Parathyroid disease and calcium metabolism

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Inverse sigmoidal relationship between parathyroid hormone (PTH) release and the extracellular calcium concentration in human studies (upper panel) and.
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Presentation transcript:

Parathyroid disease and calcium metabolism R. Mihai, J.R. Farndon  British Journal of Anaesthesia  Volume 85, Issue 1, Pages 29-43 (July 2000) DOI: 10.1093/bja/85.1.29 Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 1 (1) Schematic representation of the Ca2+ receptor's signalling mechanisms. Ca2+ receptor agonists bind to the extracellular domain of the Ca2+ receptor and trigger activation of the G protein–phospholipase C (PLC) pathway. PLC generates inositol-trisphosphate (IP3), which binds to specific receptors situated on intracellular Ca2+ stores. Upon binding of IP3 the three-dimensional structure of IP3 receptors changes and allows the release of Ca2+. The responsiveness of IP3 receptors modulates the amplitude of [Ca2+]i responses following activation of the Ca2+ receptor.63 The filling state of the intracellular Ca2+ stores is maintained by the action of specific Ca2+ pumps, i.e. the smooth endoplasmic reticulum Ca2+-ATPases (SERCA). (2) The graphs illustrate changes in cytoplasmic concentration of calcium ([Ca2+]i) in parathyroid cells. [Ca2+]i was measured using quantitative fluorescent microscopy in Fura-2-loaded cells. The upper panel illustrates responses to changes in [Ca2+]ext from 0.5 to 3 mM. The lower panel illustrates [Ca2+]i responses to the Ca2+ receptor agonist lanthanum (La3+; 15 μM). (3) [Ca2+]i increases rapidly following incubation with thapsigargin, an inhibitor of SERCA. British Journal of Anaesthesia 2000 85, 29-43DOI: (10.1093/bja/85.1.29) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions

Fig 2 Lack of correlation between the weight of parathyroid adenomas and the biochemical abnormalities. In 37 patients with primary hyperparathyroidism, the weight of parathyroid adenomas was determined immediately after surgical removal. Preoperative values for calcium (corrected for albumin concentration) and PTH were recorded. Intact PTH (1–84) was measured using a chemiluminescent assay (Immulite, DPC, Gwynedd, UK; coefficient of variance 4.7% and 5.5% for intrassay and interassay precision, respectively). British Journal of Anaesthesia 2000 85, 29-43DOI: (10.1093/bja/85.1.29) Copyright © 2000 British Journal of Anaesthesia Terms and Conditions