title: Relationship between parathyroid calcium-sensing receptor expression and potency of the calcimimetic, cinacalcet, in suppressing parathyroid hormone secretion in an in vivo murine model of primary hyperparathyroidism.
abstract: Cinacalcet HCl, an allosteric modulator of the calcium-sensing receptor (CaR), has recently been approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis, due to its suppressive effect on parathyroid hormone (PTH) secretion. Although cinacalcet's effects in patients with primary and secondary hyperparathyroidism have been reported, the crucial relationship between the effect of calcimimetics and CaR expression on the parathyroid glands requires better understanding. To investigate its suppressive effect on PTH secretion in primary hyperparathyroidism, in which hypercalcemia may already have stimulated considerable CaR activity, we investigated the effect of cinacalcet HCl on PTH-cyclin D1 transgenic mice (PC2 mice), a model of primary hyperparathyroidism with hypo-expression of CaR on their parathyroid glands. A single administration of 30 mg/kg body weight (BW) of cinacalcet HCl significantly suppressed serum calcium (Ca) levels 2 h after administration in 65- to 85-week-old PC2 mice with chronic biochemical hyperparathyroidism. The percentage reduction in serum PTH was significantly correlated with CaR hypo-expression in the parathyroid glands. In older PC2 mice (93-99 weeks old) with advanced hyperparathyroidism, serum Ca and PTH levels were not suppressed by 30 mg cinacalcet HCl/kg. However, serum Ca and PTH levels were significantly suppressed by 100 mg/kg of cinacalcet HCl, suggesting that higher doses of this compound could overcome severe hyperparathyroidism. To conclude, cinacalcet HCl demonstrated potency in a murine model of primary hyperparathyroidism in spite of any presumed endogenous CaR activation by hypercalcemia and hypo-expression of CaR in the parathyroid glands.
authors.affiliation: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Kawata
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Imanishi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Takao
authors.initials: T
authors.lastname: Kenko
authors.forename: Michihito
authors.initials: M
authors.lastname: Wada
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Takami
authors.initials: T
authors.lastname: Miki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nagano
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.forename: Andrew
authors.initials: A
authors.lastname: Arnold
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D000375:Aging; D000818:Animals; D002118:Calcium / Q000037:antagonists & inhibitors / Q000097:blood; D000069449:Cinacalcet; D019940:Genes, bcl-1; D006961:Hyperparathyroidism / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D007150:Immunohistochemistry; D051379:Mice; D008822:Mice, Transgenic; D009281:Naphthalenes / Q000494:pharmacology*; D010280:Parathyroid Glands / Q000187:drug effects / Q000378:metabolism; D010281:Parathyroid Hormone / Q000037:antagonists & inhibitors* / Q000097:blood / Q000235:genetics / Q000378:metabolism; D044169:Receptors, Calcium-Sensing / Q000378:metabolism*
chemical_list: D009281:Naphthalenes; D010281:Parathyroid Hormone; D044169:Receptors, Calcium-Sensing; D002118:Calcium; D000069449:Cinacalcet