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Rare diseases caused by abnormal calcium sensing and signalling
Judit Tőke1, Gábor Czirják2, Péter Enyedi2
1Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary.
Abstract:
The calcium-sensing receptor (CaSR) provides the major mechanism for the detection of extracellular calcium concentration in several cell types, via the induction of G-protein-coupled signalling. Accordingly, CaSR plays a pivotal role in calcium homeostasis, and the CaSR gene defects are related to diseases characterized by serum calcium level changes. Activating mutations of the CaSR gene cause enhanced sensitivity to extracellular calcium concentration resulting in autosomal dominant hypocalcemia or Bartter-syndrome type V. Inactivating CaSR gene mutations lead to resistance to extracellular calcium. In these cases, familial hypocalciuric hypercalcaemia (FHH1) or neonatal severe hyperparathyroidism (NSHPT) can develop. FHH2 and FHH3 are associated with mutations of genes of partner proteins of calcium signal transduction. The common polymorphisms of the CaSR gene have been reported not to affect the calcium homeostasis itself; however, they may be associated with the increased risk of malignancies.
Insights
The calcium-sensing receptor (CaSR) is crucial for calcium balance. Gene defects in CaSR cause disorders like hypocalcemia and hypercalcemia, impacting calcium homeostasis and potentially increasing cancer risk.
Area of Science:
- Endocrinology
- Molecular Biology
- Genetics
Background:
- The calcium-sensing receptor (CaSR) is a G-protein-coupled receptor essential for detecting extracellular calcium levels.
- CaSR plays a critical role in maintaining calcium homeostasis.
- Defects in the CaSR gene are linked to various diseases involving altered serum calcium concentrations.
Purpose of the Study:
- To summarize the role of the calcium-sensing receptor (CaSR) in calcium homeostasis.
- To describe the clinical implications of CaSR gene mutations.
- To explore the association between CaSR gene polymorphisms and malignancy risk.
Main Methods:
- Review of existing literature on CaSR function and genetics.
- Analysis of the impact of CaSR gene mutations on calcium metabolism.
- Examination of studies investigating CaSR polymorphisms and disease associations.
Main Results:
- Activating CaSR mutations lead to increased calcium sensitivity, causing autosomal dominant hypocalcemia or Bartter syndrome type V.
- Inactivating CaSR mutations result in calcium resistance, leading to familial hypocalciuric hypercalcemia (FHH1) or neonatal severe hyperparathyroidism (NSHPT).
- Mutations in genes of CaSR partner proteins are linked to FHH2 and FHH3. Common CaSR polymorphisms may increase malignancy risk but do not typically affect calcium homeostasis.
Conclusions:
- CaSR is a key regulator of calcium homeostasis, and its genetic variations have significant clinical consequences.
- CaSR gene mutations are directly implicated in hypocalcemic and hypercalcemic disorders.
- Further research into CaSR polymorphisms may reveal links to cancer susceptibility.
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