Ca2+
Calcium
body distribution Plasma calcium regulation Action control of calcium Synthesis and actions of hormones regulating calcium ions Diseases Laboratory methods and interpretations
Plasma
calcium is tightly regulated (5%) o Too low = neuronal hyper-excitability o Too high = neuronal depression Control points for calcium
Free
Vitamin
Vitamin
D3 (Cholecalciferol) o 25-Hydroxycholecalciferol
o 1,25-Dihydroxycholecalciferol
Synthesis of Vitamin D
Humans
Vitamin
D is not a classic hormone because it is not produce and secreted by an endocrine gland. Nor is it a true vitamin since it can be synthesized de novo.
Vitamin
D is a true hormone that acts on distant target cells to evoke responses after binding to high affinity receptors
A lipid
soluble hormone that binds to a typical nuclear receptor, analogous to steroid hormones.
Promotes
intestinal absorption
of calcium Causes synthesis of calciumbinding protein and related facilitated transport Takes a couple of days to fully develop response
Works
Osteoblasts,
but not osteoclasts have vitamin D receptors. 1,25-(OH)2-D acts on osteoblasts which produce a paracrine signal that activates osteoclasts to resorb Ca++ from the bone matrix. 1,25-(OH)2-D also stimulates osteocytic osteolysis.
Secreted
by parathyroid glands Polypeptide Peptide fragments can be active for periods measured in hours Operates in tissues via cAMP second messenger
Parathyroid Hormone
G-Protein
600 AA external domain
Diacylglycerol (DG) and Inositol trisphosphate (IP3) as secondary messengers o Inhibits adenylate cyclase to reduce cAMP
Hyperparathyroidism
Calcitonin
The
major stimulus of calcitonin secretion is a rise in plasma Ca++ levels Calcitonin is a physiological antagonist to PTH with regard to Ca++ homeostasis
The
Serum
Calcitonin
Pentagastrin
Calcium
Stimulation Test
Rickets
o Adults
Osteoporosis