Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary hyperparathyroidism (PHP) develops as a consequence of autonomous hypersecretion of parathyroid hormone (PTH) by parathyroid glands usually because of a solitary parathyroid adenoma. Parathyroidectomy, a surgical procedure with a high success rate, is currently the treatment of choice. Pathological parathyroid tissue excision can be achieved by surgical and non-surgical ablative therapy. Bilateral cervical surgical exploration performed by an experienced parathyroid surgeon is curative in 95-98% of PHP and is associated with a low complication rate. In some patients, such as those with a single parathyroid adenoma adequately localised in presurgical imaging studies, this type of surgery may be more extensive than is needed. Moreover, the introduction of new intraoperative parathyroid-localising techniques, such as intraoperative PTH measurement and nuclear mapping, has boosted the development of new and less invasive parathyroid surgical techniques. Other non-surgical ablative techniques, such as selective percutaneous ethanol injection and transcatheter ablation of pathological parathyroid tissue, may be adequate in cases in which surgery is contraindicated. Lastly, among the therapeutic alternatives to parathyroidectomy are antiresorptive drugs (bisphosphonates, oestrogens and selective oestrogen receptor modulators) and inhibitors of PTH secretion (calcimimetics). A combination of drugs with diverse mechanisms of action may have a synergistic effect in the symptomatic control of PHP.
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PMID:Current treatments in the management of patients with primary hyperparathyroidism. 1924 Feb 83

Osteoporotic fractures, especially in elderly people, represent a health concern as they are associated with increased morbidity and mortality together with an increased economic burden for the society. During the past 20 years a great effort has been done in order to reduce the risk of fracture and many drugs are now available for this purpose, but osteoporosis is still regarded as an inevitable consequences of the aging process. Osteoporotic fractures occur most frequently in the spine and hip and with lower frequency in the wrist, pelvis, and upper arm. They are associated with significant morbidity and those of the hip and spine are also associated with excess mortality. The correct diagnosis and the adequate treatment of osteoporosis can reduce fracture risk. Together with well known anti-resorptive agents (like bisphosphonates, oestrogen and selective oestrogen receptor modulators) in the past few years anabolic therapy with parathyroid hormone (PTH) has become available for the treatment of severe osteoporosis. Human recombinant intact parathyroid hormone (PTH 1-84) and human recombinant PTH peptide 1-34 (Teriparatide) belong to this group of agents.This paper will review PTH actions together with the anabolic effect of PTH 1-84 both in reducing fracture risk and in promoting fracture healing. Although in primary hyperparathyroidism bone catabolism prevails on bone anabolism, PTH remains a potent stimulator of osteoblasts and its anabolic properties can be seen when it is given at a low dosage and intermittently. Intermittent PTH can stimulate bone formation to a greater extent and earlier than bone resorption, thus creating the so called "anabolic window".The TOP study demonstrated that PTH 1-84 is able to reduce the risk of a new fracture in patients with prevalent vertebral fractures, but the same effect was also seen on the incidence of the first fracture in women without fractures at baseline. Moreover PTH produced a continuous increase of bone mineral density, particularly in the cancellous bone. A positive effect of PTH has been described also on fracture healing, consisting both by a shortened time for fracture repair and by an improving of all the parameters of callus formation and development. Although most of the evidence has been obtained in animals some recent studies in humans confirmed, at least in part, these findings. In elderly patients with osteoporosis and fractures PTH treatment may reduce the healing time, improve clinical outcomes and reduce the time of immobilization together with the risk of complications.
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PMID:PTH 1-84: bone rebuilding as a target for the therapy of severe osteoporosis. 2278 33

Primary hyperparathyroidism (PHPT) is a common endocrinopathy, frequently caused by a parathyroid adenoma, rarely by a parathyroid carcinoma that lacks effective oncological treatment. As the majority of cases are present in postmenopausal women, oestrogen signalling has been implicated in the tumourigenesis. Oestrogen receptor beta 1 (ERB1) and ERB2 have been recently identified in parathyroid adenomas, the former inducing genes coupled to tumour apoptosis. We applied immunohistochemistry and slide digitalisation to quantify nuclear ERB1 and ERB2 in 172 parathyroid adenomas, atypical adenomas and carcinomas, and ten normal parathyroid glands. All the normal parathyroid glands expressed ERB1 and ERB2. The majority of tumours expressed ERB1 (70.6%) at varying intensities, and ERB2 (96.5%) at strong intensities. Parathyroid carcinomas expressed ERB1 in three out of six cases and ERB2 in five out of six cases. The intensity of tumour nuclear ERB1 staining significantly correlated inversely with tumour weight (P=0.011), and patients whose tumours were classified as ERB1-negative had significantly greater tumour weight as well as higher serum calcium (P=0.002) and parathyroid hormone levels (P=0.003). Additionally, tumour nuclear ERB1 was not expressed differentially with respect to sex or age of the patient. Levels of tumour nuclear ERB2 did not correlate with clinical characteristics. In conclusion, decreased ERB1 immunoreactivity is associated with increased tumour weight in parathyroid adenomas. Given the previously reported correlation with tumour-suppressive signalling, selective oestrogen receptor modulation (SERMs) may play a role in the treatment of parathyroid carcinomas. Future studies of SERMs and oestrogen treatment in PHPT should consider tumour weight as a potential factor in pharmacological responsiveness.
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PMID:Tumour nuclear oestrogen receptor beta 1 correlates inversely with parathyroid tumour weight. 2564 60