Care A D, Caple I W, Abbas S K, Pickard D W
Placenta. 1986 Sep-Oct;7(5):417-24. doi: 10.1016/s0143-4004(86)80029-7.
The ovine fetal placenta has been perfused with autologous fetal blood under controlled conditions in eleven experiments in which the fetus was first removed. Eight of these experiments involved four pairs of twins, one lamb of which had been thyroparathyroidectomized (TXPTX) three to seven days earlier. By this time the normal placental calcium gradient from mother to fetus had either decreased or been reversed. The mean rate of transport of calcium from the mother was unchanged by previous fetal TXPTX, but the final calcium gradient achieved from the mother to the perfusing blood was significantly less than with placentae from intact fetuses. No significant alteration in fetal plasma I,25-dihydroxyvitamin D (I,25(OH)2D) concentration was observed as a result of the fetal TXPTX, indicating that hypocalcaemia can compensate for the lack of PTH in fetal production of I,25(OH)2D. Fetal thyroidectomy with replacement of thyroxine did not lead to reversal of the placental calcium gradient, indicating that calcitonin was not involved. It is suggested that in the ovine fetus, parathyroid hormone promotes the active transport of calcium from mother to fetus, so that in its absence the fetus must obtain its calcium for growth by reducing its calcaemia and thereby allow net diffusion of calcium to replace the action of the placental calcium pump. The price paid for this compensation is marked hypocalcaemia and defective calcification of osteoid.
在11个实验中,首先取出胎儿,然后在可控条件下用自体胎儿血液灌注绵羊胎儿胎盘。其中8个实验涉及4对双胞胎,每对双胞胎中的一只羔羊在3至7天前进行了甲状旁腺甲状腺切除术(TXPTX)。此时,从母体到胎儿的正常胎盘钙梯度已经降低或反转。先前的胎儿TXPTX并未改变母体钙的平均转运速率,但从母体到灌注血液所达到的最终钙梯度明显低于完整胎儿的胎盘。未观察到胎儿TXPTX导致胎儿血浆1,25-二羟维生素D(1,25(OH)2D)浓度有显著变化,这表明低钙血症可以补偿胎儿产生1,25(OH)2D时甲状旁腺激素的缺乏。胎儿甲状腺切除术并补充甲状腺素并未导致胎盘钙梯度反转,这表明降钙素未参与其中。研究表明,在绵羊胎儿中,甲状旁腺激素促进钙从母体到胎儿的主动转运,因此在缺乏甲状旁腺激素的情况下,胎儿必须通过降低血钙来获取生长所需的钙,从而使钙的净扩散来替代胎盘钙泵的作用。这种补偿所付出的代价是明显的低钙血症和类骨质钙化缺陷。