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Biomedical subjects

H Jüppner

Publications and source records attributed to H Jüppner.

At least 109 records · Page 6Linked to original sources

Characterization of fully active biotinylated parathyroid hormone analogs. Application to fluorescence-activated cell sorting of parathyroid hormone receptor bearing cells.

[Nle8,18,Tyr34]bPTH-(1-34)amide (NlePTH) was biotinylated using sulfosuccinimidyl 6-(biotinamido)hexanoate, in dimethyl sulfoxide, and the multiple resulting peptides peaks were separated by reverse-phase high performance liquid chromatography. Their biological activities were compared with those of NlePTH, the parent compound, in radioreceptor and cAMP accumulation bioassays using rat osteosarcoma 17/2.8 cells; the earliest two eluting products, bioPTH 1 and 2, were equipotent, a third, bioPTH 3, was only 10% as potent, and the remaining, later eluting derivatives all were less than 0.1% as active. Competitive avidin binding assays using [3H]biotin suggested that bioPTH 1 and 2 had a single biotin congener per molecule, while bioPTH 3 contained two biotin residues. Upon Edman degradation, bioPTH 1 contained biotin on the lysine at position 13 of NlePTH; bioPTH 2's biotin was on the lysine at position 26 (or 27) and bioPTH 3 had biotins on lysines at both positions 13 and 26 (or 27). Avidin tagged with 125I, peroxidase, or fluorescein isothiocyanate was detected on bone-derived cells which had been incubated initially with bioPTH 2 (1, 10, and 100 nM) for 4 h, but not when NlePTH (1 microM) was added with bioPTH 2. A fluorescence-activated cell sorter detected a symmetrical shift in fluorescence of bone-derived cells incubated with 10 nM of bioPTH 2 and 10 micrograms/ml fluorescein isothiocyanate-avidin. Addition of a 30-fold molar excess of NlePTH, or omission of bioPTH 2, completely reversed this fluorescence shift, and no shift in fluorescence was seen with cells lacking PTH receptors. This fully active, high affinity biotinylated PTH-derivative should prove useful in the study of PTH receptor-bearing cells.

Animals↗

Efficacy of calcium carbonate and low-dose vitamin D/1,25(OH)2D3 in reducing the risk of developing renal osteodystrophy in children on continuous ambulatory peritoneal dialysis.

Eight children with terminal renal insufficiency on continuous ambulatory peritoneal dialysis were followed for 12 months to evaluate laboratory parameters of mineral ion and bone metabolism. Calcium carbonate (range 47-295 mg/kg body weight per day) was given in combination with low doses of either vitamin D or 1,25(OH2D3. Blood urea nitrogen and serum phosphate concentrations remained well controlled throughout the observation period. A significant increase in serum calcium levels from 2.35 +/- 0.18 to 2.61 +/- 0.22 mmol/l (mean +/- SD) was observed during the first 6 months. Alkaline phosphatase activity and mid-C-regional parathyroid hormone, both indirect parameters of bone metabolism, revealed no evidence of severe secondary hyperparathyroidism. Our data indicate that calcium carbonate may be sufficient to induce relative hypercalcaemia in uraemic children, and thus reduce the risk of developing renal osteodystrophy. Unwanted side-effects of vitamin D preparations, i.e. increased intestinal phosphate absorption and hypercalcaemia after successful renal transplantation, may thus be avoided.

Administration, Oral↗

The parathyroid hormone-like peptide associated with humoral hypercalcemia of malignancy and parathyroid hormone bind to the same receptor on the plasma membrane of ROS 17/2.8 cells.

[Tyr36]human adenylate cyclase stimulating peptide (1-36)-NH2, an amino-terminal analog of a tumor peptide which is associated with hypercalcemia of malignancy, and [Nle8, Nle18, Tyr34]bovine parathyroid hormone (PTH)-(1-34)-NH2 both bind with similar affinities to receptors on rat osteosarcoma cells, ROS 17/2.8, when either of the peptides is used as the radioligand. Pretreatment of the cells with either peptide down-regulates available binding sites for either radioligand and desensitizes the cAMP accumulation stimulated by either peptide. Prior exposure of the cells to dexamethasone increases these responses to both peptides. Photoderivatized radioiodinated [Tyr36]human adenylate cyclase-stimulating peptide (1-36)-NH2 and [Nle8, Nle18, Tyr34]bovine PTH-(1-34)-NH2 both specifically label a Mr = 80,000 membrane protein on ROS 17/2.8 cells. The intensity of labeling this receptor band by either photoprobe is reduced by co-incubation with either peptide over the same dose range. Equivalent dose-dependent down-regulation of receptors which bind both photoprobes is also found when ROS 17/2.8 cells are preincubated with either peptide. Dexamethasone increases the intensity of receptor labeling. Our findings strongly indicate that both peptides recognize the same plasma membrane receptor on ROS 17/2.8 cells. Although the physiological function(s) of human adenylate cyclase-stimulating peptide is unknown, these results could explain why its biological actions on mineral ion metabolism so closely simulate those of PTH and raise interesting questions about the general biological and evolutionary significance of the use of the same receptor by chemically distinct peptides.

Animals↗

The DiGeorge syndrome. I. Clinical evaluation and course of partial and complete forms of the syndrome.

This study describes clinical signs and symptoms in 16 patients with the DiGeorge syndrome (DGS). Diagnosed on the basis of typical facial stigmata, a broad spectrum of severity is seen with respect to congenital heart disease, hypoparathyroidism and immunologic parameters. A simple index of severity is introduced that clearly differentiates complete forms of the syndrome (cDGS) with poor prognosis from partial forms of the syndrome (pDGS). Of 13 pDGS patients, 12 are still living; 8 underwent corrective heart surgery without infectious complications. Moderate to severe mental retardation is seen in all pDGS patients. Due to the lack of thymus function, immunodeficiency is a result of cDGS, whereas immunoregulatory disturbances (hypergammaglobulinaemia, high titres of specific antibody production) prevail in pDGS patients.

Adolescent↗

Somatic growth after kidney transplantation. Beneficial effect of cyclosporine in comparison with conventional immunosuppression.

Growth performance was evaluated in 69 children, aged 3 to 16 years, who had undergone kidney transplantation between 1974 and 1984. Forty children (21 boys, 19 girls) who received transplants before September 1982 were treated conventionally with azathioprine and high-dose prednisolone; 29 children (13 boys, 16 girls) who received transplants after September 1982 were treated with cyclosporine and low-dose prednisolone. The mean (+/- SD) survival times of grafts in the azathioprine and cyclosporine groups were 6.0 +/- 2.1 years and 1.4 +/- 0.5 years, respectively. Height and bone age were evaluated at the time of transplantation, one year after transplantation, and at reevaluation in December 1985. Growth rates expressed by standard deviation scores (SDS) declined in the azathioprine group for boys (mean, -2.2 at transplantation, -2.5 after one year, and -2.8 in December 1985) and girls (-2.1, -2.4, and -2.7) and improved in the cyclosporine group for boys (-2.5, -2.2, and -2.1) and girls (-2.2, -1.9, and -1.8). The difference between both groups one year after transplantation was significant. This trend continued beyond the first year after transplantation. Graft function was better in the azathioprine group than in the cyclosporine group. Bone age in December 1985 was less retarded in the cyclosporine group, but this could have been related to the shorter observation time. We conclude that somatic growth after kidney transplantation is below expected rates under azathioprine-prednisolone immunosuppression but is significantly better under cyclosporine-prednisolone immunosuppression.

Adolescent↗

Effect of verapamil on plasma parathyroid hormone.

The effects of the Ca antagonist, verapamil, on the behaviour of parathyroid hormone was studied in normal and uraemic male Wistar rats. Parathyroidectomy was by cautery. Acute uraemia was induced by bilateral nephrectomy, and moderate uraemia by s.c. injection of gentamicin (200 mg/kg). Ethylendiamine tetracetic acid (50 mg/kg X d) was injected subcutaneously. Parathyroid hormone was determined by radioimmunoassay. The degree of uraemia was determined from plasma urea levels. Renal failure resulted in a significant increase in plasma parathyroid hormone (mean +/- SEM, ng/l) (84 +/- 6, n = 10, in the control; 277 +/- 39, n = 7, in the moderate uraemics and 667 +/- 128, n = 6, in the acute uraemics). Injection of verapamil significantly increased plasma levels of parathyroid hormone, ranging from 21% in the controls to 62% in the moderate uraemia group. In the acute uraemics, parathyroid hormone levels were very high and verapamil did not cause any further elevation of the hormone in the blood. Parathyroidectomy significantly lowered plasma parathyroid hormone, and verapamil resulted in a mean increase of 29%. EDTA caused an increase of 64%, compared with the control group.

Acute Kidney Injury↗

Direct radioimmunoassay for human atrial natriuretic peptide (hANP) and its clinical evaluation.

A direct radioimmunoassay for the rapid and accurate detection of human ANP from unextracted plasma is described. The sensitivity was approximately 50 pg/ml, respectively 2.5 pg/tube, the intra-assay variation 4%, and the inter-assay variation less than 12%. Rat ANP (1-28, 5-25, 5-27 and 5-28), oxydized and reduced hANP as well as plasma samples from various patients run in parallel to the 1-28 hANP standard curve. These findings imply, that the antibody primarily recognizes the mid-region (amino acids 6-25) of the intact ANP, that the C-terminal portion further increases the immunoreactivity, and that circulating plasma hANP is reliably measured. Plasma hANP ranged from 50-166 pg/ml (mean +/- SD: 98.3 +/- 44.6) in healthy individuals, there was no significant difference between samples were drawn in upright or lying position, the apparent half-life of injected hANP was 5.65 minutes. Patients with liver cirrhosis revealed significantly higher hANP levels of 244.5 +/- 173.5 pg/ml. Patients with various forms of cardiac disease had hANP concentrations ranging from 50 to 1744 pg/ml, depending at least partially on the right atrial pressure. No difference was observed if the samples were drawn from either right or left intracardial locations. Our findings with this system demonstrate that hANP is reliably measured even without prior extraction.

Antibody Specificity↗

C-terminal PTH (70-84) after biliary ligation in rats: implications for the diagnostic importance in hepatobiliary disease.

The pathogenesis of hepatic osteodystrophy is still poorly understood. To date, there is no convincing evidence for the involvement of one of the vitamin D metabolites. Recent observations provided evidence for an disturbed hepatic metabolism of intact PTH in patients with primary biliary cirrhosis and children with biliary atresia. To confirm these data experimentally, the extrahepatic bile-duct was ligated and dissected in rats. As expected GOT and AP activity increased in ligated group, calcium and mid-C-PTH remained constant for the first 44 days post-ligation. Similar to the data in the respective groups of patients, C-terminal PTH immunoreactivity increased after biliary ligation. The radioimmunological discrimination between intact PTH and the bone-seaking N-terminal PTH peptide is still impossible without further chromatographic procedures. Therefore, C-PTH may represent an important laboratory parameter for the evaluation of the hepatic metabolism of PTH which seems to be disturbed during severe longstanding cholestasis.

Alkaline Phosphatase↗

[Mid C regional parathyroid hormone in the clinical workup: diagnostic value in extrarenal (primary) and renal (secondary) hyperparathyroidism].

The selective determination of mid-C-regional parathyroid hormone (mid-C-PTH) in combination with other laboratory parameters is a reliable tool for diagnosis and treatment of extra-renal (primary) and renal (secondary) hyperparathyroidism. Early stages, which show either high-to-normal serum calcium and elevated mid-C-PTH or increased serum calcium but normal mid-C-PTH, can be distinguished from overt hyperparathyroidism. Alkaline phosphatase (AP) activity and mid-C-regional PTH provide biochemical confirmation of histologically classified renal osteodystrophy. Since the index AP X PTH signifies osseous changes in dialysis patients at an early stage, therapeutic regimens may be altered without additional invasive procedures. After renal transplantation mid-C-PTH normalizes and serum creatinine decreases. Increased mid-C-PTH in patients with normal renal graft function reflects autonomous PTH secretion, which requires careful monitoring to prevent PTH-induced hypercalciuria.

Chronic Kidney Disease-Mineral and Bone Disorder↗

Radioimmunoassay for human osteocalcin using an antibody raised against the synthetic human (h37-49) sequence.

Radioiodination of synthetic human 37-49 osteocalcin requires optimal labeling conditions in order to obtain a maximum of mono- and di-iodinated tracer with little contamination by tri- and tetra-iodinated products or "radio-damage." The antibody raised against osteocalcin(h37-49) had the highest affinity for the C-terminal peptide used for iodination and the larger peptide (h30-49). The intact bovine osteocalcin (b1-49) revealed less immunoreactivity. This C-terminal specific radioimmunoassay detected the intact human osteocalcin in HPLC purified plasma and peritoneal dialysate from patients with terminal renal insufficiency and in extracted human bone. Some quantities of osteocalcin peptides with a higher hydrophobicity were predominantly detected in uremic plasma. These peptides that had a higher molecular weight than the intact human molecule might represent aggregated forms of the intact bone-derived osteocalcin. Immunoreactivity in plasma samples from healthy individuals revealed a remarkable difference as to which substance was employed for anticoagulation. Compared to heparin, the addition of EDTA largely reduced the osteocalcin immunoreactivity, implying that conformational changes within the N-terminal portion (containing the Gla- and Cys-residues) are extended to the C-terminal portion.

Antibodies↗

Multiple pre- and postreceptor defects in pseudohypoparathyroidism (a multicenter study with twenty four patients).

Three different pathophysiological mechanisms are probably responsible for hereditary pseudohypoparathyroidism: 1) a defect at the prereceptor-level, 2) a defective membrane N-protein accounting for diminished second messenger production, and 3) a defect in the cytosolic response to the hormone. In a cooperative, study 24 patients (mean age, 13 yr; range, 3-23 yr, 8 girls, 16 boys) receiving vitamin D metabolites (5,000-80,000 U/day) were examined and compared to a control group of 36 normal children. Immunoreactive N-terminal PTH (N-PTH), mid-C-regional PTH (mid-C-PTH), intact PTH and bio-PTH, vitamin D metabolites, and serum calcium and phosphate, alkaline phosphatase activity, and the N-protein activity of erythrocyte membranes were measured in each subject. By clinical and biochemical criteria three groups were differentiated. Eight patients had the completely expressed features of Albright's Hereditary Osteodystrophy (AHO+), including brachydactyly and/or sc calcifications, and increased N-PTH, mid-C-PTH, and alkaline phosphatase activity. Bio-PTH, intact PTH, and N-protein were normal. Nine additional patients with complete (AHO+) had elevated levels of bio-PTH, N-PTH, and mid-C PTH, normal hydroxylation of vitamin D, but decreased N-protein activity. Seven patients with pseudohypoparathyroidism had no features of AHO (AHO-), no increase of urinary cAMP excretion after exogenous PTH, normal PTH peptide levels and N-protein activity, but elevated 25-hydroxyvitamin D and decreased 1,25-dihydroxyvitamin D concentrations. In conclusion, we identified three subpopulations of PsHP: group a had a dissociation of N-PTH and bio-PTH suggesting a defective N-PTH causing renal resistance, whereas their bones respond to PTH. Group b had defective N-protein causing generalized PTH resistance. Group c was characterized by high 25-hydroxyvitamin D and relatively low 1,25-dihydroxyvitamin D levels, thus providing evidence for a defect in the cytosolic interaction of the two different second messengers for PTH, cAMP, and calcium.

Adolescent↗

Selective determination of C-terminal (70-84) hPTH: elevated concentrations in cholestatic liver disease.

In order to obtain a better resolution of circulating PTH-fragments, we developed a radioimmunoassay with an antiserum raised against the synthetic 70-84 hPTH molecule in a sheep. [125I](69 Tyr) 70-84 hPTH was used as the radioactive tracer with the antiserum at a final dilution of 1:200 000. Displacement curves showed that only the 70-84 hPTH, (69 Tyr) 70-84 hPTH and 53-84 hPTH fragments were able to compete with the tracer. Synthetic 28-48 hPTH, 44-68 hPTH, (61 Tyr)62-68 hPTH, purified 1-84 hPTH and 53-84 bPTH showed no ability to displace the tracer indicating that the idiotype of the antibody is directed against the 70-84 portion that is usually hidden within the globular structure of the intact molecule. Healthy adults revealed PTH-peptide levels of 153 +/- 86 pg/ml (mean +/- 2 SD); 2 SD range: 67-239 pg/ml. C-terminal PTH-peptide (70-84 hPTH) concentration was normal in patients with primary hyperparathyroidism and chronic renal failure, thus excluding that neither the kidney nor the parathyroid gland is involved in the generation of this C-terminal PTH-peptide sequence. Increased levels of 70-84 hPTH immunoreactivity were found in most individuals with severe cholestatic liver disease. Since the liver appears to be responsible for part of the peripheral PTH metabolism, this assay system might be used as an indicator of altered liver function.

Adult↗

Human atrial natriuretic peptide (ANP) for the treatment of patients with liver cirrhosis and ascites.

The acute effects of human atrial natriuretic peptide (ANP) were investigated in 10 patients with liver cirrhosis and ascites. In all patients, diuresis and natriuresis were stimulated with a wide individual variation (50 to 500%) in response to a bolus injection of 30 micrograms ANP. No side effects of treatment were observed. Continuous infusion of ANP (300 micrograms/10 h/d) in a patient with liver cirrhosis and ascites, resistant to conservative forms of diuretic therapy, resulted in an initial increase of diuresis and natriuresis which subsequently returned to pretreatment levels. After initiation of pulsatile nocturnal treatment (5 pulses of 30 micrograms ANP every 3 h), diuresis increased, leading to a persistent normalization of sodium and chloride excretion. The patient lost 8 kg of weight during 16 days of treatment. Out of 3 additional patients on the same therapeutic regime, only one experienced a weight loss of 5 kg due to increased natriuresis and chloruresis. The remaining 2 patients did not respond during 5 resp. 7 days of therapy.

Adult↗

Autoantibodies against parathyroid hormone in a patient with terminal renal insufficiency.

An autoantibody against mid-C-regional, possibly mid-regional, parathyroid hormone was detected in the plasma of a patient with terminal renal insufficiency who was on intermittent haemodialysis. 43-68(Tyr)hPTH and 42-55(Tyr)hPTH were selectively bound by his IgG fraction. 43-68(Tyr)hPTH had the highest affinity for the autoantibody; intact parathyroid hormone did not displace radiolabelled 42-55(Tyr)hPTH or 43-68(Tyr)hPTH. As concentrations of circulating antibodies against mid-C/mid-regional parathyroid hormone fell rises in intact and mid-C-regional parathyroid hormone levels and in alkaline phosphatase activity were observed. This autoantibody directed against the middle portion of the parathyroid hormone molecule seemed to have some protective properties against the osteoblast-stimulating activity of the hormone, implying that the mid-C-region or middle region of the molecule has some biological importance.

Adult↗

Characterisation of the binding sites of anti-parathyroid hormone antisera using synthetic parathyroid hormone peptides.

Four antisera raised against partly purified PTH preparations all showed a wide range of specificities when reacting with radioiodinated PTH peptides representing several different portions of the intact hormone sequence. In contrast, antisera raised against individual peptides were only able to cross-react with other peptides that contained all or part of their amino acid sequence in common. Cross-reacting peptides were seen to contain one or more amino acid residues having high interspecies variability in common. We have explained the antigenicity and cross-reactivity of the peptides on the basis of these common highly variable amino acid sequences. We have concluded that the selection of hormonal material in radioimmunoassays for PTH should be made on the basis of the highly variable amino acid residue content. This will allow a narrowing of the assay specificities and permit detection of a desired region of the PTH hormone.

Animals↗

Characterization of two anti-human parathyrin antisera.

Two anti-human parathyrin antisera were raised in sheep. These were characterized by radioimmunoassay using two commercially available bovine parathyrin preparations and one synthetic human parathyrin fragment (sequence 42-55 (42-Tyr)) for radioiodination. In addition, four synthetic human parathyrin fragments (sequences 1-34, 32-43, 434-68, 53-84), one bovine parathyrin peptide (sequence 28-48) and a human parathyrin standard from a tissue culture containing the intact hormone were utilized in a competitive inhibition assay against the two radiolabelled bovine parathyrin preparations. On column chromatography, both tracers revealed a difference in molecular weight, which is believed to be related to the extraction technique. The sequence fragment 44-68 of human parathyrin had the highest affinity for the two antisera when using the smaller molecular weight tracer and there were no qualitative changes observed in the presence of plasma. Using the higher molecular weight tracer, the addition of plasma to one of the antisera resulted in a higher affinity for the sequence fragment 1-34 of human parathyrin compared to that of intact parathyrin. Antiserum from a second sheep remained specific only for the mid-region (sequence 44-68) of the parathyrin molecule independent of the tracer used. Due to the antiserum's constant characteristic, it revealed a high reliability for the discrimination between plasma parathyrin levels in normal probands and in patients with hyperparathyroidism. Our data demonstrate that the specificity of the radioimmunoassay for human parathyrin is not exclusively dependent on the antibody source, but also on the tracer preparation and the protein content of the incubation medium.

Amino Acid Sequence↗

Parathyroid hormone fragments in secretory granules of human parathyroid adenomata.

The composition of human parathyroid hormone immunoreactivity in the secretory granule fraction of parathyroid hormone adenomata was investigated. Granular extracts were separated by gel filtration and the eluates assayed by radioimmunoassay and sequence specific immunoradiometric assays detecting aminoterminal and carboxyterminal activity. About half of the extracted adenomata contained fragments besides intact hormone. The fragment composition varied from adenoma to adenoma.

Adenoma↗

Preliminary results on the use of an antiserum to human parathyrin in a homologous radioimmunoassay.

A new antiserum (Ab Giselle) raised in sheep against extracted human parathyrin was evaluated and compared with an established antiserum (Ab S-478 VI) under several test conditions. The assay system contained an extracted 1--84 human parathyrin standard and a 1--84 bovine parathyrin tracer. The total assay time was 24 h and the main assay characteristics as follows: B0/T 0.28 +/- 0.02 and 50% intercept 553 +/- 47 U . 1(-1). The corresponding data for Ab S-478 VI were: B0/T 0.23 +/- 0.02 and 50% intercept 890 +/- 142 U . 1(-1). The normal range in 152 normocalcaemic volunteers (age range 16--67 years) was 10.6--423 U . 1(-1) (where 1 vial MRC reference preparation 75/549 for human parathyrin = 25 U), compared with 0--300 U . 1(-1) for Ab S-478 VI. With the new antiserum, differentiation between hypoparathyroid patients and those with normal function was often possible, and differentiation between normal and elevated levels, as in hyperparathyrinaemia, was very good. Correlation between Ab Giselle and Ab S-478 VI in 80 normal volunteers was positive (r = 0.450, p = 0.01) although the regression line showed that the antisera had different specificities (data for the regression line y = a + bx, a = 0.13, b = 0.55). Under the assay conditions, the association constant for Ab Giselle was 0.41 +/- 10(14) l . mol-1 in contrast to Ab S-478 VI which had a Ka for 0.53 x 10(10) l . mol-1 under identical conditions. Assays using Ab Giselle could be performed at room temperature, whereas those using Ab S-478 VI performed best at 0 degrees C. Preliminary results suggest that Ab Giselle is better for the routine assay of human parathyrin in serum than Ab S-478 VI, especially in the case of hypoparathyroid patients.

Adenoma↗