Hirsch P F, Imai Y, Hosoya Y, Ode H, Maeda S
Department of Pharmacology, School of Medicine, University of North Carolina, Chapel Hill 27599-7455, USA.
Endocrine. 1998 Feb;8(1):29-36. doi: 10.1385/ENDO:8:1:29.
The interaction among parathyroid hormone (PTH), calcitonin (CT), and glucocorticoids on blood calcium (Ca) was examined. Prior studies had shown that adrenalectomy (ADX) reduced the fall in blood calcium in rats after parathyroidectomy (PTX). Convincing evidence was provided showing that the ADX effect in PTX rats was due to the loss of corticosterone, the major glucocorticoid in rats; restoring physiological blood levels of corticosterone abolished the ADX effect in PTX rats. The initial attempt of the present study was to explain the failure of ADX or exogenous glucocorticoids to alter serum Ca levels in rats with intact thyroid and parathyroid glands or in thyroidectomized rats with functional parathyroid transplants (PTT). We found, as previously reported, that the 5-h level of serum Ca in rats with parathyroid glands was not affected by s.c. hydrocortisone (cortisol) or by ADX. It was also not affected by thyroparathyroidectomy (TPTX) or after both ADX and TPTX in rats with PTT. These results suggested to us that the glucocorticoid effect to lower serum was inhibited by endogenous parathyroid hormone (PTH) from the parathyroid gland and/or by normal levels of blood Ca. Both of these proposed mechanisms were examined and failed to explain the absence of the ADX effect as well as the glucocorticoid effect in normocalcemic parathyroid-intact rats, because an ADX effect was observed in TPTX rats given hypercalcemic doses of rat or bovine PTH 1-34 or calcitriol. Also, administered cortisol restricted the increased hypercalcemia induced by PTH in ADX-TPTX rats. Expanding on the results in TPTX rats with induced hypercalcemia, we found that neither the ADX effect nor the glucocorticoid effect occurred in thyroid-intact rats with or without functional PTT. These as well as previous results show that: 1. Glucocorticoids, like CT, restrict hypercalcemia in TPTX rats. 2. The ADX effect and its reversal by glucocorticoids in rats with induced hypercalcemia occur only in the absence of the thyroid gland (removal of CT). 3. Glucocorticoids, like CT, lower serum calcium during the hypocalcemia after PTX, an effect that occurs in the presence or absence of the thyroid gland. This study did not reveal why neither ADX nor exogenous glucocorticoids altered serum calcium levels in normocalcemic rats with either intact parathyroid glands or PTT. We conclude that under appropriate conditions, glucocorticoids act in a fashion similar to that of CT in restricting hypercalcemia and in lowering blood Ca.
研究了甲状旁腺激素(PTH)、降钙素(CT)和糖皮质激素对血钙(Ca)的相互作用。先前的研究表明,肾上腺切除术(ADX)可减少大鼠甲状旁腺切除术后(PTX)血钙的下降。有确凿证据表明,PTX大鼠的ADX效应是由于大鼠体内主要的糖皮质激素皮质酮的缺失;恢复皮质酮的生理血药浓度可消除PTX大鼠的ADX效应。本研究最初的尝试是解释ADX或外源性糖皮质激素未能改变甲状腺和甲状旁腺完整的大鼠或甲状旁腺功能移植(PTT)的甲状腺切除大鼠的血清钙水平的原因。我们发现,如先前报道的那样,有甲状旁腺的大鼠血清钙的5小时水平不受皮下注射氢化可的松(皮质醇)或ADX的影响。在有PTT的大鼠中,甲状腺甲状旁腺切除术(TPTX)或ADX和TPTX后,血清钙水平也不受影响。这些结果让我们认为,糖皮质激素降低血清钙的作用受到甲状旁腺分泌的内源性甲状旁腺激素(PTH)和/或正常血钙水平的抑制。我们对这两种提出的机制都进行了研究,但均未能解释正常血钙且甲状旁腺完整的大鼠中ADX效应以及糖皮质激素效应缺失的原因,因为在给予高钙剂量的大鼠或牛PTH 1-34或骨化三醇的TPTX大鼠中观察到了ADX效应。此外,给予皮质醇可限制ADX-TPTX大鼠中PTH诱导的高钙血症增加。基于TPTX大鼠诱导高钙血症的结果进行拓展,我们发现甲状腺完整且有或无功能性PTT的大鼠中既未出现ADX效应也未出现糖皮质激素效应。这些以及先前的结果表明:1. 糖皮质激素与CT一样,可限制TPTX大鼠的高钙血症。2. 在诱导高钙血症的大鼠中,ADX效应及其被糖皮质激素逆转的现象仅在无甲状腺(去除CT)的情况下发生。3. 糖皮质激素与CT一样,在PTX后的低钙血症期间可降低血清钙,这种作用在有或无甲状腺的情况下均会出现。本研究未揭示为何ADX和外源性糖皮质激素均未改变甲状旁腺完整或有PTT的正常血钙大鼠的血清钙水平。我们得出结论,在适当条件下,糖皮质激素的作用方式与CT类似,可限制高钙血症并降低血钙。