Parathyroid hormone-related protein(50–69) and response to pamidronate therapy for tumour-induced hypercalcaemia

D.J. Dodwell , S.K. Abbas , A.R. Morton , A. Howell
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引用次数: 45

Abstract

A region-specific radioimmunoassay has been employed to measure levels of immunoreactive parathyroid hormone-related protein(50–69) (iPTHrP(50–69)) in patients with tumour-induced hypercalcaemia (TIH). This assay is based on an antiserum raised against synthetic human PTHrP(50–69). The assay showed no cross-reactivity with human or bovine parathyroid hormone(1–84). The effect of a single dose (60 mg) of pamidronate was studied in 25 consecutive patients with TIH. All were rehydrated prior to treatment. All but 2 patients (8%) became normocalcaemic after treatment; both of these had very high levels of iPTHrP(50–69). Time to achieve normocalcaemia, as an index of relative resistance to pamidronate, correlated positively with pretreatment level of iPTHrP(50–69). Absence of radiological evidence of bone metastases also predicted relative resistance to pamidronate. In this study, iPTHrP(50–69)-induced osteoclastic bone resorption was a more important mechanism in the causation of TIH than PTHrP-induced renal reabsorption of calcium as assessed by the renal thresholds for calcium and phosphate.

甲状旁腺激素相关蛋白(50-69)和对帕米膦酸盐治疗肿瘤引起的高钙血症的反应
一种区域特异性放射免疫分析法被用于测量肿瘤诱导的高钙血症(TIH)患者的免疫反应性甲状旁腺激素相关蛋白(50-69)(iPTHrP(50-69))水平。该试验是基于一种针对人工合成人PTHrP(50-69)的抗血清。该试验显示与人或牛甲状旁腺激素无交叉反应性(1-84)。在25例连续的TIH患者中研究了单剂量(60mg)帕米膦酸盐的作用。所有患者在治疗前都补水。除2例(8%)患者外,其余患者治疗后均变为正常钙血症;他们的iPTHrP水平都很高(50-69)。达到正常血钙的时间作为帕米膦酸盐相对耐药指标,与iPTHrP预处理水平呈正相关(50-69)。缺乏骨转移的放射学证据也预示着对帕米膦酸盐的相对耐药性。在本研究中,通过钙和磷酸盐的肾阈值评估,iPTHrP(50-69)诱导的破骨细胞骨吸收是导致TIH的更重要机制,而不是pthrp诱导的钙肾重吸收。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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