肾性甲状旁腺功能亢进患者甲状旁腺素钙敏感受体的表达
作者：王宁宁 王笑云 吴宏飞 胡建明 赵卫红 彭韬
单位：吴宏飞(210029 南京医科大学第一附属医院泌尿外科)；王宁宁 王笑云 胡建明 赵卫红(210029 南京医科大学第一附属医院肾内科)；彭韬(南京医科大学病理教研室)
关键词：肾性甲状旁腺功能亢进症；甲状旁腺；钙敏感受体
中华肾脏病杂志000508摘 要：目的研究肾性甲状旁腺功能亢进(甲旁亢)患者甲状旁腺组织钙敏感受体(CaR)的表达，探讨CaR在肾性甲旁亢发病机制中的作用。方法用免疫组织化学的方法，比较正常对照组和继发性甲旁亢(SHPT)组甲状旁腺CaR蛋白质的表达。结果CaR在正常甲状旁腺组织的细胞膜和细胞浆均有表达，细胞阳性率为(75.20±2.31)%，而SHPT组为(27.88±4.90)%，明显减少(P<0.01)。弥漫性增生和结节性增生之间差异也有显著性[分别为(40.00±3.34)%和(15.75±1.75)%，P<0.01]。CaR表达阳性率与腺体重量呈负相关(r＝0.86，P<0.01)。结论严重肾性甲旁亢患者甲状旁腺CaR表达明显下降，结节性增生比弥漫性增生下降更显著，是引起PTH过度分泌的重要原因。上调CaR的表达或激活CaR的功能将成为肾性甲旁亢新的治疗目标。
, http://www.100md.com
Depressed expression of calcium sensing receptor in parathyroid glands of uremic hyperparathyroidism
WANG Ningning ,WANG Xiaoyun ,WU Hongfei,et al.
(Department of Nephrology,First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,China)
Abstract：Objective To study the expression of calcium sensing receptor (CaR) protein in parathyroid tissue of uremic secondary hyperparathyroidism(SHPT).Methods The expressions of CaR in normal controls(n=5) and parathyroid glands,including five diffuse hyperplasia and five nodular hyperplasia obtained from uremic hyperparathyroidism patients(n=5) were examined by immunohistochemistry.Results The CaR protein expressed both in the cellular membrane and cytoplasm in normal parathyroid tissue.The CaR expression was significantly decreased in SHPT compared to that in normal controls [(27.88±4.90)% vs(75.20±2.31)%,P<0.01].The positive cell rate was lower in nodular hyperplasia than that in diffuse hyperplasia[ (15.75±1.75)% vs.(40±3.34)%,P<0.01].In diffuse hyperplasia,the immunostaining of cytoplasm diminished markedly whereas the membrane staining was still obvious in some cells.In nodular hyperplasia,the CaR expression was decreased in both cytoplasm and membrane.There was a negative correlation between the expression of CaR and the weight of gland(r=-0.86,P<0.01).Conclusion The CaR expression in parathyroid glands of uremic hyperparathyroidism is decreased,especially in nodular hyperplastic tissue.Decreased CaR expression would be compatible with a less efficient control of PTH secretion.The parathyroid calcium receptor will be a novel therapeutic target for treating uremic byperparathyroidism.
, 百拇医药
Keywords：Uremic hyperparathyroidism;Parathyroid;Calcium sensing receptor基金项目：江苏省科委中日友好国际合作项目(182DE9902)
参考文献：
[1]王笑云,周富华.肾性甲状旁腺功能亢进患者甲状旁腺细胞增生与凋亡,中华肾脏病杂志,1999; 15: 233-235.
[2]Brown EM,Gamba G,Riccardl D,et al.Chining and characterization of an extracellular Ca2+-sensing receptor from bovine parathyroid.Nature,1993,366:575-580.
[3]Brown EM.Physiology and pathophysiology of the extracellular calcium-sensing receptor.Am J Med,1999,106:238-253.
, http://www.100md.com
[4]王笑云,吴宠飞,胡建明,等.甲状旁全切加前臂移植术治疗继发性甲状旁腺功能亢进 中华医学杂志,1997, 77:873-874.
[5]Brown EM.Four-parameter model of the sigmoidal relationship between parathyroid hormone release and extracellular calcium concentration in normal and abnormal parathyroid tissue.J Clin Endocrinol Metabol,1983,56:572-581.
[6]Garrett JE,Capuano Ⅳ,Hammerland LG,et al.Molecular cloning and functional expression of human parathyroid calcium receptor cDNAs.J Biol Chem,1995,270:12919-12925.
, 百拇医药
[7]Gogusev J,Duchambon P,Hory B,et al.Depressed expression of calcium receptor in parathyroid gland tissue of patients with hyperparathyroidism.Kidney Int,1997,51:328-336.
[8]Kifor O,Moore FD,Wang P,et al.Reduced immunostaining for the extracellular Ca2+-sensing receptor in primary and uremic secondary hyperparathyroidism.J Clin Endocrinol Metabol,1996,81:1598-1606.
[9]Brown AJ,Ritter CS,Finch JL,et al.Decreased calcium-sensing receptor expression in hyperplastic parathyroid glands of uremic rats:role of dietary phosphate.Kidney Int,1999,55:1284-1292.
收稿日期：2000-02-17, 百拇医药
单位：吴宏飞(210029 南京医科大学第一附属医院泌尿外科)；王宁宁 王笑云 胡建明 赵卫红(210029 南京医科大学第一附属医院肾内科)；彭韬(南京医科大学病理教研室)
关键词：肾性甲状旁腺功能亢进症；甲状旁腺；钙敏感受体
中华肾脏病杂志000508摘 要：目的研究肾性甲状旁腺功能亢进(甲旁亢)患者甲状旁腺组织钙敏感受体(CaR)的表达，探讨CaR在肾性甲旁亢发病机制中的作用。方法用免疫组织化学的方法，比较正常对照组和继发性甲旁亢(SHPT)组甲状旁腺CaR蛋白质的表达。结果CaR在正常甲状旁腺组织的细胞膜和细胞浆均有表达，细胞阳性率为(75.20±2.31)%，而SHPT组为(27.88±4.90)%，明显减少(P<0.01)。弥漫性增生和结节性增生之间差异也有显著性[分别为(40.00±3.34)%和(15.75±1.75)%，P<0.01]。CaR表达阳性率与腺体重量呈负相关(r＝0.86，P<0.01)。结论严重肾性甲旁亢患者甲状旁腺CaR表达明显下降，结节性增生比弥漫性增生下降更显著，是引起PTH过度分泌的重要原因。上调CaR的表达或激活CaR的功能将成为肾性甲旁亢新的治疗目标。
, http://www.100md.com
Depressed expression of calcium sensing receptor in parathyroid glands of uremic hyperparathyroidism
WANG Ningning ,WANG Xiaoyun ,WU Hongfei,et al.
(Department of Nephrology,First Affiliated Hospital,Nanjing Medical University,Nanjing 210029,China)
Abstract：Objective To study the expression of calcium sensing receptor (CaR) protein in parathyroid tissue of uremic secondary hyperparathyroidism(SHPT).Methods The expressions of CaR in normal controls(n=5) and parathyroid glands,including five diffuse hyperplasia and five nodular hyperplasia obtained from uremic hyperparathyroidism patients(n=5) were examined by immunohistochemistry.Results The CaR protein expressed both in the cellular membrane and cytoplasm in normal parathyroid tissue.The CaR expression was significantly decreased in SHPT compared to that in normal controls [(27.88±4.90)% vs(75.20±2.31)%,P<0.01].The positive cell rate was lower in nodular hyperplasia than that in diffuse hyperplasia[ (15.75±1.75)% vs.(40±3.34)%,P<0.01].In diffuse hyperplasia,the immunostaining of cytoplasm diminished markedly whereas the membrane staining was still obvious in some cells.In nodular hyperplasia,the CaR expression was decreased in both cytoplasm and membrane.There was a negative correlation between the expression of CaR and the weight of gland(r=-0.86,P<0.01).Conclusion The CaR expression in parathyroid glands of uremic hyperparathyroidism is decreased,especially in nodular hyperplastic tissue.Decreased CaR expression would be compatible with a less efficient control of PTH secretion.The parathyroid calcium receptor will be a novel therapeutic target for treating uremic byperparathyroidism.
, 百拇医药
Keywords：Uremic hyperparathyroidism;Parathyroid;Calcium sensing receptor基金项目：江苏省科委中日友好国际合作项目(182DE9902)
参考文献：
[1]王笑云,周富华.肾性甲状旁腺功能亢进患者甲状旁腺细胞增生与凋亡,中华肾脏病杂志,1999; 15: 233-235.
[2]Brown EM,Gamba G,Riccardl D,et al.Chining and characterization of an extracellular Ca2+-sensing receptor from bovine parathyroid.Nature,1993,366:575-580.
[3]Brown EM.Physiology and pathophysiology of the extracellular calcium-sensing receptor.Am J Med,1999,106:238-253.
, http://www.100md.com
[4]王笑云,吴宠飞,胡建明,等.甲状旁全切加前臂移植术治疗继发性甲状旁腺功能亢进 中华医学杂志,1997, 77:873-874.
[5]Brown EM.Four-parameter model of the sigmoidal relationship between parathyroid hormone release and extracellular calcium concentration in normal and abnormal parathyroid tissue.J Clin Endocrinol Metabol,1983,56:572-581.
[6]Garrett JE,Capuano Ⅳ,Hammerland LG,et al.Molecular cloning and functional expression of human parathyroid calcium receptor cDNAs.J Biol Chem,1995,270:12919-12925.
, 百拇医药
[7]Gogusev J,Duchambon P,Hory B,et al.Depressed expression of calcium receptor in parathyroid gland tissue of patients with hyperparathyroidism.Kidney Int,1997,51:328-336.
[8]Kifor O,Moore FD,Wang P,et al.Reduced immunostaining for the extracellular Ca2+-sensing receptor in primary and uremic secondary hyperparathyroidism.J Clin Endocrinol Metabol,1996,81:1598-1606.
[9]Brown AJ,Ritter CS,Finch JL,et al.Decreased calcium-sensing receptor expression in hyperplastic parathyroid glands of uremic rats:role of dietary phosphate.Kidney Int,1999,55:1284-1292.
收稿日期：2000-02-17, 百拇医药