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Coskun M, Babayeva A, Barlas T, Yalcin MM, Akturk M, Toruner F, Karakoc MA, Karakan T, Cindoruk M, Yetkin İ, Altinova A. EXPRESS: Relationship between Gut Microbiome and Bone Deficits in Primary Hyperparathyroidism: A Proof of Concept Pilot Study. J Investig Med 2024:10815589241251695. [PMID: 38641855 DOI: 10.1177/10815589241251695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Parathyroid hormone (PTH) interacts with components of the gut microbiota to exert its bone-regulating effects. This study aimed to investigate the gut microbial composition in patients with primary hyperparathyroidism (PHPT). Nine patients with PHPT and nine age-sex and body mass index-matched healthy controls were included. Gut microbial composition was assessed using 16S rRNA gene amplicon sequencing in both groups at baseline and one month after parathyroidectomy in the PHPT group. Data were imported into QIIME-2 and both QIIME-2 and R packages were used for microbiome analysis. Alpha and beta diversity were similar between the groups and remained unchanged after parathyroidectomy. The relative abundance of Subdoligranulum was significantly higher, whereas Ruminococcus, Alloprevotella, Phascolarctobacterium and Clostridium sensu stricto_1 were significantly lower in PHPT than in controls (p<0.001). After parathyroidectomy, the relative abundance of Subdoligranulum decreased, Ruminococcus and Alloprevotella increased (p<0.001). The PHPT group had lower total femoral and lumbar bone mineral density (BMD) than the controls (p<0.05). At baseline, Alloprevotella abundance was positively correlated with serum phosphorus and Subdoligranulum was positively correlated with total lumbar BMD. Clostridium sensu stricto_1 was negatively correlated with serum calcium and positively correlated with femoral neck BMD. Postoperatively, Alloprevotella was positively correlated with baseline serum phosphorus, and Phascolarctobacterium was positively correlated with distal radius BMD. This study demonstrated that the diversity of the gut microbiome was altered, possibly in response to electrolyte changes in PHPT, both before and after parathyroidectomy.
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Affiliation(s)
- Meric Coskun
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | - Afruz Babayeva
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | - Tugba Barlas
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | | | - Mujde Akturk
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | - Fusun Toruner
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | | | | | | | - İlhan Yetkin
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
| | - Alev Altinova
- Gazi University Faculty of Medicine, Endocrinology and Metabolism
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Gupta N, Agarwal A, Jindal R, SR S. Estimating Vitamin D threshold for the Indian population: Delving into the actual disease burden. Med J Armed Forces India 2023; 79:S224-S229. [PMID: 38144653 PMCID: PMC10746810 DOI: 10.1016/j.mjafi.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/06/2022] [Indexed: 11/07/2022] Open
Abstract
Background Based on the current guidelines in practice, a vast majority of the healthy Indian population is vitamin D deficient. Since the serum 25 hydroxycholecalciferol (25HCC) levels are affected by race and skin pigmentation, the normal range of vitamin D may differ in the Indians compared to the Western population. This study attempted to determine a population-specific threshold for 25 HCC levels associated with adequate bone health and calcium and phosphate homeostasis in healthy Indians. Methods Subjects aged 20-50 years were included in the study. The exclusion criteria were obesity, chronic renal disease, liver failure, diabetes mellitus, thyroid disorders, a recent history of fracture, constant joint pain, and postmenopausal status. In addition, participants on prescribed medication such as glucocorticoids, anticonvulsants, or antifungals, as well as vitamin D and calcium supplementation, were also excluded.Blood samples were analyzed for serum calcium, phosphate, alkaline phosphatase, 25HCC, 1,25dihydroxycholecalciferol, parathyroid hormone (PTH), procollagen type-I N propeptide, and C-terminal telopeptide of type 1 collagen.Locally estimated smoothing scatter plot (LOESS) curves and Spearman correlation were utilized to study the correlation of all the biochemical parameters with 25 HCC to achieve thresholds. Results The study consisted of 270 healthy participants, out of which 97.8% were found to have vitamin D levels below 30 ng/ml. In addition, 8.8% had raised PTH, and 1.85% had hypocalcemia. Furthermore, 1.48% had raised serum alkaline phosphatase and hypophosphatemia, respectively. A weak inverse correlation was seen between 25 HCC and PTH (rs = -0.437, p < 0.001), as well as alkaline phosphatase (rs = -0.1475, p = 0.015), while a weak positive correlation was seen with serum phosphate (rs = 0.128, p = 0.047). Conclusion For a healthy Indian population, the reference range of 25 HCC is much lower, and the lower limit of normal is approximately 13.5 ng/ml. This study indicates that vitamin D insufficiency in this population starts at 25 HCC values of 13.5 ng/ml and deficiency at 7 ng/ml.
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Affiliation(s)
- Neha Gupta
- Classified Specialist (Pathology), Air Force Hospital, Hasimara, West Bengal, India
| | - Anupam Agarwal
- Professor (Aerospace Medicine), Rajiv Gandhi University of Health Sciences, Bengaluru, India
| | - Radhika Jindal
- Associate Professor (Endocrinology), Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Santhosh SR
- Professor (Aerospace Medicine), Institute of Aerospace Medicine, Vimanpura, Bengaluru, India
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Reed SG, Fan S, Wagner CL, Lawson AB. Predictors of Developmental Defects of Enamel in Primary Maxillary Central Incisors Using Bayesian Model Selection. Caries Res 2023; 58:30-38. [PMID: 37918363 PMCID: PMC10922907 DOI: 10.1159/000534793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 10/22/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Localized non-inheritable developmental defects of tooth enamel (DDE) are classified as enamel hypoplasia (EH), opacity (OP), and post-eruptive breakdown (PEB) using the enamel defects index. To better understand the etiology of DDE, we assessed the linkages amongst exposome variables for these defects during the specific time duration for enamel mineralization of the human primary maxillary central incisor enamel crowns. In general, these two teeth develop between 13 and 14 weeks in utero and 3-4 weeks' postpartum of a full-term delivery, followed by tooth eruption at about 1 year of age. METHODS We utilized existing datasets for mother-child dyads that encompassed 12 weeks' gestation through birth and early infancy, and child DDE outcomes from digital images of the erupted primary maxillary central incisor teeth. We applied a Bayesian modeling paradigm to assess the important predictors of EH, OP, and PEB. RESULTS The results of Gibbs variable selection showed a key set of predictors: mother's prepregnancy body mass index (BMI); maternal serum concentrations of calcium and phosphorus at gestational week 28; child's gestational age; and both mother's and child's functional vitamin D deficiency (FVDD). In this sample of healthy mothers and children, significant predictors for OP included the child having a gestational period >36 weeks and FVDD at birth, and for PEB included a mother's prepregnancy BMI <21.5 and higher serum phosphorus concentration at week 28. CONCLUSION In conclusion, our methodology and results provide a roadmap for assessing timely biomarker measures of exposures during specific tooth development to better understand the etiology of DDE for future prevention.
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Affiliation(s)
- Susan G. Reed
- Department of Pediatrics, Darby Children’s Research
Institute, Medical University of South Carolina, Charleston, SC, USA
| | - Sijian Fan
- Department of Statistics, University of South Carolina,
Columbia, SC, USA
| | - Carol L. Wagner
- Department of Pediatrics, Darby Children’s Research
Institute, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew B. Lawson
- Department of Public Health Sciences, Medical University of
South Carolina, Charleston, SC, USA
- Usher Institute, School of Medicine, University of
Edinburgh, Edinburg, UK
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Tangpricha V, Markland AD, Vaughan CP, Huang AJ, Grodstein F. Total and free 25-hydroxyvitamin D concentrations and risk of urinary incontinence in women participating in Nurses Health Studies I & II. Am J Med Sci 2023; 366:330-336. [PMID: 37607593 PMCID: PMC10592066 DOI: 10.1016/j.amjms.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/23/2023] [Accepted: 08/15/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Urgency urinary incontinence (UUI) occurs in >40% of older women. Our objective was to examine the relationship of total and free plasma 25-hydroxyvitamin D (25(OH)D) and UUI to evaluate vitamin D status as a novel target for prevention of UUI. METHODS We conducted a nested case control study using the Nurses' Health Study (NHS) and NHS II. Using stored plasma samples from 2000, we measured total 25(OH)D, free 25(OH)D, and intact parathyroid hormone (PTH) levels and examined their relationship to incident UUI from 2000 to 2013. Plasma biomarker levels were categorized as quartiles. Multivariable-adjusted odds ratios of UUI were estimated by conditional logistic regression models (with matching by age) across categories of each biomarker and covariates. RESULTS The analytic sample included 398 cases of incident UUI and 398 matched controls with a mean age of 50 years. We found a strong correlation of plasma levels of total 25(OH)D with free 25(OH)D (r=0.5). Plasma total 25(OH)D and free 25(OH)D concentrations were negatively correlated with PTH (r=-0.08 AND -0.09, respectively). Overall, we found no evidence that levels of total plasma 25(OH)D, free 25(OH)D, or PTH were related to incident UUI after adjustment for obesity, physical activity, cigarette smoking, menopausal status, hypertension, and type 2 diabetes. CONCLUSIONS Free plasma 25(OH)D by quartile, as well as total plasma 25(OH)D, was not associated with incident UUI in women. We found that plasma total and free 25(OH)D were highly correlated with each other and inversely correlated with PTH. Plasma free 25(OH)D did not provide additional predictive value in determining risk of UUI.
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Affiliation(s)
- Vin Tangpricha
- Emory University Department of Medicine, Emory School of Medicine, Atlanta, GA and the Atlanta VA Medical Center, Atlanta, GA.
| | - Alayne D Markland
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA
| | - Camille P Vaughan
- Emory University Department of Medicine, Emory School of Medicine, Atlanta, GA and the Atlanta VA Medical Center, Atlanta, GA; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA
| | - Alison J Huang
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Movahedi MM, Karimaghaei GR, Noori A, Atefi M, Mahmoudi T, Gheisari F. Changes in Serum Alkaline Phosphatase, Calcium, and Parathyroid Hormone with Different Doses of Iodine Therapy:. Galen Med J 2022; 11:e2397. [PMID: 36698694 PMCID: PMC9838107 DOI: 10.31661/gmj.v11i.2397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Despite the benefits of radioactive iodine (RAI) therapy as an adjunctive treatment for thyroid cancer, it can be associated with several side effects. The main purpose of this study was to determine the changes in serum alkaline phosphatase (ALP), calcium (Ca), and parathyroid hormone (PTH) at different doses of RAI therapy among patients who were referred to the nuclear medicine department of Namazi Hospital, Shiraz. Materials and Methods: This cross-sectional study was conducted on 60 patients with papillary thyroid cancer who underwent RAI therapy at different doses of 100, 150, and 200 mCi. The ALP, Ca, and PTH levels of patients were measured before and 60 days after RAI therapy. Results: Our study revealed that RAI therapy at all doses significantly increased ALP level in comparison with baseline amounts (P≤0.05). However, changes in PTH and Ca levels were not significant among patients who received different doses of RAI (P˃0.05). Conclusion: RAI therapy could affect important hormones and enzymes such as ALP and PTH. This issue can be considered in diagnostic and therapeutic prescriptions of RAI for the treatment of thyroid cancer.[GMJ.2022;11:e2397].
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Affiliation(s)
- Mohammad Mehdi Movahedi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Ionizing and Non- Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ahmad Noori
- Novin Iran Specialized Dermatology Clinic, Shiraz, Iran
| | - Mohammad Atefi
- Ionizing and Non- Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
- Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Tahereh Mahmoudi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farshid Gheisari
- Ionizing and Non- Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
- The Hospital for Sick Children, Toronto, Canada
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Vissing Landgrebe A, Asp Vonsild Lund M, Lausten-Thomsen U, Frithioff-Bøjsøe C, Esmann Fonvig C, Lind Plesner J, Aas Holm L, Jespersen T, Hansen T, Christian Holm J. Population-based pediatric reference values for serum parathyroid hormone, vitamin D, calcium, and phosphate in Danish/North-European white children and adolescents. Clin Chim Acta 2021; 523:483-490. [PMID: 34695445 DOI: 10.1016/j.cca.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parathyroid hormone (PTH) and vitamin D are essential hormones in bone metabolism, especially during pediatric growth. Vitamin D insufficiency is often asymptomatic and is prevalent in high-latitude countries. METHODS In a Danish population-based cohort of 2211 6-18-year-olds, sex- and age-specific pediatric reference values for fasting concentrations of intact serum PTH, vitamin D (25-hydroxycholecalciferol, 25-OH-D), total calcium, and phosphate were generated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. The effect of season on these biomarkers of bone metabolism was evaluated. RESULTS In boys, PTH concentrations increased with age, while the vitamin D and phosphate concentrations decreased (all p < .001). In girls, a peak in PTH concentrations and a nadir in vitamin D concentrations were observed in the 10-14-year-olds (both p < .001). Calcium and phosphate decreased with age for both sexes (girls: both p < .001; boys calcium: p < .05, boys phosphate: p < .001). Vitamin D was 20% lower in winter than summer for both sexes (both p < .001). Individuals with vitamin D sufficiency (25-OH-D > 50 nmol/L) exhibited a 5% lower level of PTH compared to the whole sample population (p < .001). CONCLUSION The concentrations of PTH, vitamin D, calcium, and phosphate vary during childhood and adolescence, and is dependent on sex and season. These factors should be considered when screening for and treating imbalances in bone metabolism.
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Affiliation(s)
- Ann Vissing Landgrebe
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Asp Vonsild Lund
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christine Frithioff-Bøjsøe
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Cilius Esmann Fonvig
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Kolding Hospital a part of Lillebælt Hospital, Kolding, Denmark
| | - Johanne Lind Plesner
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Louise Aas Holm
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Jespersen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens Christian Holm
- The Children's Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Ying W, Zhen-Long Z, Xiao-Jing C, Li-Li P, Yan L, Ming-An Y. A study on the causes of operative failures after microwave ablation for primary hyperparathyroidism. Eur Radiol 2021; 31:6522-6530. [PMID: 33651201 PMCID: PMC8379100 DOI: 10.1007/s00330-021-07761-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
Objective To summarize the occurrence of operative failures after microwave ablation (MWA) in patients with primary hyperparathyroidism (pHPT), analyze the possible reasons, and explore strategies for preventing and managing these situations. Methods This retrospective study reviewed 91 pHPT patients who underwent MWA from April 2015 to November 2019. A cure was defined as the reestablishment of normal calcium homeostasis lasting a minimum of 6 months. An operative failure was defined as a failure to normalize serum intact parathyroid hormone (iPTH) and/or calcium levels at 6 months or longer. Patients who encountered operative failures were compared with patients who were successfully cured. Results Eighty-eight pHPT patients, consisting of 29 men and 59 women, were finally enrolled. The median follow-up duration was 15.9 months (IQR, 6.1–31.5 months). Seventy-eight patients (78/88, 88.6%) were cured. Ten (10/88, 11.4%) patients experienced operative failure, including 9 persistent pHPT (10.2%) and 1 (1.1%) recurrent pHPT. Small parathyroid nodules (maximum diameter < 0.6 cm) and incomplete ablation were the two key factors leading to operative failure. Of the 9 patients with a maximum nodule diameter less than 0.6 cm, 77.8% (7/9) of them encountered operative failure. Conclusion Operative failure occurred in 11.4% of the pHPT patients who underwent MWA. The possibility of operative failure was increased when the maximum diameter of parathyroid nodule was less than 0.6 cm. Complete ablation could help avoid operative failure. Key Points • Failed to ablate the target lesion and incomplete ablation were the key factors attributed to operative failures. • When the maximum diameter of the parathyroid nodules is less than 0.6 cm, the possibility of operative failure was higher.
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Affiliation(s)
- Wei Ying
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China
| | - Zhao Zhen-Long
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China
| | - Cao Xiao-Jing
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China
| | - Peng Li-Li
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China
| | - Li Yan
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China
| | - Yu Ming-An
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan street, Chao-yang District, Beijing, 100029, China.
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Ahmed C, Kendi F, Gebran N, Barcebal C, Dahmani K, El Houni A, Budruddin M. Use of Recombinant Human Parathyroid Hormone to Treat Hungry Bone Syndrome in Hemodialysis Patient. Oman Med J 2020; 35:e164. [PMID: 32904907 PMCID: PMC7459415 DOI: 10.5001/omj.2020.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/04/2019] [Indexed: 11/23/2022] Open
Abstract
We report the case of a 35-year-old female with end-stage renal disease on hemodialysis for nine years. She was diagnosed with secondary hyperparathyroidism complicated with a brown tumor in the mandible. After medical therapy failed, she underwent total parathyroidectomy (PTX), which was complicated by severe and prolonged hypocalcemia (hungry bone syndrome). Post-surgery, she required prolonged and frequent intravenous calcium and a high dose of vitamin D resulting in frequent admission with symptomatic hypocalcemia. Her serum magnesium was noted to be in the normal range. She continued to be hypocalcemic for nearly eight months post-surgery despite the intensive treatment. Recombinant human parathyroid hormone (teriparatide) 20 mg daily resulted in normalization of calcium within two weeks. The use of parathyroid hormone proved to be an effective treatment approach in this case. Proper pre-operative preparation and subtotal PTX with an adequate dose of vitamin D and calcium supplement may have been a rational option for this case.
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Affiliation(s)
- Chaaban Ahmed
- Department of Nephrology, Tawam Hospital in affiliation with John Hopkins, Al Ain, UAE
| | - Fatima Kendi
- Department of Nephrology, Tawam Hospital in affiliation with John Hopkins, Al Ain, UAE
| | - Nicole Gebran
- Department of Nephrology, Tawam Hospital in affiliation with John Hopkins, Al Ain, UAE
| | | | - Khalid Dahmani
- Department of Nephrology, Tawam Hospital in affiliation with John Hopkins, Al Ain, UAE
| | - Ali El Houni
- Department of Nephrology, Tawam Hospital in affiliation with John Hopkins, Al Ain, UAE
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Walker MD, Williams J, Lewis SK, Bai JC, Lebwohl B, Green PHR. Measurement of Forearm Bone Density by Dual Energy X-Ray Absorptiometry Increases the Prevalence of Osteoporosis in Men With Celiac Disease. Clin Gastroenterol Hepatol 2020; 18:99-106. [PMID: 30981003 DOI: 10.1016/j.cgh.2019.03.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Guidelines advise measurement of bone mineral density (BMD) in patients with a diagnosis of celiac disease. The lumbar spine (LS) and hip sites are usually measured. Although skeletal sites rich in trabecular bone are believed to be vulnerable to osteoporosis in patients with celiac disease, most studies have not measured the cortical distal 1/3-radius. METHODS We collected data from 721 patients (mean age, 43.6 years; 68.4% female) with celiac disease who underwent 3-site dual energy x-ray absorptiometry (DXA, at a median 1.22 years after diagnosis). We assessed skeletal site- and sex-specific osteoporosis prevalence and the incremental utility of 1/3-radius measurement by DXA. RESULTS Mean T- and Z-scores were normal in patients, but 43.3% had osteopenia and 19.6% had osteoporosis. Osteoporosis was found in 12.1% of patients at the LS, 5.3% of patients at the total hip, 7.6% of patients at the femoral neck, and 11.5% of patients at the 1/3-radius. A greater degree of villous atrophy at diagnosis was associated with male sex and lower T-scores at the 1/3-radius (P = .03), but not other skeletal sites. Isolated forearm osteoporosis was detected in 4.9% of patients. A higher proportion of patients with isolated forearm osteoporosis were male and had a greater weight and body mass index (all P < .01, compared to patients with osteoporosis only at other sites). Z-scores were lower at the LS and 1/3-radius and osteoporosis was more common in men than women. In men, the 1/3-radius was the most frequent site for osteoporosis. Among patients 50 years or older, isolated forearm osteoporosis was present in 10.7%. CONCLUSIONS Based on DXA analysis of patients with celiac disease, the prevalence of osteoporosis appears to be underestimated-particularly in men when BMD at the 1/3-radius is not measured. Degree of villous atrophy is associated with BMD at the 1/3-radius and nearly 5% of patients have osteoporosis limited to that site. Recommendations for osteoporosis screening in patients with celiac disease should include measurement of the distal 1/3-radius in addition to the hip and LS.
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Affiliation(s)
- Marcella D Walker
- Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, New York.
| | - John Williams
- Division of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Suzanne K Lewis
- Division of Gastroenterology, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Julio C Bai
- Department of Gastroenterology, Universidad del Salvador, Buenos Aires, Argentina
| | - Benjamin Lebwohl
- Division of Gastroenterology, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Peter H R Green
- Division of Gastroenterology, Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York
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Khan ZF, Lew JI. Intraoperative Parathyroid Hormone Monitoring in the Surgical Management of Sporadic Primary Hyperparathyroidism. Endocrinol Metab (Seoul) 2019; 34:327-339. [PMID: 31884732 PMCID: PMC6935782 DOI: 10.3803/enm.2019.34.4.327] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/01/2019] [Accepted: 12/04/2019] [Indexed: 01/28/2023] Open
Abstract
Intraoperative parathyroid hormone monitoring (IPM) has been shown to be a useful adjunct during parathyroidectomy to ensure operative success at many specialized medical centers worldwide. Using the Miami or ">50% intraoperative PTH drop" criterion, IPM confirms the complete excision of all hyperfunctioning parathyroid tissue before the operation is finished, and helps guide the surgeon to identify additional hyperfunctioning parathyroid glands that may necessitate further extensive neck exploration when intraoperative parathyroid hormone (PTH) levels do not drop sufficiently. The intraoperative PTH assay is also used to differentiate parathyroid from non-parathyroid tissues during operations using fine needle aspiration samples and to lateralize the side of the neck harboring the hypersecreting parathyroid through differential jugular venous sampling when preoperative localization studies are negative or equivocal. The use of IPM underscores the recognition and understanding of sporadic primary hyperparathyroidism (SPHPT) as a disease of function rather than form, where the surgeon is better equipped to treat such patients with quantitative instead of qualitative information for durable long-term operative success. There has been a significant paradigm shift over the last 2 decades from conventional to focused parathyroidectomy guided by IPM. This approach has proven to be a safe and rapid operation requiring minimal dissection performed in an ambulatory setting for the treatment of SPHPT.
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Affiliation(s)
- Zahra F Khan
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - John I Lew
- Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
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Moradi S, Shahdadian F, Mohammadi H, Rouhani MH. A comparison of the effect of supplementation and sunlight exposure on serum vitamin D and parathyroid hormone: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2019; 60:1881-1889. [PMID: 31107101 DOI: 10.1080/10408398.2019.1611538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Supplementation and getting sunlight exposure are two treatments for vitamin D deficiency. However, studies reported conteroversial findings regarding the efficacy of these two methods.Objective: To compare the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and parathyroid hormone (PTH).Methods: A computer-based literature search through PubMed, Scopus and Google scholar search engines was conducted until April 2019 to find clinical trials which compared the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and PTH. Means for serum 25-hydroxy vitamin D3 (25(OH) D3) and PTH concentration were extracted. A subgroup analysis was used to detect potential sources of inter-study heterogeneity. Mean differences (MD) were analyzed using a random-effects model (the DerSimonian-Laird approach).Results: A total of seven papers were included in the meta-analysis. Pooled analysis showed that vitamin D supplementation significantly elevated levels of serum 25(OH) D3 in comparison with sunlight exposure (MD: 8.56nmol/l, 95%CI: 4.15, 12.97, T2 = 40.32%, H2 = 9.45%, P for heterogeneity p < 0.001). Also, the difference between the effect of vitamin D supplementation and sun exposure was lower in studies which used UVB radiation compared with studies which applied direct sunlight (MD: 11.65 nmol/l, 95%CI: 7.02, 16.28; P for between subgroup heterogeneity = 0.001).Conclusion: Vitamin D supplementation was more effective than sun exposure at increasing serum 25(OH) D3. The difference between efficacy of vitamin D supplementation and sun exposure was lower in studies which used long-term sun exposure or applied UVB treatment instead of direct sunlight.
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Affiliation(s)
- Sajjad Moradi
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farnaz Shahdadian
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Méndez-Chacón P, Riccobelli N, Dionisi MP, Sánchez-Álvarez E, Bardales-Viguria F, Méndez-Chacón Rodríguez C, Cannata-Andía JB, Fernández-Martín JL. Bone and mineral metabolism at 55 haemodialysis centres in Lima. Nefrologia 2019; 38:279-285. [PMID: 29731011 DOI: 10.1016/j.nefro.2017.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 09/18/2017] [Accepted: 09/27/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mineral and bone metabolism disorders are common complications in haemodialysis patients that present significant geographical variability. OBJECTIVES The objective of this study was to assess these disorders for the first time in haemodialysis patients from Peru. METHODS The study included 1551 haemodialysis patients from 55 centres affiliated with the Social Health System of Peru in the city of Lima. Demographic data, comorbidities, treatments and biochemical parameters were collected from each patient. Serum calcium, phosphorus and PTH levels were categorised according to the recommended ranges in the KDOQI and KDIGO guidelines. RESULTS The mean age of the patients was 59.5±15.6 years, with a mean time on haemodialysis of 58.0±54.2 months. All patients were dialysed with a calcium concentration in the dialysis fluid of 3.5 mEq/l and 68.9% of patients were prescribed phosphate-binding agents (98.4% of them calcium carbonate). A high percentage of patients showed serum calcium above, and serum phosphorus below, the recommended ranges in the KDOQI guidelines (32.8% and 37.3%, respectively). More than half of the patients had serum PTH values below the recommended ranges of both the KDOQI and KDIGO guidelines (56.4% and 51.6%, respectively). CONCLUSIONS Patients included in this study were younger than those from other studies and showed both hypophosphataemia and suppressed PTH, probably due to an excessive calcium overload through dialysis fluid and the use of calcium-containing phosphate binding agents.
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Affiliation(s)
- Pedro Méndez-Chacón
- Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos. Departamento de Nefrología, Hospital Edgardo Rebagliati Martins, Lima, Perú
| | - Nicolás Riccobelli
- Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo , Asturias, España
| | - María P Dionisi
- Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo , Asturias, España
| | - Emilio Sánchez-Álvarez
- Servicio de Nefrología, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Asturias, España
| | | | | | - Jorge B Cannata-Andía
- Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo , Asturias, España.
| | - José L Fernández-Martín
- Servicio de Metabolismo Óseo y Mineral, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo , Asturias, España
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Feng R, Ding F, Mi XH, Liu SF, Jiang AL, Liu BH, Lian Y, Shi Q, Wang YJ, Zhang Y. Protective Effects of Ligustroflavone, an Active Compound from Ligustrum lucidum, on Diabetes-Induced Osteoporosis in Mice: A Potential Candidate as Calcium-Sensing Receptor Antagonist. Am J Chin Med 2019; 47:457-476. [PMID: 30834778 DOI: 10.1142/s0192415x1950023x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ligustroflavone is one major compound contained in active fraction from Fructus Ligustri Lucidi (the fruit of Ligustrum lucidum), which could regulate parathyroid hormone (PTH) levels and improve calcium balance by acting on calcium-sensing receptors (CaSR). This study aimed to explore the potency of ligustroflavone as a CaSR antagonist and its protective effects against diabetic osteoporosis in mice. LF interacted well with the allosteric site of CaSR shown by molecular docking analysis, increased PTH release of primary parathyroid gland cells and suppressed extracellular calcium influx in HEK-293 cells. The serum level of PTH attained peak value at 2 h and maintained high during the period of 1 h and 3 h than that before treatment in mice after a single dose of LF. Treatment of diabetic mice with LF inhibited the decrease in calcium level of serum and bone and the enhancement in urinary calcium excretion as well as elevated circulating PTH levels. Trabecular bone mineral density and micro-architecture were markedly improved in diabetic mice upon to LF treatment for 8 weeks. LF reduced CaSR mRNA and protein expression in the kidneys of diabetic mice. Taken together, ligustroflavone could transiently increase PTH level and regulate calcium metabolism as well as prevent osteoporosis in diabetic mice, suggesting that ligustroflavone might be an effective antagonist on CaSR.
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Affiliation(s)
- Rui Feng
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China
| | - Fan Ding
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China
| | - Xiu-Hua Mi
- † Section of Nephrology, Yangpu Traditional Chinese Medicine Hospital, Shanghai 200090, P. R. China
| | - Shu-Fen Liu
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China.,‡ Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai 200032, P. R. China
| | - Ai-Ling Jiang
- § School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China
| | - Bi-Hui Liu
- ¶ Department of Orthopaedic, Shenzhen Pingle Orthopaedic Hospital, Shenzhen 518000, P. R. China
| | - Yin Lian
- ¶ Department of Orthopaedic, Shenzhen Pingle Orthopaedic Hospital, Shenzhen 518000, P. R. China
| | - Qi Shi
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China.,‡ Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai 200032, P. R. China
| | - Yong-Jun Wang
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China.,‡ Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai 200032, P. R. China
| | - Yan Zhang
- * Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, P. R. China.,‡ Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai 200032, P. R. China
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Moore LW, Suki WN, Lunsford KE, Sabek OM, Knight RJ, Gaber AO. Cross-sectional evaluation of the relationship between vitamin D status and supplement use across levels of kidney function in adults. BMJ Open 2019; 9:e022471. [PMID: 30798303 PMCID: PMC6398648 DOI: 10.1136/bmjopen-2018-022471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess vitamin D status of US non-pregnant adults using a standardised assay across 15 mL/min/1.73 m2 increments of kidney function, report the use of dietary supplements containing vitamin D and assess relationships between vitamin D and markers of bone resorption. DESIGN This study is a cross-sectional evaluation. SETTING The study is from the US National Health and Nutrition Evaluation Survey in 2001-2012. PARTICIPANTS The participants were non-institutionalised, non-pregnant adults, age ≥20 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was serum 25OHD evaluated using liquid chromatography-tandem mass spectroscopy traceable to international reference standards. Secondary outcome measures were use of dietary supplements containing vitamin D and the serum intact parathyroid hormone and bone-specific alkaline phosphatase in a subset of participants. RESULTS The median 25OHD concentration in 27 543 US non-pregnant adults was 25.7 ng/mL (range, 2.2-150.0 ng/mL). Vitamin D supplements were used by 38.0%; mean (SE)=757 (43) international units/day. The range of 25OHD concentration across groups, stratified by kidney function, was 23.0-28.1 ng/mL. The lowest concentration of 25OHD observed was in people with higher kidney function (23.0 ng/mL for estimated glomerular filtration rate >105 mL/min/1.73 m2). Only 24% of people not taking a dietary supplement had a 25OHD concentration >30 ng/mL. Serum intact parathyroid hormone inversely correlated with 25OHD within all kidney function groups. Bone-specific alkaline phosphatase was also negatively associated with 25OHD concentration. CONCLUSIONS These data indicate that 25OHD concentrations and supplement use may be suboptimal in a significant proportion of the population, across all kidney function levels. The response of bone resorption markers further suggests that 25OHD levels could be improved. Together, these data support a re-evaluation of the 25OHD concentration associated with health in adults.
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Affiliation(s)
- Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Wadi N Suki
- Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Keri E Lunsford
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Omaima M Sabek
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Richard J Knight
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - A Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
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Taheri M, Tavasoli S, Shokrzadeh F, Amiri FB, Basiri A. Effect of vitamin D supplementation on 24-hour urine calcium in patients with calcium Urolithiasis and vitamin D deficiency. Int Braz J Urol 2019; 45:340-346. [PMID: 30735332 PMCID: PMC6541149 DOI: 10.1590/s1677-5538.ibju.2018.0522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/14/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose: Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear. Materials and Methods: In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed. Results: Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH. Conclusions: The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.
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Affiliation(s)
- Maryam Taheri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sanaz Tavasoli
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shokrzadeh
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Bagheri Amiri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Basiri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fujii H. Association between Parathyroid Hormone and Cardiovascular Disease. Ther Apher Dial 2018; 22:236-241. [PMID: 29707916 DOI: 10.1111/1744-9987.12679] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 01/21/2018] [Accepted: 02/02/2018] [Indexed: 12/01/2022]
Abstract
Although parathyroid hormone is known to be related with calcium and phosphate metabolism, it has been also reported to have several effects on the cardiovascular system including heart and vessels. However, the detailed pathophysiological mechanisms remain unclear. Clinical studies have indicated that parathyroid hormone is associated with cardiovascular events and mortality not only in patients with chronic kidney disease but also in those without chronic kidney disease. As a possible mechanism, it is thought that parathyroid hormone is associated with the renin-angiotensin-aldosterone system and has direct effects on the cardiovascular system. Therefore, we should pay attention to not only the control of serum phosphate and calcium levels but also the control of serum parathyroid hormone levels, especially in patients with chronic kidney disease.
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Affiliation(s)
- Hideki Fujii
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
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Pellicelli M, Hariri H, Miller JA, St-Arnaud R. Lrp6 is a target of the PTH-activated αNAC transcriptional coregulator. Biochim Biophys Acta Gene Regul Mech 2018; 1861:61-71. [PMID: 29413898 DOI: 10.1016/j.bbagrm.2018.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 12/20/2022]
Abstract
In the nucleus of differentiated osteoblasts, the alpha chain of nascent polypeptide associated complex (αNAC) interacts with cJUN transcription factors to regulate the expression of target genes, including Osteocalcin (Bglap2). PTH induces the phosphorylation of αNAC on serine 99 through a Gαs-PKA dependent pathway. This leads to activation of αNAC and expression of Bglap2. To identify additional target genes regulated by PTH-activated αNAC, we performed ChIP-Seq against αNAC in PTH-treated MC3T3-E1 cells. This identified Low density lipoprotein receptor-Related Protein 6 (Lrp6) as a potential αNAC target. LRP6 acts as a co-receptor for the PTH receptor to allow optimal activation of PTH signaling. PTH increased Lrp6 mRNA levels in primary osteoblasts. Conventional quantitative ChIP confirmed the ChIP-Seq results. To assess whether αNAC plays a critical role in PTH-stimulated Lrp6 expression, we knocked-down Naca expression in MC3T3-E1 cells. Reduction of αNAC levels decreased basal expression of Lrp6 by 30% and blocked the stimulation of Lrp6 expression by PTH. We cloned the proximal mouse Lrp6 promoter (-2523/+120 bp) upstream of the luciferase reporter. Deletion and point mutations analysis in electrophoretic mobility shift assays and transient transfections identified a functional αNAC binding site centered around -343 bp. ChIP and ChIP-reChIP against JUND and αNAC showed that they cohabit on the proximal Lrp6 promoter. Luciferase assays confirmed that PTH-activated αNAC potentiated JUND-mediated Lrp6 transcription and Jund knockdown abolished this response. This study identified a novel αNAC target gene induced downstream of PTH signaling and represents the first characterization of the regulation of Lrp6 transcription in osteoblasts.
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Affiliation(s)
- Martin Pellicelli
- Research Centre, Shriners Hospitals for Children - Canada, H4A 0A9, Canada
| | - Hadla Hariri
- Research Centre, Shriners Hospitals for Children - Canada, H4A 0A9, Canada; Department of Human Genetics, McGill University, H3A 1A1, Canada
| | - Julie A Miller
- Research Centre, Shriners Hospitals for Children - Canada, H4A 0A9, Canada; Department of Human Genetics, McGill University, H3A 1A1, Canada
| | - René St-Arnaud
- Research Centre, Shriners Hospitals for Children - Canada, H4A 0A9, Canada; Department of Human Genetics, McGill University, H3A 1A1, Canada; Department of Surgery, McGill University, H3A 1A1, Canada; Department of Medicine, McGill University, H3A 1A1, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec H3H 2R9, Canada.
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Erlem M, Klopp-Dutote N, Biet-Hornstein A, Strunski V, Page C. Impact of pre-operative serum 25-hydroxyvitamin D on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre: retrospective study of 246 patients. J Laryngol Otol 2017; 131:925-9. [PMID: 28874217 DOI: 10.1017/S0022215117001797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre. METHODS This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia. RESULTS Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032). CONCLUSION Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.
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Patel P, Mughal MZ, Patel P, Yagnik B, Kajale N, Mandlik R, Khadilkar V, Chiplonkar SA, Phanse S, Patwardhan V, Patel A, Khadilkar A. Dietary calcium intake influences the relationship between serum 25-hydroxyvitamin D3 (25OHD) concentration and parathyroid hormone (PTH) concentration. Arch Dis Child 2016; 101:316-9. [PMID: 26359508 DOI: 10.1136/archdischild-2015-308985] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 08/21/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate whether dietary calcium intake will modify the relationship between serum 25-hydroxyvitamin D3 (25OHD) with intact serum parathyroid hormone (PTH) concentrations in apparently healthy Indian adolescents. STUDY DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Apparently healthy adolescents aged 10-14 years (n=181), from Gujarat, western India. Study conducted from January 2012 to March 2014. METHODS Serum 25OHD concentrations and intact serum PTH concentrations (both using chemiluminescent microparticle immunoassay) were measured. Diet was recorded through 24 h diet recall and calcium intake was computed (C-diet V.2.1). To assess relationship between 25OHD and PTH, data were dichotomised according to median calcium intakes (520 mg/day) and relationship between serum 25OHD and PTH in the two subgroups was plotted. RESULTS Subjects with calcium intakes above median (>520 mg/day) had lower intact serum PTH values for given serum 25OHD concentration while those with calcium intakes below median (<520 mg/day) had higher intact serum PTH values for given serum 25OHD concentration. Serum 25OHD concentration was negatively correlated with intact serum PTH concentration at lower as well as higher calcium intakes (r=- 0.606 and -0.483, respectively, p<0.01 for both). Using a regression analysis, predicted values for intact serum PTH concentration for the given serum 25OHD concentrations were plotted. The plot revealed a negative shift with increasing calcium intake. CONCLUSIONS Dietary calcium intake modifies the relationship between serum 25OHD concentrations and intact serum PTH concentrations. Thus, dietary calcium intake should be taken into account when assessing an individual's vitamin D status.
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Affiliation(s)
- Prerna Patel
- Department of Biotechnology, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - M Zulf Mughal
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
| | - Pinal Patel
- Department of Biotechnology, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Bhrugu Yagnik
- Department of Biochemistry, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India
| | - Neha Kajale
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Rubina Mandlik
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Shashi A Chiplonkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Supriya Phanse
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vivek Patwardhan
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Ashish Patel
- Department of Biotechnology, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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Ghoghaei M, Taghdiri F, Khajeh E, Azmoudeh Ardalan F, Sedaghat M, Hosseini Shirvani S, Zarei S, Toolabi K. Parathyroid Hormone Levels May Predict Nonalcoholic Steatohepatitis in Morbidly Obese Patients. Hepat Mon 2015; 15:e29697. [PMID: 26300934 PMCID: PMC4539792 DOI: 10.5812/hepatmon.29697v2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 06/12/2015] [Accepted: 06/16/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity as a worldwide health problem is associated with nonalcoholic steatohepatitis (NASH). Since severe liver injury may be present in asymptomatic obese patients and a definite diagnosis of nonalcoholic steatohepatitis can only be made after an invasive procedure of liver biopsy, there is a need for noninvasive methods to predict the probability of NASH. OBJECTIVES To investigate the role of vitamin D endocrine system in predicting the probability of presence of NASH in asymptomatic morbidly obese candidates of bariatric surgery. PATIENTS AND METHODS From December 09 to March 11, every patient undergoing bariatric surgery had a liver biopsy. Nonalcoholic steatohepatitis was diagnosed using the Lee's criteria, the baseline labs obtained and the association between laboratory data and presence of NASH assessed. RESULTS Forty-six patients (34 women, aged 36.5 ± 10.6 years) were analyzed. The mean levels of liver enzymes were significantly higher in the group with NASH (P value < 0.01). In an unadjusted logistic model, PTH was the only variable in vitamin D endocrine system which was significantly associated with NASH (odds ratio (OR): 1.04, 95%CI: 1.01 - 1.07). After adjustment for possible confounding factors, age (OR: 1.22, 95%CI: 1.00 - 1.50) and PTH (OR: 1.08, 95%CI: 1.01 - 1.16) were predictive factors for NASH (P value < 0.05). CONCLUSIONS Elevated serum PTH level was the predictive factor for NASH in morbidly obese patients. Also, we reported elevated serum liver enzymes, high serum PTH levels and older age as predictors of NASH in patients seeking obesity surgical treatments.
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Affiliation(s)
- Morteza Ghoghaei
- Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Foad Taghdiri
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Elias Khajeh
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Farid Azmoudeh Ardalan
- Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mojtaba Sedaghat
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Shadi Zarei
- Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Karamollah Toolabi
- Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Karamollah Toolabi, Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9123212787, Fax: +98-66486772, E-mail:
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Chow TL, Choi CY, Lam SH. Focused parathyroidectomy without intra-operative parathyroid hormone monitoring for primary hyperparathyroidism: results in a low-volume hospital. J Laryngol Otol 2015; 129:788-94. [PMID: 26072937 DOI: 10.1017/S0022215115000651] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The role of routine intra-operative parathyroid hormone monitoring for sporadic primary hyperparathyroidism is contentious. Satisfactory results can be achieved in high-volume centres. The results of low-volume hospitals are rarely studied. METHODS A retrospective, non-comparative study was conducted. From November 2002 to October 2012, 105 patients with clinically sporadic primary hyperparathyroidism underwent focused parathyroidectomy without intra-operative parathyroid hormone monitoring. Single adenoma was localised on pre-operative ultrasonography or sestamibi scan. The cure rate, surgical complication rate and pathology findings were evaluated. RESULTS Most of the operations (63.8 per cent) were performed under local anaesthesia. All but two patients (98.1 per cent) were cured after surgery. There was only one case of double adenomas. No recurrent hyperparathyroidism was observed after a mean follow up of 56.9 months. Surgical complications comprised two cases (1.9 per cent) of transient vocal fold palsy and one case (1.0 per cent) of permanent vocal fold palsy. Seven patients (6.7 per cent) suffered temporary hypocalcaemia. CONCLUSION Satisfactory results of focused parathyroidectomy without routine intra-operative parathyroid hormone monitoring for appropriately selected primary hyperparathyroidism cases can be attained in a low-volume hospital.
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Fei Y, Shimizu E, McBurney MW, Partridge NC. Sirtuin 1 is a negative regulator of parathyroid hormone stimulation of matrix metalloproteinase 13 expression in osteoblastic cells: role of sirtuin 1 in the action of PTH on osteoblasts. J Biol Chem 2015; 290:8373-82. [PMID: 25631045 DOI: 10.1074/jbc.m114.602763] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Parathyroid hormone (PTH) is the only current anabolic treatment for osteoporosis in the United States. PTH stimulates expression of matrix metalloproteinase 13 (MMP13) in bone. Sirtuin 1 (SIRT1), an NAD-dependent deacetylase, participates in a variety of human diseases. Here we identify a role for SIRT1 in the action of PTH in osteoblasts. We observed increased Mmp13 mRNA expression and protein levels in bone from Sirt1 knock-out mice compared with wild type mice. PTH-induced Mmp13 expression was significantly blocked by the SIRT1 activator, resveratrol, in osteoblastic UMR 106-01 cells. In contrast, the SIRT1 inhibitor, EX527, significantly enhanced PTH-induced Mmp13 expression. Two h of PTH treatment augmented SIRT1 association with c-Jun, a component of the transcription factor complex, activator protein 1 (AP-1), and promoted SIRT1 association with the AP-1 site of the Mmp13 promoter. This binding was further increased by resveratrol, implicating SIRT1 as a feedback inhibitor regulating Mmp13 transcription. The AP-1 site of the Mmp13 promoter is required for PTH stimulation of Mmp13 transcriptional activity. When the AP-1 site was mutated, EX527 was unable to increase PTH-stimulated Mmp13 promoter activity, indicating a role for the AP-1 site in SIRT1 inhibition. We further showed that SIRT1 deacetylates c-Jun and that the cAMP pathway participates in this deacetylation process. These data indicate that SIRT1 is a negative regulator of MMP13 expression, SIRT1 activation inhibits PTH stimulation of Mmp13 expression, and this regulation is mediated by SIRT1 association with c-Jun at the AP-1 site of the Mmp13 promoter.
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Affiliation(s)
- Yurong Fei
- From the Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York 10010 and
| | - Emi Shimizu
- From the Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York 10010 and
| | - Michael W McBurney
- the Ottawa Health Research Center Institute, Ottawa, Ontario K1H 8L6, Canada
| | - Nicola C Partridge
- From the Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York 10010 and
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23
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Chandra A, Lin T, Zhu J, Tong W, Huo Y, Jia H, Zhang Y, Liu XS, Cengel K, Xia B, Qin L. PTH1-34 blocks radiation-induced osteoblast apoptosis by enhancing DNA repair through canonical Wnt pathway. J Biol Chem 2014; 290:157-67. [PMID: 25336648 DOI: 10.1074/jbc.m114.608158] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Focal radiotherapy for cancer patients has detrimental effects on bones within the radiation field and the primary clinical signs of bone damage include the loss of functional osteoblasts. We reported previously that daily injection of parathyroid hormone (PTH, 1-34) alleviates radiation-induced osteopenia in a preclinical radiotherapy model by improving osteoblast survival. To elucidate the molecular mechanisms, we irradiated osteoblastic UMR 106-01 cells and calvarial organ culture and demonstrated an anti-apoptosis effect of PTH1-34 on these cultures. Inhibitor assay indicated that PTH exerts its radioprotective action mainly through protein kinase A/β-catenin pathway. γ-H2AX foci staining and comet assay revealed that PTH efficiently promotes the repair of DNA double strand breaks (DSBs) in irradiated osteoblasts via activating the β-catenin pathway. Interestingly, Wnt3a alone also blocked cell death and accelerated DNA repair in primary osteoprogenitors, osteoblastic and osteocytic cells after radiation through the canonical signaling. Further investigations revealed that both Wnt3a and PTH increase the amount of Ku70, a core protein for initiating the assembly of DSB repair machinery, in osteoblasts after radiation. Moreover, down-regulation of Ku70 by siRNA abrogated the prosurvival effect of PTH and Wnt3a on irradiated osteoblasts. In summary, our results identify a novel role of PTH and canonical Wnt signaling in regulating DSB repair machinery and apoptosis in osteoblasts and shed light on using PTH1-34 or Wnt agonist as possible therapy for radiation-induced osteoporosis.
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Affiliation(s)
| | - Tiao Lin
- From the Department of Orthopaedic Surgery, the Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Ji Zhu
- From the Department of Orthopaedic Surgery
| | - Wei Tong
- From the Department of Orthopaedic Surgery, the Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 Hubei, China
| | - Yanying Huo
- the Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, New Brunswick, New Jersey 08903, and
| | - Haoruo Jia
- From the Department of Orthopaedic Surgery
| | - Yejia Zhang
- Departments of Physical Medicine & Rehabilitation and Orthopedic Surgery, and the Translational Musculoskeletal Research Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104
| | | | - Keith Cengel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Bing Xia
- the Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, New Brunswick, New Jersey 08903, and
| | - Ling Qin
- From the Department of Orthopaedic Surgery,
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Halaj Zadeh J, Ghorbanihaghjo A, Rashtchizadeh N, Argani H, Valizadeh S, Halaj N, Vatankhah AM. Cross-talk between endothelin-1 and mineral metabolism in hemodialysis patients: a cross-sectional study. Iran Red Crescent Med J 2014; 16:e18115. [PMID: 25068056 PMCID: PMC4102989 DOI: 10.5812/ircmj.18115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 03/17/2014] [Accepted: 03/30/2014] [Indexed: 12/01/2022]
Abstract
Background: Endotheline-1 (ET-1), an endothelial mediator, influences on mineral metabolism; especially vascular calcification in uremic patients. Objectives: The aim of the present study was to evaluate of ET-1, high-sensitivity C-reactive protein (hs-CRP) and mineral metabolites as the main factors for vascular calcification and inflammation in hemodialysis (HD) patients. Patients and Methods: In this cross-sectional study, 46 chronic stable HD patients were selected from nephrology departments of Tabriz University of Medical Sciences affiliated hospitals and classified based on phosphorus (P), Ca-P product (Ca × P) and intact Parathyroid Hormone (iPTH) levels. We evaluated fasting serum ET-1and hs-CRP levels by the standard methods and compared with 46 healthy control subjects. Results: The levels of serum hs-CRP and ET-1 were significantly higher in the patient’s group compared with controls (4.40 ± 1.26 vs. 1.38 ± 1.61, P < 0.0001, and 2.31 ± 0.87 vs. 0.75 ± 0.48, P < 0.0001, respectively) and with regard to Ca × P product cut-off point (3.99 ± 0.78 vs. 5.33 ± 1.64, P < 0.0001, and 2 ± 0.73 vs. 3.04 ± 0.73, P < 0.0001 respectively). ET-1 was correlated significantly with hs-CRP level (r = 0.776, P < 0.0001). Serum P, Ca × P and iPTH levels directly and Ca indirectly were correlated with serum ET-1 in HD patients (r = 0.932, P < 0.0001, r = 0.766, P < 0.0001, r = 0.514, P < 0.0001, r = -0.538, P < 0.0001 respectively). Multiple regression analysis demonstrated that serum P were independently associated with ET-1 levels (β = 0.932, P < 0.0001). Conclusions: Serum P and iPTH levels were independently associated with ET-1 and those may play a role in development of endothelial dysfunction in chronic kidney disease.
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Affiliation(s)
- Jamal Halaj Zadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Amir Ghorbanihaghjo
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Amir Ghorbanihaghjo, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran, E-mail:
| | - Nadereh Rashtchizadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Hassan Argani
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Shahnam Valizadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Najat Halaj
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Baertschi S, Baur N, Lueders-Lefevre V, Voshol J, Keller H. Class I and IIa histone deacetylases have opposite effects on sclerostin gene regulation. J Biol Chem 2014; 289:24995-5009. [PMID: 25012661 DOI: 10.1074/jbc.m114.564997] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Adult bone mass is controlled by the bone formation repressor sclerostin (SOST). Previously, we have shown that intermittent parathyroid hormone (PTH) bone anabolic therapy involves SOST expression reduction by inhibiting myocyte enhancer factor 2 (MEF2), which activates a distant bone enhancer. Here, we extended our SOST gene regulation studies by analyzing a role of class I and IIa histone deacetylases (HDACs), which are known regulators of MEF2s. Expression analysis using quantitative PCR (qPCR) showed high expression of HDACs 1 and 2, lower amounts of HDACs 3, 5, and 7, low amounts of HDAC4, and no expression of HDACs 8 and 9 in constitutively SOST-expressing UMR106 osteocytic cells. PTH-induced Sost suppression was associated with specific rapid nuclear accumulation of HDAC5 and co-localization with MEF2s in nuclear speckles requiring serine residues 259 and 498, whose phosphorylations control nucleocytoplasmic shuttling. Increasing nuclear levels of HDAC5 in UMR106 by blocking nuclear export with leptomycin B (LepB) or overexpression in transient transfection assays inhibited endogenous Sost transcription and reporter gene expression, respectively. This repressor effect of HDAC5 did not require catalytic activity using specific HDAC inhibitors. In contrast, inhibition of class I HDAC activities and expression using RNA interference suppressed constitutive Sost expression in UMR106 cells. An unbiased comprehensive search for involved HDAC targets using an acetylome analysis revealed several non-histone proteins as candidates. These findings suggest that PTH-mediated Sost repression involves nuclear accumulation of HDAC inhibiting the MEF2-dependent Sost bone enhancer, and class I HDACs are required for constitutive Sost expression in osteocytes.
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Affiliation(s)
| | - Nina Baur
- Developmental and Molecular Pathways, Novartis Institutes for BioMedical Research, 4056 Basel, Switzerland
| | | | - Johannes Voshol
- Developmental and Molecular Pathways, Novartis Institutes for BioMedical Research, 4056 Basel, Switzerland
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26
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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: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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27
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Han SW, Kim SJ, Lee DJ, Kim KM, Joo NS. The Relationship between Serum 25-Hydroxyvitamin D, Parathyroid Hormone and the Glomerular Filtration Rate in Korean Adults: The Korea National Health and Nutrition Examination Survey between 2009 and 2011. Korean J Fam Med 2014; 35:98-106. [PMID: 24724005 PMCID: PMC3978191 DOI: 10.4082/kjfm.2014.35.2.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/27/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The glomerular filtration rate (GFR) decreases with age, while parathyroid hormone (PTH) increases. There are a few reports only on the relationship between GFR and PTH under the category of serum 25-hydroxyvitamin D (25[OH]D) concentration. METHODS Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, a cross-sectional study was conducted on the association between serum 25(OH)D concentration, GFR and PTH in Korean adults aged 50 years or older. Serum PTH concentration was compared to the tertiles of GFR after adjustment for relevant variables. In addition, the serum PTH concentration was compared with the GFR under the category of serum 25(OH) D concentration (<20, 20-30, >30 ng/mL). RESULTS The mean estimated GFR (eGFR) was 74.8 mL/min in men and 73.1 mL/min in women. The mean PTH and 25(OH) D was 66.8 pg/mL, 20.5 ng/mL in men and 69.0 pg/mL, 18.2 ng/mL in women. The serum PTH concentration showed a significant negative correlation with the serum 25(OH) D and eGFR in both genders. The serum PTH concentration significantly increased at the lower tertile of eGFR in male adults In addition, a decrease of serum PTH concentration was marked in the vitamin D sufficient male adults (>30 ng/mL). CONCLUSION This present study demonstrated that serum PTH concentration showed negative correlation with eGFR, however, serum PTH increase may be minimized by maintaining proper serum 25(OH)D concentrations under similar eGFR status in Korean adults aged 50 and above.
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Affiliation(s)
- Sung-Woo Han
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Sung-Jin Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Duck-Joo Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kwang-Min Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
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28
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Kawai M, Kinoshita S, Shimba S, Ozono K, Michigami T. Sympathetic activation induces skeletal Fgf23 expression in a circadian rhythm-dependent manner. J Biol Chem 2014; 289:1457-66. [PMID: 24302726 PMCID: PMC3894328 DOI: 10.1074/jbc.m113.500850] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/18/2013] [Indexed: 12/20/2022] Open
Abstract
The circadian clock network is well known to link food intake and metabolic outputs. Phosphorus is a pivotal nutritional factor involved in energy and skeletal metabolisms and possesses a circadian profile in the circulation; however, the precise mechanisms whereby phosphate metabolism is regulated by the circadian clock network remain largely unknown. Because sympathetic tone, which displays a circadian profile, is activated by food intake, we tested the hypothesis that phosphate metabolism was regulated by the circadian clock network through the modification of food intake-associated sympathetic activation. Skeletal Fgf23 expression showed higher expression during the dark phase (DP) associated with elevated circulating FGF23 levels and enhanced phosphate excretion in the urine. The peaks in skeletal Fgf23 expression and urine epinephrine levels, a marker for sympathetic tone, shifted from DP to the light phase (LP) when mice were fed during LP. Interestingly, β-adrenergic agonist, isoproterenol (ISO), induced skeletal Fgf23 expression when administered at ZT12, but this was not observed in Bmal1-deficient mice. In vitro reporter assays revealed that ISO trans-activated Fgf23 promoter through a cAMP responsive element in osteoblastic UMR-106 cells. The mechanism of circadian regulation of Fgf23 induction by ISO in vivo was partly explained by the suppressive effect of Cryptochrome1 (Cry1) on ISO signaling. These results indicate that the regulation of skeletal Fgf23 expression by sympathetic activity is dependent on the circadian clock system and may shed light on new regulatory networks of FGF23 that could be important for understanding the physiology of phosphate metabolism.
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Affiliation(s)
- Masanobu Kawai
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Saori Kinoshita
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Shigeki Shimba
- the Department of Health Science, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi, Chiba 274-8555, Japan, and
| | - Keiichi Ozono
- the Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshimi Michigami
- From the Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
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29
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Affiliation(s)
- Akihiko Kato
- Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Japan
- Corresponding author: Akihiko Kato, Blood Purification Unit, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. Tel/Fax: +81-534352756, E-mail:
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30
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Biniaz V, Nemati E, Tayebi A, Sadeghi Shermeh M, Ebadi A. The effect of vitamin C on parathyroid hormone in patients on hemodialysis with secondary hyperparathyroidism: a double blind, placebo-controlled study. Nephrourol Mon 2013; 5:962-6. [PMID: 24693502 PMCID: PMC3955287 DOI: 10.5812/numonthly.12404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 06/12/2013] [Accepted: 06/25/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Secondary hyperparathyroidism (SHPT) is a prevalent disorder in patients with chronic kidney disease. It is proffered that there is a contradictory relation between serum level of vitamin C and parathyroid hormone (PTH) in hemodialysis patients with secondary hyperparathyroidism. OBJECTIVES The goal of this study was to assess the effects of the supplemental vitamin C on parathyroid hormone among hemodialysis patients with secondary hyperparathyroidism. PATIENTS AND METHODS This randomized, placebo-controlled, double-blind and parallel-group trial was conducted on 82 hemodialysis patients with serum levels of PTH more than 200 pg/mL. In intervention group, 250 mg vitamin C was injected three times a week for 8 weeks in a row immediately at the end of each dialysis session via the intravenous route. In the control group, same term of placebo saline was injected. RESULTS The mean of serum PTH was 699.81 (± 318.8) and 596.03 (± 410.7) pg/mL in intervention and control groups respectively at baseline (reference range, 6 to 66 pg/mL), and at the end of study it changed to 441.4 and 424.6 in these groups. The values of serum Calcium and Phosphate did not significantly change during the study (8.4 ± 0.6 mg/dL versus 8.1 ± 0.8 mg/dL, P = 0.39; 5.89 ± 1.7 mg/dL versus 5.9 ± 1.9 mg/dL, P = 0.08, respectively). CONCLUSIONS This study finding does not warranted therapeutic effect of vitamin C on secondary hyperparathyroidism.
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Affiliation(s)
- Vajihe Biniaz
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Eghlim Nemati
- Nephrology and Urology Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ali Tayebi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Tayebi, Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Velayat Complex, Nobonyad Square, Tehran, Iran. Tel: +98-9121058516, Fax: +98-2126127253, E-mail:
| | - Mehdi Sadeghi Shermeh
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Abbas Ebadi
- Department of Medical Surgical Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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31
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Rhee Y, Lee EY, Lezcano V, Ronda AC, Condon KW, Allen MR, Plotkin LI, Bellido T. Resorption controls bone anabolism driven by parathyroid hormone (PTH) receptor signaling in osteocytes. J Biol Chem 2013; 288:29809-20. [PMID: 23963454 DOI: 10.1074/jbc.m113.485938] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The contribution of remodeling-based bone formation coupled to osteoclast activity versus modeling-based bone formation that occurs independently of resorption, to the anabolic effect of PTH remains unclear. We addressed this question using transgenic mice with activated PTH receptor signaling in osteocytes that exhibit increased bone mass and remodeling, recognized skeletal effects of PTH elevation. Direct inhibition of bone formation was accomplished genetically by overexpressing the Wnt antagonist Sost/sclerostin; and resorption-dependent bone formation was inhibited pharmacologically with the bisphosphonate alendronate. We found that bone formation induced by osteocytic PTH receptor signaling on the periosteal surface depends on Wnt signaling but not on resorption. In contrast, bone formation on the endocortical surface results from a combination of Wnt-driven increased osteoblast number and resorption-dependent osteoblast activity. Moreover, elevated osteoclasts and intracortical/calvarial porosity is exacerbated by overexpressing Sost and reversed by blocking resorption. Furthermore, increased cancellous bone is abolished by Wnt inhibition but further increased by blocking resorption. Thus, resorption induced by PTH receptor signaling in osteocytes is critical for full anabolism in cortical bone, but tempers bone gain in cancellous bone. Dissecting underlying mechanisms of PTH receptor signaling would allow targeting actions in different bone compartments, enhancing the therapeutic potential of the pathway.
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Affiliation(s)
- Yumie Rhee
- From the Departments of Anatomy and Cell Biology and
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Saini V, Marengi DA, Barry KJ, Fulzele KS, Heiden E, Liu X, Dedic C, Maeda A, Lotinun S, Baron R, Pajevic PD. Parathyroid hormone (PTH)/PTH-related peptide type 1 receptor (PPR) signaling in osteocytes regulates anabolic and catabolic skeletal responses to PTH. J Biol Chem 2013; 288:20122-34. [PMID: 23729679 DOI: 10.1074/jbc.m112.441360] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Parathyroid hormone (PTH) is the only Food and Drug Administration-approved anabolic agent to treat osteoporosis; however, the cellular targets of PTH action in bone remain controversial. PTH modulates bone turnover by binding to the PTH/PTH-related peptide (PTHrP) type 1 receptor (PPR), a G-protein-coupled receptor highly expressed in bone and kidneys. Osteocytes, the most abundant cells in adult bone, also express PPR. However, the physiological relevance of PPR signaling in osteocytes remains to be elucidated. Toward this goal, we generated mice with PPR deletion in osteocytes (Ocy-PPRKO). Skeletal analysis of these mice revealed a significant increase in bone mineral density and trabecular and cortical bone parameters. Osteoblast activities were reduced in these animals, as demonstrated by decreased collagen type I α1 mRNA and receptor activator of NF-κB ligand (RANKL) expression. Importantly, when subjected to an anabolic or catabolic PTH regimen, Ocy-PPRKO animals demonstrated blunted skeletal responses. PTH failed to suppress SOST/Sclerostin or induce RANKL expression in Ocy-PPRKO animals compared with controls. In vitro, osteoclastogenesis was significantly impaired in Ocy-PPRKO upon PTH administration, indicating that osteocytes control osteoclast formation through a PPR-mediated mechanism. Taken together, these data indicate that PPR signaling in osteocytes is required for bone remodeling, and receptor signaling in osteocytes is needed for anabolic and catabolic skeletal responses.
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Affiliation(s)
- Vaibhav Saini
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
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Affiliation(s)
- Daniel J Drucker
- Departments of Medicine, Clinical Biochemistry, and Genetics, Toronto General Hospital, University of Toronto, Toronto, Canada
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