Shai F, Baker R K, Wallach S
J Clin Invest. 1971 Sep;50(9):1927-40. doi: 10.1172/JCI106685.
The clinical and metabolic effects of porcine calcitonin were assessed in six patients with Paget's disease and two patients with osteoporosis under metabolic balance conditions. The administration of calcitonin for 4-17 wk resulted in an amelioration of the clinical phenomena associated with Paget's disease, including bone pain, increased skeletal vascularity, congestive heart failure, and neurologic deficits secondary to skeletal impingement. The major metabolic effects of calcitonin in Paget's disease included the induction of positive calcium balance of +50 to +240 mg/day, reduction in hyperphosphatasia and hydroxyprolinuria of 15 to 60%, and a deceleration of radiocalcium turnover by 12 to 46%. Natriuresis, phosphaturia, and reduced urinary calcium excretion were observed, whereas sustained hypocalcemia and hypophosphatemia did not occur. The administration of porcine calcitonin was not associated with adverse objective or subjective reactions, toxic effects, or allergic phenomena. There was no evidence of antibody formation or loss of therapeutic potency. Although the response of individual patients with Paget's disease varied widely, the data indicate that calcitonin, presumably through its skeletal anti-resorptive action, is able to reduce skeletal turnover and volume in Paget's disease, and thereby improve the associated clinical and metabolic abnormalities. Long term therapeutic studies in progress suggest that prolonged periods of control of the generalized condition may be feasible. In osteoporosis, neither clinical improvement nor consistent metabolic changes indicative of amelioration of the skeletal disease were observed.
在代谢平衡条件下，对6例佩吉特病患者和2例骨质疏松症患者评估了猪降钙素的临床和代谢效应。给予降钙素4 - 17周可改善与佩吉特病相关的临床症状，包括骨痛、骨骼血管增多、充血性心力衰竭以及骨骼压迫继发的神经功能缺损。降钙素对佩吉特病的主要代谢效应包括诱导每日钙平衡正向增加50至240毫克、血磷酸酯酶过多症和羟脯氨酸尿症降低15%至60%，以及放射性钙周转率减慢12%至46%。观察到利钠、利磷以及尿钙排泄减少，但未出现持续性低钙血症和低磷血症。给予猪降钙素未出现不良客观或主观反应、毒性作用或过敏现象。没有证据表明有抗体形成或治疗效力丧失。尽管佩吉特病个体患者的反应差异很大，但数据表明降钙素可能通过其骨骼抗吸收作用，能够降低佩吉特病患者的骨骼更新率和骨骼体积，从而改善相关的临床和代谢异常。正在进行的长期治疗研究表明，长期控制全身性疾病可能是可行的。在骨质疏松症患者中，未观察到临床改善或表明骨骼疾病改善的一致代谢变化。
