Bover Jordi, Trinidad Pedro, Jara Aquiles, Soler-Majoral Jordi, Martín-Malo Alejandro, Torres Armando, Frazão João, Ureña Pablo, Dusso Adriana, Arana Carolt, Graterol Fredzzia, Romero-González Gregorio, Troya Maribel, Samaniego Diana, D'Marco Luis, Valdivielso José Manuel, Fernández Elvira, Arenas María Dolores, Torregrosa Vicente, Navarro-González Juan F, Lloret María Jesús, Ballarín J A, Bosch Ricardo J, Górriz José L, de Francisco Agl, Gutiérrez Orlando, Ara Jordi, Felsenfeld Arnold, Canalejo Antonio, Almadén Yolanda
Servicio de Nefrología, Hospital Universitario Germans Trias i Pujol, RICORS, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain.
Departamento de Nefrología, HECMN siglo XXI, IMSS, Ciudad de México, México.
Nefrologia (Engl Ed). 2022 Nov-Dec;42(6):645-655. doi: 10.1016/j.nefroe.2023.02.008. Epub 2023 Mar 14.
Although phosphorus is an essential element for life, it is not found in nature in its native state but rather combined in the form of inorganic phosphates (PO), with tightly regulated plasma levels that are associated with deleterious effects and mortality when these are out of bounds. The growing interest in the accumulation of PO in human pathophysiology originated in its attributed role in the pathogenesis of secondary hyperparathyroidism (SHPT) in chronic kidney disease. In this article, we review the mechanisms by which this effect was justified and we commemorate the important contribution of a Spanish group led by Dr. M. Rodríguez, just 25 years ago, when they first demonstrated the direct effect of PO on the regulation of the synthesis and secretion of parathyroid hormone by maintaining the structural integrity of the parathyroid glands in their original experimental model. In addition to demonstrating the importance of arachidonic acid (AA) and the phospholipase A2-AA pathway as a mediator of parathyroid gland response, these findings were predecessors of the recent description of the important role of PO on the activity of the calcium sensor-receptor, and also fueled various lines of research on the importance of PO overload not only for the pathophysiology of SHPT but also in its systemic pathogenic role.
尽管磷是生命必需元素,但在自然界中它并非以单质状态存在,而是以无机磷酸盐(PO)的形式结合,其血浆水平受到严格调控,当超出界限时会产生有害影响并导致死亡。人们对PO在人类病理生理学中的蓄积越来越感兴趣,这源于其在慢性肾脏病继发性甲状旁腺功能亢进(SHPT)发病机制中所起的作用。在本文中,我们回顾了这种作用被证实的机制,并纪念了25年前由M. Rodríguez博士领导的一个西班牙团队所做出的重要贡献,当时他们在最初的实验模型中首次证明了PO通过维持甲状旁腺的结构完整性对甲状旁腺激素合成和分泌调节的直接作用。除了证明花生四烯酸(AA)和磷脂酶A2-AA途径作为甲状旁腺反应介质的重要性外,这些发现还是近期关于PO对钙敏感受体活性重要作用描述的先驱,也推动了关于PO过载不仅对SHPT病理生理学而且对其全身致病作用重要性的各种研究方向。