Mutations in the calcium-sensing receptor and their clinical implications

被引:36
作者
Brown, EM
机构
[1] Endocrine-Hypertension Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
关键词
extracellular calcium-sensing receptor; familial hypocalciuric hypercalcemia; neonatal severe hyperparathyroidism; autosomal dominant hypocalcemia; parathyroid; kidney; calcium homeostasis;
D O I
10.1159/000185516
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Specialized cells (i.e., parathyroid chief cells) that sense changes in the extracellular calcium concentration are a key element in mineral ion homeostasis. The Ca-0(2+)-sensing receptor (CaR) originally cloned from bovine parathyroid is also present in multiple nephron segments involved in Ca-0(2+) homeostasis as well as in other sites that are not, such as brain, lung, large and small intestine. The physiological relevance of the CaR has been established by identifying hyper-and hypocalcemic disorders resulting from CaR mutations: familial hypocalciuric hypercalcemia (FHH) and neonatal severe hyperparathyroidism result from inactivating CaR mutations, while an autosomal dominant form of hypocalcemia is caused by activating mutations. In addition to sensing Ca-0(2+) and Mg-0(2+) abnormally (the latter suggesting the CaR acts as an Mg-0(2+)-sensing receptor), persons with FHH have alterations in their handling of water, supporting a role for the CaR in integrating mineral ion and water metabolism. Drugs that activate the CaR ('calcimimetics') are currently undergoing clinical trials and will permit pharmacological manipulation of the receptor when it functions abnormally (e.g., in primary hyperparathyroidism).
引用
收藏
页码:199 / 208
页数:10
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