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Immunoheterogeneity of parathyroid hormone pre- and postoperatively in primary hyperparathyroidism

Bergenfelz, A LU ; Valdermarsson, S and Ahrén, B LU (1995) In Deutsche Zeitschrift für Chirurgie 380(2). p.24-119
Abstract

In primary hyperparathyroidism (pHPT), a preferential release of intact PTH (i-PTH) versus carboxylterminal PTH fragments is known to occur. We studied whether the release of amino-terminal PTH fragments (N-PTH) is also changed. Serum levels of i-PTH and N-PTH were determined under basal conditions and following oral intake of calcium in six patients with pHPT before and immediately after surgery and in seven healthy subjects. In the patients, baseline levels of both i-PTH and N-PTH were increased preoperatively. The increase was larger in i-PTH compared to N-PTH. Therefore, the N/i ratio was reduced compared to healthy subjects (P < 0.05). On the first postoperative day, serum i-PTH decreased to a larger extent than N-PTH, which... (More)

In primary hyperparathyroidism (pHPT), a preferential release of intact PTH (i-PTH) versus carboxylterminal PTH fragments is known to occur. We studied whether the release of amino-terminal PTH fragments (N-PTH) is also changed. Serum levels of i-PTH and N-PTH were determined under basal conditions and following oral intake of calcium in six patients with pHPT before and immediately after surgery and in seven healthy subjects. In the patients, baseline levels of both i-PTH and N-PTH were increased preoperatively. The increase was larger in i-PTH compared to N-PTH. Therefore, the N/i ratio was reduced compared to healthy subjects (P < 0.05). On the first postoperative day, serum i-PTH decreased to a larger extent than N-PTH, which increased the N/i ratio above that in healthy subjects (P < 0.05). On the 5th postoperative day, the N/i ratio was normalized. Preoperatively, the suppressibility of i-PTH calcium was impaired in the patients (P < 0.05), whereas the suppressibility of N-PTH was normal, resulting in unchanged N/i ratio during the oral calcium load. In contrast, the N/i ratio increased normally during the calcium load at day 5 postoperatively (P < 0.05). We therefore conclude that: (1) in pHPT, circulating PTH immunoheterogeneity is altered with a preferential release of intact PTH compared to N-terminal PTH fragments and this alteration is normalized after surgery, (2) the secretion of intact PTH and N-terminal PTH shows different sensitivity to inhibition by calcium.

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keywords
Adenoma, Adult, Calcium, Female, Humans, Hyperparathyroidism, Immunoradiometric Assay, Male, Middle Aged, Parathyroid Hormone, Parathyroid Neoplasms, Parathyroidectomy, Peptide Fragments, Postoperative Complications, Reference Values, Journal Article, Research Support, Non-U.S. Gov't
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Deutsche Zeitschrift für Chirurgie
volume
380
issue
2
pages
6 pages
publisher
Springer
external identifiers
  • scopus:0028947366
ISSN
0023-8236
language
English
LU publication?
yes
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7a510271-6dcd-4c0a-ae23-6d53802a950b
date added to LUP
2017-05-10 17:42:05
date last changed
2017-09-08 15:48:27
@article{7a510271-6dcd-4c0a-ae23-6d53802a950b,
  abstract     = {<p>In primary hyperparathyroidism (pHPT), a preferential release of intact PTH (i-PTH) versus carboxylterminal PTH fragments is known to occur. We studied whether the release of amino-terminal PTH fragments (N-PTH) is also changed. Serum levels of i-PTH and N-PTH were determined under basal conditions and following oral intake of calcium in six patients with pHPT before and immediately after surgery and in seven healthy subjects. In the patients, baseline levels of both i-PTH and N-PTH were increased preoperatively. The increase was larger in i-PTH compared to N-PTH. Therefore, the N/i ratio was reduced compared to healthy subjects (P &lt; 0.05). On the first postoperative day, serum i-PTH decreased to a larger extent than N-PTH, which increased the N/i ratio above that in healthy subjects (P &lt; 0.05). On the 5th postoperative day, the N/i ratio was normalized. Preoperatively, the suppressibility of i-PTH calcium was impaired in the patients (P &lt; 0.05), whereas the suppressibility of N-PTH was normal, resulting in unchanged N/i ratio during the oral calcium load. In contrast, the N/i ratio increased normally during the calcium load at day 5 postoperatively (P &lt; 0.05). We therefore conclude that: (1) in pHPT, circulating PTH immunoheterogeneity is altered with a preferential release of intact PTH compared to N-terminal PTH fragments and this alteration is normalized after surgery, (2) the secretion of intact PTH and N-terminal PTH shows different sensitivity to inhibition by calcium.</p>},
  author       = {Bergenfelz, A and Valdermarsson, S and Ahrén, B},
  issn         = {0023-8236},
  keyword      = {Adenoma,Adult,Calcium,Female,Humans,Hyperparathyroidism,Immunoradiometric Assay,Male,Middle Aged,Parathyroid Hormone,Parathyroid Neoplasms,Parathyroidectomy,Peptide Fragments,Postoperative Complications,Reference Values,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {2},
  pages        = {24--119},
  publisher    = {Springer},
  series       = {Deutsche Zeitschrift für Chirurgie},
  title        = {Immunoheterogeneity of parathyroid hormone pre- and postoperatively in primary hyperparathyroidism},
  volume       = {380},
  year         = {1995},
}