Calcium in plasma

Approximately 50% of the total calcium in plasma is either bound to albumin or complexed to small ligands. The remaining ionized fraction is the biologically active form. Whenever... 

Unbound calcium is the biologically active fraction of the total calcium in plasma and maintenance of its concentration within tight limits is required for nerve function, membrane pcmieability, muscle contraction and glandular secretion. It is the unbound calcium concentration W hich is recognized by the parathyroid glands, and PTH acts to keep this concentration constant. 

It is apparent that more detailed information is needed of aluminium distribution in the plasma of normals and patients on chronic intermittent hemodialysis. Such information would clarify the variability of reports on aluminium loading during hemodialysis. Recent work in the authors laboratory (King et al., 1982 1979) has been directed towards an attempt to separate aluminium species in plasma into more than just ultrafiltrable and protein-bound fractions. The approach used to define the plasma distribution and binding of aluminium was to employ gel filtration under equilibrium conditions which was a technique used previously in our laboratory for studying the distribution of calcium in plasma CToffaletti et al., 1977). 

INORGANIC CHEMISTRY IN BIOLOGY AND MEDICINE NTA/CALCIUM IN PLASMA... 

The reference method should be used to evaluate routine methods for measurement of ionized calcium in plasma. Routine methods are based on a cell similar to that of the reference method and are usually calibrated with secondary calibration solutions. These are aqueous buffer solutions to which values of ionized calcium concentration have been assigned by means of the routine instrument using the primary calibration solutions as reference material. Routine method often produce highly precise, but not necessary accurate ionized calcium data because of variations in electrode systems, liquid/liquid junctions, calibration and measurement procedures. In order to monitor the inaccuracy of routine ionized calcium measurements, it is necessary to employ quality control solutions, e.g., plasma samples for which the ionized calcium value have been established with the reference method. 

The ionic or free calcium in plasma and serum is associated mainly with chloride ions [46] and represents the calcium that is not bound to protein (normally 30—SS per cent and non-diffusible) or other complexing species such as phosphate, citrate or bicarbonate (normally S-IS per cent and diffusible). In the average healthy person, the calcium ion level is just below one-half of the total and is so closely ibgulated that no gross variability can be detected [47], Furthermore, even in the absence of an adequate calcium intake and a negative calcium balance, plasma calcium remains unchanged for a considerable length of time as the calcium stores in bone are called upon [3,48]. 

Calcitonin is secreted when abnormally high calcium levels occur in plasma. Although plasma concentrations are normally minute (<100 pg/mL), they increase two- to threefold after calcium infusion. Calcitonin has a short plasma half-life (ca 10 min). Certain thyroid tumors are the result of CT concentrations 50—500 times normal. The mechanism of action is a direct inhibition of bone resorption. Calcitonin is used clinically in various diseases in which hypercalcemia is present, eg, Paget s disease (46). 

Three hormones regulate turnover of calcium in the body (22). 1,25-Dihydroxycholecalciferol is a steroid derivative made by the combined action of the skin, Hver, and kidneys, or furnished by dietary factors with vitamin D activity. The apparent action of this compound is to promote the transcription of genes for proteins that faciUtate transport of calcium and phosphate ions through the plasma membrane. Parathormone (PTH) is a polypeptide hormone secreted by the parathyroid gland, in response to a fall in extracellular Ca(Il). It acts on bones and kidneys in concert with 1,25-dihydroxycholecalciferol to stimulate resorption of bone and reabsorption of calcium from the glomerular filtrate. Calcitonin, the third hormone, is a polypeptide secreted by the thyroid gland in response to a rise in blood Ca(Il) concentration. Its production leads to an increase in bone deposition, increased loss of calcium and phosphate in the urine, and inhibition of the synthesis of 1,25-dihydroxycholecalciferol. 

Medical Uses. Citric acid and citrate salts are used to buffer a wide range of pharmaceuticals at their optimum pH for stabiUty and effectiveness (65—74). Effervescent formulations use citric acid and bicarbonate to provide rapid dissolution of active ingredients and improve palatabiUty. Citrates are used to chelate trace metal ions, preventing degradation of ingredients. Citrates are used to prevent the coagulation of both human and animal blood in plasma and blood fractionation. Calcium and ferric ammonium citrates are used in mineral supplements. 

ATPase inhibitor. In such patients, inhibition of the sodium pump in the cells lining the blood vessel wall results in accumulation of sodium and calcium in these cells and the narrowing of the vessels to create hypertension. An 8-year study aimed at the isolation and identification of the agent responsible for these effects by researchers at the University of Maryland Medical School and the Upjohn Laboratories in Michigan recently yielded a surprising result. Mass spectrometric analysis of compounds isolated from many hundreds of gallons of blood plasma has revealed that the hypertensive agent is ouabain itself or a closely related molecule ... 

In addition to intracellular heme-containing proteins, big-conductance calcium-dependent K+ (BKCa) channels and calcium-spark activated transient Kca channels in plasma membrane are also tar geted by CO [3]. As well known, nitric oxide (NO) also activates BKca channels in vascular smooth muscle cells. While both NO and CO open BKCa channels, CO mainly acts on alpha subunit of BKCa channels and NO mainly acts on beta subunit of BKca channels in vascular smooth muscle cells. Rather than a redundant machinery, CO and NO provide a coordinated regulation of BKca channel function by acting on different subunits of the same protein complex. Furthermore, pretreatment of vascular smooth muscle... 

A major regulator of bone metabolism and calcium homeostasis, parathyroid hormone (PTH) is stimulated through a decrease in plasma ionised calcium and increases plasma calcium by activating osteoclasts. PTH also increases renal tubular calcium re-absorption as well as intestinal calcium absorption. Synthetic PTH (1-34) has been successfully used for the treatment of osteoporosis, where it leads to substantial increases in bone density and a 60-70% reduction in vertebral fractures. 

Bames, D.W.H., Bishop, M., Harrison, G.E. and Sutton, A. 1961 Comparison of the plasma concentration and urinary excretion of strontium and calcium in man. InternationalJournal of Radiation Biology 3 637-646. 

Calcium exists in the human body as Ca(II) protein-bound and free Ca (II) ions (Dilana et al. 1994). For total extracellular Ca in plasma, serum and urine a definitive isotope dilution-mass spectrometry (ID-MS) method exist. Free Ca(II) in plasma/serum can be determined with PISE, but no definitive and reference methods exist. For Ca in faeces, tissue and blood flame atomic absorption (FAAS) is used widely. 

The increase in hematocrit on decreasing the plasma compartment has an effect of concentrating citrate and thus effectively increasing its concentration in plasma. The extra citrate present in the plasma compartment will complex with calcium added during PT and APTT measurements, thereby artifactually elevating both PT and APTT, because of insufficient calcium. This effect can be minimized by adjusting the citrate concentration in accordance with the hematocrit value by us-... 

The release of calcitonin from the thyroid is regulated by plasma calcium levels through negative feedback. An increase in the level of calcium in the... 

Calcium is freely filtered along with other components of the plasma through the nephrons of the kidney. Most of this calcium is reabsorbed into the blood from the proximal tubule of the nephron. However, because the kidneys produce about 1801 of filtrate per day, the amount of calcium filtered is substantial. Therefore, the physiological regulation of even a small percentage of calcium reabsorption may have a significant effect on the amount of calcium in the blood. Parathyroid hormone acts on the Loop of Henle to increase the reabsorption of calcium from this segment of the tubule and... 

The final mechanism of action of PTH involves the activation of vitamin D3 through the stimulation of la-hydroxylase in the kidney. In the gastrointestinal tract, vitamin D3 is essential for the absorption of calcium. Enhanced absorption of calcium from dietary sources serves to further increase the concentration of calcium in the blood. Many foods, in particular, dairy products, which are rich in calcium, are fortified with vitamin D. The release of PTH from the parathyroid glands is regulated by plasma calcium levels through negative feedback. A decrease in the level of calcium in the blood stimulates the secretion of PTH and an increase in the calcium level in the blood inhibits it. 

Cadmium is nutritionally non-essential, toxic and a ubiquitous environmental pollutant. It is found in leafy vegetables, grains and cereals, and since it is present in substantial amounts in tobacco leaves, cigarette smokers on a packet a day can easily double their cadmium intake. It has a long biological half-life (17-30 years in man), accumulates in liver and kidneys and its toxicity involves principally kidney and bone (Goyer, 1997).While Cd interferes primarily with calcium, it also interacts with zinc and can induce the synthesis of metallothionein. Cadmium bound to metallothionein in liver or kidney is thought to be non-toxic, but cadmium in plasma... 

Calcium-selective electrodes have long been in use for the estimation of calcium concentrations - early applications included their use in complexometric titrations, especially of calcium in the presence of magnesium (42). Subsequently they have found use in a variety of systems, particularly for determining stability constants. Examples include determinations for ligands such as chloride, nitrate, acetate, and malonate (mal) (43), several diazacrown ethers (44,45), and methyl aldofuranosides (46). Other applications have included the estimation of Ca2+ levels in blood plasma (47) and in human hair (where the results compared satisfactorily with those from neutron activation analysis) (48). Ion-selective electrodes based on carboxylic polyether ionophores are mentioned in Section IV.B below. Though calcium-selective electrodes are convenient they are not particularly sensitive, and have slow response times. 

Several recent determinations of the alkali and alkaline earth metals in serum or urine have been reported. Barrett 29) determined potassium, sodium, and calcium in semm by diluting the samples with lanthanum chloride solution. Suttle and Field 3°) used atomic absorption spectroscopy to determine potassium and magnesium in sheep plasma. 

Kola H, Peramaki P, Valimaki I. Correction of spectral interferences of calcium in sulfur determination by inductively coupled plasma optical emission spectroscopy using multiple hnear regression. J. Anal. At. Spectrom. 2002 17 104-108. 

As can be seen from the results in Table V, fluoride levels in plasma, liver and kidney increased 3 to 8 times but there was no significant effect on the calcium or phosphorus content, although the kidney Ca level in fluoride treated rats was 40 higher than in the controls. Whereas the normal exposure to fluoride from air, food and water did not cause any increase in soft tissue levels, more than ten times the normal levels in soft tissues, including liver and kidney, were found in human fatalities due to fluoride poisoning (15). 

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