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Calcium and Phosphate Methabolism
Calcium and Phosphate Methabolism
Methabolism
Overview
Calcium (Ca2+) Characteristic Phosphate (HPO42-)
PTH acts
on the
distal
tubule
Calcitonin
• Product of
parafollicular C cells
of the thyroid
• 32 aa
• Inhibits osteoclast
mediated bone
resorption
– This decreases serum
Ca2+
• Promotes renal
excretion of Ca2+
Calcitonin
• Probably not essential for human survival
• Potential treatment for hypercalcemia
• 7 transmembrane segment receptor
• Stimulates cAMP production in bone and
kidney
Vitamin D Metabolism
Transport and Metabolic Sequence of
Activation of Vitamin D
Proposed Mechanism of Action of
1,25-DihydroxyD3 in Intestine
Vitamin D-dependent Ca Absorption 2+
• Duodenum>jejunun>ileum
• Absorption is greater at low pH
– The pH of the stomach is about 2
– Peak absorption at the beginning of the
duodenum
Vitamin D Deficiency: Rickets
• Inadequate intake and absence of sunlight
• The most prominent clinical effect of Vitamin D
deficiency is osteomalacia, or the defective
mineralization of the bone matrix
• Osteoblasts contain the vitamin D receptor
• Vitamin D deficiency in children produces rickets
• A deficiency of renal 1α-hydroxylase produces
vitamin D-resistant rickets
– Sex linked gene on the X chromosome
– Renal tubular defect of phosphate resorption
– Teeth may be hypoplastic and eruption may be retarded
Rickets
Vitamin D-Resistant
Rickets
• Above: Hypoplastic teeth
• http://www.nal.usda.gov/fnic/foodcomp/Data
/SR16/wtrank/wt_rank.html
Selected Web Sites
Properties of Parathyroid Hormone
• It is a small protein hormone
• It acts on its 7 transmembrane segment receptor
– Gs protein-coupled receptors in osteoblasts increase [cAMP] and
activates protein kinase A
– Parathyroid hormone acts directly on bone to stimulate resorption
and release of Ca2+ into the extracellular space (slow)
– Parathyroid hormone acts directly on kidney to increase calcium
reabsorption and phosphate excretion (rapid)
– Parathyroid hormone acts on distal tubule and stimulates calcium
resorption
– Parathyroid hormone stimulates transcription of 1-alpha
hydroxylase for vitamin D activation in kidney
• Know how 7 transmembrane segment receptors activate or
inhibit adenylyl cyclase via the G-protein cycle
• Know the pathway for the formation of active vitamin D
Transport and Metabolic Sequence of
Activation of Vitamin D
PTH
Biosynthesis
• PTH is co-secreted
with chromogranin
A, a protein;
significance
unknown
Sequence of Adjustments to
Hypocalcemia