Paricalcitol and cinacalcet have disparate actions on parathyroid oxyphil cell content in patients with chronic kidney disease
| Autor: | Daniel W. Coyne, Eduardo Slatopolsky, Sijie Zheng, Cynthia S. Ritter, Diptesh Gupta, Alex J. Brown, Brent W. Miller |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Parathyroidectomy Paricalcitol medicine.medical_specialty Cinacalcet Calcimimetic medicine.medical_treatment 030232 urology & nephrology Urology Calcimimetic Agents Parathyroid Glands 03 medical and health sciences 0302 clinical medicine Calcitriol Internal medicine Humans Medicine Renal Insufficiency Chronic Vitamin D Uremia Oxyphil cell (parathyroid) Hyperparathyroidism Oxyphil Cells business.industry Middle Aged medicine.disease Endocrinology Nephrology Cinacalcet Hydrochloride 030220 oncology & carcinogenesis Cell Transdifferentiation Ergocalciferols Drug Therapy Combination Female Hyperparathyroidism Secondary Secondary hyperparathyroidism business Receptors Calcium-Sensing medicine.drug |
| Zdroj: | Kidney International. 92:1217-1222 |
| ISSN: | 0085-2538 |
| Popis: | The parathyroid oxyphil cell content increases in patients with chronic kidney disease (CKD), and even more in patients treated with the calcimimetic cinacalcet and/or calcitriol for hyperparathyroidism. Oxyphil cells have significantly more calcium-sensing receptors than chief cells, suggesting that the calcium-sensing receptor and calcimimetics are involved in the transdifferentiation of a chief cell to an oxyphil cell type. Here, we compared the effect of the vitamin D analog paricalcitol (a less calcemic analog of calcitriol) and/or cinacalcet on the oxyphil cell content in patients with CKD to further investigate the genesis of these cells. Parathyroid tissue from four normal individuals and 27 patients with CKD who underwent parathyroidectomy for secondary hyperparathyroidism were analyzed. Prior to parathyroidectomy, patients had received the following treatment: seven with no treatment, seven with cinacalcet only, eight with paricalcitol only, or cinacalcet plus paricalcitol in five. Oxyphilic areas of parathyroid tissue, reported as the mean percent of total tissue area per patient, were normal, 1.03; no treatment, 5.3; cinacalcet, 26.7 (significant vs. no treatment); paricalcitol, 6.9 (significant vs. cinacalcet; not significant vs. no treatment); and cinacalcet plus paricalcitol, 12.7. Cinacalcet treatment leads to a significant increase in parathyroid oxyphil cell content but paricalcitol does not, reinforcing a role for the calcium-sensing receptor activation in the transdifferentiation of chief-to-oxyphil cell type. Thus, two conventional treatments for hyperparathyroidism have disparate effects on parathyroid composition, and perhaps function. This finding is provocative and may be useful when evaluating future drugs for hyperparathyroidism. |
| Databáze: | OpenAIRE |
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