Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the present work was to reveal the relationship between vitamin A serum levels and some indicators of metabolic calcium and phosphorus disorders in patients in a long-term dialyzation programme. Thirty-six patients in a long-term dialyzation programme were divided into three groups. Group A comprised 11 patients who were treated for 3-9 months but without specific treatment, group B was formed by 10 patients treated for 2-5 years who were given calcium carbonate, 3 g/24 h, by the oral route for a period of six months and group C which comprised 15 patients treated for 3-10 years who were given 1 alpha, 25-dihydroxycholecalciferol (Rocaltrol), 0.25 micrograms/24 h for a period of six months. At the end of the investigation a significant rise of total calcium and serum Ca2+ occurred in all three groups of patients an a significant decrease of increased value of phosphorus, C-PTH and vitamin A in serum in groups B and C. In group A which was without treatment there was a significant increase of serum C-PTH and vitamin A after six months. The concentration of retinyl esters in serum was within the reference range of there were undetectable values throughout the investigation in all patients. A direct relationship was found between total calcium and vitamin A, alkaline phosphatase and C-PTH in serum in all 36 patients at the onset of the dialyzation programme. Moreover there was a direct relationship between C-PTH and vitamin A in groups, A, B and C at the onset of the investigation and in groups and vitamin C at the end of the investigation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Vitamin A and metabolic disorders of calcium and phosphorus in patients on a long-term dialysis program]. 205 9

Clinical investigations have shown that 1 alpha-hydroxycholecalciferol (oxydevit, alphacalcidiol) and 1 alpha, 25-dihydroxycholecalciferol (rocaltrol) are act vitamin D3 agents producing a positive clinical effect in different types of osteoporosis and osteomalacia. Clinical improvement of the patients' status (alleviation of the pain syndrome, an increase in motor activity) was noted in 1-2 mos., an x-ray picture of regeneration of the bone structure of both axial and peripheral skeleton--in 6-12 mos. after the initiation of therapy. Therapy was attended by an increase in the serum content of total and ionized calcium, the return of alkaline phosphatase activity to normal, and a decrease in the level of parathormone. During prolonged therapy these agents administered at daily doses of 0.25-2 micrograms caused no pathological side-effects and hypercalcemia. In osteoporotic conditions all these drugs were equal in their clinical effectiveness. Rocaltrol has some advantages in the presence of associated liver pathology.
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PMID:[Comparative evaluation of the effectiveness of vitamin D3 preparations (1-alpha-hydroxy- and 1-alpha,25-dihydroxycholecalciferol in various forms of osteoporosis and osteomalacia]. 276 60

A patient with carcinoma of the prostate, extensive bony metastases, and osteomalacia is reported. The diagnosis of osteomalacia was suspected because of generalized weakness and bone pains, hypocalcemia, hypophosphatemia, and raised alkaline phosphatase. It was documented by low 1,25-dihydroxyvitamin D level. Furthermore, it was confirmed by improvement in patient's symptomatology and normalization of serum calcium and phosphorus after treatment with 1,25-dihydroxyvitamin D3 (Rocaltrol).
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PMID:Osteomalacia associated with prostatic cancer and osteoblastic metastases. 668 13

Estrogen has been shown to modify calcium and skeletal homeostasis. In this study, we tested the ability of estrogen to influence the effects of short-term 1,25(OH)2D administration on biochemical indices of bone formation and resorption in a cross-sectional analysis of untreated (n = 10) and estrogen-treated (n = 14) osteoporotic women. Patients were given oral 1,25(OH)2D (Rocaltrol) 0.5 microgram twice a day for 5 days. Serum and urine were sampled at baseline and then 1 h after the first daily Rocaltrol dose for the 5 days of the study. 1,25(OH)2D levels rose similarly in both groups with plateaus reached by the third day of the investigation. Serum PTH levels decreased by the first sampling period (1 h after first Rocaltrol dose; p < 0.008 both groups) and continued to fall gradually in both groups. There were no changes in serum calcium but serum phosphorus rose by the second day (p < 0.05 both groups) and remained elevated throughout the remainder of the protocol. Serum bone Gla protein increased approximately 40% (p < 0.05) with no group differences. In contrast, total alkaline phosphatase and carboxy-terminal propeptide of type I collagen did not increase in either group. Furthermore, there were no significant increments in any bone resorption indicators, including serum tartrate-resistant acid phosphatase and cross-linked carboxy-terminal telopeptide of type I collagen, as well as urine hydroxyproline and pyridinoline. Serum IGF-1 levels also remained unchanged in both groups. We conclude that oral 1,25(OH)2D administration decreased 1-84PTH levels, probably due to a suppression of parathyroid production, and did not stimulate bone resorption.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Oral 1,25-dihydroxyvitamin D administration in osteoporotic women: effects of estrogen therapy. 761 Sep 30

The authors classified sixty chronic renal failure (CRF) patients receiving hemodialysis (HD) treatment into four groups for clinical study. Forty patients received HD for more than five years and the remaining twenty patients received HD for less than two years. These two groups were further divided into two subgroups according to whether they took Rocaltrol or not. The levels of parathyroid hormone (PTH), calcitonin (CT), alkaline phosphatase (AKP) and bone X-ray were studied in each patient. The results showed: the levels of PTH and CT were obviously increased in all the patients. The levels of PTH and CT were higher in the patients having received HD for more than five years than those for less than two years. They were also higher in patients who had not taken Rocatrol than those who had. Ninety-five percent of the patients having received HD for more than five years had renal osteodystrophy (ROD) without receiving Rocaltrol treatment, while only sixty-five percent of the patients developed ROD with Rocatrol treatment. The longer the HD time, the higher the ROD incidence. The cause, prevention and treatment of ROD were discussed.
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PMID:[A study on the relative factors for secondary parathyroidosis and renal osteodystrophy in long-term hemodialysis patients]. 764 35

In a 47-year-old female patient distal renal tubular acidosis (dRTA) led to the development of osteomalacia following 13 years of the first episode of hypokalemic respiratory paralysis and 7 years of KHCO3 treatment. In spite of the musculoskeletal disability, intense bone pain and myopathy, the values of serum calcium (Ca++) and phosphorous (P) showed minimal deviation from the normal levels. The bone scintigraphy was the first indicator of the bone disease. As the disease progressed the serum level of alkaline phosphatase increased gradually and 25-hydroxyvitamin-D level decreased and bone scintigraphy showed multiple areas of increased radioisotope uptake. By that time the patient's condition deteriorated severely, she became almost unable to walk. Rocaltrol (calcitriol) therapy led to dramatic clinical improvement and the complete resolution of the laboratory values. When the alkaline therapy of dRTA does not prevent the development of osteomalacia, administration of a modern vitamin-D preparation can result complete healing of the bone disease.
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PMID:[Effect of calcitriol, a vitamin D compound, in bone disease associated with distal renal tubular acidosis]. 797 Jun 47

In order to investigate the influence on bone metabolism of growth hormone (GH), we evaluated the response to an acute load of 1,25(OH)2D3 (Rocaltrol) (1.5 micrograms/day for 4 days) in 16 growth hormone-deficient prepubertal children (11 boys and 5 girls, aged from 6.2 to 9.6 years) both before and after 1 month of human GH (hGH) therapy (0.1 IU/kg/day, 6 times per week). Before and after the 1,25(OH)2D3 load, serum IGF-I, osteocalcin, Ca, P, alkaline phosphatase (ALP) and urinary excretion of Ca and P were measured. The serum levels of osteocalcin rose significantly after the first 1,25(OH)2D3 load, without an increase in IGF-I values and with a slight non-significant increase in serum Ca and P. Almost superimposable increases of osteocalcin, Ca and P were observed after 1 month of hGH therapy, with a significant increase of IGF-I, but they did not rise further after the second 1,25(OH)2D3 load. On the basis of our results, 1,25(OH)2D3 seems to have a stimulatory action on osteoblastic activity even in the absence of normal levels of GH. However, there is no apparent additional stimulatory activity after administration of hGH. Osteocalcin level behaviour during our study might suggest that GH and 1,25(OH)2D3 have a common and easily saturable stimulatory pathway on osteoblastic function.
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PMID:Effects of 1,25-dihydroxyvitamin D3 and growth hormone therapy on serum osteocalcin levels in children with growth hormone deficiency. 835 52

In the submitted case-history the authors describe the clinical picture, diagnosis and treatment of the non-complicated form of Paget's disease in a 68-year-old patient with typical X-ray findings on the vertebrae, pelvis and left tibia. The laboratory findings revealed liminal alkaline phosphatase (ALP) values, 2.5 times raised values of the aminoterminal telopeptide of collagen I in the organic bone matrix (NTx) in the 24-hour diuresis and slightly elevated osteocalcin (OSCA) levels. The finding of whole-body skeletal scintigraphy was atypical and thus was no diagnostic asset. Aimed transiliacal bone biopsy according to Bordier taken from the pathological focus confirmed the diagnosis of morbus Paget. The patient was treated for six months with the following preparations: Fosamax (monosodium alendronate tablets a 10 mg, Merck Sharp and Dohme, USA) 1 tablet per day, Vitacalcin (calcium carbonate, tablets a 250 mg elemental calcium, Slovakofarma, Slovak Republic) 2 x 1 tablet per day, Rocaltrol (calcitriol tablets a 0.25 ug, Hoffman La Roche, Switzerland) 1 tablet on alternate days). Because of gastrointestinal complaints the authors did not administer 40 mg alendronate per day, as recommended in the American literature. Based on the laboratory finding of normalization of the bone turnover, reduction of the number of osteoplastic foci on the X-ray image of vertebrae and pelvis, regression of the vertebrogenic algic syndrome and improved mobility of the patient, the authors consider the 6-month administration of alendronate, 10 mg per day, calcium carbonate and calcitriol therapeutically effective and successful.
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PMID:[Paget's disease of bone--treatment with alendronate, calcium and calcitriol]. 1095 69

We report a case of an 80-year-old man with osteoblastic metastases from advanced carcinoma of the prostate presenting with a grand mal seizure resulting from severe hypocalcaemia. He had low serum phosphate and ionised calcium levels, elevated serum skeletal alkaline phosphatase and intact parathormone levels. 99mTc radioisotope bone scan revealed a "super bone scan" suggestive of osteomalacia. The serum 1, 25-dihydroxycholecalciferol level was unexpectedly elevated. The biochemical abnormalities persisted despite high dose calcium replacement, but improved with supraphysiological doses of 1,25 (OH)2 vitamin D3 (Rocaltrol) therapy. We hypothesise that the hypocalcaemia in this patient was due to vitamin D resistance secondary to a humoral factor secreted by the tumour.
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PMID:A man with osteoblastic metastasis and hypocalcaemia. 1106 7

This double-blind, placebo-controlled study evaluated the safety and efficacy of intravenous (i.v.) calcitriol (Calcijex) for treatment of secondary hyperparathyroidism (secondary HPT) in pediatric end-stage renal disease (ESRD) patients on hemodialysis (HD). After a 2 to 6-week washout period of all vitamin D compounds, patients with two consecutive PTH values > 400 pg mL(-1), calcium levels < or = 10.5 mg dL(-1) and calcium x phosphorus product values < or = 70 mg2 dL(-2) were eligible for the treatment phase. Patients received a bolus injection of calcitriol or placebo three times a week, immediately after dialysis for up to 12 weeks. Initial doses (0.5-1.5 microg) were based on the severity of secondary HPT. The dose was increased every two weeks by 0.25 microg until there was at least a 30% decrease in PTH from baseline, or Ca > 11.0 mg dL(-1), or Ca x P > 75 mg2 dL(-2). Overall, 11/21 (52%) patients in the calcitriol group had two consecutive > or = 30% decreases from baseline in serum PTH compared with 5/26 (19%) patients in the placebo group (P=0.03). The mean total alkaline phosphatase decreased from 274 to 232 IU L(-1) in the calcitriol group and increased from 547 to 669 IU L(-1) in the placebo group (P=0.002). The mean bone-specific alkaline phosphatase decreased from 72.5 to 68 microg L(-1) in the calcitriol group and increased from 105.3 to 148.5 microg L(-1) in the placebo group (P=0.03). The incidence of two consecutive occurrences of elevated calcium x phosphorus (Ca x P > 75 mg2 dL(-2)) product was higher in the calcitriol group than in the placebo group (P=0.01). Two consecutive occurrences of phosphorus > 6.5 mg dL(-1) occurred in 71% of the calcitriol group and 46% of the placebo group (P=0.14). Calcium levels > 10.5 mg dL(-1) were more common in the calcitriol group than in the placebo group (P=0.01). There was a direct relationship between serum phosphorus concentration and the percentage change in PTH from baseline in both the calcitriol group (r=0.46; P<0.0001) and the placebo group (r=0.21; P=0.0005). This study demonstrates that i.v. calcitriol, at initial doses of 0.5-1.5 microg, effectively reduces PTH levels in pediatric HD patients and that patients should be closely monitored for hyperphosphatemia and elevated Ca x P product.
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PMID:Intravenous calcitriol for treatment of hyperparathyroidism in children on hemodialysis. 1578 41


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