Texas Medical Branch
[ Summary ] Vitamin D receptor (VDR) is a member of the nuclear receptor superfamily. They function as ligand-inducible transcription factors. VDR is expressed in various organs such as bones or kidneys, and has many aspects related to physiological roles. Recently, we showed that 1,25-dihydroxyvitamin D3 [1,25(OH)2D]-bound VDR specifically inhibits TGF-β-Smad signal transduction through direct interaction with Smad3. TGF-β-Smad signal transduction, which is known to be involved in tissue fibrosis, including renal fibrosis. In mouse models, 1,25(OH)2D3 prevented renal fibrosis through the suppression of TGF-β-Smad signal transduction. Based on the structure of the VDR-ligand complex, we generated a synthetic ligand, DLAM-4P. DLAM-4P selectively inhibits TGF-β-Smad signal transduction without activating VDR-mediated transcription. It significantly attenuated renal fibrosis in mice. In addition, DLAM-4P did not cause hypercalcemia resulting from stimulation of the transcriptional activity of the VDR. In relation to our study, a general method to develop synthetic ligands which stimulate specific nonclassical functions of nuclear receptors should be developed. Our findings may provide a paradigm for the development of drugs to treat various human diseases by specifically stimulating certain activities of nuclear receptors.
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