Calcitonin marker

Kaskani E, Lyritis GP, Kosmidis C, et al. Effect of intermittent administration of 200 IU intranasal salmon calcitonin and low doses of 1 alpha(OH) vitamin D3 on bone mineral density of the lumbar spine and hip region and biochemical bone markers in women with postmenopausal osteoporosis a pilot study. Clin Rheumatol. 2005 24 232-238. 

Clinical PK/PD Calcitonin has a well-established mechanism of action published literature supports that salmon calcitonin, mediated through calcitonin receptors located on osteoclasts, inhibits bone resorption, thereby increasing bone mineral density. Since serum beta-CTx (C-telopeptides of type 1 collagen, corrected for creatinine) is a recognized marker of bone resorption, the effect of administered salmon calcitonin on serum beta-CTx is considered to be an adequate surrogate for pharmacodynamic comparisons. 

Osteoclasts are multinucleated cells found on the endosteal surface of bone, in Haversian systems and periosteal surfaces. PTH activates osteoclasts (indirectly via osteoblasts that possess PTH receptors). Calcitonin is a potent inhibitor of osteoclast activity. Local cytokine factors, including interleukin-1 (IL-1), tumour-necrosis factor (TNF), TGF- 0 and interferon-y (INF-y), are important regulators. Osteoclast resorption of bone releases collagen peptides, pyridinoline cross-links and calcium from the bone matrix, through the action of lysosomal enzymes (collagenases and cathepsins). The collagen breakdown products in serum and urine (e.g. hydroxyproline) can be used as biochemical markers. 

Takami, H. et al. (1992) Calcitonin gene-related peptide as a tumour marker for medullary thyroid carcinoma. Int. Surg.. 77.181-185. 

Calcitonin levels are also elevated in some patients with carcinoid and cancer of the lung, breast, Iddney, and liver. The usefulness of calcitonin as a tumor marker in these malignancies has not been proven. Calcitonin elevation has been reported in other nonmahgnant conditions, such as pulmonary disease, pancreatitis, hyperparathyroidism, pernicious anemia, Pagefs disease of bone, and pregnancy. 

Therapy is directed at decreasing osteoclastic bone resorption. Bisphosphonates (alendronate, risedronate, pamidronate, and etidronate) and calcitonin are effective in decreasing bone pain, serum ALP, and markers of bone resorption. Patients may occasionally need surgery for skeletal deformity that limits mobility or for arthritic changes, fractures, or nerve compression. 

Wallach SR, Royston I, Taetle R, Wohl H, Deftos LJ, Plasma calcitonin as a marker of disease activity in patients with small cell carcinoma of the lung. J Chn Endocrinol Metab 1981 53 602-6. 

Calcitonin is a useful marker for medullary carcinoma of the thyroid, which occurs both sporadically and as a dominantly inherited disease. In this type of tumor, the plasma concentration of calcitonin is 1-1000 mg/mL (normal concentration ranges from undetectable to 0.05 ng/mL). Also, urinary hydroxyproline excretion is decreased. Ectopic secretion of calcitonin also occurs from several types of pulmonary tumor in addition to other hormones. 

Morara S, Rosina A, Provini A (1992) CGRP as a marker of the climbing fibers during the development of the cerebellum in the rat. Calcitonin gene-related peptide. Ann. N. . Acad. Scl, 651, 461-463. 

These three neuroendocrine tumors of the larynx all display positivity for typical neuroendocrine markers such as chromogranin, synaptophysin, and neuron-specific enolase. They may also be positive for carcinoembryonic antigen (CEA) or epithelial membrane antigen (EMA). Atypical carcinoid and SCNEC can also express other neuroendocrine markers such as serotonin, calcitonin, and somatostatin. TTE-1 is probably not a useful marker to distinguish metastatic pulmonary small cell carcinoma from primary tumors in the head and neck because up to 50% of extrapulmonary small cell carcinomas are positive for TTR-l.i 8... 

FIGURE 10.46 Distribution of markers in large cell NE carcinoma. CEA(m), monoclonal carcinoembryonic antigen PGP, protein gene product 9.5 CK, cytokeratin NSE, neuron-specific enoiase CgA, chromogranin A SYN, synaptophysin GRP, gastrin-reieasing peptide ACTH (b), big adrenocorticotropic hormone CT, calcitonin. 

CA 19-9 tumor marker CA-125 tumor marker Calcitonin Calcium... 

Paget s disease (Table 35.6) is characterized by excessive bone resorption, followed by replacement of the normally mineralized bone with soft, poorly mineralized tissue (20). It has been determined that the osteoclasts have an abnormal structure, are hyperactive, and are present at elevated levels (20). Patients afflicted with this painful condition often suffer from multiple compression fractures. Administration of calcitonin and oral calcium and phosphate supplements had been the treatment of choice until the bisphosphonate risedronate was approved by the U.S. Food and Drug Administration (FDA). Daily administration of risedronate results in a decreased rate of bone turnover and a decrease in the levels of serum alkaline phosphatase and urinary hydroxyproline, two biochemical markers of bone turnover (4,20). A significant advantage to treatment with the bisphosphonates is long-term suppression of the disease (20). Calcium supplementation, which often is necessary in these patients, must be dosed separately from risedronate, because calcium- and aluminum- or... 

P.M. et al. (2001) Circulating calcitonin and carcinoembryonic antigen m-RNA detected by RT-PCR as tumor markers in medullary thyroid carcinoma. Br J Cancer, 85, 154-1550. 

Research on oral liposomal delivery systems has moved forward with the development of polymer-modified liposomes. For example, targeted PEGylated liposomes furnished with folic acid for oral delivery were promising, showing enhanced permeability of dextran (used as a marker) across Caco-2 cell monolayers (Anderson et al., 1999). PEG and chitosan-coated lipid nanoparticles were constmcted as oral delivery systems for salmon calcitonin (sCT). The PEG-coated nanoparticles did not alter the transepithelial electrical resistance of Caco-2 cell monolayers, while the chitosan-coated nanoparticles showed a dose-dependent increase in the permeability of dextran across the monolayers (Garcia-Fuentes et al., 2005). It demonstrated that the favourable interaction of the chitosan-coated nanoparticles with intestinal mucosa, together with their permeation enhancing characteristics, could improve the oral absorption of sCT. 

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