Role of Parathyroid Hormone and Parathyroid Hormone-Related Protein in Protein-Energy Malnutrition
Issued Date
2023-08-15
Resource Type
eISSN
27686698
Scopus ID
2-s2.0-85169651494
Pubmed ID
37664938
Journal Title
Frontiers in bioscience (Landmark edition)
Volume
28
Issue
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Frontiers in bioscience (Landmark edition) Vol.28 No.8 (2023) , 167
Suggested Citation
Srisuwarn P., Disthabanchong S. Role of Parathyroid Hormone and Parathyroid Hormone-Related Protein in Protein-Energy Malnutrition. Frontiers in bioscience (Landmark edition) Vol.28 No.8 (2023) , 167. doi:10.31083/j.fbl2808167 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/89589
Title
Role of Parathyroid Hormone and Parathyroid Hormone-Related Protein in Protein-Energy Malnutrition
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Parathyroid hormone (PTH) is an endocrine peptide found exclusively in the parathyroid glands, whereas parathyroid hormone-related protein (PTHrP) is expressed in a wide range of tissues and organs and exerts endocrine, paracrine, and autocrine actions. PTH and PTHrP have a similar homology, sharing the initial 13 amino acid residues at the N-terminus and binding to the same type 1 PTH receptor (PTH1R), which regulates calcium homeostasis. An abnormal increase in PTH production can occur in primary and secondary hyperparathyroidism, whereas PTHrP can be produced in large quantities by malignant cancer cells from solid organs. In addition to increased bone resorption and hypercalcemia, recent evidence suggests that excess PTH and PTHrP can result in protein-energy wasting, malnutrition, and cachexia. Through binding to PTH1R and activation of cyclic adenosine monophosphate (cAMP)-dependent protein kinase A in white adipose tissue, PTH and PTHrP can stimulate the expression of thermogenic genes causing adipose tissue browning. This change results in an increase in resting energy expenditure, loss of muscle and fat mass, and weight loss. These findings provide a mechanistic link for the long-established relationship between hyperparathyroidism and myopathy, as well as cancer and cachexia. The purpose of this review is to provide a summary of the emerging evidence from both experimental and clinical studies on the role of PTH and PTHrP in protein-energy malnutrition.