Abstract:
Klotho is a protein mainly produced in the parathyroid glands, in the distal convoluted tubules of the kidney and the choroid plexus. It can function as a membrane protein or it can be secreted into blood or cerebrospinal fluid. Klotho counteracts aging by its various functions. It participates in the inhibitory effect of FGF23 on the formation of 1,25(OH)2D3. Furthermore it takes part in the regulation of renal tubular phosphate reabsorption and stimulates renal tubular Ca2+ reabsorption. Klotho-hypomorphic mice suffer from increased calcitriol concentrations in plasma, severe growth deficit and an extremely reduced life span, effects largely reversed by Vitamin-D-deficient diet. Vitamin D3 stimulates Ca2+ entry in a variety of cells. In erythrocytes increased Ca2+ entry stimulates eryptosis, the suicidal erythrocyte death, which is characterized by cell shrinkage and phosphatidylserine exposure at the cell surface.
The present study explores the possible effects of Klotho on eryptosis. With the aid of Fluo3 fluorescence it could be observed that intracellular Ca2+ concentration was significantly larger in klothokl/kl erythrocytes than in klotho+/+ erythrocytes. Annexin V-binding which represents phosphatidylserine exposure on the cell surface was also significantly enhanced in klothokl/kl erythrocytes. The measurement of forward scatter revealed a significantly smaller cell volume of klothokl/kl erythrocytes compared to klotho+/+ erythrocytes. These observations show that eryptosis is stimulated in the erythrocytes of Klotho-deficient mice. Reticulocyte number was significantly increased in klothokl/kl mice, pointing to enhanced erythrocyte turnover. Vitamin D-deficient diet lead to normalisation of the enhanced Ca2+ entry and annexin V-binding of klothokl/kl erythrocytes. These results reveal a novel function of Klotho, that is to say an at least partially vitamin D-dependent regulation of cytosolic Ca2+ activity in erythrocytes and their suicidal death.
Moreover the present study explores the role of Klotho-deficiency on mineral and electrolyte metabolism. For this purpose Klotho-deficient (klothokl/kl) mice and wild type mice (klotho+/+) were fed different diets and compared to each other. They received Vitamin-D-containing control diet (D+) or Vitamin-D-deficient (D-) diet or Vitamin-D-deficient diet for their first 4 weeks of life followed by control diet (D-/+). At the age of 8 weeks, body weight was significantly smaller in klothokl/klD+ mice than in klotho+/+D+ mice, klothokl/klD- mice and klothokl/klD-/+ mice. Plasma concentrations of 1,25(OH)2D3, ACTH (adrenocorticotropic hormone), AVP (Argininvasopressin), and aldosterone were significantly higher in klothokl/klD+ mice than in klotho+/+D+ mice. Additionaly, plasma osmolality, plasma urea, Ca2+, phosphate and Na+, but not K+ concentrations were significantly higher in klothokl/klD+ mice than in klotho+/+D+ mice. In contrast to this, klothokl/klD-/+ mice showed a significantly lower blood pressure than klotho+/+D+ mice.
In conclusion, the present observations point to a secondary hyperaldosteronism in Klotho-deficient mice attributable to volume depletion. The differences were partially abrogated by a Vitamin D-deficient diet. Ussing chamber experiments revealed an increased amiloride-sensitive current across the colonic epithelium, indicating an enhanced epithelial sodium channel (ENaC) activity in klothokl/klD+ mice.
As a result, the present observations disclose that the excessive formation of calcitriol in Klotho-deficient mice influences not only the mineral but also the electrolyte and fluid balance.