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Basic Aspects of PTH in Skeletal Health

  • Chapter
Osteoporosis

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Small clinical trials using the synthetic fragment human parathyroid hormone (hPTH) 1–34 in the early 1970s suggested PTH could be used as an anabolic therapy for osteoporosis (1,2). Since these initial clinical trials, numerous studies in animal models and humans have demonstrated that PTH anabolic effect is dependent on its intermittent administration. Continuous infusion of PTH results in decreased bone mass due to a change in bone balance to favor bone resorption (1–6). Emphasizing the complexity of the skeletal response to PTH, prolonged continued exposure to PTH as a consequence of hyperparathyroidism shifts bone distribution from cortical bone to trabecular bone, resulting in thinned cortical bone (1–10). PTH uniformly stimulates bone turnover. Whether this results in bone mass gain, loss or equilibrium, is determined by regimen or the presence of disease. Recent work with transgenic mice expressing a constitutively activated PTH1 G-protein coupled receptor (PTH1R) implicated the up-regulation and distribution of this receptor as a key step in determining outcomes at specific bone sites (11). Despite a wealth of in vitro research on the cell and molecular actions of PTH, we still do not understand the mechanisms resulting in these multiple effects in vivo. Moreover, none of the in vitro models fully recapitulates the anabolic effects of PTH observed in vivo, to result in osteoblast induction and a net increase in matrix proteins.

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  1. Janet M. Hock DDS, PhD
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Hock, J.M. (2003). Basic Aspects of PTH in Skeletal Health. In: Orwoll, E.S., Bliziotes, M. (eds) Osteoporosis. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-278-4_24

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  • DOI: https://doi.org/10.1007/978-1-59259-278-4_24

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