Osaka City University Graduate School of Medicine, Metabolism, Endocrinology and Molecular Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545 8585, Japan +81 6 6645 3806 ; +81 6 6645 3808 ;
Expert Opin Drug Discov. 2009 Jul;4(7):727-40. doi: 10.1517/17460440903022743.
Disorders of mineral and bone metabolism have been implicated as a risk factor in the high mortality in patients with chronic kidney disease (CKD). Hyperphosphatemia, disorders of vitamin D metabolism and secondary hyperparathyroidism of uremia (SHPT) are therapeutic targets in these patients to improve the mortality. Animal models for CKD are indispensable and uremic rats produced by 5/6-nephrectomies are one of the most useful animal models for the development of new therapeutic agents. As there are limitations of uremic rats such as short lifespan and less severity of secondary hyperparathyroidism distinct from CKD patients on maintenance hemodialysis, the development of new model animals is expected.
This review discusses the molecular pathogenesis of hyperfunctioning parathyroid diseases and the applications of animal models exhibiting hyperparathyroidisms in the aspect of the development of new therapeutics.
PTH-cyclin D1 transgenic mice, with parathyroid-targeted overexpression of cyclin D1 oncogene, not only developed abnormal parathyroid cell proliferation but, notably, also developed biochemical hyperparathyroidism with characteristic abnormalities in bone. The mice exhibit age-dependent development of biochemical hyperparathyroidism, which enables testing of the drug precisely. In addition, the mice develop parathyroid cell hyperplasia, followed by monoclonal expansion, which is observed in refractory SHPT patients.
矿物质和骨代谢紊乱被认为是慢性肾脏病(CKD)患者高死亡率的一个危险因素。高磷血症、维生素 D 代谢紊乱和尿毒症继发性甲状旁腺功能亢进(SHPT)是这些患者的治疗靶点,以改善死亡率。CKD 的动物模型是不可或缺的,5/6 肾切除术产生的尿毒症大鼠是开发新治疗药物最有用的动物模型之一。由于尿毒症大鼠的寿命有限,且继发性甲状旁腺功能亢进的严重程度不如维持性血液透析的 CKD 患者,因此需要开发新的模型动物。
本综述讨论了甲状旁腺功能亢进疾病的分子发病机制以及表现出甲状旁腺功能亢进的动物模型在开发新疗法方面的应用。
甲状旁腺靶向过表达细胞周期蛋白 D1 癌基因的 PTH-cyclin D1 转基因小鼠不仅发生异常甲状旁腺细胞增殖,而且还发生了生化性甲状旁腺功能亢进,表现为骨骼的特征性异常。这些小鼠表现出年龄依赖性的生化性甲状旁腺功能亢进的发展,这使得药物测试能够精确进行。此外,这些小鼠还发生了甲状旁腺细胞增生,随后是克隆性扩张,这在难治性 SHPT 患者中观察到。