Concluding Comments

The regulation of calcium homeostasis provides good examples of some of the principles of hormonal integration discussed in Chapter 37. The principle of cooperativity is illustrated by the multiple actions of PTH on different tissues to produce a variety of effects that contribute to the central theme of increasing calcium in the extracellular compartment. Overlapping effects of PTH and 1,25(OH)2D3 illustrate redundancy. The opposing actions of PTH and calcitonin on osteoclasts are typical of a push-pull system. The thoughtful student will undoubtedly find other examples in this exquisitely coordinated system.

Suggested Reading

Brommage R, DeLuca HF. Evidence that 1,25-dihydroxyvitamin D3 is the physiologically active metabolite of vitamin D3. Endocr Rev 1985;6:491-511.

Brown EM, Pollak M, Seidman CE, Seidman JG, Chou YH, Riccardi D, Hebert SC. Calcium ion-sensing cell-surface receptors. New Engl J Med 1995;333:234-240.

Diaz R, Fuleihan GEH, Brown EM. Parathyroid hormone and polyhormones: Production and export. In Fray, JCS, ed., Endocrine regulation of water and electrolyte balance, Vol 3, Handbook of physiology, Section 7, The endocrine system. Oxford University Press, New York, 2000, pp 607-662.

Jones G, Strugnall SA, DeLuca H. Current understanding of the molecular actions of vitamin D. Physiol Rev 1998;78:1193-1231.

Malloy PJ, Pike JW, Feldman D. The vitamin D receptor and the syndrome of hereditary 1,25-dihydroxyvitamin D-resistant rickets. Endocr Rev 1999;20:156-188.

Mannstadt M, J├╝ppner H, Gardella TJ. Receptors for PTH and PTHrP: Their biological importance and functional properties. Am J Physiol 1999;277:F665-F675.

Muff R, Fischer JA. Parathyroid hormone receptors in control of proximal tubular function. Ann Rev Physiol 1992;54:67-79.

Nijweide PJ, Burger EH, Feyen JHM. Cells of bone: Proliferation, differentiation, and hormonal regulation. Physiol Rev 1986; 66:855-886.

Suda T, Takahashi N, Udagawa N, Jimi E, Gillespie MT, Martin TJ. Modulation of osteoclast differentiation and function by new members of the tumor necrosis factor receptor and ligand families. Endocr Rev 1999;20:245-397.

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