[The mechanisms of parathyroid hyperplasia and its regression].
Parathyroid gland (PTG) is a unique endocrine organ in which the quiescent glandular cells begin to proliferate in the progressive course of renal failure, leading to secondary hypereparathyroidism (SHPT). SHPT is characterized by continuous over-secretion of parathyroid hormone (PTH) and parathyroid hyperplasia, and the major contributing factors are a deficiency of active vitamin D, hypocalcemia and phosphate retention. Many experimental and human studies have revealed that the down-regulations of vitamin D receptor (VDR), calcium (Ca) -sensing receptor (CaSR), and retinoid X receptor (RXR) in parathyroid hyperplasia of SHPT, especially nodular hyperplasia, which is a severe form of hyperplasia. These also contribute to progression of parathyroid hyperplasia. Recently, mechanisms by which active vitamin D and Ca regulate parathyroid hyperplasia via their receptors have been clarified. In this paper, we review mechanisms for progression of parathyroid hyperplasia and the possibility for regression of parathyroid hyperplasia.
Tokumoto
Masanori
M
Washington University School of Medicine, Department of Internal Medicine, Renal Division, USA.
Taniguchi
Masatomo
M
D000818:Animals; D002118:Calcium / Q000378:metabolism; D006801:Humans; D006965:Hyperplasia; D010280:Parathyroid Glands / Q000473:pathology*; D014807:Vitamin D / Q000378:metabolism
D014807:Vitamin D; D002118:Calcium