title: Autoregulation in the parathyroid glands by PTH/PTHrP receptor ligands in normal and uremic rats.
abstract: BACKGROUND
  The secretion of parathyroid hormone (PTH) from the parathyroid glands might be regulated by autocrine/paracrine factors. We have previously shown that N-terminal parathyroid hormone-related protein (PTHrP) enhanced the secretory PTH response to low calcium in vivo and in vitro in rat parathyroid glands. N-terminal PTHrP fragments are equipotent to N-terminal PTH as ligands for the PTH/PTHrP receptor that is demonstrated in parathyroid tissue. This supports the possibility that the parathyroid cells respond to PTH/PTHrP receptor ligands and as such are target for an autoregulatory action of PTH and PTHrP. Our aim was to search for the PTH/PTHrP receptor in rat parathyroid glands and to examine the effects of PTHrP 1-40 on PTH secretion in in vivo models of secondary hyperparathyroidism (HPT) in uremic rats.
  
  
  METHODS
  PTH secretion was examined during ethyleneglycol tetraacetic acid (EGTA)-induced hypocalcemia both with and without PTHrP. Five groups, each of six normal rats, received a bolus of increasing doses of 0.1, 1.0, 10, and 100 microg of PTHrP 1-40, or vehicle only. Chronic renal failure (CRF) was induced by 5/6 nephrectomy. One group of 12 CRF rats received a standard diet, while another CRF group of 18 rats received a high phosphorus diet to induce more severe HPT. After 8 weeks of uremia, the rats were infused with EGTA and PTHrP 1-40 or vehicle. The presence of the PTH/PTHrP receptor in the rat parathyroid glands was examined by reverse transcription-polymerase chain reaction (RT-PCR) technique. PTH was measured by a rat PTH assay that does not cross-react with PTHrP.
  
  
  RESULTS
  In a dose-related manner, PTHrP enhanced the PTH response to hypocalcemia in normal rats. A similar rate of decrease of plasma Ca++ was induced by EGTA in all experimental groups. In CRF rats, plasma creatinine (0.99 +/- 0.10 mmol/L vs. 0.33 +/- 0.01 mmol/L, P < 0.001) and plasma PTH (226 +/- 32 pg/mL vs. 69 +/- 16 pg/mL, P < 0.001) levels were significantly increased. The CRF rats on high phosphorus diet had significant hypocalcemia (Ca++, 1.04 +/- 0.02 mmol/L vs. 1.28 +/- 0.03 mmol/L, P < 0.001), hyperphosphatemia (3.48 +/- 0.3 mmol/L vs. 2.25 +/- 0.1 mmol/L, P < 0.001) and severe secondary HPT, PTH (984 +/- 52 pg/mL vs. 226 +/- 32 pg/mL, P < 0.001) compared to CRF rats on a standard phosphorus diet. The maximal PTH response to hypocalcemia was enhanced in CRF rats (maximum PTH 382 +/- 58 pg/mL vs. 196 +/- 29 pg/mL in normal rats, P < 0.01) and further enhanced by PTHrP 1-40 to 826 +/- 184 pg/mL (P < 0.01). The secretory capacity of the parathyroid glands in response to low Ca++ was severely diminished in uremia. In CRF rats given a high phosphorus diet, the basal PTH levels were at the upper part of the calcium/PTH curve, and the induction of more marked hypocalcemia did not stimulate PTH secretion further (maximum PTH 1475 +/- 208 pg/mL vs. basal 1097 +/- 69 pg/mL, NS). PTHrP, however, further enhanced the maximal PTH levels significantly (maximum PTH 3142 +/- 296 pg/mL, P < 0.01). The presence of the PTH/PTHrP receptor in the rat parathyroid glands was confirmed by RT-PCR technique.
  
  
  CONCLUSIONS
  PTHrP enhanced significantly, in a dose-related manner, the low Ca++-stimulated PTH secretion in normal rats. The PTH/PTHrP receptor is present in rat parathyroid glands. The impaired secretory capacity of the parathyroid glands in uremic rats is significantly enhanced by PTHrP. An autocrine/paracrine role in the parathyroid glands of the PTH/PTHrP receptor targeting peptides, PTHrP and PTH, is suggested. Thus, it is hypothesized that PTH during hypocalcemia might have a positive auto-feedback regulatory role on its own secretion.
authors.affiliation: Nephrological Department B, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. lewin@dadlnet.dk
authors.forename: Ewa
authors.initials: E
authors.lastname: Lewin
authors.forename: Bartolome
authors.initials: B
authors.lastname: Garfia
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Almaden
authors.forename: Mariano
authors.initials: M
authors.lastname: Rodriguez
authors.forename: Klaus
authors.initials: K
authors.lastname: Olgaard
mesh_terms: D000818:Animals; D004305:Dose-Response Relationship, Drug; D006706:Homeostasis; D006996:Hypocalcemia / Q000378:metabolism; D008024:Ligands; D008297:Male; D010280:Parathyroid Glands / Q000378:metabolism / Q000503:physiopathology*; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism; D044162:Parathyroid Hormone-Related Protein / Q000008:administration & dosage; D010446:Peptide Fragments / Q000008:administration & dosage; D016226:Phosphorus, Dietary / Q000008:administration & dosage; D051381:Rats; D011919:Rats, Inbred Strains; D044168:Receptor, Parathyroid Hormone, Type 1 / Q000378:metabolism*; D014511:Uremia / Q000503:physiopathology*
chemical_list: D008024:Ligands; D010281:Parathyroid Hormone; D044162:Parathyroid Hormone-Related Protein; D010446:Peptide Fragments; D016226:Phosphorus, Dietary; D044168:Receptor, Parathyroid Hormone, Type 1; C482462:parathyroid hormone-related protein (1-40)