Percutaneous maxacalcitol injection therapy regresses hyperplasia of parathyroid and induces apoptosis in uremia
| Autor: | Kazuhiro Shiizaki, Tadao Akizawa, Shigeo Negi, Ikuji Hatamura, Nobuhiko Narukawa, Akira Ooshima, Masahide Mizobuchi, Toshifumi Sakaguchi |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Parathyroid hormone DNA fragmentation Apoptosis Injections Intralesional Administration Cutaneous Parathyroid Glands Calcitriol secondary hyperparathyroidism Internal medicine Biopsy interventional ultrasonography medicine Humans RNA Messenger Aged Uremia TUNEL assay Hyperplasia medicine.diagnostic_test business.industry Reverse Transcriptase Polymerase Chain Reaction vitamin D analogue in vivo effects Parathyroid chief cell Middle Aged medicine.disease Endocrinology medicine.anatomical_structure end-stage renal disease (ESRD) Nephrology Parathyroid Hormone Secondary hyperparathyroidism Parathyroid gland Female Hyperparathyroidism Secondary business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Kidney international. 64(3) |
| ISSN: | 0085-2538 |
| Popis: | Percutaneous maxacalcitol injection therapy regresses hyperplasia of parathyroid and induces apoptosis in uremia. Background A high level of parathyroid hormone (PTH) is considered to be an indicator of poor prognosis and a poor quality of life of dialysis patients; therefore, an effective and safe therapy for secondary hyperparathyroidism (SHPT) has been developed. Methods In 20 patients with SHPT resistant to maxacalcitol (OCT) intravenously administered, all detectably enlarged parathyroid glands were treated by percutaneous maxacalcitol injection therapy (PMIT) under ultrasonographic guidance consecutively 6 times, which was followed by OCT that was intravenously administered. The clinical effects of PMIT were evaluated based on the changes in the serum intact-PTH, adjusted Ca, phosphorus, and bone marker levels, and the parathyroid gland volume determined by ultrasonography. Morphologic examination, apoptosis analysis, and PTH mRNA expression level determination by reverse transcription-polymerase chain reaction (RT-PCR) using parathyroid tissues obtained by a biopsy technique were performed. Results PMIT and subsequent intravenous OCT administrations significantly decreased the serum intact-PTH level and parathyroid gland volume for at least 12weeks after PMIT without major complications. Parathyroid tissues obtained after PMIT exhibited some partial defects of parathyroid cells, a marked increase in the number of the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL)–positive cells, the ladder formation determined by DNA electrophoresis, and the decrease in the PTH mRNA expression level. Conclusion PMIT is effective and safe for the treatment of refractory SHPT, and a locally high level of OCT suppresses PTH secretion and regresses parathyroid hyperplasia, which is involved in the induction of apoptosis of parathyroid cells. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|