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Related Experiment Videos

Hypercalcemia in malignancy.

G J Strewler1, R A Nissenson

  • 1Endocrine Unit, Veterans Administration Medical Center, San Francisco, CA 94121.

The Western Journal of Medicine
|December 1, 1990
PubMed
Summary
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Hypercalcemia in cancer is often caused by a parathyroid hormone-related protein, which mimics parathyroid hormone. New diagnostic assays and bisphosphonate treatments are improving patient outcomes.

Area of Science:

  • Endocrinology
  • Oncology
  • Molecular Biology

Background:

  • The cause of hypercalcemia in malignancy was previously unclear.
  • Advances in bioassays in 1980 revealed a substance cross-reacting with parathyroid hormone in cancer patients.

Purpose of the Study:

  • To elucidate the pathogenesis of hypercalcemia in malignancy.
  • To identify the specific protein responsible for cancer-related hypercalcemia.
  • To discuss advancements in diagnosis and treatment.

Main Methods:

  • Purification and molecular cloning of the parathyroid hormone-related protein.
  • Biochemical analysis to determine its homology with parathyroid hormone.
  • Development of new diagnostic assays for the hormone and related peptide.

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Main Results:

  • A 141-amino acid peptide, parathyroid hormone-related protein, was identified.
  • This protein shares limited homology with parathyroid hormone but activates the same receptor.
  • Parathyroid hormone-related protein is the primary cause of hypercalcemia in most solid tumors, including squamous and renal carcinomas.

Conclusions:

  • Parathyroid hormone-related protein is the main driver of hypercalcemia in most malignancies.
  • New assays simplify the differential diagnosis of hypercalcemia.
  • Bisphosphonates represent a significant advancement in managing hypercalcemia.