title: Involvement of α-klotho, fibroblast growth factor-, vitamin-D- and calcium-sensing receptor in 53 patients with primary hyperparathyroidism.
abstract: The presentation of patients with primary hyperparathyroidism is often atypical and ranges from normocalcemic, primary hyperparathyroidism to severe, symptomatic hypercalcemia. G-protein-coupled, calcium-sensing receptor (CaSR), vitamin D receptor (VDR), and fibroblast growth factor receptor (FGFR)/klotho complexes seem to be involved in the development of pHPT. Parathyroid glands from 53 patients with pHPT and normal parathyroid tissue from 7 patients were obtained during parathyroidectomy. Conventional detailed morphological and immunohistochemical analyses of parathyroid glands were performed after dividing each slide in a 3 × 3 array. From morphology, the number of lipocytes was significantly lower in parathyroid tissue glands in the pHPT group (p < 0.001). Protein expressions of klotho, CaSR, and VDR were significantly reduced in the pHPT compared with the control group (p = 0.004, p = 0.007, p < 0.001). No differences were seen between the two groups (p = 0.35) regarding expression of FGFR. Correlations between expression showed significant positively correlations between klotho and CaSR and FGFR and VDR. No correlations between klotho expression and serum calcium levels could be detected (R = -0.13, p = 0.66), but there were positive correlations between expressions of CaSR/serum phosphate and klotho/serum phosphate. Impaired protein expression of CaSR and VDR seem to be involved in the development of pHPT. The role of the FGFR/klotho-axis remains still unclear. Correlations between protein expression of CaSR and serum phosphate and klotho and serum phosphate levels could be detected. Whether these findings give new insights into the pathogenesis of the disease is yet unknown and has to be elucidated.
authors: Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Auerbachstrasse 110, 70376, Stuttgart, Germany. Joerg.latus@googlemail.com
authors: Joerg
authors: J
authors: Latus
authors: Renate
authors: R
authors: Lehmann
authors: Meike
authors: M
authors: Roesel
authors: Peter
authors: P
authors: Fritz
authors: Niko
authors: N
authors: Braun
authors: Christoph
authors: C
authors: Ulmer
authors: Wolfgang
authors: W
authors: Steurer
authors: Dagmar
authors: D
authors: Biegger
authors: German
authors: G
authors: Ott
authors: Juergen
authors: J
authors: Dippon
authors: M Dominik
authors: MD
authors: Alscher
authors: Martin
authors: M
authors: Kimmel
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005346:Fibroblast Growth Factors / Q000502:physiology; D005966:Glucuronidase / Q000502:physiology*; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000209:etiology* / Q000378:metabolism*; D007150:Immunohistochemistry; D000090265:Klotho Proteins; D008297:Male; D008875:Middle Aged; D018167:Receptors, Calcitriol / Q000502:physiology*; D044169:Receptors, Calcium-Sensing / Q000502:physiology*; D017468:Receptors, Fibroblast Growth Factor / Q000502:physiology*
chemical_list: D018167:Receptors, Calcitriol; D044169:Receptors, Calcium-Sensing; D017468:Receptors, Fibroblast Growth Factor; D005346:Fibroblast Growth Factors; D005966:Glucuronidase; D000090265:Klotho Proteins