Increased bone mass is an unexpected phenotype associated with deletion of the calcitonin gene

The cholecystokinin2-receptor mediates calcitonin secretion, gene expression, and proliferation in the human medullary thyroid carcinoma cell line, TT

Gastrin-induced release of calcitonin from medullary thyroid carcinomas (MTC) is based on the expression of the cholecystokinin(2)-receptor (CCK(2)R) in these tumors. Recently, we have shown that the CCK(2)R is expressed not only in MTC but also in C-cells within the normal thyroid gland. The functions of the CCK(2)R in MTC and C-cells are largely unknown. We therefore explored the effects of gastrin-induced CCK(2)R stimulation in the highly differentiated MTC cell line, TT. CCK(2)R expression in TT-cells is detectable by RT-PCR as well as immunocytochemistry. Stimulation of the CCK(2)R by gastrin induces immediate release of calcitonin from TT-cells. Moreover, quantitative (LightCycler) RT-PCR demonstrates that gastrin stimulates transcription of the calcitonin and chromogranin A genes in TT-cells. TT-cell proliferation, assessed by counting of viable cells and (3)H-thymidine uptake, is markedly increased by gastrin. This effect is inhibited by the CCK(2)R-specific antagonist L-365,260. Our findings suggest physiological functions for the CCK(2)R in calcitonin-secretion and gene expression as well as a pathophysiological role in MTC proliferation. CCK(2)R antagonists might have therapeutic potential in these tumors.

Emerging neuroskeletal signalling pathways: a review

Recent work has demonstrated that neurotransmitters, signalling molecules primarily associated with the nervous system, can have profound effects on the skeleton. Bone cells express a broad range of neurotransmitter receptors and transporters, and respond to receptor activation by initiating diverse intracellular signalling pathways, which modulate cellular function. Evidence of neuronal innervation in skeletal tissues, neurotransmitter release directly from bone cells and functional effects of pharmacological manipulation support the existence of a complex and functionally significant neurotransmitter-mediated signalling network in bone. This review aims to concisely summarise our current understanding of how neurotransmitters affect the skeletal system, focusing on their origin, cellular targets and functional effects in bone.

Time to reevaluate the therapeutic use of calcitonin and biological role attributable to parafollicular (C) cells

There is rich anecdotal evidence that calcitonin significantly increases bone mineral density and reduces fracture risk. However, observation in a previous study of an increased bone formation in calcitonin-deficient mice has led us to reevaluate the therapeutic use of calcitonin and to investigate the primary role of parafollicular (C) cells of the thyroid gland. We found that C cells are involved mainly in the regulation of follicular cell activity in a paracrine manner and in doing so they may regulate the growth rate in newborn by affecting the thyroid hormone levels in the early postnatal period. In the light of reports that showed thyroid physiology is different between populations and it is affected by environmental factors we suggested that C cells may be involved in population differences in thyroid physiology and environmental adaptation. We conclude that C cells may facilitate the adaptation of the follicular cells to environmental changes, enabling more effective coordinated functions of the body and producing variations between populations.

Impact of congenital calcitonin deficiency due to dysgenetic hypothyroidism on bone mineral density

The objective of the present study was to determine the effect of chronic calcitonin deficiency on bone mass development. The results of 11 patients with thyroid dysgenesis (TD) were compared to those of 17 normal individuals (C) and of 9 patients with other forms of hypothyroidism (OH): 4 with hypothyroidism due to inborn errors of thyroid hormone synthesis and 5 with Hashimoto's thyroiditis. The subjects received an intravenous calcium stimulus and blood was collected for the determination of ionized calcium (Ca2+), calcitonin, and intact parathyroid hormone. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. After calcium administration the levels of Ca2+ in the two groups of hypothyroidism were significantly higher than in the normal control group (10 min after starting calcium infusion: C=1.29 +/- 0.08 vs TD=1.34 +/- 0.03 vs OH=1.34 +/- 0.02 mmol/l; P<0.05), and only the TD group showed no calcitonin response (5 min after starting calcium infusion: C = 27.9 5.8 vs TD = 6.6 0.3 vs OH = 43.0 13.4 ng/l). BMD values did not differ significantly between groups (L2-L4: C=1.116 +/- 0.02 vs TD=1.109 +/- 0.03 vs OH=1.050 +/- 0.04 g/cm2). These results indicate that early deficiency of calcitonin secretion has no detrimental effect on bone mass development. Furthermore, the increased calcitonin secretion observed in patients with inborn errors of thyroid hormone biosynthesis does not confer any advantage in terms of BMD.

Is calcitonin an important physiological substance?

That calcitonin (CT) at supraphysiological doses is hypocalcemic led to the mistaken conclusion that it was important for calcium homeostasis and this idea has persisted to this day. Despite these findings, there is no readily apparent pathology due to CT excess or deficiency and there is no evidence that circulating CT is of substantial benefit to any mammal. Mammalian CT at physiological doses is not essential and very likely the CT gene has survived because of the gene's alternate mRNA pathway to produce calcitonin-gene-related peptide found in neural tissues. CT is not involved in calcium homeostasis or any other important physiological function, except, possibly, as an adjunct to protection of the skeleton under conditions of calcium stress, and appears to be in the process of becoming vestigial. CT produced in other tissues has paracrine actions that modulate functions such as proton transport, acid-base balance, prolactin secretion, and gastrointestinal motility. C-cells in mammals evolved from the ultimobranchial body that secretes CT in all lower vertebrates. It is highly probable that changes in amino acid sequence during evolution are responsible for the loss of activity, as fish CT is about 40 times as potent as human CT. CT may have been very important to survival in seawater fish, but the presence of the parathyroid gland and other evolutionary changes occurring in tetrapods suggest that the function of CT is no longer important.

Osteoclastogenesis, bone resorption, and osteoclast-based therapeutics

Over the past decade, advances in molecular tools, stem cell differentiation, osteoclast and osteoblast signaling mechanisms, and genetically manipulated mice models have resulted in major breakthroughs in understanding osteoclast biology. This review focuses on key advances in our understanding of molecular mechanisms underlying the formation, function, and survival of osteoclasts. These include key signals mediating osteoclast differentiation, including PU.1, RANK, CSF-1/c-fms, and src, and key specializations of the osteoclast including HCl secretion driven by H+-ATPase and the secretion of collagenolytic enzymes including cathepsin K and matrix metalloproteinases (MMPs). These pathways and highly expressed proteins provide targets for specific therapies to modify bone degradation. The main outstanding issues, basic and translational, will be considered in relation to the osteoclast as a target for antiresorptive therapies.