[Frontiers in Bioscience S2, 299-312, January 1, 2010]

Parathyroid hormone-related peptide and primary hyperparathyroidism

Mario Testini1, Angela Gurrado1, Germana Lissidini1, Giuseppe Piccinni1, Luigi Greco2, Francesco Basile3, Antonio Biondi3

1Section of General Surgery, Department of Applications in Surgery of Innovative Technologies, University Medical School of Bari, Italy, 2Section of General Surgery, Department of Emergency and Organ Transplantation, University Medical School of Bari, Italy, 3Section of General Surgery and Oncology, Department of General Surgery, University Medical School of Catania, Italy


1. Abstract
2. Introduction
3. Hypercalcaemia
4. Primary Hyperparathyroidism and Humoral Hypercalcaemia
5. Parathyroid Hormone-Related protein
6. Parathyroid Hormone-Related protein and parathyroid adenoma
7. Summary and perspective
8. References


The parathyroid hormone-related peptide (PTHrP) has been shown to be the major pathogenic factor to humoral hypercalcemia of malignancy (HHM). The presence of PTHrP in many normal tissues and in normal or abnormal parathyroids has been described in literature and its role has been investigated. PTHrP release from parathyroid cells into the extracellular space has been demonstrated to depend on the extracellular calcium concentration. The hormone binds to PTH type 1 Receptor (PTH1R) with a high affinity, as well as parathyroid hormone (PTH). These hormones' amino-terminal (1-34) peptide fragments are considered sufficient to achieve efficient receptor activation and action on mineral ion homeostasis. Generally, diagnosis of primary hyperparathyroidism (PHPT) is based on hypercalcaemia and elevated levels of PTH. The advent of intact-PTH immunoradiometric assay allowed us to distinguish PHPT from non-parathyroid-dependent hypercalcaemia, but the presentation of normal PTH level and hypercalcaemia due to a parathyroid adenoma is possible. The aim of the study is to identify the relationship between the production of PTHrP without malignancy and the diagnosis of PHPT by a systematic review.