Stay tuned to PXR: an orphan actor that may not be D-structive only to bone

Pregnane X receptor (PXR) plays an important role in detoxifying xenobiotics and drugs. In this issue of the JCI, Pascussi et al. provide convincing evidence that PXR can also induce vitamin D deficiency and bone disease because of its ability to cross-talk with the vitamin D-responsive gene that catabolizes 25-hydroxy-vitamin D and 1,25-dihydroxyvitamin D. This cross-talk behavior has important health ramifications and can be mitigated through the identification and treatment of PXR-induced vitamin D deficiency.