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Parathyroid Hormone

- Discussion:
    - parathyroid hormone is 84 aa petide made & secreted from chief cells in 4 parathyroid glands; 
    - parathyroid hormone (PTH) has been approved as an anabolic treatment for osteoporosis;
    - all actions of PTH are either directly or indirectly involved w/ maintaining serum ionic Ca concetration (see Ca hemostatsis);
    - it stimulates the differentiation of osteoclastic progenitor cells and effects bone resorption thru stimulation of osteoclasts (thru  indirect mechanisms - not
            direct receptor mediation);
    - enhances synthesis of 1,25-dihydroxyvitamin D, (increase GI absorption of Ca & renal reabsorption of calcium);
    - over secretion may cause hypercalcemia and hyperparathyroidism;
    - specific effects:
            - bone:
                    - indirectly increases the number of osteoclasts
                    - osteoblast-mediated new bone formation are enhanced in response to intermittent PTH treatment;
                    - increase the efflux of calcium and phosphorous from bone;
            - gut: indirectly increase the intestinal Ca absorption (thru vit D);
            - kidney:
                    - increases tubular reabsorption of Ca from kidney (increases c-AMP in proximal tubule);
                    - decreases in tubular reabsorption of phosphate which leads to significant phosphaturia (resulting in borderline hypophosphatemia);
                            - note that normal phosphorous reabsorption is about 85% 

Humoral hypercalcemia of cancer: identification of a novel parathyroid hormone-like peptide.

Parathyroid hormone: chemistry, biosynthesis, and mode of action.                                           

The Effects of Parathyroid Hormone and Alendronate Alone or in Combination in Postmenopausal Osteoporosis

The Effects of Parathyroid Hormone, Alendronate, or Both in Men with Osteoporosis

Combination of local and systemic parathyroid hormone enhances bone regeneration.

Parathyroid hormone--a drug for orthopedic surgery?

One Year of Alendronate after One Year of Parathyroid Hormone (1–84) for Osteoporosis.

Daily and Cyclic Parathyroid Hormone in Women Receiving Alendronate.

The combined effect of parathyroid hormone and bone graft on implant fixation

Parathyroid Hormone 1-84 Accelerates Fracture-Healing in Pubic Bones of Elderly Osteoporotic Women