DECREASED 1,25-DIHYDROXYVITAMIN-D(3) RECEPTOR DENSITY IS ASSOCIATED WITH A MORE SEVERE FORM OF PARATHYROID HYPERPLASIA IN CHRONIC UREMIC PATIENTS
DECREASED 1,25-DIHYDROXYVITAMIN-D(3) RECEPTOR DENSITY IS ASSOCIATED WITH A MORE SEVERE FORM OF PARATHYROID HYPERPLASIA IN CHRONIC UREMIC PATIENTS
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DOI：
10.1172/jci116720
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发表时间：
1993-09-01
影响因子：
15.9
通讯作者：
SEINO, Y
中科院分区：
文献类型：
--
作者：
FUKUDA, N;TANAKA, H;SEINO, Y
尿毒症性甲状旁腺机能亢进症中甲状旁腺细胞对1，25-二羟维生素D3（1，25（OH）2D 3）的抵抗被认为部分是由甲状旁腺中1，25（OH）2D 3受体（VDR）缺乏引起的。然而，在甲状旁腺VDR数量的生化研究结果是有争议的。几项研究发现，维生素D受体的含量减少，尿毒症患者和动物的甲状旁腺，而其他人已经发现没有这样的减少，在甲状旁腺尿毒症animals.To澄清的作用，维生素D受体，我们调查了维生素D受体的分布在vacuically-excited甲状旁腺获得慢性透析患者的免疫组化。我们将甲状旁腺分为结节性或弥漫性增生。我们的研究表明，在结节性增生的甲状旁腺中VDR的密度低于弥漫性增生。即使在显示弥漫性增生的甲状旁腺中，也存在结节形成区域;这些区域的VDR染色几乎为阴性。VDR密度与甲状旁腺重量呈显著负相关。这些发现表明，生化研究的矛盾结果可能是由VDR的不均匀分布引起的;甲状旁腺中VDR密度降低可能有助于继发性甲状旁腺功能亢进的进展和尿毒症中可见的甲状旁腺细胞增殖。
The resistance of parathyroid cells to 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in uremic hyperparathyroidism is thought to be caused, in part, by a 1,25(OH)2D3 receptor (VDR) deficiency in the parathyroids. However, results of biochemical studies addressing VDR numbers in the parathyroids are controversial. Several studies have found VDR content to be decreased in the parathyroids of uremic patients and animals, while others have found no such decrease in the parathyroids of uremic animals.To clarify the role of VDR, we investigated VDR distribution in surgically-excised parathyroids obtained from chronic dialysis patients by immunohistochemistry. We classified the parathyroids as exhibiting nodular or diffuse hyperplasia. Our studies demonstrated a lower density of VDR in the parathyroids showing nodular hyperplasia than in those showing diffuse hyperplasia. Even in the parathyroids showing diffuse hyperplasia, nodule-forming areas were present; these areas were virtually negative for VDR staining. A significant negative correlation was found between VDR density and the weight of the parathyroids. These findings indicate that the conflicting results of biochemical studies may be caused by the heterogeneous distribution of VDR; the decreased VDR density in parathyroids may contribute to the progression of secondary hyperparathyroidism and to the proliferation of parathyroid cells that is seen in uremia.