Durán C E, Torregrosa J V, Canalejo A, Almadén Y, Campistol J M, Rodríguez Portillo M
Unidad de Trasplante Renal, Hospital Clínic, Barcelona.
Nefrologia. 2010;30(4):413-9. doi: 10.3265/Nefrologia.pre2010.Apr.10302.
To compare the dynamics of calcium-regulated PTH secretion in vitro from adenomatous versus hyperplastic glands and to investigate the relationship between the parathyroid cell cycle and the calcium-regulated PTH secretion in these glands.
A total of 31 parathyroid glands (8 adenomatous and 23 hyperplastic) from 8 patients with primary hyperparathyroidism and 7 with secondary hyperparathyroidism respectively were studied. For the evaluation of calcium-regulated PTH secretion, small parathyroid pieces of 1 mm were sequentially transferred to wells with varying Ca concentrations: 0.4, 0.6, 0.8, 1, 1.25 and 1.35 or 1.5 mM. PTH concentrations were determined in the medium. For the parathyroid cell cycle studies, parathyroid cells were isolated without the use of enzymes and cell cycle was analyzed using the method described by Vindelov. The nuclei were acquired by flow cytometer and analyzed using the CELLFIT software.
In parathyroid tissues from hyperplastic glands, the increase in extracellular calcium produced a decrease in PTH secretion which was apparent with a calcium level as low as 0.8 mM and the maximal inhibition of PTH secretion was obtained with a calcium of 1.25 mM, by the contrary, adenomatous glands required a calcium of 1.2 mM to produce a minimal decrease in PTH secretion. In hyperplastic parathyroid glands but not in parathyroid adenomas there was a significant correlation between the percentage of cells in G0/G1 phase with the set point (r = 0.914; P < 0.005) and the basal serum Ca (r = 0.862; P < 0.02).
The control of the extracellular calcium-PTH release in vitro is less sensitive in parathyroid adenomas than hyperplasic parathyroid glands. In parathyroid hyperplasia the cell proliferation may be regulated by the extracellular calcium concentration (higher calcemia less proliferation).
比较腺瘤性与增生性甲状旁腺体外钙调节甲状旁腺激素(PTH)分泌的动态变化,并研究这些腺体中甲状旁腺细胞周期与钙调节PTH分泌之间的关系。
分别对8例原发性甲状旁腺功能亢进患者的31个甲状旁腺(8个腺瘤性和23个增生性)以及7例继发性甲状旁腺功能亢进患者的甲状旁腺进行研究。为评估钙调节的PTH分泌,将1mm的小甲状旁腺组织依次转移至钙浓度不同的孔中:0.4、0.6、0.8、1、1.25以及1.35或1.5mM。测定培养基中的PTH浓度。对于甲状旁腺细胞周期研究,不使用酶分离甲状旁腺细胞,并使用Vindelov描述的方法分析细胞周期。通过流式细胞仪获取细胞核并使用CELLFIT软件进行分析。
在增生性腺体的甲状旁腺组织中,细胞外钙的增加导致PTH分泌减少,在钙水平低至0.8mM时就很明显,而在钙浓度为1.25mM时PTH分泌受到最大抑制;相反,腺瘤性腺体需要钙浓度达到1.2mM才能使PTH分泌有最小程度的减少。在增生性甲状旁腺而非甲状旁腺腺瘤中,G0/G1期细胞百分比与设定点(r = 0.914;P < 0.005)以及基础血清钙(r = 0.862;P < 0.02)之间存在显著相关性。
体外甲状旁腺腺瘤中细胞外钙 - PTH释放的控制比增生性甲状旁腺腺体更不敏感。在甲状旁腺增生中,细胞增殖可能受细胞外钙浓度调节(血钙越高,增殖越少)。