1,25-Dihydroxyvitamin D3 [1,25(OH)2D3] is a principal regulator of calcium and phosphorus homeostasis through actions on intestine, kidney, and bone. 1,25(OH) 2D3 is not considered to play a significant role in bone formation, except for its role in supporting mineralization. We report here on the properties of 2-methylene-19-nor-(20S)-1␣,25(OH) 2D3 (2MD), a highly potent analog of 1,25(OH)2D3 that induces bone formation both in vitro and in vivo. Selectivity for bone was first demonstrated through the observation that 2MD is at least 30-fold more effective than 1,25(OH) 2D3 in stimulating osteoblast-mediated bone calcium mobilization while being only slightly more potent in supporting intestinal calcium transport. 2MD is also highly potent in promoting osteoblast-mediated osteoclast formation in vitro, a process essential to both bone resorption and formation. Most significantly, 2MD at concentrations as low as 10 ؊12 M causes primary cultures of osteoblasts to produce bone in vitro. This effect is not found with 1,25(OH) 2D3 even at 10 ؊8 M, suggesting that 2MD might be osteogenic in vivo. Indeed, 2MD (7 pmol͞day) causes a substantial increase (9%) in total body bone mass in ovariectomized rats over a 23-week period. 1,25(OH) 2D3 (500 pmol three times a week) only prevented the bone loss associated with ovariectomy and did not increase bone mass. These results indicate that 2MD is a potent bone-selective analog of 1,25(OH) 2D3 potentially effective in treating bone loss diseases.V itamin D-deficiency diseases such as rickets and osteomalacia represent a failure in bone formation primarily caused by a failure of mineralization (1-3). Indeed, early investigations into the underlying defect associated with rickets revealed that incubation of bone slices in media containing physiologic levels of calcium and phosphorus resulted in normal mineralization of rachitic matrix (3). Underwood and DeLuca (4) subsequently demonstrated that the mineralization defect associated with vitamin D deficiency is due directly to insufficient calcium and phosphorus in plasma at sites of mineralization. These early conclusions have been supported independently by recent studies that show that skeletal disease, which arises from deletion of the vitamin D receptor (VDR), the exclusive transcriptional mediator of vitamin D action in vivo, can be normalized in mice through lactose-containing diets high in calcium and phosphorus (5). Thus, there is little evidence that vitamin D plays a direct role in new bone formation apart from its action to maintain calcium and phosphorus levels in the blood.We recently discovered a class of vitamin D compounds modified at the 2-carbon position of the A ring that is highly potent. The introduction of a methylene group at carbon 2, removal of a methylene group at carbon 10, and alteration of the stereochemistry of the 20-carbon to yield the 20S-derivative resulted in 2-methylene-19-nor-(20S)-1␣,25(OH) 2 D 3 (2MD), a compound that exhibits an affinity for the VDR equal to that of 1,25-dihydroxyvitamin D...