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PubMed · 8488377

[Hypercalcemia as an emergency].

A Rosenmund
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Abstract

The hypercalcemic syndrome and the relation of serum calcium with the concentration of ionic calcium and albumin are shortly described. The pathogenetic significance of local, cytokine-induced bone destruction and of the osteoclast-stimulating effect by "parathyroid hormone related peptide" leading to "humoral hypercalcemia of malignancy" is underscored. In a hypercalcemic emergency the therapeutic strategy should combine adequate rehydration and induction of calciuresis by furosemide and the intravenous application of a rapid-onset, calcium lowering substance such as calcitonin and, simultaneously, of a slow-onset, long-acting bisphosphonate such as pamidromate, which may be infused as a single dose.

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CalcitoninCalciumDiphosphonatesEmergenciesFluid TherapyFurosemideHumansHypercalcemiaHyperparathyroidismNeoplasmsPamidronateJournal ArticleReview

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A Rosenmund. 1993-04-17. [Hypercalcemia as an emergency].. https://pubmed.ncbi.nlm.nih.gov/8488377/

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Human calcitonin is the physiological hormone involved in calcium-phosphorus homeostasis. However, its use is limited by its propensity to form aggregates. We find that the type of host lipid has a pronounced influence on human calcitonin fibrillation or incorporation, as assessed by channel formation, in planar lipid membranes at neutral pH. At pH 7, human calcitonin is able to interact and form channels with negatively charged dioleoyl-phosphatidylglycerol (DOPG) bilayers and with zwitterionic palmitoyl-oleoyl phosphatidylcholine (POPC) bilayers containing 15% negatively-charged DOPG, but not with POPC bilayers. At low pH (4.5 and 3.8), the conformational variation of the peptide enables it to insert into POPC and POPC:DOPG but not into DOPG bilayers. The model proposed for human calcitonin interaction and channel formation at acidic pH was based on theoretical predictions of the protonation-deprotonation state of some amino acids, in particular in the fibrillating sequence of peptide molecules; the length of the alpha-helix, and the electrostatic and/or hydrophobic interaction also seem to be relevant. These results may suggest that human calcitonin at low local pH could be involved in osteoclasts' calcium-sensitive permeability through channel formation and/or receptor interaction.

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