Intestinal calcium absorption revisited: a molecular and clinical approach

TALAMONI G; ARECO V; TOLOSA DE TALAMONI N; KOHAN R; PERALTA LOPEZ M

WORLD JOURNAL OF GASTROENTEROLOGY

W J G PRESS

Lugar: Beijing; Año: 2020 vol. 26 p. 3344 - 3364

1007-9327

Ca2+ has an importantrole in the maintenance of the skeleton and is involved in the mainphysiological processes. Its homeostasis is controlled by the intestine,kidney, bone and parathyroid glands. The intestinal Ca2+ absorptionoccurs mainly via the paracellular and the transcellularpathways. The proteins involved in both ways are regulated by calcitriol andother hormones as well as dietary factors. Fibroblast growth factor (FGF-23) isa strong antagonist of vitamin D action. Part of the intestinal Ca2+ movementseems to be vitamin D independent. Intestinal Ca2+ absorptionchanges according to different physiological conditions. It is promoted underhigh Ca2+ demands such as growth, pregnancy, lactation, dietaryCa2+ deficiency and high physical activity. In contrast, theintestinal Ca2+ transport decreases with aging. Oxidativestress inhibits the intestinal Ca2+ absorption whereas theantioxidants counteract the effects of prooxidants leading to the normalizationof this physiological process. Several pathologies such as celiac disease,inflammatory bowel diseases, Turner syndrome and others occur with inhibitionof intestinal Ca2+ absorption, some hypercalciurias show Ca2+ hyperabsorption,most of these alterations are related to the vitamin D endocrine system.Further research work should be accomplished in order not only to know moremolecular details but also to detect possible therapeutic targets to ameliorateor avoid the consequences of altered intestinal Ca2+ absorption.