Cinacalcet Upregulates Calcium-Sensing Receptors of Parathyroid Glands in Hemodialysis Patients
| Autor: | Kenmei Takaichi, Kiho Tanaka, Yoshifumi Ubara, Shinji Tomikawa, Michio Nakamura, Yuji Marui, Keiichi Sumida, Naoko Inoshita, Kenichi Ohashi |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Cinacalcet Calcimimetic chemistry.chemical_element Naphthalenes Calcium Parathyroid Glands Renal Dialysis Internal medicine Humans Medicine Receptor business.industry Middle Aged medicine.disease Up-Regulation Endocrinology medicine.anatomical_structure chemistry Nephrology Cinacalcet Hydrochloride Kidney Failure Chronic Female Hyperparathyroidism Secondary Parathyroid gland Secondary hyperparathyroidism Calcium-sensing receptor business Receptors Calcium-Sensing medicine.drug |
| Zdroj: | American Journal of Nephrology. 37:405-412 |
| ISSN: | 1421-9670 0250-8095 |
| Popis: | Background: Cinacalcet hydrochloride (cinacalcet), a calcimimetic, has been shown to upregulate calcium-sensing receptor (CaSR) expression in parathyroid glands of rats with chronic renal insufficiency. However, the effect of cinacalcet on the reduced CaSR expression in human parathyroid glands remains to be elucidated. Methods: Four normal parathyroid glands and 71 hyperplastic parathyroid glands from 18 hemodialysis patients with refractory secondary hyperparathyroidism (SHPT) treated with (n = 10; cinacalcet group) or without (n = 8; conventional group) cinacalcet were examined immunohistochemically with a specific antibody against CaSR. The expression level of CaSR was analyzed semiquantitatively. Results: Compared with normal glands, the immunohistochemical expression of CaSR was decreased significantly in both the cinacalcet and conventional groups. In the cinacalcet group, the expression of CaSR was increased significantly compared with that in the conventional group (1.83 ± 0.14 vs. 0.87 ± 0.15, p < 0.001), even though the proportion of patients using vitamin D sterols and the mean administered dose of calcitriol equivalents were not significantly different between the two groups. The expression of CaSR was significantly decreased in the larger glands (>500 mg) compared with that in the smaller glands (Conclusions: Our results indicate that cinacalcet upregulates the depressed expression of CaSR in hemodialysis patients with SHPT, and that insufficient expression of CaSR, especially in larger glands with advanced nodular hyperplasia, underlies the pathogenesis of SHPT in patients who are resistant to cinacalcet. |
| Databáze: | OpenAIRE |
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