Upregulation of reduced folate carrier by Vitamin D enhances brain folate uptake in mice lacking folate receptor alpha

Camille Alam, Susanne Aufreiter, Constantine J. Georgiou, Md Tozammel Hoque, Richard H. Finnell, Deborah L. O'Connor, I. David Goldman, Reina Bendayan

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Folates are critical for central nervous system function. Folate transport is mediated by 3 major pathways, reduced folate carrier (RFC), proton-coupled folate transporter (PCFT), and folate receptor alpha (FRα/Folr1), known to be regulated by ligandactivated nuclear receptors. Cerebral folate delivery primarily occurs at the choroid plexus through FRα and PCFT; inactivation of these transport systems can result in very low folate levels in the cerebrospinal fluid causing childhood neurodegenerative disorders. These disorders have devastating effects in young children, and current therapeutic approaches are not sufficiently effective. Our group has previously reported in vitro that functional expression of RFC at the blood-brain barrier (BBB) and its upregulation by the vitamin D nuclear receptor (VDR) could provide an alternative route for brain folate uptake. In this study, we further demonstrated in vivo, using Folr1 knockout (KO) mice, that loss of FRα led to a substantial decrease of folate delivery to the brain and that pretreatment of Folr1 KO mice with the VDR activating ligand, calcitriol (1,25-dihydroxyvitamin D3), resulted in over a 6-fold increase in [13C5]-5-formyltetrahydrofolate ([13C5]-5-formylTHF) concentration in brain tissues, with levels comparable to wild-type animals. Brain-to-plasma concentration ratio of [13C5]-5-formylTHF was also significantly higher in calcitriol-treated Folr1 KO mice (15- fold), indicating a remarkable enhancement in brain folate delivery. These findings demonstrate that augmenting RFC functional expression at the BBB could effectively compensate for the loss of Folr1-mediated folate uptake at the choroid plexus, providing a therapeutic approach for neurometabolic disorders caused by defective brain folate transport.

Original languageEnglish (US)
Pages (from-to)17531-17540
Number of pages10
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number35
StatePublished - Aug 27 2019


  • Blood-brain barrier
  • Brain folate transport
  • Vitamin D receptor

ASJC Scopus subject areas

  • General


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