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Athonvarangkul D, Wysolmerski JJ. Crosstalk within a brain-breast-bone axis regulates mineral and skeletal metabolism during lactation. Front Physiol 2023; 14:1121579. [PMID: 36875035 PMCID: PMC9979219 DOI: 10.3389/fphys.2023.1121579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/27/2023] [Indexed: 02/18/2023] Open
Abstract
To support the increased calcium demands for milk production during lactation, a dramatic and reversible physiological response occurs to alter bone and mineral metabolism. This coordinated process involves a brain-breast-bone axis that integrates hormonal signals that allow for adequate calcium delivery to milk yet also protects the maternal skeletal from excessive bone loss or decreases in bone quality or function. Here, we review the current knowledge on the crosstalk between the hypothalamus, mammary gland, and skeleton during lactation. We discuss the rare entity of pregnancy and lactation associated osteoporosis and consider how the physiology of bone turnover in lactation may impact the pathophysiology of postmenopausal osteoporosis. Further understanding of the regulators of bone loss during lactation, particularly in humans, may provide insights into new therapies for osteoporosis and other diseases of excess bone loss.
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Affiliation(s)
- Diana Athonvarangkul
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States
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Groysman AY, Poloju A, Majety P, Vyas M, Rosen HN. Bisphosphonate-resistant hypercalcemia in a rare case of paraneoplastic PTH secretion. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.jecr.2022.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Grunbaum A, Kremer R. Parathyroid hormone-related protein (PTHrP) and malignancy. VITAMINS AND HORMONES 2022; 120:133-177. [PMID: 35953108 DOI: 10.1016/bs.vh.2022.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PTHrP (parathyroid hormone related protein) is an important mediator of malignancy-related tumor progression and hypercalcemia that shares considerable homology and functionality with parathyroid hormone. In this chapter, we review what has been elucidated to date regarding PTHrP's role in malignancies. Starting with a review of calcium metabolism and regulation, we then summarize the discovery and structure of PTHrP and development of sensitive immunoassays for specific measurement. Subsequently, we explore its role in tumor progression, with emphasis on the primary tumor as well as skeletal and non-osseus metastases. We then consider the clinical implications of PTHrP in cancer before concluding with a discussion of both established and potential treatments for malignancy associated hypercalcemia and bone metastases.
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Affiliation(s)
- Ami Grunbaum
- Calcium Research Laboratories and Department of Medicine, McGill University and McGill University Health Centre, Montreal, QC, Canada
| | - Richard Kremer
- Calcium Research Laboratories and Department of Medicine, McGill University and McGill University Health Centre, Montreal, QC, Canada.
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Patel K, Mangu SR, Sukhdeo SV, Sharan K. Ethanolic extract from the root and leaf of Sida cordifolia promotes osteoblast activity and prevents ovariectomy-induced bone loss in mice. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 99:154024. [PMID: 35263671 DOI: 10.1016/j.phymed.2022.154024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sida cordifolia is traditionally found in the Indian system of medicine, well known for its medicinal and nutritional properties among local natives. PURPOSE The present study aims to investigate the osteo-protective effect of root and leaf ethanolic extract of S. cordifolia (RE and LE) and its underlying mechanism. METHODS Antioxidant activity of RE and LE was assessed. Total phenolic and flavonoid content were determined. HPLC profiling of RE and LE was performed to examine the polyphenol content. The effect of RE and LE on osteoblast cells proliferation, differentiation, mineralization, and expression of the protein associated with osteogenesis were evaluated using primary calvarial osteoblast culture. Skeletal effects of RE and LE of S. cordifolia were investigated in C57BL/6J ovariectomized mice. Micro CT was employed to evaluate the alteration in trabecular and cortical bone microarchitecture. Histology studies were performed on the isolated vertebra. qPCR analysis and western blotting was done to check the key bone markers. RESULTS RE and LE showed a potent antioxidant activity, owing to a notable polyphenol content. Both RE and LE did not alter the cell viability but significantly increased the osteoblast cell proliferation, differentiation, and mineralization. Moreover, they enhanced the mRNA expression of osteogenic genes. Both RE and LE stimulated the activation of ERK, AKT, and CREB. Both RE and LE had no direct effect on osteoclastogenesis, but both increased Opg/Rankl ratio expression in osteoblast cells. Both RE and LE at 750 mg/kg/day significantly improved the trabecular and cortical microarchitecture of femur and tibia by increasing bone mineral density, bone volume fraction, trabecular number, and trabecular thickness, and decreasing trabecular separation and structural model index in ovariectomized mice. Furthermore, vertebral histology of lumbar vertebrae revealed that RE and LE significantly enhance the vertebral bone mass and exert osteo-protective effects by stimulating osteoblast function and inhibiting osteoclast function. CONCLUSION In conclusion, both RE and LE stimulate osteoblast differentiation through activating ERK, AKT, and CREB signalling pathways and indirectly inhibits osteoclast differentiation. RE and LE also improve the trabecular and cortical microarchitecture of ovariectomized mice, making it a promising agent to prevent postmenopausal bone loss.
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Affiliation(s)
- Kalpana Patel
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Svvs Ravi Mangu
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Shinde Vijay Sukhdeo
- Department of Meat and Marine Sciences, CSIR- Central Food Technological Research Institute, Mysuru, India
| | - Kunal Sharan
- Department of Molecular Nutrition, CSIR-Central Food Technological Research Institute, Mysuru, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Johnson RW, Rhoades J, Martin TJ. Parathyroid hormone-related protein in breast cancer bone metastasis. VITAMINS AND HORMONES 2022; 120:215-230. [PMID: 35953110 DOI: 10.1016/bs.vh.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Parathyroid hormone-related protein (PTHrP) was discovered as the tumor product causing the humoral hypercalcemia of malignancy. Its structural similarity to the hormone, PTH, with 8 of the first 13 amino acids identical, was sufficient to explain the sharing by PTHrP and PTH of a common receptor, PTH1R, although the remainder of the sequences are unique. PTHrP has important roles in development of several organs, including breast and bone, and functions as a paracrine factor postnatally in these and other tissues. In addition to its hormonal role in cancer, PTHrP is produced by two thirds of primary breast cancers and 90% of bone metastases from breast cancer, leading to the concept that its production in bone by breast cancer cells promotes bone resorption, thus favoring tumor establishment and expansion, and an exit from tumor dormancy in bone through downregulation of leukemia inducing factor receptor (LIFR). Cancer production of PTHrP is increased by bone-derived growth factors, with particular attention paid to TGFβ, as well as by promoter-driven transcriptional effects, such as the hedgehog signaling factor, GLI2, and microenvironment effects including changes in underlying stiffness of substrates for cells. Although interest has been focused on PTHrP-induced bone resorption in bone metastasis, a mechanistically separate, protective effect against tumor progression has been proposed. Although there is conflicting mouse data, there are clinical studies suggesting that increased production of PTHrP by breast cancers confers upon them a less invasive phenotype, an effect distinct from the bone resorption-stimulating action that favors bone metastasis.
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Affiliation(s)
- Rachelle W Johnson
- Department of Medicine, Division of Clinical Pharmacology, and Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Julie Rhoades
- Department of Medicine, Division of Clinical Pharmacology, and Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, United States
| | - T John Martin
- St Vincent's Institute of Medical Research, University of Melbourne, St Vincent's Health, Melbourne, VIC, Australia.
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Abstract
Hypercalcemia of malignancy (HCM) is considered an oncologic emergency associated with significant symptom burden and increased comorbid conditions and mortality. Underlying pathologic processes most often stimulate osteoclast-mediated bone resorption. Although long-term control of HCM depends on effective management of the underlying cancer, temporizing management strategies for acute and/or symptomatic HCM include hydration and antiresorptive bone-modifying agents. Although most patients respond well to the antiresorptive therapies available, further investigation into other agents for those who are refractory to both bisphosphonates and denosumab is needed.
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Affiliation(s)
- Mimi I Hu
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.
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Mohamed W, El Ansari W, Al Hassan MS, Sibira RM, Abusabeib A. Water clear cell ectopic non-iatrogenic giant parathyroid adenoma in sternohyoid muscle with thyroid nodule and asymptomatic hypercalcemia due to primary hyperparathyroidism: Case report and literature review. Int J Surg Case Rep 2021; 86:106295. [PMID: 34450530 PMCID: PMC8397889 DOI: 10.1016/j.ijscr.2021.106295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background Ectopic parathyroid gland is not uncommon, and is associated with primary hyperparathyroidism. Giant parathyroid adenoma (PA) and concurrent presence of enlarged thyroid nodule increases the probability of ectopic location. The combination of a giant PA that is ectopic (within the strap muscle) in the neck is very rare, especially in cases with no previous surgery. The rare histopathological findings of the current case, water clear cell parathyroid adenoma (WCCPA), could explain the patient's presentation, since it has low endocrine function. Case presentation A 56-year-old Qatari female on routine visit to primary health care physician for hypertension, was incidentally discovered to be hypercalcemic and was referred to the emergency department of our institution. Neck ultrasound showed a thyroid nodule on the left side, but 99mTc-sestamibi scintigraphy identified a left PA. FNAC of the thyroid nodule showed that it was a colloid nodule. She underwent left hemithyroidectomy and excision of left PA. Intraoperatively, the PA was giant and in the sternohyoid muscle. Intraoperative monitoring of intact PTH (IOiPTH) confirmed successful excision. Discussion Ectopic giant parathyroid adenoma is rare especially with the intramuscular location in sternohyoid muscle in the neck without previous neck surgeries. The presence of thyroid nodule could be a precipitating factor for migration of the PA. Preoperative assessment with the radiological image is crucial for diagnosis but sometimes fail to localized the PA. Conclusion Giant asymptomatic PA with long standing low function before hyperfunctioning should raise the suspicion of WCCPA. If diagnosis is confirmed, metastasis from a clear cell renal cell carcinoma should be ruled out. We report a unique rare case of non-iatrogenic ectopic giant water clear cell parathyroid adenoma (WCCPA) A parathyroid adenoma >3.5 gm, asymptomatic and with low function before hyperfunctioning, should raise suspicion of WCCPA. History, examination, ultrasound, sesta-MIBI scintigraphy and immunohistochemical studies are important for diagnosis. High preoperative parathyroid hormone and calcium need monitoring in post-operative period to avoid hypocalcemia.
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Affiliation(s)
- Walla Mohamed
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar; School of Health and Education, University of Skovde, Skovde, Sweden.
| | - Mohamed S Al Hassan
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rayan M Sibira
- Department of Laboratory Medicine & Pathology, Hamad General Hospital, Doha, Qatar
| | - Abdelrahman Abusabeib
- Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Al-Khan AA, Al Balushi NR, Richardson SJ, Danks JA. Roles of Parathyroid Hormone-Related Protein (PTHrP) and Its Receptor (PTHR1) in Normal and Tumor Tissues: Focus on Their Roles in Osteosarcoma. Front Vet Sci 2021; 8:637614. [PMID: 33796580 PMCID: PMC8008073 DOI: 10.3389/fvets.2021.637614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/17/2021] [Indexed: 12/17/2022] Open
Abstract
Osteosarcoma (OS) is the most common primary bone tumor and originates from bone forming mesenchymal cells and primarily affects children and adolescents. The 5-year survival rate for OS is 60 to 65%, with little improvement in prognosis during the last four decades. Studies have demonstrated the evolving roles of parathyroid hormone-related protein (PTHrP) and its receptor (PTHR1) in bone formation, bone remodeling, regulation of calcium transport from blood to milk, regulation of maternal calcium transport to the fetus and reabsorption of calcium in kidneys. These two molecules also play critical roles in the development, progression and metastasis of several tumors such as breast cancer, lung carcinoma, chondrosarcoma, squamous cell carcinoma, melanoma and OS. The protein expression of both PTHrP and PTHR1 have been demonstrated in OS, and their functions and proposed signaling pathways have been investigated yet their roles in OS have not been fully elucidated. This review aims to discuss the latest research with PTHrP and PTHR1 in OS tumorigenesis and possible mechanistic pathways. This review is dedicated to Professor Michael Day who died in May 2020 and was a very generous collaborator.
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Affiliation(s)
- Awf A Al-Khan
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.,Department of Pathology, Sohar Hospital, Sohar, Oman
| | - Noora R Al Balushi
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Samantha J Richardson
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.,School of Science, RMIT University, Bundoora, VIC, Australia
| | - Janine A Danks
- School of Science, RMIT University, Bundoora, VIC, Australia.,The University of Melbourne, Department of Medicine, Austin Health, Heidelberg, VIC, Australia
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Effect of gynecological cancer and its treatment on bone mineral density and the risk of osteoporosis and osteoporotic fracture. Obstet Gynecol Sci 2020; 63:470-479. [PMID: 32689773 PMCID: PMC7393757 DOI: 10.5468/ogs.20012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/19/2020] [Indexed: 11/14/2022] Open
Abstract
Objective The purpose of this study was to evaluate the risk of osteopenia and osteoporosis by examining the bone mineral density (BMD) of the lumbar spine and femur in patients with gynecological cancer without bone metastasis and to evaluate the impact of treatment for different cancers on BMD. Methods This study retrospectively reviewed the medical records of 243 women with gynecological cancer and 240 controls between March 2010 and December 2016. Patients with cervical cancer (n=105), endometrial cancer (n=63), and ovarian cancer (n=75) were treated with total hysterectomy including bilateral salpingo-oophorectomy and/or chemotherapy and/or radiotherapy. For the control group, healthy post-menopausal women without gynecologic cancer were selected. Results Before anticancer treatment, the BMD of patients with cervical cancer and ovarian cancer was significantly lower than that of the controls, and the BMD of patients with endometrial cancer was not significantly different from that of the controls. However, the BMD of endometrial cancer significantly decreased after treatment. According to the treatment methods, there were significant differences in the BMD of L3, L4, and the femur neck. Changes in the BMD were lowest in patients who underwent surgical treatment only, and the highest bone loss was found in patients who underwent postoperative concurrent chemoradiotherapy. Conclusion Patients with cervical and ovarian cancer had lower BMD than those in the control group before treatment, and patients with endometrial cancer had decreased bone density after treatment. Therefore, during the treatment of gynecological cancer, strategies should be implemented to mitigate these risks.
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Kim MR, Choi SH, Lee BN, Min KS, Hwang YC. Effect of parathyroid hormone-related protein on odontogenic differentiation in human dental pulp cells. BMC Oral Health 2020; 20:101. [PMID: 32276610 PMCID: PMC7146980 DOI: 10.1186/s12903-020-01085-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 03/25/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Parathyroid hormone-related protein (PTHrP) plays an important role in many physiological processes, including bone regeneration. The function of PTHrP is similar to PTH. It promotes osteogenic differentiation in MC3T3-E1 cells. The aim of this study was to investigate whether PTHrP might have odontogenic differentiation ability in human dental pulp cells (hDPCs). METHODS The viability of hDPCs after stimulation with PTHrP was measured. Real-time polymerase chain reaction and Western blot analysis were performed to evaluate the expression levels of odontogenic markers and activation of protein kinase B (PKB/AKT), extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 mitogen-activated protein kinase (MAPK). To evaluate mineralized nodule formation, alkaline phosphatase (ALP) staining and alizarin red S staining were performed. RESULTS PTHrP promoted odontogenic differentiation as evidenced by the formation of mineralized nodules, the induction of ALP activity, and the upregulation of odontogenic markers (dentin sialophosphoprotein and dentin matrix protein-1). The phosphorylation of AKT, ERK, JNK, and p38 was increased by PTHrP. However, an AKT inhibitor (LY294002), an ERK inhibitor (U0126), a JNK inhibitor (SP600125), and a p38 inhibitor (SB203580) inhibited the increase of mineralization induced by PTHrP. CONCLUSION The present study revealed that PTHrP could promote odontogenic differentiation and mineralization through activating the AKT, ERK, JNK, and p38 signaling pathways. These results provide novel insights into the odontogenic action of PTHrP.
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Affiliation(s)
- Mi-Ra Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Youngbong-ro 77, Buk-gu, Gwangju, 61186, South Korea
| | - Sung-Hyeon Choi
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Youngbong-ro 77, Buk-gu, Gwangju, 61186, South Korea
| | - Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Youngbong-ro 77, Buk-gu, Gwangju, 61186, South Korea
| | - Kyung-San Min
- Department of Conservative Dentistry, School of Dentistry, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, South Korea
| | - Yun-Chan Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Youngbong-ro 77, Buk-gu, Gwangju, 61186, South Korea.
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Ceddia RP, Collins S. A compendium of G-protein-coupled receptors and cyclic nucleotide regulation of adipose tissue metabolism and energy expenditure. Clin Sci (Lond) 2020; 134:473-512. [PMID: 32149342 PMCID: PMC9137350 DOI: 10.1042/cs20190579] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 12/15/2022]
Abstract
With the ever-increasing burden of obesity and Type 2 diabetes, it is generally acknowledged that there remains a need for developing new therapeutics. One potential mechanism to combat obesity is to raise energy expenditure via increasing the amount of uncoupled respiration from the mitochondria-rich brown and beige adipocytes. With the recent appreciation of thermogenic adipocytes in humans, much effort is being made to elucidate the signaling pathways that regulate the browning of adipose tissue. In this review, we focus on the ligand-receptor signaling pathways that influence the cyclic nucleotides, cAMP and cGMP, in adipocytes. We chose to focus on G-protein-coupled receptor (GPCR), guanylyl cyclase and phosphodiesterase regulation of adipocytes because they are the targets of a large proportion of all currently available therapeutics. Furthermore, there is a large overlap in their signaling pathways, as signaling events that raise cAMP or cGMP generally increase adipocyte lipolysis and cause changes that are commonly referred to as browning: increasing mitochondrial biogenesis, uncoupling protein 1 (UCP1) expression and respiration.
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Affiliation(s)
- Ryan P Ceddia
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, U.S.A
| | - Sheila Collins
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, U.S.A
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Zhang R, Li J, Assaker G, Camirand A, Sabri S, Karaplis AC, Kremer R. Parathyroid Hormone-Related Protein (PTHrP): An Emerging Target in Cancer Progression and Metastasis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1164:161-178. [DOI: 10.1007/978-3-030-22254-3_13] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Yang L, Huang J, Yang S, Cui W, Wang J, Zhang Y, Li J, Guo X. Bone Regeneration Induced by Local Delivery of a Modified PTH-Derived Peptide from Nanohydroxyapatite/Chitosan Coated True Bone Ceramics. ACS Biomater Sci Eng 2018; 4:3246-3258. [PMID: 33435063 DOI: 10.1021/acsbiomaterials.7b00780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Liang Yang
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430071, People’s Republic of China
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, People’s Republic of China
| | - Jinghuan Huang
- Department of Orthopaedics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233, People’s Republic of China
| | - Shuyi Yang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, People’s Republic of China
| | - Wei Cui
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, People’s Republic of China
| | - Jianping Wang
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430071, People’s Republic of China
| | - Yinping Zhang
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430071, People’s Republic of China
| | - Jingfeng Li
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430071, People’s Republic of China
| | - Xiaodong Guo
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, People’s Republic of China
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Yang Y, Wang B. PTH1R-CaSR Cross Talk: New Treatment Options for Breast Cancer Osteolytic Bone Metastases. Int J Endocrinol 2018; 2018:7120979. [PMID: 30151009 PMCID: PMC6087585 DOI: 10.1155/2018/7120979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/14/2018] [Indexed: 12/11/2022] Open
Abstract
Metastatic breast cancer (BrCa) is currently incurable despite great improvements in treatment of primary BrCa. The incidence of skeletal metastases in advanced BrCa occurs up to 70%. Recent findings have established that the distribution of BrCa metastases to the skeleton is not a random process but due to the favorable microenvironment for tumor invasion and growth. The complex interplay among BrCa cells, stromal/osteoblastic cells, and osteoclasts in the osseous microenvironment creates a bone-tumor vicious cycle (a feed-forward loop) that results in excessive bone destruction and progressive tumor growth. Both the type 1 PTH receptor (PTH1R) and extracellular calcium-sensing receptor (CaSR) participate in the vicious cycle and influence the skeletal metastatic niche. Thus, this review focuses on how the PTH1R and CaSR signaling pathways interact and contribute to the pathogenesis of BrCa bone metastases. The effects of intermittent PTH and allosteric modulators of CaSR for the use of bone-anabolic agents and prevention of BrCa bone metastases constitute a proof of principle for therapeutic consideration. Understanding the interplay between PTH1R and CaSR signaling in the development of BrCa bone metastases could lead to a novel therapeutic approach to control both osteolysis and tumor burden in the bone.
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Affiliation(s)
- Yanmei Yang
- Center for Translational Medicine, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Bin Wang
- Center for Translational Medicine, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Shallis RM, Rome RS, Reagan JL. Mechanisms of Hypercalcemia in Non-Hodgkin Lymphoma and Associated Outcomes: A Retrospective Review. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 18:e123-e129. [PMID: 29361495 DOI: 10.1016/j.clml.2017.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/26/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The etiology of hypercalcemia in non-Hodgkin lymphoma (NHL) has been most often attributed to either elevated serum levels of 1,25-dihydroxycholecalciferol (calcitriol) or parathyroid-related protein (PTHrP). In a single-center retrospective review, we evaluated the incidence of, and outcomes associated with, hypercalcemia in NHL. PATIENTS AND METHODS The medical records of patients with a histologically confirmed diagnosis of NHL and ≥ 1 episode of hypercalcemia were evaluated for demographic and lymphoma-specific factors, including the response to therapy and overall survival. RESULTS Fifty-four patients with NHL met the inclusion criteria. Most patients (57.4%) had diffuse large B-cell lymphoma, of which, 70% were the nongerminal center subtype. Approximately one half (42.6%) of the included patients had undergone serologic investigation into the etiology of hypercalcemia; however, only 17 patients (31.5%) had both a serum PTHrP and a calcitriol level properly collected. Of the 17 cases for which both a serum calcitriol and a PTHrP were collected, most (61.1%) were found to have neither an elevation of serum calcitriol nor an elevation of PTHrP. The degree of calcitriol elevation correlated with worse progression-free survival (P = .04) but not overall survival. CONCLUSION The major mechanism by which NHL patients develop hypercalcemia is not mediated by calcitriol or PTHrP. Hypercalcemia is most prevalent in patients with diffuse large B-cell lymphoma of the nongerminal cell subtype. Patients with calcitriol-mediated hypercalcemia showed a trend toward worse outcomes, suggesting that calcitriol might be a marker of high-grade lymphoma, transformation to such, or a surrogate for more advanced disease.
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MESH Headings
- Calcitriol/blood
- Female
- Humans
- Hypercalcemia/blood
- Hypercalcemia/etiology
- Kaplan-Meier Estimate
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Non-Hodgkin/blood
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/therapy
- Male
- Middle Aged
- Outcome Assessment, Health Care
- Parathyroid Hormone-Related Protein/blood
- Retrospective Studies
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Affiliation(s)
- Rory M Shallis
- Department of Internal Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Rachel S Rome
- Department of Internal Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - John L Reagan
- Department of Internal Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Division of Hematology and Oncology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI.
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16
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Shyh-Chang N. Metabolic Changes During Cancer Cachexia Pathogenesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1026:233-249. [PMID: 29282687 DOI: 10.1007/978-981-10-6020-5_11] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Wasting of adipose tissue and skeletal muscle is a hallmark of metastatic cancer and a major cause of death. Like patients with cachexia caused by other chronic infections or inflammatory diseases, the cancer subject manifests both malnutrition and metabolic stress. Both carbohydrate utilization and amino acid incorporation are decreased in the muscles of cancer cachexia patients. Cancer cells affect host metabolism in two ways: (a) their own metabolism of nutrients into other metabolites and (b) circulating factors they secrete or induce the host to secrete. Accelerated glycolysis and lactate production, i.e., the Warburg effect and the resultant increase in Cori cycle activity, are the most widely discussed metabolic effects. Meanwhile, although a large number of pro-cachexia circulating factors have been found, such as TNFa, IL-6, myostatin, and PTHrp, none have been shown to be a dominant factor that can be targeted singly to treat cancer cachexia in humans. It is possible that given the complex multifactorial nature of the cachexia secretome, and the personalized differences between cancer patients, targeting any single circulating factor would always be insufficient to treat cachexia for all patients. Here we review the metabolic changes that occur in response to tumor growth and tumor-secreted factors during cachexia.
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Affiliation(s)
- Ng Shyh-Chang
- Genome Institute of Singapore, Agency for Science Technology and Research, Singapore, Singapore.
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17
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Otieno BA, Krause CE, Jones AL, Kremer RB, Rusling JF. Cancer Diagnostics via Ultrasensitive Multiplexed Detection of Parathyroid Hormone-Related Peptides with a Microfluidic Immunoarray. Anal Chem 2016; 88:9269-75. [PMID: 27558535 PMCID: PMC5032051 DOI: 10.1021/acs.analchem.6b02637] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
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Parathyroid hormone-related
peptide (PTHrP) is recognized as the
major causative agent of humoral hypercalcemia of malignancy (HHM).
The paraneoplastic PTHrP has also been implicated in tumor progression
and metastasis of many human cancers. Conventional PTHrP detection
methods like immunoradiometric assay (IRMA) lack the sensitivity required
to measure target peptide levels prior to the development of hypercalcemia.
In general, sensitive, multiplexed peptide measurement by immunoassay
represents challenges that we address in this paper. We describe here
the first ultrasensitive multiplexed peptide assay to measure intact
PTHrP 1-173 as well as circulating N-terminal and C-terminal peptide
fragments. This versatile approach should apply to almost any collection
of peptides that are long enough to present binding sites for two
antibodies. To target PTHrP, we employed a microfluidic immunoarray
featuring a chamber for online capture of the peptides from serum
onto magnetic beads decorated with massive numbers of peptide-specific
antibodies and enzyme labels. Magnetic bead-peptide conjugates were
then washed and sent to a detection chamber housing an antibody-modified
8-electrode array fabricated by inkjet printing of gold nanoparticles.
Limits of detection (LODs) of 150 aM (∼1000-fold lower than
IRMA) in 5 μL of serum were achieved for simultaneous detection
of PTHrP isoforms and peptide fragments in 30 min. Good correlation
for patient samples was found with IRMA (n = 57); r2 = 0.99 assaying PTHrP 1-86 equiv fragments.
Analysis by a receiver operating characteristic (ROC) plot gave an
area under the curve of 0.96, 80–83% clinical sensitivity,
and 96–100% clinical specificity. Results suggest that PTHrP1-173
isoform and its short C-terminal fragments are the predominant circulating
forms of PTHrP. This new ultrasensitive, multiplexed assay for PTHrP
and fragments is promising for clinical diagnosis, prognosis, and
therapeutic monitoring from early to advanced stage cancer patients
and to examine underlying mechanisms of PTHrP overproduction.
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Affiliation(s)
- Brunah A Otieno
- Department of Chemistry, University of Connecticut , Storrs, Connecticut 06269, United States
| | - Colleen E Krause
- Department of Chemistry, University of Connecticut , Storrs, Connecticut 06269, United States.,Department of Chemistry, University of Hartford , West Hartford, Connecticut 06117, United States
| | - Abby L Jones
- Department of Chemistry, University of Connecticut , Storrs, Connecticut 06269, United States
| | - Richard B Kremer
- Department of Medicine, McGill University , Montreal, Quebec H3A 1A1, Canada
| | - James F Rusling
- Department of Chemistry, University of Connecticut , Storrs, Connecticut 06269, United States.,Institute of Materials Science, University of Connecticut , Storrs, Connecticut 06269, United States.,Department of Surgery and Neag Cancer Center, University of Connecticut Health Center , Farmington, Connecticut 06232, United States.,School of Chemistry, National University of Ireland at Galway , Galway, Ireland
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18
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Martin TJ. Parathyroid Hormone-Related Protein, Its Regulation of Cartilage and Bone Development, and Role in Treating Bone Diseases. Physiol Rev 2016; 96:831-71. [DOI: 10.1152/physrev.00031.2015] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although parathyroid hormone-related protein (PTHrP) was discovered as a cancer-derived hormone, it has been revealed as an important paracrine/autocrine regulator in many tissues, where its effects are context dependent. Thus its location and action in the vasculature explained decades-long observations that injection of PTH into animals rapidly lowered blood pressure by producing vasodilatation. Its roles have been specified in development and maturity in cartilage and bone as a crucial regulator of endochondral bone formation and bone remodeling, respectively. Although it shares actions with parathyroid hormone (PTH) through the use of their common receptor, PTHR1, PTHrP has other actions mediated by regions within the molecule beyond the amino-terminal sequence that resembles PTH, including the ability to promote placental transfer of calcium from mother to fetus. A striking feature of the physiology of PTHrP is that it possesses structural features that equip it to be transported in and out of the nucleus, and makes use of a specific nuclear import mechanism to do so. Evidence from mouse genetic experiments shows that PTHrP generated locally in bone is essential for normal bone remodeling. Whereas the main physiological function of PTH is the hormonal regulation of calcium metabolism, locally generated PTHrP is the important physiological mediator of bone remodeling postnatally. Thus the use of intermittent injection of PTH as an anabolic therapy for bone appears to be a pharmacological application of the physiological function of PTHrP. There is much current interest in the possibility of developing PTHrP analogs that might enhance the therapeutic anabolic effects.
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Affiliation(s)
- T. John Martin
- St Vincent's Institute of Medical Research, Department of Medicine, University of Melbourne, St Vincent's Hospital, Melbourne, Australia
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19
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Kovacs CS. Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery. Physiol Rev 2016; 96:449-547. [PMID: 26887676 DOI: 10.1152/physrev.00027.2015] [Citation(s) in RCA: 251] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ∼30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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20
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Shimomura-Kuroki J, Farooq M, Sekimoto T, Amizuka N, Shimomura Y. Characterization of a PTH1R missense mutation responsible for Jansen type metaphyseal chondrodysplasia. Odontology 2016; 105:150-154. [PMID: 27160269 DOI: 10.1007/s10266-016-0247-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 04/17/2016] [Indexed: 01/01/2023]
Abstract
Parathyroid hormone and parathyroid hormone-related peptide (PTHrP), and its receptor (PTH1R) play an important role in differentiation of bone and cartilage in the developing stages. Constitutive dimers of PTH1R are believed to be dissociated by ligand binding, and monomeric PTH1R is capable of activating G protein. Jansen type metaphyseal chondrodysplasia is caused by missense mutations in PTH1R, which are constitutively active even without the presence of the ligands. However, the underlying pathomechanisms remained largely unknown. In this study, we have attempted to further characterize a PTH1R missense mutation H223R responsible for Jansen type metaphyseal chondrodysplasia. cDNAs encoding wild-type (Wt)- and H223R mutant (Mut)-PTH1R were transfected into HEK293T cells, and as a consequence of western blots, both the Wt- and Mut-PTH1R proteins showed several fragments between 55 and 65 kDa in size, while the patterns of N-glycosylation were distinct between them. Then we hypothesized that the Mut-PTH1R might physically interact with the Wt-PTH1R, leading to affect the downstream cAMP accumulation. Co-immunoprecipitation assays clearly showed that interaction occurred not only between the Wt-PTH1R themselves, but also between the Wt- and Mut-PTH1R. Furthermore, we performed CRE reporter assays to investigate cAMP accumulation. Constitutive, ligand-independent cAMP accumulation was observed in HEK293T cells expressing the Mut-PTH1R. Interestingly, there was a statistically lower constitutive activity in HEK293T cells co-expressing the Wt- and Mut-PTH1R proteins. Summarizing, it seems likely that Mut-PTH1R may be, at least in part, co-localized with Wt-PTH1R by forming a heterodimer, leading to affect the function to each other.
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Affiliation(s)
- Junko Shimomura-Kuroki
- Department of Pediatric Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata, 951-8580, Japan.
| | - Muhammad Farooq
- Laboratory of Genetic Skin Diseases, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Tsuneo Sekimoto
- Department of Pediatric Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata, 951-8580, Japan
| | - Norio Amizuka
- Department of Developmental Biology of Hard Tissue, Hokkaido University Graduate School of Dental Medicine, Kita 13 Nishi 7, Kita-ku, Sapporo, 060-8586, Japan
| | - Yutaka Shimomura
- Department of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
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21
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Ricarte F, Nakatani T, Partridge N. PTH Signaling and Epigenetic Control of Bone Remodeling. ACTA ACUST UNITED AC 2016; 2:55-61. [PMID: 27152252 DOI: 10.1007/s40610-016-0033-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
As our understanding of the mechanisms that govern bone development advance, the role of epigenetic modifications in these processes become increasingly evident. Interestingly, in parathyroid hormone (PTH)-induced bone metabolism and remodeling, recent evidence shows that PTH signaling employs a particular facet of the epigenetic machinery to elicit its desired effects. In this review, we briefly discuss the known epigenetic events occurring in cells of the osteoblast lineage. More specifically, we elaborate on current findings that reveal the utilization of histone deacetylating enzymes (HDACs) in PTH-regulated modulation of gene expression in bone.
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Affiliation(s)
- Florante Ricarte
- New York University School of Medicine, Sackler Institute of Graduate Biomedical Sciences, Department of Biochemistry and Molecular Pharmacology, New York, NY 10016
| | - Teruyo Nakatani
- New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, NY 10010
| | - Nicola Partridge
- New York University School of Medicine, Sackler Institute of Graduate Biomedical Sciences, Department of Biochemistry and Molecular Pharmacology, New York, NY 10016; New York University College of Dentistry, Department of Basic Science and Craniofacial Biology, New York, NY 10010
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22
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Galindo RJ, Romao I, Valsamis A, Weinerman S, Harris YT. Hypercalcemia of Malignancy and Colorectal Cancer. World J Oncol 2016; 7:5-12. [PMID: 26998187 PMCID: PMC4797652 DOI: 10.14740/wjon953w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Our aim is to describe the association between colorectal cancer (CRC) and humoral hypercalcemia of malignancy (HHM). Causes of hypercalcemia of malignancy include parathyroid hormone-related peptide (PTHrP) secretion, local osteolysis, calcitriol production and ectopic parathyroid hormone (PTH) secretion. Hypercalcemia of malignancy in patients with CRCs is a rare scenario. A patient with anal squamous cell carcinoma was admitted with hypercalcemia, suppressed PTH and hypophosphatemia. He was found to have metastatic anal squamous cell carcinoma to the liver. Further evaluation revealed elevated PTHrP and 1,25-dihydroxyvitamin D and low 25-hydroxyvitamin D. Over a 5-month course, the hypercalcemia responded poorly to bisphosphonates, transiently to prednisone, but showed marked improvement with chemotherapy. A review of English language publications in Pubmed and a reference search of retrieved articles revealed 29 cases of CRC causing PTHrP-mediated hypercalcemia. Most patients were middle-aged men (mean ± SD: 56.7 ± 13.4 years), with advanced metastatic cancer (85% with hepatic metastasis) and severe hypercalcemia (mean ± SD: 15.6 ± 1.9 mg/dL, 62% with Ca > 14). This condition is associated with high mortality (79%) and short survival (median 54.5 days, CI: 21 - 168). Despite being uncommon, HHM (PTHrP-mediated) should be considered in patients with metastatic CRC presenting with hypercalcemia. Clinicians should be aware that combined etiologies may be present, particularly in cases of resistant hypercalcemia. Treatment of the underlying malignancy is essential for calcium control.
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Affiliation(s)
- Rodolfo J Galindo
- Icahn School of Medicine at Mount Sinai, Division of Endocrinology, Diabetes and Bone Diseases, Mount Sinai St. Luke's Hospital, 1111 Amsterdam Ave, Babcock Building 10th Floor, Room 1020, New York, NY 10025, USA
| | - Isabela Romao
- Hofstra North-Shore LIJ School of Medicine, Division of Endocrinology Diabetes and Metabolism, 865 Northern Boulevard, Suite 203, Great Neck, NY 11021, USA
| | - Ageliki Valsamis
- Hofstra North-Shore LIJ School of Medicine, Division of Endocrinology Diabetes and Metabolism, 865 Northern Boulevard, Suite 203, Great Neck, NY 11021, USA
| | - Stuart Weinerman
- Hofstra North-Shore LIJ School of Medicine, Division of Endocrinology Diabetes and Metabolism, 865 Northern Boulevard, Suite 203, Great Neck, NY 11021, USA
| | - Yael Tobi Harris
- Hofstra North-Shore LIJ School of Medicine, Division of Endocrinology Diabetes and Metabolism, 865 Northern Boulevard, Suite 203, Great Neck, NY 11021, USA
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23
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Kushnir MM, Rockwood AL, Strathmann FG, Frank EL, Straseski JA, Meikle AW. LC-MS/MS Measurement of Parathyroid Hormone-Related Peptide. Clin Chem 2015; 62:218-26. [PMID: 26578690 DOI: 10.1373/clinchem.2015.244012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 10/19/2015] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Parathyroid hormone-related peptide (PTHrP) is involved in activating pathways, allowing tumor cells to form bone metastases. Measurement of PTHrP is used for the diagnosis and clinical management of patients suspected of hypercalcemia of malignancy. We developed an LC-MS/MS method for measuring PTHrP, established sex-specific reference intervals, and assessed the method's performance. METHODS PTHrP was enriched from plasma samples with rabbit polyclonal anti-PTHrP antibody conjugated to magnetic beads. Enriched PTHrP was digested with trypsin, and PTHrP-specific tryptic peptide was analyzed with 2-dimensional LC-MS/MS in multiple reaction monitoring mode. RESULTS The lower limit of quantification was 0.6 pmol/L, and the upper limit of linearity was 600 pmol/L. Total imprecision was <10%. Very poor agreement was observed with the RIA (n = 207; Deming regression RIA = 0.059 × LC-MS/MS - 1.8, r = 0.483; Sy|x = 3.9). Evaluation of the clinical performance of the assay using samples from patients with and without hypercalcemia (n = 199) resulted in an area under the ROC curve of 0.874. In sets of consecutively analyzed routine samples of patients assessed for hypercalcemia, the PTHrP positivity rate by RIA (n = 1376) was 1.9%, and 26.6% by LC-MS/MS (n = 1705). Concentrations were below the lower limit of quantification in 95.6% of the samples by RIA and 2.0% by LC-MS/MS. CONCLUSIONS PTHrP is a normal constituent in circulating blood and its concentrations are substantially underestimated by commercial RIAs, causing false-negative results in samples from patients suspected of hypercalcemia. Our observations suggest a link between increased concentrations of PTHrP in postmenopausal women with low body mass index and increased incidence of osteoporosis.
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Affiliation(s)
- Mark M Kushnir
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology and
| | - Alan L Rockwood
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology and
| | - Frederick G Strathmann
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology and
| | - Elizabeth L Frank
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology and
| | - Joely A Straseski
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT; Department of Pathology and
| | - A Wayne Meikle
- Department of Pathology and Department of Medicine, University of Utah, Salt Lake City, UT
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24
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Kurabayashi A, Inoue K, Fukuhara H, Karashima T, Fukata S, Kawada C, Shuin T, Furihata M. Combination with third-generation bisphosphonate (YM529) and interferon-alpha can inhibit the progression of established bone renal cell carcinoma. Cancer Sci 2015; 106:1092-9. [PMID: 26041278 PMCID: PMC4556400 DOI: 10.1111/cas.12711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/25/2015] [Accepted: 05/27/2015] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to investigate whether the third-generation nitrogen-containing bisphosphonate (YM529) can inhibit the progression of established bone renal cell carcinoma (RCC) and to elucidate its mechanism. Antiproliferative effect and apoptosis induction of RCC cells and mouse osteoclasts by YM529 and/or interferon-alpha (IFN-α) were evaluated in vitro using cell counting and in vivo using soft X-ray, the TUNEL method and tartrate-resistant acid phosphatase stain. For the in vivo study, male athymic BALB/cA Jc1-nu nude mice bearing human RCC cell line RBM1-IT4 cells were treated with YM529 and/or IFN-α. The biological activity of osteoclasts was evaluated using the pit formation assay. The antiangiogenetic effect by YM529 and/or IFN-α was analyzed using micro-vessel density and in situ mRNA hybridization. Osteoclast number in bone tumors was decreased in YM529-treated mouse. YM529 also inhibited osteoclast activity and proliferation in vitro, whereas basic fibroblast growth factor expressions and micro-vessel density within tumors were inhibited by IFN-α. Neither YM529 nor IFN-α alone significantly inhibited the growth of established bone metastatic tumors. Combined treatment with YM529 and IFN-α may be beneficial in patients with human RCC bone metastasis. Their effects are mediated by osteoclast recruitment inhibition and inactivation by YM529 and antiangiogenesis by IFN-α.
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Affiliation(s)
| | - Keiji Inoue
- Department of Urology, Kochi Medical School, Nankoku, Japan
| | - Hideo Fukuhara
- Department of Urology, Kochi Medical School, Nankoku, Japan
| | | | - Satoshi Fukata
- Department of Urology, Kochi Medical School, Nankoku, Japan
| | - Chiaki Kawada
- Department of Urology, Kochi Medical School, Nankoku, Japan
| | - Taro Shuin
- Department of Urology, Kochi Medical School, Nankoku, Japan
| | - Mutsuo Furihata
- Department of Pathology, Kochi Medical School, Nankoku, Japan
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25
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Lee Y, Kim A, Kim HY, Eo WK, Lee ES, Chun S. Bone Density in Patients with Cervical Cancer or Endometrial Cancer in comparison with Healthy Control; According to the stages. J Cancer 2015; 6:686-93. [PMID: 26185529 PMCID: PMC4504103 DOI: 10.7150/jca.11490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/05/2015] [Indexed: 12/18/2022] Open
Abstract
Objective: To evaluate the bone mineral density (BMD) in the lumbar spine and femur in postmenopausal women with cervical cancer and endometrial cancer without bone metastasis in comparison with that in healthy control postmenopausal women, and to assess the loss of BMD according to the cancer stage. Materials and methods: We analyzed the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry (DXA) in 218 patients with cervical cancer, 85 patients with endometrial cancer, and 259 healthy controls. The serum levels of calcium (Ca), phosphorus (P), osteocalcin (OSC), and total alkaline phosphatase (ALP), and urine deoxypyridinoline(DPL) were measured in all participants. Results: Age, body mass index, parity, and time since menopause were not significantly different between the three groups. Serum Ca level was higher in the cervical cancer group (p = 0.000), however, urine DPL was lower in endometrial cancer group (p = 0.000). The T-scores of basal BMD at the second and fourth lumbar vertebra (L2, L4) were significantly lower in patients with cervical cancer (p = 0.038, 0.000, respectively) compared to those in the healthy control groups. Additionally, the incidence of osteoporosis and osteopenia basal status of bone mass was significantly higher in patients with cervical cancer compared to that in controls (p = 0.016). No differences in basal BMD of the lumbar spine and femur were observed between patients with cervical cancer according to their stages. Conclusion: Our results suggest that postmenopausal women with cervical cancer have a lower BMD and are at increased risk of osteoporosis in the lumbar spine before receiving anticancer treatment compared with postmenopausal women with endometrial cancer.
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Affiliation(s)
- Yubin Lee
- 1. Department of Obstetrics and Gynecology, Cha Gangnam Medical center, Cha University, Seoul, Korea
| | - Ari Kim
- 2. Department of Obstetrics and Gynecology, College of Medicine, Wonkwang University, Iksan, Korea
| | - Heung Yeol Kim
- 3. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea
| | - Wan Kyu Eo
- 4. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Eun Sil Lee
- 5. Department of Obstetrics and Gynecology, College of Medicine, Soon Chun Hyang University, Seoul, Korea
| | - Sungwook Chun
- 6. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Busan, Korea
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27
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Oh YL, Yoon MS, Suh DS, Kim A, Kim MJ, Lee JY, Song YJ, Ji YI, Kim KH, Chun S. Changes in bone density after cancer treatment in patients with cervical and endometrial cancer. J Cancer 2015; 6:82-9. [PMID: 25553092 PMCID: PMC4278918 DOI: 10.7150/jca.10679] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/14/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer.
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Affiliation(s)
- Young Lim Oh
- 1. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Republic of Korea
| | - Man Soo Yoon
- 2. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Dong Soo Suh
- 2. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ari Kim
- 3. Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, College of Medicine, Wonkwang University, Iksan, Korea
| | - Min Joung Kim
- 4. Department of Obstetrics and Gynecology, Catholic University School of Medicine, Seoul, Republic of Korea
| | - Ji Young Lee
- 5. Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Yong Jung Song
- 6. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Yong Il Ji
- 7. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Busan, Republic of Korea
| | - Ki Hyung Kim
- 2. Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Sungwook Chun
- 7. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Busan, Republic of Korea
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28
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Kovacs CS. Bone development and mineral homeostasis in the fetus and neonate: roles of the calciotropic and phosphotropic hormones. Physiol Rev 2014; 94:1143-218. [PMID: 25287862 DOI: 10.1152/physrev.00014.2014] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Mineral and bone metabolism are regulated differently in utero compared with the adult. The fetal kidneys, intestines, and skeleton are not dominant sources of mineral supply for the fetus. Instead, the placenta meets the fetal need for mineral by actively transporting calcium, phosphorus, and magnesium from the maternal circulation. These minerals are maintained in the fetal circulation at higher concentrations than in the mother and normal adult, and such high levels appear necessary for the developing skeleton to accrete a normal amount of mineral by term. Parathyroid hormone (PTH) and calcitriol circulate at low concentrations in the fetal circulation. Fetal bone development and the regulation of serum minerals are critically dependent on PTH and PTH-related protein, but not vitamin D/calcitriol, fibroblast growth factor-23, calcitonin, or the sex steroids. After birth, the serum calcium falls and phosphorus rises before gradually reaching adult values over the subsequent 24-48 h. The intestines are the main source of mineral for the neonate, while the kidneys reabsorb mineral, and bone turnover contributes mineral to the circulation. This switch in the regulation of mineral homeostasis is triggered by loss of the placenta and a postnatal fall in serum calcium, and is followed in sequence by a rise in PTH and then an increase in calcitriol. Intestinal calcium absorption is initially a passive process facilitated by lactose, but later becomes active and calcitriol-dependent. However, calcitriol's role can be bypassed by increasing the calcium content of the diet, or by parenteral administration of calcium.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Dong Q, Zhang Y, Yang XH, Jing W, Zheng LQ, Liu YP, Qu XJ, Li Z. Serum calcium level used as a prognostic predictor in patients with resectable pancreatic ductal adenocarcinoma. Clin Res Hepatol Gastroenterol 2014; 38:639-48. [PMID: 24630955 DOI: 10.1016/j.clinre.2014.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/26/2013] [Accepted: 01/23/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND OBJECTIVE There is a relative scarcity of reports to evaluate the associations between serum calcium level and the prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to determine whether serum calcium level is a significant predictor for survival in PDAC patients. METHODS This is a retrospective cohort study. The clinicopathological characteristics, preoperative serum calcium levels and the survival data of 114 patients who underwent surgery for PDAC between January 1, 2009 and January 31, 2012 were collected. The associations between serum calcium level and overall survival were evaluated using the multivariate Cox proportional hazards model. RESULTS The median age of the patients was 60 years, and 64 (56.1%) of them were male. Eighty-one cases (71.1%) were dead at the last follow up. Forty-four patients (38.6%) died within the first year after surgery. The receiver operating characteristics (ROC) curve indicated a significant result for serum calcium level in predicting one-year death after surgery [area under the curve (AUC), 0.629; 95% CI 0.527-0.730, P=0.021]. In multivariate analysis, higher serum calcium levels [hazard ratio (HR), 1.922; P=0.036], diabetes (HR, 1.820; P=0.017), histologically poorly-differentiated tumor (HR, 3.342; P=0.001) and vessel invasion (HR, 1.729; P=0.023) were independent predictors of poor prognosis. Similarly, the albumin-adjusted albumin level was also an independent prognostic factor. CONCLUSIONS The higher serum calcium level is associated with poor prognosis in patients with resectable PDAC and the level of serum calcium can predict death within one year after surgery.
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Affiliation(s)
- Qian Dong
- Department of Oncology, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District, Shenyang 110004, China
| | - Yao Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiang-Hong Yang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Wei Jing
- Department of Oncology, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District, Shenyang 110004, China
| | - Li-Qiang Zheng
- Library, Shengjing Hospital of China Medical University, 36, Sanhao Street Heping District Shenyang 110004, China
| | - Yun-Peng Liu
- Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China
| | - Xiu-Juan Qu
- Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China
| | - Zhi Li
- Department of Oncology, the First Affiliated Hospital of China Medical University, 155, Nanjing North Street, Heping District, Shenyang 110001, China
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Hu MI, Glezerman IG, Leboulleux S, Insogna K, Gucalp R, Misiorowski W, Yu B, Zorsky P, Tosi D, Bessudo A, Jaccard A, Tonini G, Ying W, Braun A, Jain RK. Denosumab for treatment of hypercalcemia of malignancy. J Clin Endocrinol Metab 2014; 99:3144-52. [PMID: 24915117 PMCID: PMC4154084 DOI: 10.1210/jc.2014-1001] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 05/21/2014] [Indexed: 12/29/2022]
Abstract
CONTEXT Hypercalcemia of malignancy (HCM) in patients with advanced cancer is often caused by excessive osteoclast-mediated bone resorption. Patients may not respond to or may relapse after iv bisphosphonate therapy. OBJECTIVE We investigated whether denosumab, a potent inhibitor of osteoclast-mediated bone resorption, reduces serum calcium in patients with bisphosphonate-refractory HCM. DESIGN, SETTING, AND PARTICIPANTS In this single-arm international study, participants had serum calcium levels corrected for albumin (CSC) >12.5 mg/dL (3.1 mmol/L) despite bisphosphonates given >7 and ≤30 days before screening. INTERVENTION Patients received 120 mg sc denosumab on days 1, 8, 15, and 29 and then every 4 weeks. MAIN OUTCOME MEASURES The primary endpoint was the proportion of patients with CSC ≤11.5 mg/dL (2.9 mmol/L) (response) by day 10. Secondary endpoints included response by visit, duration of response, and the proportion of patients with a complete response (CSC ≤10.8 mg/dL [2.7 mmol/L]) by day 10 and during the study. RESULTS Patients (N = 33) had solid tumors or hematologic malignancies. By day 10, 21 patients (64%) reached CSC ≤11.5 mg/dL, and 12 patients (33%) reached CSC ≤10.8 mg/dL. During the study, 23 patients (70%) reached CSC ≤11.5 mg/dL, and 21 patients (64%) reached CSC ≤10.8 mg/dL. Estimated median response duration was 104 days. The most common serious adverse events were hypercalcemia worsening (5 patients, 15%) and dyspnea (3 patients, 9%). CONCLUSIONS In patients with HCM despite recent iv bisphosphonate treatment, denosumab lowered serum calcium in 64% of patients within 10 days, inducing durable responses. Denosumab may offer a new treatment option for HCM.
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Affiliation(s)
- Mimi I Hu
- University of Texas, MD Anderson Cancer Center (M.I.H.), Houston, Texas 77030; Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College (I.G.G.), New York, New York 10065; Institut Gustave Roussy (S.L.), Villejuif, France; Yale School of Medicine (K.I.), New Haven, Connecticut 06510; Montefiore Medical Center-Bronx (R.G.), New York, New York 10467; Endocrinology Department, Medical Center for Postgraduate Education (W.M.), Warsaw, Poland; Lee Moffitt Cancer Center and Research Institute (B.Y.), Tampa, Florida 33607; Peninsula Regional Medical Center (P.Z.), Salisbury, Maryland 21801; Institut Régional du Cancer de Montpellier-Val d'Aurelle (D.T.), Montpellier, France; California Cancer Associates for Research and Excellence (A.B.), Encinitas, California 92024; Centre Hospitalier Universitaire de Limoges-Hôpital Dupuytren (A.J.), Limoges, France; Policlinico Universitario Campus Bio-Medico (G.T.), Rome, Italy; and Amgen Inc (W.Y., A.B., R.K.J.), Thousand Oaks, California 91320
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Erbach GT, Biggers JD, Manning PC, Nowak RA. Localization of parathyroid hormone-related protein in the preimplantation mouse embryo is associated with events of blastocyst hatching. J Assist Reprod Genet 2014; 30:1009-15. [PMID: 24052330 DOI: 10.1007/s10815-013-0094-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the pattern of expression of parathyroid hormone-related protein (PTHrP) and its receptor, parathyroid hormone receptor 1 (PTHR1), in mouse embryos in different stages of preimplantation development. METHODS Embryos were cultured from the pronuclear zygote stage and harvested as 2-cell, 4-cell and 8-cell embryos, morulae and blastocysts. RT-PCR was carried out on mRNAs of these and of trophoblast outgrowths for detection of PTHrP and PTHR1. Whole mounted embryos intact or stripped of zonae pellucidae were immunofluorescently stained for PTHrP and PTH receptor and observed with confocal microscopy. RESULTS PTHrP mRNA was present in the pronuclear zygote, not present in 2-cell, 4-cell and uncompacted 8-cell embryos, present in the 8-cell compacting embryo, and not detected in 16-cell morulae or blastocysts. The mRNA was present in trophoblasts growing on fibronectin beds. mRNA for PTHR1 was detected in the pronuclear zygote, then undetected until the compacted 8-cell stage and thereafter. PTH receptor protein was observed in 2-cell embryos, morulae and in the inner cell mass and trophectoderm of blastocysts. PTHrP was observed dispersed in the cytoplasm of 2-cell, 4-cell and uncompacted 8-cell embryos, and in distinct foci near the nuclei of morulae. In blastocysts, PTHrP appeared on the apical surface of only trophoblast cells which had extruded from the zona pellucida. Fully hatched blastocysts expressed the protein on the apical side of all trophoblasts. When morulae were prematurely stripped of their zonae, PTHrP was observed on the embryos' outer surface. CONCLUSIONS PTHrP protein is expressed throughout early embryo development, and its receptor PTHR1 is expressed from the morula stage. Embryo hatching is associated with translocation of PTHrP to the apical plasma membrane of trophoblasts. PTHrP may thus have autocrine effects on the developing blastocyst.
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Affiliation(s)
- Gregory T Erbach
- Department of Animal Sciences, University of Illinois, 310 Animal Science Laboratory, 1207 W. Gregory Drive, Urbana, IL, 61801, USA
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Shimizu E, Nakatani T, He Z, Partridge NC. Parathyroid hormone regulates histone deacetylase (HDAC) 4 through protein kinase A-mediated phosphorylation and dephosphorylation in osteoblastic cells. J Biol Chem 2014; 289:21340-50. [PMID: 24904057 DOI: 10.1074/jbc.m114.550699] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Histone deacetylases (HDACs) are crucial regulators of gene expression in transcriptional co-repressor complexes. Previously, we reported that HDAC4 was a basal repressor of matrix metalloproteinase-13 (MMP-13) transcription and parathyroid hormone (PTH) regulates HDAC4 to control MMP-13 promoter activity through dissociation from Runx2. Here, we show that PTH induces the protein kinase A (PKA)-dependent phosphorylation of HDAC4 in the nucleus of the rat osteoblastic cell line, UMR 106-01. We demonstrate that PKA-dependent phosphorylated HDAC4 is released from Runx2 bound to the MMP-13 promoter in these cells. Point mutation of Ser-740 in rHDAC4 prevents the release of HDAC4 from Runx2 on the MMP-13 promoter and also prevents the PTH stimulation of MMP-13 transcription. Thus, PTH-induced phosphorylation of rHDAC4 at Ser-740 is crucial for regulating MMP-13 transcription in osteoblasts. PTH causes degradation of HDAC4, and this product appears in the cytoplasm. The cytoplasmic degradation of HDAC4 is blocked by PKA and lysosomal inhibitors, but is not affected by proteasome, caspase-3, or serine and aspartic protease inhibitors. In addition, the phosphatase inhibitor, okadaic acid, prevents degradation indicating that dephosphorylation is associated with degradation. These mechanisms regulating HDAC4 and their roles in such processes are crucial for bone and chondrocyte development. Our data support a link between PTH regulating HDAC4 phosphorylation by PKA, trafficking, partial degradation, and the control of MMP-13 transcription through association with Runx2.
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Affiliation(s)
- Emi Shimizu
- From the Departments of Basic Science and Craniofacial Biology and Endodontics, New York University College of Dentistry, New York, New York 10010
| | - Teruyo Nakatani
- From the Departments of Basic Science and Craniofacial Biology and
| | - Zhiming He
- From the Departments of Basic Science and Craniofacial Biology and
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Boras-Granic K, Dann P, VanHouten J, Karaplis A, Wysolmerski J. Deletion of the nuclear localization sequences and C-terminus of PTHrP impairs embryonic mammary development but also inhibits PTHrP production. PLoS One 2014; 9:e90418. [PMID: 24785493 PMCID: PMC4006745 DOI: 10.1371/journal.pone.0090418] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/29/2014] [Indexed: 12/18/2022] Open
Abstract
Parathyroid hormone-related protein (PTHrP) can be secreted from cells and interact with its receptor, the Type 1 PTH/PTHrP Receptor (PTHR1) in an autocrine, paracrine or endocrine fashion. PTHrP can also remain inside cells and be transported into the nucleus, where its functions are unclear, although recent experiments suggest that it may broadly regulate cell survival and senescence. Disruption of either the PTHrP or PTHR1 gene results in many abnormalities including a failure of embryonic mammary gland development in mice and in humans. In order to examine the potential functions of nuclear PTHrP in the breast, we examined mammary gland development in PTHrP (1-84) knock-in mice, which express a mutant form of PTHrP that lacks the C-terminus and nuclear localization signals and which can be secreted but cannot enter the nucleus. Interestingly, we found that PTHrP (1-84) knock-in mice had defects in mammary mesenchyme differentiation and mammary duct outgrowth that were nearly identical to those previously described in PTHrP-/- and PTHR1-/- mice. However, the mammary buds in PTHrP (1-84) knock-in mice had severe reductions in mutant PTHrP mRNA levels, suggesting that the developmental defects were due to insufficient production of PTHrP by mammary epithelial cells and not loss of PTHrP nuclear function. Examination of the effects of nuclear PTHrP in the mammary gland in vivo will require the development of alternative animal models.
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Affiliation(s)
- Kata Boras-Granic
- Section of Endocrinology and Metabolism, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Pamela Dann
- Section of Endocrinology and Metabolism, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Joshua VanHouten
- Section of Endocrinology and Metabolism, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Andrew Karaplis
- Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada
| | - John Wysolmerski
- Section of Endocrinology and Metabolism, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
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Danks JA, Freeman AN, Martin TJ. Historical Perspective and Evolutionary Origins of Parathyroid Hormone-Related Protein. Clin Rev Bone Miner Metab 2014. [DOI: 10.1007/s12018-014-9163-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wright LE, Guise TA. The Role of PTHrP in Skeletal Metastases and Hypercalcemia of Malignancy. Clin Rev Bone Miner Metab 2014. [DOI: 10.1007/s12018-014-9160-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kovacs CS. The Role of PTHrP in Regulating Mineral Metabolism During Pregnancy, Lactation, and Fetal/Neonatal Development. Clin Rev Bone Miner Metab 2014. [DOI: 10.1007/s12018-014-9157-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Cafforio P, Savonarola A, Stucci S, De Matteo M, Tucci M, Brunetti AE, Vecchio VM, Silvestris F. PTHrP produced by myeloma plasma cells regulates their survival and pro-osteoclast activity for bone disease progression. J Bone Miner Res 2014; 29:55-66. [PMID: 23787729 DOI: 10.1002/jbmr.2022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/31/2013] [Accepted: 06/10/2013] [Indexed: 11/07/2022]
Abstract
To promote their survival and progression in the skeleton, osteotropic malignancies of breast, lung, and prostate produce parathyroid hormone-related protein (PTHrP), which induces hypercalcemia. PTHrP serum elevations have also been described in multiple myeloma (MM), although their role is not well defined. When we investigated MM cells from patients and cell lines, we found that PTHrP and its receptor (PTH-R1) are highly expressed, and that PTHrP is secreted both as a full-length molecule and as small subunits. Among these subunits, the mid-region, including the nuclear localization sequence (NLS), exerted a proliferative effect because it was accumulated in nuclei of MM cells surviving in starvation conditions. This was confirmed by increased transcription of several genes enrolled in proliferation and apoptosis control. PTHrP was also found to stimulate PTH-R1 in MM cells. PTH-R1's selective activation by the full-length PTHrP molecule or the NH2 -terminal fragment resulted in a significant increase of intracellular Ca(2+) influx, cyclic adenosine monophosphate (cAMP) content, and expression of receptor activator of NF-κB ligand (RANKL) and monocyte chemoattractant protein-1 (MCP-1). Our data definitely clarify the role of PTHrP in MM. The PTHrP peptide is functionally secreted by malignant plasma cells and contributes to MM tumor biology and progression, both by intracrine maintenance of cell proliferation in stress conditions and by autocrine or paracrine stimulation of PTH-R1, which in turn reinforces the production of osteoclastogenic factors. © 2014 American Society for Bone and Mineral Research.
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Affiliation(s)
- Paola Cafforio
- Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Oncology, University of Bari "Aldo Moro,", Bari, Italy
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Abstract
Objective To report the case of a 28-year-old woman who presented with hypercalcemia (total calcium =4.11 mmol/L), elevated parathyroid hormone (PTH) 24.6 pmol/L, normal parathyroid hormone-related peptide 7.8 pg/mL, and a 63 mm × 57 mm, poorly differentiated neuroendocrine carcinoma (small-cell type) pancreatic mass with liver metastases. Investigations and treatment Hypercalcemia was acutely managed with intravenous fluids, pamidronate and calcitonin. Investigations for multiple endocrine neoplasia type 1 and parathyroid adenoma were initiated. The identified neuroendocrine tumor was treated with cisplatinum/etoposide chemotherapy. Results The pancreatic mass (56 mm × 49 mm) and metastases decreased in size with chemotherapy and calcium levels normalized. Eight months later, calcium increased to 3.23 mmol/L, PTH increased to 48.2 pmol/L, and the pancreatic mass increased in size to 67 mm × 58 mm. The patient was given a trial of cinacalcet but was unable to tolerate it. Chemotherapy was restarted and resulted in a decrease in the pancreatic mass (49 mm × 42 mm), a reduction in PTH levels (16.6 pmol/L), and calcium levels (2.34 mmol/L). Conclusion Ectopic PTH secreting tumors should be considered when there is no parathyroid related cause for an elevated PTH. Recognizing the association between PTH and hypercalcemia of malignancy may lead to an earlier detection of an undiagnosed malignancy.
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Affiliation(s)
- Mary-Anne Doyle
- Division of Endocrinology, University of Ottawa, Ottawa, ON, Canada
| | - Janine C Malcolm
- Division of Endocrinology, University of Ottawa, Ottawa, ON, Canada
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Chun S, Ji YI. RETRACTED: Bone mineral density of lumbar spine and femur in patients with gynecologic cancer. Climacteric 2013:1-7. [PMID: 24228804 DOI: 10.3109/13697137.2013.861815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective To compare the bone mineral density (BMD) of the lumbar spine and femur in postmenopausal women with cervical and endometrial cancer without bone metastasis with that in normal control postmenopausal women Methods We retrospectively analyzed the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. Results The serum levels of calcium, phosphorus, osteocalcin, total alkaline phosphatase and urine deoxypyridinoline were measured in all participants. Age, body mass index, parity and time since menopause were not significantly different between the three groups. The T-scores of basal BMD at the fourth lumbar vertebra (L4) were significantly lower in patients with cervical cancer (- 0.68 ± 0.10) compared to those in the other two groups. Additionally, the incidence of osteoporosis at L4 according to the basal status of bone mass was significantly higher in patients with cervical cancer (10.0%) compared to that in controls (0.4%). Urine deoxypyridinoline levels were significantly higher in patients with cervical cancer compared to those in controls. No differences in basal BMD of the lumbar spine and femur were observed between patients with endometrial cancer and controls, and no significant differences in biochemical markers were detected between patients with endometrial cancer and controls. Conclusion Our results suggest that postmenopausal women with cervical cancer have a lower BMD and are at increased risk of osteoporosis in the lumbar spine before receiving anticancer treatment compared with postmenopausal women with endometrial cancer.
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Affiliation(s)
- S Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital , Busan , Korea
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Lee ES, Park BR, Kim A, Choi CH, Kim HY. RETRACTED: Different bone mineral density in cervical and endometrial cancer. Climacteric 2013:1-6. [PMID: 24138177 DOI: 10.3109/13697137.2013.850479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives Patients with cervical cancer have lower bone mass than women without cancer, whereas women with endometrial cancer have higher bone mineral density (BMD) than control subjects, possibly due to the prevalence of high body-fat mass. The aim of this study was to compare BMD in patients with cervical cancer, endometrial cancer and controls. Methods We analyzed and compared spinal and femoral BMD in 130 patients with cervical cancer, 68 with endometrial cancer, and 140 age-matched menopausal female control subjects. We also compared serum calcium, phosphorus, total alkaline phosphatase, osteocalcin, and urinary deoxypyridinoline levels. Results Compared with the control group, T-scores for some lumbar vertebrae (L4), the femoral neck, and Ward's triangle were lower in patients with cervical cancer, whereas only L4 T-scores were significantly lower in patients with endometrial cancer. Deoxypyridinoline levels were significantly lower in women with endometrial cancer (p < 0.002) than in women with cervical cancer, but no other biochemical variables differed among groups. Conclusions Cervical cancer was associated with lower BMD, especially in femoral BMD, and may be a risk factor for secondary osteoporosis. However, endometrial cancer generally seemed to have no damaging effect on bone except at L4. A further larger follow-up study in more populations is required to clarify these findings.
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Affiliation(s)
- E S Lee
- Department of Obstetrics and Gynecology, College of Medicine, Soonchunhyang University , Seoul
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Hu MI, Glezerman I, Leboulleux S, Insogna K, Gucalp R, Misiorowski W, Yu B, Ying W, Jain RK. Denosumab for patients with persistent or relapsed hypercalcemia of malignancy despite recent bisphosphonate treatment. J Natl Cancer Inst 2013; 105:1417-20. [PMID: 23990665 PMCID: PMC3776443 DOI: 10.1093/jnci/djt225] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hypercalcemia of malignancy (HCM), caused primarily by tumor-induced bone resorption, may
lead to renal failure, coma, and death. Although HCM can be treated with intravenous
bisphosphonates, patients may not respond or may relapse on therapy. Denosumab binds the
bone resorption mediator RANKL. In this single-arm, open-label, proof-of-concept study,
HCM patients with albumin-corrected serum calcium (CSC) levels greater than 12.5mg/dL
(Common Terminology Criteria for Adverse Events grade ≥3) despite recent
intravenous bisphosphonate treatment received subcutaneous denosumab on days 1, 8, 15, and
29, and then every 4 weeks. The primary endpoint was the proportion of patients with CSC
11.5mg/dL or less (grade ≤1) within 10 days of denosumab initiation. In a
prespecified interim analysis, 15 patients received denosumab (median CSC =
13.6mg/dL). Time to response and response duration were analyzed with Kaplan–Meier
methods. All statistical tests were two-sided. By day 10, 12 patients (80%; 95% exact
confidence interval [CI] = 52% to 96%) responded (CSC ≤11.5mg/dL); median
response duration was 26 days. Ten patients (67%; 95% exact CI = 38% to 88%) had
complete responses (CSC ≤10.8mg/dL) by day 10. Denosumab may offer a new treatment
option for HCM. Clinicaltrials.gov identifier: NCT00896454.
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Affiliation(s)
- Mimi I Hu
- Affiliations of authors: University of Texas MD Anderson Cancer Center, Houston, TX (MIH); Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY (IG); Institut Gustave Roussy, Villejuif, France (SL); Yale School of Medicine, New Haven, CT (KI); Montefiore Medical Center-Bronx, New York, NY (RG); Endocrinology Department, Medical Center for Postgraduate Education, Warsaw, Poland (WM); Peninsula Regional Medical Center, Salisbury, MD (BY); Amgen Inc., Thousand Oaks, CA, USA (WY, RKJ)
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Cao Y, Zhang W, Gao X, Zhang G, Falzon M, Townsend CM, Hellmich MR, Ko TC. PTHrP is a novel mediator for TGF-β-induced apoptosis. ACTA ACUST UNITED AC 2013; 184:40-6. [PMID: 23499802 DOI: 10.1016/j.regpep.2013.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 10/23/2012] [Accepted: 03/03/2013] [Indexed: 02/04/2023]
Abstract
Parathyroid hormone-related protein (PTHrP) is a polyhormone secretory protein that plays fundamental roles in the development and function of various tissues. Transforming growth factor (TGF)-β is an important tumor suppressor that induces cell cycle arrest and apoptosis. Increased PTHrP expression has been implicated in TGF-β-induced growth inhibition in human hepatocellular carcinoma cells. However, whether PTHrP is involved in TGF-β-induced apoptosis remains unknown. Using Hep3B and HuH-7, two human hepatocellular carcinoma cell lines, the current study examined the hypothesis that TGF-β-induced apoptosis is mediated by the induction of PTHrP expression. We found that (1) TGF-β induces PTHrP mRNA expression, protein expression and secretion in a time-dependent fashion; (2) knockdown of PTHrP gene expression or neutralization of secreted PTHrP isoforms blocks TGF-β-induced apoptosis; and (3) TGF-β-induced PTHrP expression is Smad3-dependent. Thus, we have identified PTHrP as a novel mediator for TGF-β-induced apoptosis in Hep3B cells. Our findings provide further insights into the mechanisms through which TGF-β conveys tumor suppression activity.
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Affiliation(s)
- Yanna Cao
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Kim JM, Choi JS, Kim YH, Jin SH, Lim S, Jang HJ, Kim KT, Ryu SH, Suh PG. An activator of the cAMP/PKA/CREB pathway promotes osteogenesis from human mesenchymal stem cells. J Cell Physiol 2013; 228:617-26. [PMID: 22886506 DOI: 10.1002/jcp.24171] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 07/31/2012] [Indexed: 02/06/2023]
Abstract
Mesenchymal stem cells (MSCs) are multipotent adult stem cells capable of differentiating along the osteoblast, adipocyte, and chondrocyte lineages. Regulation of MSCs differentiation may be a useful tool for regenerative medicine and cell-based therapy. The discovery of small molecule that activates the osteogenic differentiation of MSCs could aid in the development of a new anabolic drug for osteoporosis treatment. We identified CW008, a derivative of pyrazole-pyridine, that stimulates osteoblast differentiation of human MSCs and increases bone formation in ovariectomized mice. CW008 promotes osteogenesis by activating cAMP/PKA/CREB signaling pathway and inhibiting leptin secretion. These results suggest that CW008 is an agonist of cAMP/PKA/CREB pathway in osteogenic differentiation and that application of CW008 may be useful for the treatment of bone-related diseases and for the study of bone biology.
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Affiliation(s)
- Jung-Min Kim
- School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
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Soki FN, Park SI, McCauley LK. The multifaceted actions of PTHrP in skeletal metastasis. Future Oncol 2013; 8:803-17. [PMID: 22830401 DOI: 10.2217/fon.12.76] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PTHrP, identified during the elucidation of mediators of malignancy-induced hypercalcemia, plays numerous roles in normal physiology as well as pathological conditions. Recent data support direct functions of PTHrP in metastasis, particularly from tumors with strong bone tropism. Bone provides a unique metastatic environment because of mineralization and the diverse cell populations in the bone marrow. PTHrP is a key regulator of tumor-bone interactions and regulates cells in the bone microenvironment through proliferative and prosurvival activities that prime the 'seed' and the 'soil' of the metastatic lesion. This review highlights recent findings regarding the role of PTHrP in skeletal metastasis, including direct actions in tumor cells, as well as alterations in the bone microenvironment and future perspectives involving the potential roles of PTHrP in the premetastatic niche, and tumor dormancy.
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Affiliation(s)
- Fabiana N Soki
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA
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Wölfl C, Wöfl C, Englert S, Moghaddam AA, Zimmermann G, Schmidt-Gayk H, Schmidt-Gayk G, Höner B, Hogan A, Lehnhardt M, Grützner PA, Kolios L. Time course of 25(OH)D3 vitamin D3 as well as PTH (parathyroid hormone) during fracture healing of patients with normal and low bone mineral density (BMD). BMC Musculoskelet Disord 2013; 14:6. [PMID: 23286544 PMCID: PMC3544577 DOI: 10.1186/1471-2474-14-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 12/26/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Until now the exact biochemical processes during healing of metaphyseal fractures of healthy and osteoporotic bone remain unclear. Especially the physiological time courses of 25(OH)D(3) (Vitamin D) as well as PTH (Parathyroid Hormone) the most important modulators of calcium and bone homeostasis are not yet examined sufficiently. The purpose of this study was to focus on the time course of these parameters during fracture healing. METHODS In the presented study, we analyse the time course of 25(OH)D3 and PTH during fracture healing of low BMD level fractures versus normal BMD level fractures in a matched pair analysis. Between March 2007 and February 2009 30 patients older than 50 years of age who had suffered a metaphyseal fracture of the proximal humerus, the distal radius or the proximal femur were included in our study. Osteoporosis was verified by DEXA measuring. The time courses of 25(OH)D(3) and PTH were examined over an eight week period. Friedmann test, the Wilcoxon signed rank test and the Mann-Withney U test were used as post-hoc tests. A p-value ≤ 0.05 was considered significant. RESULTS Serum levels of 25(OH)D(3) showed no differences in both groups. In the first phase of fracture healing PTH levels in the low BMD level group remained below those of the normal BMD group in absolute figures. Over all no significant differences between low BMD level bone and normal BMD level bone could be detected in our study. CONCLUSIONS The time course of 25(OH)D(3) and PTH during fracture healing of patients with normal and low bone mineral density were examined for the first time in humans in this setting and allowing molecular biological insights into fracture healing in metaphyseal bones on a molecural level. There were no significant differences between patients with normal and low BMD levels. Hence further studies will be necessary to obtain more detailed insight into fracture healing in order to provide reliable decision criteria for therapy and the monitoring of fracture healing.
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Affiliation(s)
| | - Christoph Wöfl
- Department of Trauma- and Orthopaedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
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Wölfl C, Wöfl C, Englert S, Moghaddam AA, Zimmermann G, Schmidt-Gayk H, Schmidt-Gayk G, Höner B, Hogan A, Lehnhardt M, Grützner PA, Kolios L. Time course of 25(OH)D3 vitamin D3 as well as PTH (parathyroid hormone) during fracture healing of patients with normal and low bone mineral density (BMD). BMC Musculoskelet Disord 2013; 14:16. [PMID: 23298183 PMCID: PMC3544561 DOI: 10.1186/1471-2474-14-16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 01/03/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Until now the exact biochemical processes during healing of metaphyseal fractures of healthy and osteoporotic bone remain unclear. Especially the physiological time courses of 25(OH)D(3) (Vitamin D) as well as PTH (Parathyroid Hormone) the most important modulators of calcium and bone homeostasis are not yet examined sufficiently. The purpose of this study was to focus on the time course of these parameters during fracture healing. METHODS In the presented study, we analyse the time course of 25(OH)D3 and PTH during fracture healing of low BMD level fractures versus normal BMD level fractures in a matched pair analysis. Between March 2007 and February 2009 30 patients older than 50 years of age who had suffered a metaphyseal fracture of the proximal humerus, the distal radius or the proximal femur were included in our study. Osteoporosis was verified by DEXA measuring. The time courses of 25(OH)D(3) and PTH were examined over an eight week period. Friedmann test, the Wilcoxon signed rank test and the Mann-Withney U test were used as post-hoc tests. A p-value ≤ 0.05 was considered significant. RESULTS Serum levels of 25(OH)D(3) showed no differences in both groups. In the first phase of fracture healing PTH levels in the low BMD level group remained below those of the normal BMD group in absolute figures. Over all no significant differences between low BMD level bone and normal BMD level bone could be detected in our study. CONCLUSIONS The time course of 25(OH)D(3) and PTH during fracture healing of patients with normal and low bone mineral density were examined for the first time in humans in this setting and allowing molecular biological insights into fracture healing in metaphyseal bones on a molecural level. There were no significant differences between patients with normal and low BMD levels. Hence further studies will be necessary to obtain more detailed insight into fracture healing in order to provide reliable decision criteria for therapy and the monitoring of fracture healing.
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Affiliation(s)
| | - Christoph Wöfl
- Department of Trauma- and Orthopaedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
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Zheng Y, Zhou H, Dunstan CR, Sutherland RL, Seibel MJ. The role of the bone microenvironment in skeletal metastasis. J Bone Oncol 2012; 2:47-57. [PMID: 26909265 PMCID: PMC4723345 DOI: 10.1016/j.jbo.2012.11.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 11/22/2012] [Accepted: 11/22/2012] [Indexed: 01/27/2023] Open
Abstract
The bone microenvironment provides a fertile soil for cancer cells. It is therefore not surprising that the skeleton is a frequent site of cancer metastasis. It is believed that reciprocal interactions between tumour and bone cells, known as the “vicious cycle of bone metastasis” support the establishment and orchestrate the expansion of malignant cancers in bone. While the full range of molecular mechanisms of cancer metastasis to bone remain to be elucidated, recent research has deepened our understanding of the cell-mediated processes that may be involved in cancer cell survival and growth in bone. This review aims to address the importance of the bone microenvironment in skeletal cancer metastasis and discusses potential therapeutic implications of novel insights.
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Affiliation(s)
- Yu Zheng
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW 2139, Australia; The Kinghorn Cancer Centre and Cancer Research Program, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
| | - Hong Zhou
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW 2139, Australia
| | - Colin R Dunstan
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW 2139, Australia; Department of Biomedical Engineering, University of Sydney, NSW 2006, Australia
| | - Robert L Sutherland
- The Kinghorn Cancer Centre and Cancer Research Program, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, University of Sydney, NSW 2139, Australia; Department of Endocrinology & Metabolism, Concord Hospital, Concord, Sydney, NSW 2139, Australia
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Bai S, LiVolsi VA, Fraker DL, Bing Z. Water-clear parathyroid adenoma: report of two cases and literature review. Endocr Pathol 2012; 23:196-200. [PMID: 22638654 DOI: 10.1007/s12022-012-9211-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Shuting Bai
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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Abstract
PTHrP was identified as a cause of hypercalcemia in cancer patients 25 yr ago. In the intervening years, we have learned that PTHrP and PTH are encoded by related genes that are part of a larger "PTH gene family." This evolutionary relationship permits them to bind to the same type 1 PTH/PTHrP receptor, which explains why humoral hypercalcemia of malignancy resembles hyperparathyroidism. This review will outline basic facts about PTHrP biology and its normal physiological functions, with an emphasis on new findings of the past 5-10 yr. The medical and research communities first became aware of PTHrP because of its involvement in a common paraneoplastic syndrome. Now, research into the basic biology of PTHrP has suggested previously unrecognized connections to a variety of disease states such as osteoporosis, osteoarthritis, and breast cancer and has highlighted how PTHrP itself might be used in therapy for osteoporosis and diabetes. Therefore, the story of this remarkable protein is a paradigm for translational research, having gone from bedside to bench and now back to bedside.
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Affiliation(s)
- John J Wysolmerski
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Yale School of Medicine, TAC S131, Box 208020, New Haven, Connecticut 06520-8020, USA.
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Cowan RW, Singh G, Ghert M. PTHrP increases RANKL expression by stromal cells from giant cell tumor of bone. J Orthop Res 2012; 30:877-84. [PMID: 22102368 DOI: 10.1002/jor.22020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 10/31/2011] [Indexed: 02/04/2023]
Abstract
Giant cell tumor of bone (GCT) presents with numerous osteoclast-like multinucleated giant cells that are principally responsible for the extensive bone resorption by the tumor. Although the precise etiology of GCT remains uncertain, the accumulation of giant cells is partially due to the high expression of the receptor activator of nuclear factor-κB ligand (RANKL) from the neoplastic stromal cells. Here, we have investigated whether parathyroid hormone-related protein (PTHrP) plays a role in the pathogenesis of GCT. Immunohistochemistry results revealed PTHrP expression in the stromal cells of the tumor, and that its receptor, the parathyroid hormone type 1 receptor (PTH1R), is expressed by both the stromal cells and giant cells. PCR and Western blot analyses confirmed the expression of PTHrP and PTH1R by isolated stromal cells from five patients presenting with GCT. Treatment of GCT stromal cells with varying concentrations of PTHrP (1-34) significantly increased both RANKL gene expression and the number of multinucleated cells formed from RAW 264.7 cells in co-culture experiments, whereas inhibition of PTHrP with a neutralizing antibody decreased RANKL gene expression. These results suggest that PTHrP is expressed within GCT by the stromal cells and can contribute to the abundant RANKL expression and giant cell formation within the tumor.
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Affiliation(s)
- Robert W Cowan
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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