The control of calcium and phosphorus metabolism by the vitamin D endocrine system.

Vitamin D, which is normally produced in the skin under ultraviolet irradiation, is the building block for a new endocrine system that involves hydroxylation on the 25-position in the liver followed by 1 alpha-hydroxylation in the kidney to produce the vitamin D hormone, 1 alpha, 25-(OH)2D3. This vitamin D hormone functions in the intestine, bone, and kidney to stimulate transport of calcium and phosphorus into the extracellular fluid compartment upon demand. The production of the vitamin D hormone is tightly feedback regulated directly or indirectly by calcium and phosphorus levels of the plasma. The vitamin D endocrine system is an important one in the regulation of calcium and phosphorus metabolism but is not solely responsible for the calcium and phosphorus transfer reactions occurring during reproduction. The vitamin D hormone functions in the target organs by a nuclear-mediated receptor-based mechanism probably involving the biogenesis of calcium and phosphorus transfer proteins. New target sites of 1,25-(OH)2D3 action in several tissues are suggested by this nuclear localization in those cells. Study of the vitamin D endocrine system has provided a new understanding of metabolic bone diseases and has provided new forms of vitamin D for their treatment. Thus a basic investigation of the regulation of calcium and phosphorus metabolism has rewarded medicine and science with new therapeutic approaches to disease problems.