Oleh:

Elis Rohmah Pri Hartini

3415111383
Hormonal Regulation Of Plasma
Calcium And Calcium Metabolism
Figure 1
Figure 2
Calcium Balance in the Body
[free Ca
2+
]
0.001 mM
Active
transport
Cells
[Ca
2+
]


2.5 mM
ECF
Electrochemical
gradient
PTH = parathyroid
hormone
KEY
Calcium in the ECF is
either bound to
proteins or free to
diffuse.
Calcium in ICF is
stored in
mitochondria, or ER,
or free in cytosol
Function of Ca
2+
in ECF
1. Neuromuskulus
2. Incorporation of stimulus-secretion
3. Thrombosis
Regulation of calcium metabolism
Ca
2+
homeostasis
Ca
2+
balance

Regulation of calcium metabolism
1. Parathyroid hormone
2. Calcitonin
3. Vitamin D
5
Parathormon
6
Parathyroid Glands
7
Figure 3
PTH increases the calcium levels through their
effects on bone
Bone Remodeling

Osteoblast
Osteocyt
Osteoclast
kinds of cells in the
bone
Ligan RANK (RANKL)
Osteoproteginin (OPG)
Process
Actions of PTH: Bone
PTH acts to increase degradation of bone (release of calcium).
--Rapid action
--Delayed action
- causes osteoblasts to release cytokines, which stimulate
osteoclast activity
- stimulates bone stem cells to develop into osteoclasts
-- net result: increased release of calcium from bone
-- effects on bone are dependent upon presence of vitamin D
9
Increase the activity of osteoclasts
RANK ligand binds to RANK and triggering
macrophages differentiate into osteoclasts
Ligan RANK (RANKL)
Osteoproteginin (OPG)
Decrease in osteoclast development
OPG secreted into the matrix and serves as a
response to detractors that binds to RANKL, causing
inactivation of osteoclasts to bone meresorpsi.
Osteoblasts and their
precursors
Makrofag/
osteoclast
Differentiation
of macrophages
into osteoclasts
RANK Ligan
suppression of
osteoclast
apoptosis
RANKL bound to
OPG
inhibits RANK
OPG
Activation of
osteoclasts
Activation of
osteoclasts
bone mass
bone mass
PTH pull calcium from bones
a. Ca trigger rapid efflux to plasma

b. Stimulates bone dissolution
Bone organization
a. Ca
2+
trigger rapid efflux to plasma

PTH activates the pump
ca
2+

Encourage ca
2+
to move
from bone fluid to bone
cells
Through membrane-
osteoblastic osteositik,
plasma calcium moved
to central canaliculus

Figure 4
b. Stimulates bone dissolution
Osteoclast stimulated by PTH to resorption
the bone
Increase osteoclast activation, decrease
osteoblast activation
PTH dissolved Ca3PO4)2 Ca
2+
dan PO4
3-

(in plasma)

Bone dissolution
Calcium Balance in the Body
[free Ca
2+
]
0.001 mM
Active
transport
Cells
[Ca
2+
]


2.5 mM
Calcitonin
Ca
2+
PTH
Calcitriol
Cortisol
Bone ECF
Electrochemical
gradient
PTH = parathyroid
hormone
KEY
Bone is largest
calcium reservoir.
It is stored as
hydroxyapartite
crystals. Calcium
is released to
maintain plasma
levels
Figure 6
Actions of PTH: Kidney
PTH acts on the kidney the reabsorption of calcium
(excretion).
excretion of phosphate
ALSO, Stimulates transcription of 1-alpha hydroxylase for
Vitamin D activation in kidneythe active metabolite of
vitamin D3 (required for calcium absorption from the
small intestine, bone demineralization).
NET RESULT: increased plasma calcium levels
18
Calcitonin
19
Produced by C cell tyroid gland
The target cell for calcitonin is the osteoclast.
--Calcitonin acts via increased cAMP concentrations to inhibit
osteoclast motility and cell shape and inactivates them.
15min 70%mainly in children but not in adult
Ca
2+
concentration


Actions of Calcitonin
20
Ca
2+
plasma
Calcitonin
C cell Thyroid
-
+
Ca
2+
plasma
PTH
Ca
2+
plasma
Ca
2+
plasma
Parathyroid gland
-
+
Vitamin D
22
Effects of Active Form of Vit D3
Promotes intestinal absorption of calcium and
posphate
Stimulate by PTH
Active vitamin D 1,25-(OH)2-vitaminD3
Has slight effect to increase calcium re-absorption in
kidneys
23
Calcium Balance in the Body
Ca
2+

Small intestine
Dietary
calcium
[free Ca
2+
]
0.001 mM
Calcitrol
(PTH, prolactin)
Active
transport
Cells
[Ca
2+
]


2.5 mM
Calcitonin
Ca
2+
PTH
Calcitriol
Cortisol
Bone ECF
Electrochemical
gradient
PTH = parathyroid
hormone
KEY
Only 1/3 of the
calcium ingested is
absorbed. Absorption
is regulated by a
hormone. A healthy
diet needs to be high in
calcium in order to
match the amount
excreted
Figure 7
Endocrine Control of Calcium Balance
Figure 8
Calcium Balance
Phosphate Metabolism
27
+
-
PO4
3-
plasma
Absorbtion Ca
2+

in Intestine
Vit. D
PO4
3-
plasma
PTH
Ca
2+
plasma
Kidney
Parathyroid gland
Absorbtion PO4
3-

in Intestine
Reabsorbtion
PO4
3-
in kidney
Reabsorbtion
Ca
2
in kidney
Excretion of
PO4
3-

Excretion of Ca
2

Ca
2+
levels konstant
Disturbance of calsium metabolism
Hypersectretion PTH
- Hypercalcemia
Hyposecretion PTH
- Hypocalcemia
Deficienci vitamin D
- Rachitis
3-