Audran M, Alix E, Jallet P, Renier J C
Rev Rhum Mal Osteoartic. 1982 Jul-Sep;49(8-9):599-608.
The authors propose to study parathyroid hormone receptors in humans by means of a test "inspired by the Ellsworth-Howard test" using the active synthetic 1-34 fragment of the hormone PTH-1-34. The use of this test in 44 patients (29 healthy subjects, 7 patients with idiopathic hypercalciuria 5 cases of Paget's disease, 1 patient with idiopathic hypoparathyroidism, 2 cases of basal cell nevus syndrome) who received different doses of this substance intravenously, revealed a marked dose-dependent stimulation of adenyl-cyclase as objectified by an increase in urinary excretion of cyclic AMP (AMPcU). Distal tubular calcium reabsorption was also significantly affected as demonstrated by a decrease in urinary calcium in the first hours following administration of the 1-34 fragment even in the case of idiopathic hypercalciuria. In comparison to the "classical" Ellsworth-Howard test, however, no significant urinary phosphate response was observed during the present test. Similarly, urinary hydroxyproline and phosphate and calcium blood levels remained stable. As the results obtained for the case of hypoparathyroidism demonstrate, this easily performed test is useful for valuating parathormone receptors in kidney by means of two sensitive parameters (AMPcU and the ratio of fractional urinary calcium to urinary creatinine). In addition to its action, synthetic fragment h PTH-1-34 offers the advantage of being totally innocuous.
作者提议通过一项“受埃尔斯沃思 - 霍华德试验启发”的测试来研究人类甲状旁腺激素受体，该测试使用激素PTH - 1 - 34的活性合成1 - 34片段。在44名患者（29名健康受试者、7名特发性高钙尿症患者、5例佩吉特病患者、1例特发性甲状旁腺功能减退患者、2例基底细胞痣综合征患者）中静脉注射不同剂量的该物质后进行此项测试，结果显示，尿中环磷酸腺苷（AMPcU）排泄增加，表明腺苷酸环化酶受到显著的剂量依赖性刺激。即使在特发性高钙尿症患者中，注射1 - 34片段后的最初几个小时内尿钙减少，也表明远端肾小管钙重吸收也受到显著影响。然而，与“经典的”埃尔斯沃思 - 霍华德试验相比，此次测试中未观察到明显的尿磷酸盐反应。同样，尿羟脯氨酸、磷酸盐以及血钙水平保持稳定。甲状旁腺功能减退患者的测试结果表明，这项易于操作的测试通过两个敏感参数（AMPcU以及尿钙分数与尿肌酐的比值）来评估肾脏中的甲状旁腺激素受体是有用的。除了其作用外，合成片段h PTH - 1 - 34还具有完全无害的优点。
