151 DOI 10. 3969 /j. issn. 1674-2591. 2012. 02. 014 * PTH rhpth PTH rhpth R681 A The progression of PTH supplements on osteoporosis LIU Ming PAN Wei CHEN De-cai * Department of Endocrinology West China Hospital Sichuan University Chengdu 610041 China Abstract Parathyroid hormone PTH and recombinant human parathyroid hormone rhpth as bone formation a- gents are receiving increasing attention. This review is mean to illustrate its basic research animal experiment and clinical observation briefly. Key words osteoporosis parathyroid hormone bone formation agents PTH PTH PTH 84 9 500 D PTH 10 ~ 50 ng /L PTH camp PTH PTH PTH 610041 * E-mail cdecai@ yahoo. com. cn
152 OH 2 -Vit D 3 1 25- OH 2 -Vit D 3 Ca 2 + OB PTH OB OC PTH 1ɑ- OB PTH 25-OH-VitD 3 1 25- Ⅰ IGF-Ⅰ PTH B G TGF-β Pfalschifter 2 PTH 2 PTH 1 PTH 2 OB TGF-β TGF-β 6 PTH 1 PTH IL-6 Gs AC ATP- PG Mg 2 + camp A PTH OC PTH OB PKA PTH 1 Gq OC 3 - C PKC DG IP 3 C 4 PKC Ca 2 + PTH 2 camp PTH PTH PTH PTH 35-84 PTH 1-34 PTH 1-84 PTH 1-84 PTH hpth 2-34 hpth 3-34 5 hpth 1-34 N Ser1 Val2 anabolic window 6 1 < 24 PTH PTH hrpth1-84 preotact hrpth1-34 teriparatide 1 Preotact PTH OC β Prank 1 PTH PTH 2 PTH PTH 1 PTH Fig 1 The effects of PTH on bone formation and bone resorption
153 PTH 100 μg /d Teriparatide PTH 18 ~ 24 Preotact PTH PTHR1 55% 90 min FDA 20 μg /d Teriparatide FDA 18 24 95% 75 min Table 1 1 hrpth 1-84 hrpth 1-34 The relative comparison between hrpth 1-84 and hrpth 1-34 min % min μg /d hrpth 1-84 preotact 90 55 90 100% hrpth 1-34 teriparatide 30 95 75 20 20% ~ 30% 1935 PTH 25% 70% ~ 80% PTH > 70% 20 70 17-β Reeve 7 PTH 1-34 PTH PTH PTH 10 8 80 4 Wistar 6 0. 9% 0. 2 ml / PTHrP 1 ~ 34 20 μg /d PTHrP 1 ~ 34 40 μg /d PTHrP 1 ~ 34 80 μg /d Sato 11 3 1 12 PTH 1-34 BMD 18 X PTHrP 40 0. 178 ± 0. 01 g /cm 2 PTHrP 80 20 μg PTH 1-34 0. 182 ± 0. 008 g /cm 2 P < 0. 01 BMD 9% BMD 3% BMD PTHrP 20 BMD 40 μg PTH BMD 0. 165 ± 0. 008 g /cm 2 0. 9% PTH 1-34 1 /d 15 20% ~ 1-34 BMD 13% 0. 159 ± 0. 008 g /cm 2 BMD 6% BMD BMD Lindsay 12 Moselilde 9 3 1 25 μg PTH 1-34 3
154 13% PTH1-34 n = 14 PTH1-34 2. 7% 1% PTH n = 14 2 1-34 GIOP BMD 10. 2 % 7. 9 % BMD P < 0. 001 2 BMD 5% ~ 10% 13-14 PTH Neer 15 1 637 PTH1-34 + n = 17 n = 19 17 3 PTH1-34 + 15% PTH 1-34 13. 0% 20 μg /d 5% 2. 7% 8. 0% BMD 65% PTH 1-34 40 μg /d Black 19 238 55 ~ 85 4% 3 1 PTH 69% 6% 1-84 100 μg /d 2 PTH 1-84 PTH 3% 100 μg /d Alendronate 10 mg /d 3 Alendronate 10 mg /d 500 mg /d Vit D 3 400 U /d 1 3 6. 3% Ⅰ 16 rhpth BMD 4. 9% 2 1 BMD 1. 7% rhpth 2 3 Alendronate 10 mg /d 1 1 ~ 4 μg /kg BMD 4. 6% 5 μg /kg 6 4 PTH 3 μg /kg d 7 d 8 1 PTH 4 μg /kg d 7 d 8 3 17 rhpth Paget's rhpth 2 BMD Lindsay 12 > 1 6. 1% 4. 6% 1 2 1 Alendronate 10 mg /d 1 rhpth rhpth T - 2. 5 T < rhpth - 3 Paget's rhpth rhpth Hodsman 18 18 ~ 24 20
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