Parathyroid gland, cells

The primary factor regulating PTH release is the level of calcium in the bloodstream.42 Parathyroid gland cells appear to act as calcium sensors that monitor circulating calcium levels. As circulating calcium levels fall below a certain point, PTH secretion is increased. Conversely, elevated plasma calcium titers inhibit PTH secretion. The ability of PTH to control plasma calcium levels and regulate bone mineral metabolism is discussed in more detail in Chapter 31... 

Calcium ions are mostly present in bones or chelated to biological molecules. In blood plasma, only 1% of the calcium ions present are unbound 78% is bound to albumin, 8% to citrate, and 13% to other plasma proteins. The free calcium ions are prevented from precipitating by plasma pyrophosphate. Calcium ions are also stored in the endoplasmic reticulum (ER), mostly chelated to ER-resident proteins and phosphatidylser-ine. Free calcium ions may be released through transient receptor potential channels to the cytosol where it activates numerous physiological processes. If the free calcium ion concentration of blood plasma falls, parathyroid hormone (PTH) is secreted by the parathyroid gland cells. PTH speeds up the transport of demineralized bone products by osteoclasts. In the kidney, it increases the excretion of phosphate and decreases the excretion of calcium. PTH also acts on kidney cells to make calcitriol from vitamin D, which induces calcium transporters in the intestine and osteoclasts. PTH mediates these effects by activating G-protein-coupled receptors in the kidney and osteoclasts. 

H)2D2 may play a role in tissues other than those involved in calcium transport. In particular, Stumpf and coworkers have shown that 1,25-(0H)2D2 specifically localizes in the nuclei of skin cells, especially the malpighlan layerin endocrine cells of the stomach in the islet cells of the pancreas parathyroid gland cells 3 certain cells of the pituitary,91 and of the brain in addition to the expected target sites, such as osteoblasts, osteocytes, intestinal... 

In the periphery, dopamine receptor levels are generally lower than those observed in brain, particularly in comparison to striatal dopamine receptor levels. Due to these low levels, knowledge of receptor distribution in the periphery is not yet comprehensive. Nevertheless, Dl-like receptors have been reported in the parathyroid gland and in the tubular cells of the kidney. D2-like dopamine receptors have also been observed in the kidney. In addition, dopamine D2 and D4 receptors have been found in the adrenal cortex, where they modulate aldosterone secretion. The... 

Mecfianism of Action Afat-soluble vitamin that is essential for absorption, utilization of calcium phosphafe, and normal calcification of bone. Therapeutic Effect Stimulates calcium and phosphate absorption from small inf esf ine, promof es secretion of calcium from bone fo blood, promofes renal tubule phosphate resorption, acts on bone cells to stimulate skeletal growth and on parathyroid gland to suppress hormone synthesis and secretion. 

The receptor for l,25(OH)2D exists in a wide variety of tissues—not just bone, gut, and kidney. In these "nonclassic" tissues, l,25(OH)2D exerts a number of actions including regulation of parathyroid hormone secretion from the parathyroid gland, insulin secretion from the pancreas, cytokine production by macrophages and T cells, and proliferation and differentiation of a large number of cells, including cancer cells. Thus, the clinical utility of l,25(OH)2D and its... 

Other target organs for the action of 1,25-dihydroxyvitamin D include the kidneys, bone, muscle,vwand skin. The hormone promotes reabsorption of both Ca2+ and inorganic phosphate by kidney tubules. In bone it binds to a specific receptor where it promotes the mobilization of calcium ions. This effect may result in part from stimulation of calcium-activated ATPase of the outer membrane of bone cells. Dissolution of bone also requires the presence of parathyroid hormone (PTH), the 83-residue hormone secreted by the parathyroid gland. In women past the age of menopause and in elderly men the production of 1,25-dihydroxyvitamin D decreases.w This may be a cause of the serious bone loss (osteoporosis) frequently observed. Treatment with 1,25-dihydroxyvitamin D3 or a synthetic analog seems to be helpful to such individuals. /Xy See also Chapter 30, Section A,5. 

Vitamin D3 is a precursor of the hormone 1,25-dihy-droxyvitamin D3. Vitamin D3 is essential for normal calcium and phosphorus metabolism. It is formed from 7-dehydrocholesterol by ultraviolet photolysis in the skin. Insufficient exposure to sunlight and absence of vitamin D3 in the diet leads to rickets, a condition characterized by weak, malformed bones. Vitamin D3 is inactive, but it is converted into an active compound by two hydroxylation reactions that occur in different organs. The first hydroxylation occurs in the liver, which produces 25-hydroxyvita-min D3, abbreviated 25(OH)D3 the second hydroxylation occurs in the kidney and gives rise to the active product 1,25-dihydroxy vitamin D3 24,25 (OH)2D3 (fig. 24.13). The hydroxylation at position 1 that occurs in the kidney is stimulated by parathyroid hormone (PTH), which is secreted from the parathyroid gland in response to low circulating levels of calcium. In the presence of adequate calcium, 25(OH)D3 is converted into an inactive metabolite, 24,25 (OH)2D3. The active derivative of vitamin D3 is considered a hormone because it is transported from the kidneys to target cells, where it binds to nuclear receptors that are analogous to those of typical steroid hormones. l,25(OH)2D3 stimulates calcium transport by intestinal cells and increases calcium uptake by osteoblasts (precursors of bone cells). 

The release of Ca2+ in response to such second messengers is known to activate the phosphorylation of a range of cytosolic proteins by Ca2+-dependent protein kinases, for example in hepatocytes,417 adrenal cortex418 and other cells.419 Ca2+ inhibits cAMP-activated protein kinase in parathyroid glands.420 Phosphorylation of proteins produced in the pancreatic /8-cell in response to enhanced [Ca2+] may involve calmodulin, while the stimulus produced by glucose is potentiated by cAMP 421 A calmodulin-activated NAD kinase is present in the outer mitochondrial membrane of com.422... 

CaR expression is greatest in the parathyroid glands, calcitonin-secreting C-cells of the thyroid gland, and kidney, but the CaR is also found in the two other key organs that participate in calcium homeostasis gut and bone (Brown and MacLeod, 2001). This review will focus on the structure and function of the CaR, its role in normal physiology and in various disorders of Ca -sensing, and the development of CaR-based therapeutics. 

Although bone is not considered a major calcium sensing organ in humans, the cells of bone tissue control over 99% of the human body s calcium content. The principal calcium sensors that regulate bone calcium uptake and release are in the parathyroid glands. Bone function is also modified by vitamin D and by calcium transport in the kidney and intestine. These indirect mechanisms of controlling bone calcium metabolism are beyond the scope of our considerations here. In spite of processing... 

PTH is a polypeptide hormone that is synthesized within the cells of the parathyroid glands. The primary factor controlling the release of PTH is the amount of calcium in the bloodstream.36 A calciumsensing receptor is located on the outer surface of the parathyroid cell membrane, and this receptor monitors plasma calcium levels.11,88 A decrease in plasma calcium activates this receptor and causes increased release of PTH. As blood calcium levels increase, the receptor is inhibited, and PTH release is reduced. 

The evidence supporting the existence of a specific category of dopamine receptor on the parenchymal cells of the bovine parathyroid gland and the possible biochemical mechanisms by which dopamine stimulates the release of parathyroid hormone are reviewed. The dopamine receptor on the bovine parathyroid cell is compared to other dopamine receptors. 

In other cell types, guanine nucleotides interact with a guanine nucleotide subunit (G- or Ng-subunit) to translate receptor stimulation into increased adenylate cyclase activity (12.) Cholera toxin inhibits a specific GTPase on this guanine nucleotide subunit and thereby increases adenylate cyclase activity (13.). In dispersed cells from the bovine parathyroid gland, cholera toxin markedly increases cAMP formation and causes a 3 to 10-fold increase in the apparent affinity cf dopamine for its receptor (as determined by cAMP accumulation or IR-PTH secretion (J y.). The effects of guanine nucleotides and cholera toxin on cAMP accumulation in parathyroid cells result from interactions with the guanine nucleotide subunit in this cell. 

The physiological role of dopamine and other catecholamines in PTH secretion is unknown. It is of interest that large quantities of dopamine (3 9 to 13.9 pg/g) occur in the bovine parathyroid gland. This dopamine is localized within mast cells (28) which occur throughout the gland (2). 

In contrast, the content of norepinephrine is substantially lower than the content of dopamine (28). Catecholamine-containing neurons do not innervate the parenchymal cells of the bovine parathyroid gland only an occasional norepinephrine-containing neuron terminating upon a blood vessel is demonstrated by fluorescence histochemistry (22). 

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