Conversion of Natural Products from Renewable Resources in Pharmaceuticals by Cytochromes P450
Peter Grunwald in Pharmaceutical Biocatalysis, 2019
Vitamin D2 (VD2) is physiologically produced from ergosterol in yeast or fungi, while VD3 is produced from 7-deoxycholesterol in mammals. The bioactive forms of vitamin D2 and D3, as well as their analogs, have been employed for the clinical treatment of different diseases including rickets, osteoporosis, hyperparathyroidism, and cancers. Paricalcitol (19-nor-1,25D2) and doxercalciferol (1α(OH)D2) that are vitamin D2 analogs, are currently used as drugs for the treatment of secondary hyperparathyroidism (Bover et al., 2014) and paricalcitol was shown to have anticancer activity (Alagbala et al., 2006; Chodyński et al., 2002).
Main Classes of Drugs
Jerome Z. Litt, Neil H. Shear in Litt's Drug Eruption & Reaction Manual, 2017
Vitamin D receptor agonistDihydrotachysterolDoxercalciferolParicalcitol
Proteomics based drug repositioning applied to improve in vitro fertilization implantation: an artificial intelligence model
Published in Systems Biology in Reproductive Medicine, 2021
Roberto Matorras, Raquel Valls, Mikel Azkargorta, Jorge Burgos, Aintzane Rabanal, Felix Elortza, Jose Manuel Mas, Teresa Sardon
Among the drug candidates in Table 3, three vitamin D-related compounds, doxercalciferol, calcidiol, and dihydrotachysterol, were identified. The decidua produces calcitriol in response to IL-1B secreted by the blastocyst. It may help support implantation by attenuating decidual T-cell function (Barrera et al. 2015; Thangamani et al. 2015). Decidual NK cells treated with calcitriol show decreased cytokine synthesis, such as IL-6 and TNFα, which are linked to pregnancy failure (Tamblyn et al. 2015). Additionally, vitamin D may play an important autocrine role through its regulation of the transcription of genes such as HOXA10, critical for EI and placentation (Evans et al. 2004). Several studies have shown worse IVF outcomes in women with deficient vitamin D levels (Chu et al. 2018; Iliuta et al. 2020), and vitamin D supplementation is recommended in IVF deficient and insufficient women (Chu et al. 2018; Iliuta et al. 2020).
Evaluating extended-release calcifediol as a treatment option for chronic kidney disease-mineral and bone disorder (CKD-MBD)
Published in Expert Opinion on Pharmacotherapy, 2019
Mario Cozzolino, Markus Ketteler
Calcitriol and other active (1α-hydroxylated) vitamin D analogues, such as paricalcitol, alfacalcidol, or doxercalciferol, are another treatment option for SHPT in ND-CKD patients. Although RCTs show active vitamin D and its analogues can effectively suppress PTH levels in ND-CKD, these agents are associated with an increased risk of hypercalcemia due to their effects on increasing intestinal calcium absorption [52–54]. As a consequence, the 2017 CKD-MBD KDIGO guideline recommends that these agents should not be routinely used in ND-CKD patients. Instead, their use should be restricted to patients with stage 4 and 5 CKD who have severe and progressive hyperparathyroidism [55]. Active vitamin D analogues have also been associated with increased intestinal absorption of phosphorus, which can potentially result in hyperphosphatemia. This potential combination of hyperphosphatemia and hypercalcemia with active vitamin D analogues increases the risk of vascular calcification [56].
Sagliker syndrome in a patient with end-stage renal disease with secondary hyperparathyroidism
Published in Baylor University Medical Center Proceedings, 2019
Muhammad Ajmal Panezai, Sana Ahmed, Gates B. Colbert
The patient had been on in-center hemodialysis for 14 years beginning at age 17. He initially presented to medical care with chronic kidney disease (CKD) stage 5 and never had a kidney biopsy. He had severe secondary hyperparathyroidism with hyperphosphatemia. He recently was meeting dialysis adequacy and receiving treatment through an upper-extremity brachiocephalic fistula without complication. He weighed 48 kg and his body mass index was 18.2 kg/m2. Although he was prescribed cinacalcet 60 mg twice daily, doxercalciferol 20 mcg per dialysis treatment, and sevelamer carbonate 3200 mg three times a day with meals, he confirmed chronic nonadherence to medications, missing some scheduled treatment sessions, and repeated refusal of recommendations for parathyroidectomy evaluation.